Hypertensive Urgency; < 160/100 mmHg in 24-48 hours
(A) is the correct answer here. Lets follow this systematically.
Even if it doesnt seem relevant, look for age and gender: 58 year old male. He has a blood pressure of 200/130. To even be considered as a hypertensive crisis, you have to have a systolic blood pressure of at least 180 OR a diastolic blood pressure of at least 110.
The key part here is distinguishing between urgency and emergency. The difference is that hypertensive urgency is WITHOUT end organ damage. If organ damage had been present, you would have seen statements such as retinal damage and serum creatinine. These indicate dysfunction with an organ, which is NOT the case here, so this is a hypertensive urgency.
In a hypertensive urgency, you still want to act fast, but you have a little leeway in time. Emergencies would obviously require swift action since organs are failing, but an urgency buys you some time. This is why you only need to lower the blood pressure to