CHS Blood Pressure Measurement Techniques & Monitoring 3

Question 1

Which cuff size is appropriate for a patient with an arm circumference of 38 cm?

Accepted Answer

Large adult cuff (bladder 16 × 38 cm)

Answer

For arm circumferences of 35–44 cm, a large adult cuff is required; using a cuff that is too small results in falsely elevated readings.

Question 2

Pseudohypertension—falsely elevated cuff readings due to arterial stiffness—is most commonly encountered in which patient population?

Accepted Answer

Elderly patients with heavily calcified arteries

Answer

Pseudohypertension results from arterial calcification that prevents the cuff from fully compressing the artery, leading to falsely high readings; it is most common in elderly patients.

Question 3

The Osler maneuver is performed to identify which condition?

Accepted Answer

Pseudohypertension

Answer

The Osler maneuver inflates the cuff above systolic pressure; a still-palpable radial or brachial artery indicates arterial stiffness consistent with pseudohypertension.

Question 4

What effect does talking during blood pressure measurement have on the reading?

Accepted Answer

Increases blood pressure by approximately 10–15 mmHg

Answer

Verbal activity during measurement activates the sympathetic nervous system and can raise both systolic and diastolic BP by 10–15 mmHg, causing spuriously elevated readings.

Question 5

Which patient population requires blood pressure assessment in both seated and standing positions, and why?

Accepted Answer

Older adults and patients with possible orthostatic hypotension

Answer

Orthostatic hypotension—defined as a ≥20 mmHg systolic or ≥10 mmHg diastolic drop upon standing—is common in older adults and requires positional measurements for detection.

(CHS) Certified Hypertension Specialist Practice Test

(CHS) Certified Hypertension Specialist Practice Test

CHS Blood Pressure Measurement Techniques & Monitoring 3