APEA FNP CARDIO EXAM 2026/2027 | Questions
and Answers|Top Score | Free Cardiology
Certification
Hypertension & Pharmacology
1. A 75-year-old male has a blood pressure of 172/84 mm Hg on two separate
visits. He has no other comorbidities. What is the best first-line medication?
• A) Lisinopril
• B) Metoprolol
• C) Amlodipine
• D) Hydrochlorothiazide
*Rationale: Calcium channel blockers (amlodipine) are first-line for isolated
systolic hypertension in elderly patients. Goal BP <150/90 for this
population per JNC VIII guidelines .*
2. A 40-year-old African American male has BP readings of 175/100 and 170/102.
What is the most reasonable plan today?
• A) Start low-dose HCTZ only
• B) Initiate amlodipine or a beta-blocker
• C) Start an ACE inhibitor twice daily
• D) Initiate low-dose HCTZ and candesartan
*Rationale: BP >20/10 above goal (140/90) justifies starting two
medications per JNC VIII, or one agent if preferred. In African Americans,
, ACE inhibitors are less effective as monotherapy; CCBs or thiazides are
preferred first-line .*
3. A patient taking lisinopril should avoid which supplement?
• A) Magnesium
• B) Calcium
• C) Potassium
• D) Zinc
Rationale: ACE inhibitors cause potassium retention by reducing
aldosterone. Potassium supplements increase hyperkalemia risk, especially
in patients with CKD or on concurrent NSAIDs .
4. Which medication may produce exercise intolerance in a patient with
hypertension?
• A) Hydrochlorothiazide
• B) Amlodipine
• C) Metoprolol
• D) Fosinopril
Rationale: Beta-blockers (metoprolol) limit heart rate increase during
exercise, reducing cardiac output and causing fatigue/exercise intolerance .
5. A patient with hypertension and angina takes multiple medications. Which one
decreases the likelihood of angina?
• A) ACE inhibitor
• B) Beta blocker
• C) Diuretic
• D) ARB
Rationale: Beta-blockers slow heart rate, decrease myocardial contractility,
, and reduce sympathetic stimulation, lowering myocardial oxygen demand
and improving angina symptoms .
6. A 77-year-old patient's BP increased from 144/90 to 168/88. What is a good
first-choice medication?
• A) ACE inhibitor
• B) Beta blocker
• C) Calcium channel blocker
• D) Thiazide diuretic
*Rationale: CCBs effectively treat isolated systolic hypertension in the
elderly, targeting goal <150/90. Amlodipine is preferred due to efficacy and
tolerability .*
7. A patient on atorvastatin for new dyslipidemia reports muscle aches for 3
weeks. How should this be evaluated?
• A) Stop atorvastatin immediately
• B) Check liver enzymes first
• C) Order a CPK level
• D) Ask about nighttime muscle cramps
Rationale: CPK (creatine phosphokinase) assesses for rhabdomyolysis, a
statin-related risk, before stopping the drug. Mild myalgias without CPK
elevation may be managed conservatively .
Heart Failure & Cardiomyopathy
8. A patient is diagnosed with mild heart failure (HF). Which drug reduces
morbidity and mortality long-term?
• A) Verapamil
• B) Digoxin
and Answers|Top Score | Free Cardiology
Certification
Hypertension & Pharmacology
1. A 75-year-old male has a blood pressure of 172/84 mm Hg on two separate
visits. He has no other comorbidities. What is the best first-line medication?
• A) Lisinopril
• B) Metoprolol
• C) Amlodipine
• D) Hydrochlorothiazide
*Rationale: Calcium channel blockers (amlodipine) are first-line for isolated
systolic hypertension in elderly patients. Goal BP <150/90 for this
population per JNC VIII guidelines .*
2. A 40-year-old African American male has BP readings of 175/100 and 170/102.
What is the most reasonable plan today?
• A) Start low-dose HCTZ only
• B) Initiate amlodipine or a beta-blocker
• C) Start an ACE inhibitor twice daily
• D) Initiate low-dose HCTZ and candesartan
*Rationale: BP >20/10 above goal (140/90) justifies starting two
medications per JNC VIII, or one agent if preferred. In African Americans,
, ACE inhibitors are less effective as monotherapy; CCBs or thiazides are
preferred first-line .*
3. A patient taking lisinopril should avoid which supplement?
• A) Magnesium
• B) Calcium
• C) Potassium
• D) Zinc
Rationale: ACE inhibitors cause potassium retention by reducing
aldosterone. Potassium supplements increase hyperkalemia risk, especially
in patients with CKD or on concurrent NSAIDs .
4. Which medication may produce exercise intolerance in a patient with
hypertension?
• A) Hydrochlorothiazide
• B) Amlodipine
• C) Metoprolol
• D) Fosinopril
Rationale: Beta-blockers (metoprolol) limit heart rate increase during
exercise, reducing cardiac output and causing fatigue/exercise intolerance .
5. A patient with hypertension and angina takes multiple medications. Which one
decreases the likelihood of angina?
• A) ACE inhibitor
• B) Beta blocker
• C) Diuretic
• D) ARB
Rationale: Beta-blockers slow heart rate, decrease myocardial contractility,
, and reduce sympathetic stimulation, lowering myocardial oxygen demand
and improving angina symptoms .
6. A 77-year-old patient's BP increased from 144/90 to 168/88. What is a good
first-choice medication?
• A) ACE inhibitor
• B) Beta blocker
• C) Calcium channel blocker
• D) Thiazide diuretic
*Rationale: CCBs effectively treat isolated systolic hypertension in the
elderly, targeting goal <150/90. Amlodipine is preferred due to efficacy and
tolerability .*
7. A patient on atorvastatin for new dyslipidemia reports muscle aches for 3
weeks. How should this be evaluated?
• A) Stop atorvastatin immediately
• B) Check liver enzymes first
• C) Order a CPK level
• D) Ask about nighttime muscle cramps
Rationale: CPK (creatine phosphokinase) assesses for rhabdomyolysis, a
statin-related risk, before stopping the drug. Mild myalgias without CPK
elevation may be managed conservatively .
Heart Failure & Cardiomyopathy
8. A patient is diagnosed with mild heart failure (HF). Which drug reduces
morbidity and mortality long-term?
• A) Verapamil
• B) Digoxin
