NR 565 Pharmacotherapeutics for Primary
Care Week 1 Quiz 20-Question Practice Quiz
ACTUAL EXAM 2026/2027 | Chamberlain
NR 565 Week 1 | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Health (Questions 1–10)
Q1: A 58-year-old Black male with hypertension and no other comorbidities has a BP of 148/92 mmHg
on two separate visits. According to the 2026 ACC/AHA hypertension guidelines, what is the most
appropriate initial pharmacologic therapy?
A. Hydrochlorothiazide 12.5 mg daily
B. Lisinopril 10 mg daily
C. Amlodipine 5 mg daily
D. Metoprolol succinate 50 mg daily
Correct Answer: C
Rationale: ACC/AHA guidelines recommend thiazide diuretics, CCBs, or ACEi/ARB as first-line for
hypertension. In Black patients without CKD or heart failure, CCBs or thiazides demonstrate superior BP
reduction compared to ACEi/ARB monotherapy, making amlodipine the evidence-based choice for this
patient. [CORRECT]
Q2: A 72-year-old female with heart failure with preserved ejection fraction (HFpEF, EF 55%) presents
with dyspnea on exertion and peripheral edema. She has a history of hypertension and obesity (BMI 34).
Which medication has been shown in recent trials to improve outcomes specifically in HFpEF?
A. Spironolactone 25 mg daily
B. Metoprolol tartrate 25 mg BID
C. Digoxin 0.125 mg daily
D. Sacubitril/valsartan 24/26 mg BID
Correct Answer: D
Rationale: Sacubitril/valsartan received expanded FDA indication for HFpEF based on the PARAGON-HF
,and PARAGLIDE-HF trials, demonstrating reduced heart failure hospitalizations and cardiovascular death
in patients with LVEF ≥45%, particularly those with elevated NT-proBNP. [CORRECT]
Q3: A 64-year-old male with type 2 diabetes and established ASCVD presents for follow-up. His LDL is
110 mg/dL on atorvastatin 20 mg. According to 2026 ACC/AHA cholesterol guidelines, what is the most
appropriate next step?
A. Continue current statin dose and recheck in 6 months
B. Increase atorvastatin to 40 mg to achieve ≥50% LDL reduction
C. Add ezetimibe 10 mg daily
D. Switch to rosuvastatin 10 mg daily
Correct Answer: B
Rationale: Patients with clinical ASCVD require high-intensity statin therapy (≥50% LDL reduction); since
his current LDL represents less than 50% reduction from typical baseline, uptitrating atorvastatin to 40
mg is the appropriate evidence-based step before adding non-statin therapy. [CORRECT]
Q4: A 68-year-old female with hypertension, diabetes, and CKD stage 3b (eGFR 38) has a BP of 156/88
mmHg on amlodipine 5 mg. What is the most appropriate add-on antihypertensive?
A. Hydrochlorothiazide 25 mg daily
B. Lisinopril 10 mg daily
C. Metoprolol succinate 50 mg daily
D. Clonidine 0.1 mg BID
Correct Answer: B
Rationale: In patients with diabetes and CKD, ACE inhibitors (or ARBs) are preferred as they slow
progression of diabetic nephropathy and reduce proteinuria; lisinopril also provides cardiovascular
protection and is first-line in this high-risk population per KDIGO and ADA guidelines. [CORRECT]
Q5: A 75-year-old male with nonvalvular atrial fibrillation (CHADS₂-VASc score 4) is started on apixaban
5 mg BID. Which monitoring parameter is essential during follow-up?
A. Monthly INR testing
B. Annual renal function and assessment for bleeding
C. Weekly CBC with differential
D. Therapeutic drug monitoring of anti-Xa levels
Correct Answer: B
Rationale: Apixaban does not require routine INR or anti-Xa monitoring; however, annual renal function
assessment is essential as drug clearance is partially renal, and ongoing clinical evaluation for bleeding
signs (GI, intracranial) is required per anticoagulation management guidelines. [CORRECT]
, Q6: A 55-year-old female presents with chest pressure radiating to her left arm, diaphoresis, and nausea
for 45 minutes. Her ECG shows ST-elevation in leads V1–V4. What is the most appropriate immediate
action?
