Family Nurse Practitioner Exam

What condition indicates target organ damage commonly seen in long-term uncontrolled hypertension?

1. Pedal edema, hepatomegaly, and enlarged kidneys

2. Hepatomegaly, AV nicking, bibasilar crackles

3. Renal infection, S3, neuromuscular abnormalities

4. Glaucoma, jugular vein atrophy, heart failure

The correct answer is: Hepatomegaly, AV nicking, bibasilar crackles

The presence of AV nicking and bibasilar crackles in the context of long-term uncontrolled hypertension suggests target organ damage. AV nicking, or arteriovenous nicking, is a finding on fundoscopic examination associated with hypertensive retinopathy, indicating that the small blood vessels in the retina have been affected by chronically elevated blood pressure. This signifies damage to the vascular system, which is a typical consequence of sustained hypertension. Bibasilar crackles are indicative of fluid overload and potential heart failure, which can result from long-standing high blood pressure leading to left ventricular hypertrophy and eventually heart failure. The combination of these two findings reflects significant organ impairment due to prolonged hypertension, highlighting the importance of regular monitoring and management in patients with high blood pressure to prevent progression to end-organ damage.