BCEN CEN Practice Question

Current guidelines and reviews state that hypertensive emergencies are defined by severely elevated blood pressure accompanied by signs of acute target-organ damage (e.g., encephalopathy, acute coronary syndrome, pulmonary edema, aortic dissection, acute kidney injury). These cases require rapid blood-pressure reduction with parenteral agents in a monitored setting. In contrast, asymptomatic patients who have a single markedly elevated reading but no objective evidence of organ injury generally do not benefit from immediate IV antihypertensive therapy or aggressive BP reduction. Instead, management focuses on confirming the reading, initiating or adjusting oral therapy, providing education, and arranging close outpatient follow-up-ideally within 24-72 hours-while avoiding precipitous decreases that could cause hypoperfusion. Options suggesting mandatory rapid IV therapy for every isolated elevation, redefining hypertensive urgency as having organ damage, or claiming that rapid reduction is harmless are inconsistent with these recommendations.