A. Administer aspirin 325 mg and arrange urgent cardiology referral within 24 hours
B. Activate EMS for immediate transport to PCI-capable center
C. Perform stress testing after symptom resolution
D. Start heparin infusion and admit for medical management
Correct Answer: B
Rationale: ST-elevation myocardial infarction (STEMI) requires immediate reperfusion therapy; primary
PCI within 90 minutes of first medical contact is the gold standard, necessitating EMS activation and
direct transport to a PCI-capable center without delay for further evaluation. [CORRECT]
Q7: A 62-year-old male with HFrEF (EF 30%) on lisinopril 20 mg and furosemide 40 mg has persistent
dyspnea. His potassium is 4.2 mEq/L and creatinine is 1.1 mg/dL. What evidence-based medication
should be added next?
A. Digoxin 0.125 mg daily
B. Spironolactone 25 mg daily
C. Amlodipine 5 mg daily
D. Hydralazine/isosorbide dinitrate
Correct Answer: B
Rationale: The EMPHASIS-HF and RALES trials demonstrated that mineralocorticoid receptor antagonists
(spironolactone, eplerenone) reduce mortality and heart failure hospitalizations in HFrEF when added to
ACEi and loop diuretics, provided potassium and renal function are monitored. [CORRECT]
Q8: A 45-year-old female with no cardiac history presents with palpitations, lightheadedness, and an
irregularly irregular pulse at 140 bpm. Her ECG confirms atrial fibrillation with rapid ventricular
response. Her BP is 110/72 mmHg. What is the most appropriate initial management?
A. Immediate synchronized cardioversion
B. Rate control with metoprolol IV and anticoagulation assessment
C. Rhythm control with amiodarone infusion
D. Anticoagulation with warfarin only
Correct Answer: B
Rationale: In hemodynamically stable acute atrial fibrillation, initial management focuses on rate control
(beta-blocker or non-DHP CCB) and assessment for anticoagulation need based on CHADS₂-VASc score;
Care Week 1 Quiz 20-Question Practice Quiz
ACTUAL EXAM 2026/2027 | Chamberlain
NR 565 Week 1 | Verified Q&A | Pass
Guaranteed - A+ Graded
Section 1: Cardiovascular Health (Questions 1–10)
Q1: A 58-year-old Black male with hypertension and no other comorbidities has a BP of 148/92 mmHg
on two separate visits. According to the 2026 ACC/AHA hypertension guidelines, what is the most
appropriate initial pharmacologic therapy?
A. Hydrochlorothiazide 12.5 mg daily
B. Lisinopril 10 mg daily
C. Amlodipine 5 mg daily
D. Metoprolol succinate 50 mg daily
Correct Answer: C
Rationale: ACC/AHA guidelines recommend thiazide diuretics, CCBs, or ACEi/ARB as first-line for
hypertension. In Black patients without CKD or heart failure, CCBs or thiazides demonstrate superior BP
reduction compared to ACEi/ARB monotherapy, making amlodipine the evidence-based choice for this
patient. [CORRECT]
Q2: A 72-year-old female with heart failure with preserved ejection fraction (HFpEF, EF 55%) presents
with dyspnea on exertion and peripheral edema. She has a history of hypertension and obesity (BMI 34).
Which medication has been shown in recent trials to improve outcomes specifically in HFpEF?
A. Spironolactone 25 mg daily
B. Metoprolol tartrate 25 mg BID
C. Digoxin 0.125 mg daily
D. Sacubitril/valsartan 24/26 mg BID
Correct Answer: D
Rationale: Sacubitril/valsartan received expanded FDA indication for HFpEF based on the PARAGON-HF
,and PARAGLIDE-HF trials, demonstrating reduced heart failure hospitalizations and cardiovascular death
in patients with LVEF ≥45%, particularly those with elevated NT-proBNP. [CORRECT]
Q3: A 64-year-old male with type 2 diabetes and established ASCVD presents for follow-up. His LDL is
110 mg/dL on atorvastatin 20 mg. According to 2026 ACC/AHA cholesterol guidelines, what is the most
appropriate next step?
