Which class of antihypertensive medications is least likely to be effective for a 61-year-old Black man with chronic hypertension?
Calcium channel blockers (CCBs)
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin receptor blockers (ARBs)
Beta blockers
The Correct Answer is B
Choice A reason: CCBs are effective in Black patients with hypertension, especially in monotherapy. They work by relaxing vascular smooth muscle and reducing peripheral resistance, which is beneficial in salt-sensitive hypertension.
Choice B reason: ACE inhibitors are less effective as monotherapy in Black patients due to lower plasma renin activity. They may be used in combination therapy but are not preferred as initial treatment unless there are compelling indications such as heart failure or diabetic nephropathy.
Choice C reason: ARBs have similar limitations to ACE inhibitors in Black populations but may be better tolerated due to lower risk of cough. They are more effective when combined with diuretics or CCBs.
Choice D reason: Beta blockers are generally less effective in controlling blood pressure in Black patients unless there are specific indications such as arrhythmias or post-MI management. However, ACE inhibitors are still considered less effective overall in this demographic.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: This describes osteoarthritis, not Paget’s disease. Osteoarthritis involves degeneration of joint cartilage and synovial structures, whereas Paget’s disease affects bone remodeling.
Choice B reason: Paget’s disease of bone is characterized by excessive osteoclastic bone resorption followed by disorganized osteoblastic bone formation. The newly formed bone is structurally abnormal—larger, less dense, and more vascular—making it prone to deformity and fracture. This explains the patient’s bowing and neurological symptoms due to nerve compression.
Choice C reason: This describes rheumatoid arthritis, an autoimmune condition affecting the synovium. Paget’s disease is not autoimmune and does not primarily involve joint inflammation.
Choice D reason: While PDB does involve abnormal bone remodeling, it does not lead to decreased skeletal mass. Instead, it results in structurally unsound bone that may be enlarged but weakened.
Correct Answer is A
Explanation
Choice A reason: A diagnosis of obstructive sleep apnea (OSA) is confirmed when polysomnography reveals at least 5 episodes of apnea or hypopnea per hour of sleep in the presence of symptoms such as snoring, gasping, or daytime sleepiness. This threshold is consistent with clinical guidelines and reflects mild OSA.
Choice B reason: While 15 or more episodes per hour indicate moderate to severe OSA, the minimum diagnostic threshold is 5 events per hour with associated symptoms. Therefore, this choice is overly restrictive and not the best initial diagnostic criterion.
Choice C reason: Polysomnography is the gold standard for diagnosing OSA. Clinical symptoms alone are insufficient for a definitive diagnosis, especially when treatment decisions depend on severity classification.
Choice D reason: Resolution of apneas/hypopneas with CPAP confirms treatment efficacy but does not establish the initial diagnosis. This finding is relevant after diagnosis and during titration studies, not for confirming OSA.
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