APEA FNP CARDIO EXAM 2026/2027 |
Questions and Answers|Top Score | Free
Cardiology Certification
SECTION 1: HYPERTENSION MANAGEMENT
1. First-line treatment for hypertension in a diabetic patient is:
A) Beta-blocker
B) ACE inhibitor
C) Loop diuretic
D) Calcium supplement
Rationale: ACE inhibitors (and ARBs) are first-line for hypertensive diabetics
because they provide renoprotective effects, slowing the progression of diabetic
nephropathy.
2. According to current JNC/ACC/AHA guidelines, which antihypertensive class is
recommended as first-line for a Black patient without comorbidities?
A) ACE inhibitor
B) Angiotensin receptor blocker (ARB)
C) Thiazide diuretic or calcium channel blocker (CCB)
D) Beta-blocker
Rationale: Guidelines recommend thiazide diuretics or CCBs as initial therapy for
Black patients with hypertension and no comorbid conditions such as heart failure
or CKD. ACE inhibitors/ARBs are less effective as monotherapy in this population.
3. A 68-year-old patient with hypertension and stage 3 CKD (eGFR 45 mL/min)
has a BP of 148/90 mmHg. The most appropriate next step is:
, A) Add a beta-blocker
B) Increase the thiazide diuretic dose
C) Add an ACE inhibitor or ARB
D) Start a direct vasodilator
*Rationale: ACE inhibitors/ARBs are preferred in CKD for both BP control and renal
protection, regardless of race. Thiazides become less effective at eGFR <30-45
mL/min. *
4. A patient reports a persistent dry cough after starting lisinopril. What is the
most appropriate next step?
A) Continue the medication and add a cough suppressant
B) Switch to an ARB (e.g., losartan)
C) Double the dose of lisinopril
D) Switch to a beta-blocker
*Rationale: ACE inhibitor-induced cough (due to bradykinin accumulation) affects
10-20% of patients. ARBs do not inhibit bradykinin breakdown and are excellent
substitutes. *
5. Which laboratory finding is most concerning in a patient taking
hydrochlorothiazide?
A) Sodium 138 mEq/L
B) Potassium 2.9 mEq/L
C) Glucose 110 mg/dL
D) Creatinine 0.9 mg/dL
*Rationale: Thiazides cause hypokalemia via urinary potassium wasting. A level of
2.9 mEq/L is severe and increases arrhythmia risk, especially in patients on
digoxin. *
6. Which medication is contraindicated in pregnancy?
A) Methyldopa
B) Nifedipine
Questions and Answers|Top Score | Free
Cardiology Certification
SECTION 1: HYPERTENSION MANAGEMENT
1. First-line treatment for hypertension in a diabetic patient is:
A) Beta-blocker
B) ACE inhibitor
C) Loop diuretic
D) Calcium supplement
Rationale: ACE inhibitors (and ARBs) are first-line for hypertensive diabetics
because they provide renoprotective effects, slowing the progression of diabetic
nephropathy.
2. According to current JNC/ACC/AHA guidelines, which antihypertensive class is
recommended as first-line for a Black patient without comorbidities?
A) ACE inhibitor
B) Angiotensin receptor blocker (ARB)
C) Thiazide diuretic or calcium channel blocker (CCB)
D) Beta-blocker
Rationale: Guidelines recommend thiazide diuretics or CCBs as initial therapy for
Black patients with hypertension and no comorbid conditions such as heart failure
or CKD. ACE inhibitors/ARBs are less effective as monotherapy in this population.
3. A 68-year-old patient with hypertension and stage 3 CKD (eGFR 45 mL/min)
has a BP of 148/90 mmHg. The most appropriate next step is:
, A) Add a beta-blocker
B) Increase the thiazide diuretic dose
C) Add an ACE inhibitor or ARB
D) Start a direct vasodilator
*Rationale: ACE inhibitors/ARBs are preferred in CKD for both BP control and renal
protection, regardless of race. Thiazides become less effective at eGFR <30-45
mL/min. *
4. A patient reports a persistent dry cough after starting lisinopril. What is the
most appropriate next step?
A) Continue the medication and add a cough suppressant
B) Switch to an ARB (e.g., losartan)
C) Double the dose of lisinopril
D) Switch to a beta-blocker
*Rationale: ACE inhibitor-induced cough (due to bradykinin accumulation) affects
10-20% of patients. ARBs do not inhibit bradykinin breakdown and are excellent
substitutes. *
5. Which laboratory finding is most concerning in a patient taking
hydrochlorothiazide?
A) Sodium 138 mEq/L
B) Potassium 2.9 mEq/L
C) Glucose 110 mg/dL
D) Creatinine 0.9 mg/dL
*Rationale: Thiazides cause hypokalemia via urinary potassium wasting. A level of
2.9 mEq/L is severe and increases arrhythmia risk, especially in patients on
digoxin. *
6. Which medication is contraindicated in pregnancy?
A) Methyldopa
B) Nifedipine
