BCACP - Board Certified Ambulatory Care Pharmacist Cardiovascular Disease Management Questions and Answers

Question 1

A 68-year-old male with a history of myocardial infarction 2 years ago presents for a follow-up visit.
His current medications include atorvastatin 80 mg daily, lisinopril 20 mg daily, metoprolol succinate 100 mg daily, and aspirin 81 mg daily.
His recent lipid panel shows an LDL-C of 85 mg/dL.
According to the 2026 ACC/AHA Guideline on the Management of Dyslipidemia, which of the following is the most appropriate next step?

Accepted Answer

Add ezetimibe 10 mg daily.

Answer

Continue current therapy and recheck lipids in 6 months.

Answer

Increase atorvastatin to 80 mg twice daily.

Answer

Initiate fenofibrate for additional LDL-C lowering.

Question 2

A 52-year-old female is diagnosed with Stage 1 hypertension with a blood pressure reading of 136/88 mmHg. She has no other medical conditions. Her calculated 10-year PREVENT-ASCVD risk score is 4%. Based on the 2025 ACC/AHA hypertension guideline, what is the MOST appropriate initial recommendation?

Accepted Answer

Recommend lifestyle modifications, including dietary changes and physical activity, and re-evaluate in 3-6 months.

Answer

Initiate hydrochlorothiazide 12.5 mg daily.

Answer

Initiate amlodipine 5 mg daily.

Answer

Recommend lifestyle modifications and re-evaluate in 1 month.

Question 3

Which of the following medication classes is now considered one of the four essential pillars of guideline-directed medical therapy (GDMT) for all patients with heart failure with reduced ejection fraction (HFrEF), regardless of diabetes status?

Accepted Answer

Sodium-glucose cotransporter-2 (SGLT2) inhibitors

Answer

Ivabradine

Answer

Digoxin

Answer

Loop diuretics

Question 4

A 76-year-old female with hypertension and type 2 diabetes is newly diagnosed with paroxysmal atrial fibrillation. She has no history of stroke. What is her CHA2DS2-VASc score, and what is the most appropriate anticoagulant recommendation according to the 2023 ACC/AHA/ACCP/HRS guideline?

Accepted Answer

Score of 4; recommend apixaban or another direct oral anticoagulant (DOAC).

Answer

Score of 3; recommend aspirin 81 mg daily.

Answer

Score of 2; shared decision-making regarding oral anticoagulation.

Answer

Score of 4; recommend warfarin with a target INR of 2.0-3.0.

Question 5

A 65-year-old man with hyperlipidemia but no history of ASCVD, diabetes, or increased bleeding risk asks about starting aspirin for primary prevention of a heart attack. His 10-year ASCVD risk is calculated to be 12%. According to the 2022 US Preventive Services Task Force (USPSTF) recommendations, what should the pharmacist advise?

Accepted Answer

Aspirin should not be initiated for primary prevention in this age group.

Answer

Aspirin is strongly recommended and should be initiated immediately.

Answer

Aspirin initiation can be considered after a shared decision-making discussion of risks and benefits.

Answer

Aspirin should only be started if his ASCVD risk is >20%.

Question 6

A patient with newly diagnosed atrial fibrillation and a BMI of 31 kg/m² is being counseled on management strategies. According to the 2023 AFib guidelines, which of the following non-pharmacologic interventions is a pillar of management to prevent disease progression and adverse outcomes?

Accepted Answer

Weight loss and moderate-intensity exercise targeting 210 minutes per week.

Answer

High-intensity interval training for 30 minutes weekly.

Answer

Strict limitation of dietary potassium.

Answer

A low-carbohydrate, high-fat diet.