Board Certified Ambulatory Care Pharmacist
(BCACP) practice exam Verified Questions,
Correct Answers, and Detailed Explanations
for Science Students||Already Graded A+
1. Which of the following is the most appropriate first-line therapy for a
patient newly diagnosed with type 2 diabetes and no contraindications?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
Answer: B. Metformin
Rationale: Metformin is recommended as first-line therapy due to its efficacy,
safety profile, weight neutrality, and cardiovascular benefits.
2. A 65-year-old patient with hypertension and chronic kidney disease (CKD
stage 3) needs antihypertensive therapy. Which is preferred?
A. Lisinopril
B. Amlodipine
C. Hydrochlorothiazide
D. Atenolol
Answer: A. Lisinopril
Rationale: ACE inhibitors slow CKD progression and protect renal function; they
are first-line in CKD with proteinuria.
3. Which immunization is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. Pneumococcal
D. Shingles
Answer: B. Influenza
Rationale: Annual influenza vaccination is recommended for all adults to
reduce morbidity and mortality.
4. For a patient with heart failure with reduced ejection fraction (HFrEF),
which therapy improves mortality?
,A. Furosemide
B. Metoprolol succinate
C. Digoxin
D. Hydrochlorothiazide
Answer: B. Metoprolol succinate
Rationale: Beta-blockers (metoprolol succinate, carvedilol, bisoprolol) reduce
mortality and hospitalizations in HFrEF.
5. Which statin is most appropriate for high-intensity therapy in a 55-year-old
patient with atherosclerotic cardiovascular disease (ASCVD)?
A. Pravastatin 40 mg
B. Simvastatin 20 mg
C. Atorvastatin 80 mg
D. Lovastatin 20 mg
Answer: C. Atorvastatin 80 mg
Rationale: High-intensity statins (atorvastatin 40–80 mg or rosuvastatin 20–40
mg) lower LDL by ≥50% in high-risk patients.
6. A patient presents with uncontrolled asthma despite low-dose inhaled
corticosteroid. The next step is:
A. Add a long-acting beta-agonist (LABA)
B. Increase ICS dose to high
C. Add montelukast
D. Discontinue ICS
Answer: A. Add a long-acting beta-agonist (LABA)
Rationale: Stepwise therapy recommends adding a LABA to low-dose ICS for
better asthma control before increasing ICS dose.
7. Which laboratory test is most sensitive for monitoring warfarin therapy?
A. PT/INR
B. aPTT
C. Platelet count
D. Fibrinogen
Answer: A. PT/INR
Rationale: INR standardizes PT and is used to monitor warfarin anticoagulation
and reduce risk of bleeding or thrombosis.
, 8. A patient with chronic stable angina is already on a beta-blocker. Which
agent is appropriate to add for symptom control?
A. Nitroglycerin PRN
B. Ranolazine
C. Aspirin
D. Atorvastatin
Answer: B. Ranolazine
Rationale: Ranolazine is used as add-on therapy when beta-blockers are
insufficient, improving exercise tolerance and reducing angina.
9. Which medication is contraindicated in pregnancy?
A. Lisinopril
B. Insulin
C. Acetaminophen
D. Labetalol
Answer: A. Lisinopril
Rationale: ACE inhibitors are teratogenic, especially in the second and third
trimesters, and should be avoided in pregnancy.
10. For a patient with chronic pain and opioid therapy, which risk mitigation
strategy is recommended?
A. Routine MRI
B. Urine drug screening
C. Daily CBC
D. Monthly ECG
Answer: B. Urine drug screening
Rationale: Regular urine drug screens help detect misuse and improve safety in
chronic opioid therapy.
11. Which drug class reduces mortality in post-MI patients with reduced
ejection fraction?
A. Calcium channel blockers
B. ACE inhibitors
C. Nitrates
D. Antiplatelets only
Answer: B. ACE inhibitors
(BCACP) practice exam Verified Questions,
Correct Answers, and Detailed Explanations
for Science Students||Already Graded A+
1. Which of the following is the most appropriate first-line therapy for a
patient newly diagnosed with type 2 diabetes and no contraindications?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
Answer: B. Metformin
Rationale: Metformin is recommended as first-line therapy due to its efficacy,
safety profile, weight neutrality, and cardiovascular benefits.
2. A 65-year-old patient with hypertension and chronic kidney disease (CKD
stage 3) needs antihypertensive therapy. Which is preferred?
A. Lisinopril
B. Amlodipine
C. Hydrochlorothiazide
D. Atenolol
Answer: A. Lisinopril
Rationale: ACE inhibitors slow CKD progression and protect renal function; they
are first-line in CKD with proteinuria.
3. Which immunization is recommended annually for all adults?
A. Hepatitis B
B. Influenza
C. