Hypertension and Vascular Disease Practice Questions
25 free Hypertension and Vascular Disease practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
In vascular disease assessment, a bruit heard over the carotid or femoral artery suggests:
- A Normal smooth laminar flow through the artery
- B Turbulent flow through a narrowed atherosclerotic lumen
- C Complete venous occlusion of the limb
- D Compression of the artery by surrounding tissue
Correct answer: Turbulent flow through a narrowed atherosclerotic lumen
A bruit is caused by turbulent flow through a narrowed artery, often due to atherosclerosis and vascular disease.
A blood pressure reading in the right arm of 160/95 mmHg and in the right leg of 135/80 mmHg suggests:
- A A normal physiological variation between the limbs
- B Coarctation of the aorta
- C Postural (orthostatic) hypotension on standing
- D An incorrectly sized blood pressure cuff
Correct answer: Coarctation of the aorta
A significant difference between upper and lower extremity BP may indicate coarctation of the aorta or other vascular narrowing.
Which lifestyle modification is least effective in reducing high blood pressure?
- A Reducing sodium intake
- B Increasing physical activity
- C Managing weight
- D Increasing alcohol intake
Correct answer: Increasing alcohol intake
Excessive alcohol increases blood pressure and cardiovascular risk; reducing alcohol is part of lifestyle modification for hypertension.
When caring for a patient with peripheral arterial disease, which symptom would alert the nurse to critical limb ischemia?
- A Intermittent claudication relieved by rest
- B Rest pain with non-healing ulcers or gangrene
- C Mild dependent leg swelling after standing
- D Muscle cramps occurring only after vigorous exercise
Correct answer: Rest pain with non-healing ulcers or gangrene
Critical limb ischemia features rest pain, non-healing ulcers or gangrene from severe arterial perfusion deficit—an urgent vascular problem.
Which antihypertensive class works by blocking the renin-angiotensin-aldosterone system (RAAS)?
- A Beta-blockers
- B Calcium channel blockers
- C ACE inhibitors
- D Loop diuretics
Correct answer: ACE inhibitors
ACE inhibitors block conversion of angiotensin I to II in RAAS, reducing vasoconstriction and sodium/water retention, thereby lowering blood pressure.
A patient’s blood pressure is measured as 138/88 mmHg on two separate visits. According to current guidelines, this is classified as:
- A Normal blood pressure
- B Elevated blood pressure
- C Stage 1 hypertension
- D Stage 2 hypertension
Correct answer: Stage 1 hypertension
According to recent ACC/AHA guidelines, a systolic BP of 130-139 or diastolic BP of 80-89 is classified as Stage 1 hypertension.
What is the classification of a blood pressure reading of 138/88 mmHg according to recent ACC/AHA guidelines?
- A Normal blood pressure
- B Elevated blood pressure
- C Stage 1 hypertension
- D Stage 2 hypertension
Correct answer: Stage 1 hypertension
According to recent ACC/AHA guidelines, a systolic BP of 130-139 or diastolic BP of 80-89 is classified as Stage 1 hypertension.
Why is hypertension often referred to as the 'silent killer'?
- A It produces dramatic, easily recognized symptoms early in the disease
- B It is frequently asymptomatic until target organ damage develops
- C It selectively affects only elderly patients with comorbidities
- D It spares the kidneys while damaging other major organs
Correct answer: It is frequently asymptomatic until target organ damage develops
Hypertension often presents without symptoms and may only be discovered after significant organ damage (heart, brain, kidneys) has occurred.
Which of the following is a modifiable risk factor for essential hypertension?
- A Advancing chronological age
- B Family history of premature hypertension
- C Obesity and high dietary sodium intake
- D Ethnic and racial background
Correct answer: Obesity and high dietary sodium intake
Although age, family history, and ethnicity are non-modifiable, lifestyle factors like obesity and high sodium intake are modifiable risk factors for hypertension.
What does a bruit heard over the carotid or femoral artery suggest?
- A Normal smooth laminar blood flow
- B Turbulent flow through a narrowed arterial lumen
- C Complete venous occlusion of the limb
- D A benign venous hum unrelated to arteries
Correct answer: Turbulent flow through a narrowed arterial lumen
A bruit is caused by turbulent flow through a narrowed artery, often due to atherosclerosis and vascular disease.
What does a blood pressure reading in the right arm of 160/95 mmHg and in the right leg of 135/80 mmHg suggest?
- A Expected physiologic variation between limbs
- B Coarctation of the aorta narrowing the lumen
- C Postural orthostatic hypotension on standing
- D A spurious laboratory measurement error
Correct answer: Coarctation of the aorta narrowing the lumen
A significant difference between upper and lower extremity BP may indicate coarctation of the aorta or other vascular narrowing.
Which lifestyle factor is recommended for a patient diagnosed with hypertension?
- A Increase sodium and saturated-fat intake daily
- B Adopt the DASH diet: more produce, low-fat dairy, less sodium
- C Eliminate all carbohydrates from every meal
- D Eat protein exclusively and avoid vegetables
Correct answer: Adopt the DASH diet: more produce, low-fat dairy, less sodium
The DASH diet (Dietary Approaches to Stop Hypertension) is recommended to reduce blood pressure by increasing fruits/vegetables, low-fat dairy and lowering sodium.
Which antihypertensive class blocks the renin-angiotensin-aldosterone system (RAAS)?
- A Beta-blockers
- B Calcium channel blockers
- C ACE inhibitors
- D Loop diuretics
Correct answer: ACE inhibitors
ACE inhibitors block conversion of angiotensin I to II in RAAS, reducing vasoconstriction and sodium/water retention, thereby lowering blood pressure.
What target organ damage finding would be expected in a hypertensive patient?
