Hypertension

The exam loves the urgency vs. emergency split: both show BP ≥180/120, but only a hypertensive emergency has acute target-organ damage (chest pain, neuro changes, papilledema, rising creatinine) and demands an IV titratable drug (labetalol, nicardipine, nitroprusside) — lower the MAP by no more than ~25% in the first hour to avoid cerebral ischemia from over-correction. Urgency, now often called asymptomatic markedly elevated BP (no organ damage), is managed with oral agents over hours. A second classic stem hands you an asymptomatic client who “feels fine and stopped the pills” — the right answer reinforces adherence, never validates stopping. Watch too for orthostatic hypotension teaching: rise slowly when starting therapy.

Don’t confuse hypertension (a sustained high pressure and chronic risk factor) with shock, where the danger is falling perfusion and hypotension is a late sign — opposite ends. Edema signals fluid overload, not a BP reading, and arrhythmia is a rhythm problem (atrial fibrillation, via LVH) that hypertension breeds over years. The trap is treating a one-time elevated reading as a diagnosis — confirm on repeated, properly measured visits.