A. Continue current statin dose and recheck in 6 months
B. Increase atorvastatin to 40 mg to achieve ≥50% LDL reduction
C. Add ezetimibe 10 mg daily
D. Switch to rosuvastatin 10 mg daily
Correct Answer: B
Rationale: Patients with clinical ASCVD require high-intensity statin therapy (≥50% LDL reduction); since
his current LDL represents less than 50% reduction from typical baseline, uptitrating atorvastatin to 40
mg is the appropriate evidence-based step before adding non-statin therapy. [CORRECT]
Q4: A 68-year-old female with hypertension, diabetes, and CKD stage 3b (eGFR 38) has a BP of 156/88
mmHg on amlodipine 5 mg. What is the most appropriate add-on antihypertensive?
A. Hydrochlorothiazide 25 mg daily
B. Lisinopril 10 mg daily
C. Metoprolol succinate 50 mg daily
D. Clonidine 0.1 mg BID
Correct Answer: B
Rationale: In patients with diabetes and CKD, ACE inhibitors (or ARBs) are preferred as they slow
progression of diabetic nephropathy and reduce proteinuria; lisinopril also provides cardiovascular
protection and is first-line in this high-risk population per KDIGO and ADA guidelines. [CORRECT]
Q5: A 75-year-old male with nonvalvular atrial fibrillation (CHADS₂-VASc score 4) is started on apixaban
5 mg BID. Which monitoring parameter is essential during follow-up?
A. Monthly INR testing
B. Annual renal function and assessment for bleeding
C. Weekly CBC with differential
D. Therapeutic drug monitoring of anti-Xa levels
Correct Answer: B
Rationale: Apixaban does not require routine INR or anti-Xa monitoring; however, annual renal function
assessment is essential as drug clearance is partially renal, and ongoing clinical evaluation for bleeding
signs (GI, intracranial) is required per anticoagulation management guidelines. [CORRECT]
, Q6: A 55-year-old female presents with chest pressure radiating to her left arm, diaphoresis, and nausea
for 45 minutes. Her ECG shows ST-elevation in leads V1–V4. What is the most appropriate immediate
action?
A. Administer aspirin 325 mg and arrange urgent cardiology referral within 24 hours
B. Activate EMS for immediate transport to PCI-capable center
C. Perform stress testing after symptom resolution
D. Start heparin infusion and admit for medical management
Correct Answer: B
Rationale: ST-elevation myocardial infarction (STEMI) requires immediate reperfusion therapy; primary
PCI within 90 minutes of first medical contact is the gold standard, necessitating EMS activation and
direct transport to a PCI-capable center without delay for further evaluation. [CORRECT]
Q7: A 62-year-old male with HFrEF (EF 30%) on lisinopril 20 mg and furosemide 40 mg has persistent
dyspnea. His potassium is 4.2 mEq/L and creatinine is 1.1 mg/dL. What evidence-based medication
should be added next?
A. Digoxin 0.125 mg daily
B. Spironolactone 25 mg daily
C. Amlodipine 5 mg daily
D. Hydralazine/isosorbide dinitrate
Correct Answer: B
Rationale: The EMPHASIS-HF and RALES trials demonstrated that mineralocorticoid receptor antagonists
(spironolactone, eplerenone) reduce mortality and heart failure hospitalizations in HFrEF when added to
ACEi and loop diuretics, provided potassium and renal function are monitored. [CORRECT]
Q8: A 45-year-old female with no cardiac history presents with palpitations, lightheadedness, and an
irregularly irregular pulse at 140 bpm. Her ECG confirms atrial fibrillation with rapid ventricular
response. Her BP is 110/72 mmHg. What is the most appropriate initial management?
A. Immediate synchronized cardioversion
B. Rate control with metoprolol IV and anticoagulation assessment
C. Rhythm control with amiodarone infusion
D. Anticoagulation with warfarin only
Correct Answer: B
Rationale: In hemodynamically stable acute atrial fibrillation, initial management focuses on rate control
(beta-blocker or non-DHP CCB) and assessment for anticoagulation need based on CHADS₂-VASc score;