- A Retinal hemorrhages or papilledema on fundoscopy
- B Isolated tension headaches without other findings
- C Preserved kidney and cardiac function on workup
- D Acutely severe symptoms in every affected patient
Correct answer: Retinal hemorrhages or papilledema on fundoscopy
Chronic hypertension can damage organs such as eyes (retinal hemorrhages, papilledema), heart (LVH), kidneys (nephropathy) and brain (stroke).
What is a nursing priority for a patient with peripheral vascular disease (PVD)?
- A Disregarding changes in skin temperature or pulses
- B Assessing peripheral pulses, capillary refill, skin colour and temperature
- C Providing dietary teaching without any physical assessment
- D Limiting assessment to the upper extremities alone
Correct answer: Assessing peripheral pulses, capillary refill, skin colour and temperature
In vascular disease such as PVD, assessing peripheral pulses, capillary refill, skin temp and colour is essential to detect impaired perfusion.
Which statement about secondary hypertension is correct?
- A It is idiopathic with no identifiable underlying cause
- B It stems from an underlying condition or medication (renal or endocrine disease)
- C It carries no added cardiovascular risk to the patient
- D It is seen exclusively during early childhood years
Correct answer: It stems from an underlying condition or medication (renal or endocrine disease)
Secondary hypertension has a known cause (e.g., kidney disease, endocrine disorders, certain drugs) and may require treatment of that underlying cause.
What side effect should a nurse monitor for in a patient starting a thiazide diuretic for hypertension?
- A Hyperkalemia
- B Hypokalemia
- C Increased insulin resistance only
- D Bradycardia only
Correct answer: Hypokalemia
Thiazide diuretics increase sodium and water excretion and also potassium excretion, which can lead to hypokalemia.
What is a high-risk complication for a client with longstanding hypertension and narrowing of peripheral pulses?
- A Isolated chronic joint pain in the limbs
- B Atherosclerosis and peripheral arterial disease
- C Primary chronic respiratory disease
- D Persistent symptomatic systemic hypotension
Correct answer: Atherosclerosis and peripheral arterial disease
Persistent hypertension contributes to arterial wall damage and atherosclerosis, leading to vascular disease and PAD.
How is a hypertensive emergency defined?
- A Mild BP elevation with no associated symptoms
- B Severely elevated BP (>180/120) with target organ damage
- C Blood pressure that is abnormally low at rest
- D Blood pressure that rises transiently only with exertion
Correct answer: Severely elevated BP (>180/120) with target organ damage
A hypertensive emergency involves a markedly elevated blood pressure plus evidence of acute target organ damage (brain, kidney, heart) and requires immediate treatment.
What symptom alerts a nurse to critical limb ischemia in a patient with peripheral arterial disease?
- A Intermittent claudication that resolves fully with rest
- B Rest pain, non-healing ulcers, and tissue gangrene
- C Mild dependent leg swelling after prolonged activity
- D Muscle cramps occurring only after vigorous exercise
Correct answer: Rest pain, non-healing ulcers, and tissue gangrene
Critical limb ischemia features rest pain, non-healing ulcers or gangrene from severe arterial perfusion deficit—an urgent vascular problem.
What side effect should a nurse caution a patient prescribed a calcium channel blocker about?
- A Persistent dry cough with hyperkalemia
- B Peripheral edema and dizziness from vasodilation
- C Bradycardia occurring in adolescent patients
- D A marked increase in daily urine output
Correct answer: Peripheral edema and dizziness from vasodilation
Calcium channel blockers (especially dihydropyridines) can cause vasodilation-related side effects such as peripheral edema and dizziness due to hypotension.
Which vascular disease is characterised by an 'ABI' (ankle-brachial index) of < 0.90?
- A Acute deep vein thrombosis of the calf
- B Peripheral arterial disease (PAD)
- C Superficial varicose veins of the legs
- D Essential hypertension without vascular change
Correct answer: Peripheral arterial disease (PAD)
An ABI < 0.90 is a diagnostic indicator of peripheral arterial disease (PAD) due to arterial occlusion and reduced perfusion.
What is the best advice for self-monitoring blood pressure according to hypertension patient teaching?
- A Take a single clinic measurement once a month
- B Use a validated home cuff at the same time daily, no caffeine or smoking beforehand
- C Measure blood pressure only when symptoms appear
- D Judge blood-pressure control by how the patient feels
Correct answer: Use a validated home cuff at the same time daily, no caffeine or smoking beforehand
Consistent home monitoring (same time each day, proper cuff, pre-measurement rest) helps detect trends and assess control of hypertension.
What do frequent headaches, blurred vision, and shortness of breath in a patient with uncontrolled hypertension suggest?
- A Mild, asymptomatic chronic hypertension
- B Hypertensive crisis with possible end-organ damage
- C An acute generalized anxiety reaction
- D An expected, harmless effect of normal aging
Correct answer: Hypertensive crisis with possible end-organ damage
Symptoms like headache, blurred vision, shortness of breath in hypertension suggest possible acute target organ damage, a hypertensive crisis scenario requiring urgent care.
Why is smoking cessation critical in vascular disease management?
- A It raises cholesterol but does not alter vessel wall structure
- B It affects only the lungs, not blood vessels
- C It raises heart rate without affecting vessel diameter
- D It causes vasoconstriction and accelerates atherosclerosis
Correct answer: It causes vasoconstriction and accelerates atherosclerosis
Nicotine produces acute vasoconstriction while the oxidants in tobacco smoke injure the endothelium, promote platelet aggregation and accelerate atherosclerotic plaque formation, which together worsen hypertension and claudication. Endothelial function begins to recover within weeks of quitting, which is why cessation is the single highest-yield intervention in vascular disease.