American Association of Critical-Care Nurses (AACN) Certification Practice Test

What is the initial treatment for hypertensive urgency?

1. Amlodipine 5-10 mg PO

2. Losartan 50-100 mg PO

3. Captopril 12.5-200 mg PO TID

4. Hydrochlorothiazide 25-50 mg PO

The correct answer is: Captopril 12.5-200 mg PO TID

The initial treatment for hypertensive urgency focuses on the appropriate management of elevated blood pressure while avoiding rapid lowering of blood pressure that could lead to ischemic complications. Captopril, an ACE inhibitor, is effective in this context because it acts quickly to lower blood pressure without the risk of causing a rapid, drastic decrease that could result in inadequate organ perfusion. When selecting an oral medication for hypertensive urgency, it's crucial to ensure that it has a rapid onset of action, and captopril fits this requirement. This medication can be administered in a controlled manner and can be adjusted based on the patient's response. Additionally, the dosing flexibility of captopril allows for titration based on the individual’s blood pressure response. Other medications mentioned, while useful in different contexts for managing hypertension, may not provide the same rapidity of action or the balance of safety that captopril offers in the immediate management of a hypertensive urgency.