APEA FNP Cardio Practice
Exam Questions with 100%
Correct Answers (2025/2026
Latest Update)
1. A common lab findings with ACE Inhibitors:
Increase K+ ACE inhibitor =
retention of potassium.
Measure potassium one month after starting and one month after changing a dose
2. What should you do?
Pt on Monopril and HCTZ for hypertension. His blood pressure is 160-
170/92-98 on several blood pressure checks
? Would you add an ARB?: If these are at maximum doses, consideration should be given to
adding a medication from a ditterent class.
CALCIUM CHANNEL BLOCKER
NOT ARB - Adding an ARB may result in a precipitous decrease in his blood pressure because he takes an
ACE inhibitor and both of these medications work in the renin-angiotensin-aldosterone system.
,3. Significance of sildenafil and any blood pressure meds: Any
antihypertensive medication
... could have an additive ettect with sildenafil (or another medication in this
A specific drug-drug interaction to be aware of is the one that can occur with sildenafil and alpha blockers
like tamsulosin, alfuzosin, prazosin, doxazosin, or terazosin. This combination of medications may increase
the risk of symptomatic hypotension because the ettect of these two drugs is additive
4. : Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC VIII. Since he is more than 20 points
above systolic goal (or greater than 10 points above diastolic goal) it is reasonable to consider two
medications
5. Risk assessment for dyslipidemia- what age to start assessment: Start
at age 2
Dyslipidemia assessment does not necessarily mean a Dyslipidemia assessment refers to assessing
family history of dyslipidemia, premature cardiovascular disease, or diabetes, body mass index > 85% for
age and sex, or history of other systemic diseases like Kawasaki Disease or treatment, or renal disease.
6. When to start lipid profiles: recommended between 18 and 21 years of age.
,7. A patient taking an ACE inhibitor should avoid:: No K supplements
ACE inhibitor potentially can produce hyperkalemia because its mechanism of action is in the renin-
angiotensin-aldos- terone system where potassium is spared. If potassium is taken in the form of
potassium supplements, the ettect will be additive and the risk of hyperkalemia can be great.
8. An 80 year-old female who is otherwise well, has a blood pressure of
176/80. How should she be managed pharmacologically?: CCB
This patient has isolated systolic hypertension (ISH). This is common in older adults and is associated
with tragic cardiac and cerebrovascular events. The drug class of choice to treat these patients is a long-
acting calcium channel blocker. The class of calcium channel blockers recommended for ISH has the
suflx "pine" (amlodipine, felodipine, etc).
Remember
ISH = PINE
9. ACE inhibitor is specifically indicated in patients who have ...:
hypertension, diabetes with proteinuria, heart failure.
10. 77 year-old patient has had an increase in blood pressure since
the last exam. The blood pressure has risen to 168/88 with 2 readings.
The last exam's reading was 144/90. If medication is to be started on
this patient, what would be a good first choice?: CCB
This patient is 77 years old and should have a goal blood pressure of < 150/90. A thiazide diuretic is
not a good first choice in this patient because it will not be potent enough to decrease blood pressure
by 25 points to get him to goal. A long acting calcium channel blocker is appropriate for patients with
isolated systolic hypertension and will be more likely to get this patient to goal pressure than HCTZ.
Beta-blockers are no longer recommended first line for uncomplicated hypertension. ACE inhibitors are
very ettective in patients who are high renin producers. Elderly patients tend to produce lower amounts of
3 yi/
yi56
, renin.
11. A 63 year-old male has been your patient for several
years. He is a former smoker who takes simvastatin, ramipril, and an
aspirin daily. His blood pressure and lipids are well controlled. He
presents to your clinic with complaints of fatigue and "just not
feeling well" for the last few days. His vital signs and exam are
normal. What should be done next?
4 yi/
yi56
Exam Questions with 100%
Correct Answers (2025/2026
Latest Update)
1. A common lab findings with ACE Inhibitors:
Increase K+ ACE inhibitor =
retention of potassium.
Measure potassium one month after starting and one month after changing a dose
2. What should you do?
Pt on Monopril and HCTZ for hypertension. His blood pressure is 160-
170/92-98 on several blood pressure checks
? Would you add an ARB?: If these are at maximum doses, consideration should be given to
adding a medication from a ditterent class.
CALCIUM CHANNEL BLOCKER
NOT ARB - Adding an ARB may result in a precipitous decrease in his blood pressure because he takes an
ACE inhibitor and both of these medications work in the renin-angiotensin-aldosterone system.
,3. Significance of sildenafil and any blood pressure meds: Any
antihypertensive medication
... could have an additive ettect with sildenafil (or another medication in this
A specific drug-drug interaction to be aware of is the one that can occur with sildenafil and alpha blockers
like tamsulosin, alfuzosin, prazosin, doxazosin, or terazosin. This combination of medications may increase
the risk of symptomatic hypotension because the ettect of these two drugs is additive
4. : Consider two meds
low dose HCTZ and ARB or ace
This patient's blood pressure goal is < 140/90 according to JNC VIII. Since he is more than 20 points
above systolic goal (or greater than 10 points above diastolic goal) it is reasonable to consider two
medications
5. Risk assessment for dyslipidemia- what age to start assessment: Start
at age 2
Dyslipidemia assessment does not necessarily mean a Dyslipidemia assessment refers to assessing
family history of dyslipidemia, premature cardiovascular disease, or diabetes, body mass index > 85% for
age and sex, or history of other systemic diseases like Kawasaki Disease or treatment, or renal disease.
6. When to start lipid profiles: recommended between 18 and 21 years of age.
,7. A patient taking an ACE inhibitor should avoid:: No K supplements
ACE inhibitor potentially can produce hyperkalemia because its mechanism of action is in the renin-
angiotensin-aldos- terone system where potassium is spared. If potassium is taken in the form of
potassium supplements, the ettect will be additive and the risk of hyperkalemia can be great.
8. An 80 year-old female who is otherwise well, has a blood pressure of
176/80. How should she be managed pharmacologically?: CCB
This patient has isolated systolic hypertension (ISH). This is common in older adults and is associated
with tragic cardiac and cerebrovascular events. The drug class of choice to treat these patients is a long-
acting calcium channel blocker. The class of calcium channel blockers recommended for ISH has the
suflx "pine" (amlodipine, felodipine, etc).
Remember
ISH = PINE
9. ACE inhibitor is specifically indicated in patients who have ...:
hypertension, diabetes with proteinuria, heart failure.
10. 77 year-old patient has had an increase in blood pressure since
the last exam. The blood pressure has risen to 168/88 with 2 readings.
The last exam's reading was 144/90. If medication is to be started on
this patient, what would be a good first choice?: CCB
This patient is 77 years old and should have a goal blood pressure of < 150/90. A thiazide diuretic is
not a good first choice in this patient because it will not be potent enough to decrease blood pressure
by 25 points to get him to goal. A long acting calcium channel blocker is appropriate for patients with
isolated systolic hypertension and will be more likely to get this patient to goal pressure than HCTZ.
Beta-blockers are no longer recommended first line for uncomplicated hypertension. ACE inhibitors are
very ettective in patients who are high renin producers. Elderly patients tend to produce lower amounts of
3 yi/
yi56
, renin.
11. A 63 year-old male has been your patient for several
years. He is a former smoker who takes simvastatin, ramipril, and an
aspirin daily. His blood pressure and lipids are well controlled. He
presents to your clinic with complaints of fatigue and "just not
feeling well" for the last few days. His vital signs and exam are
normal. What should be done next?
4 yi/
yi56
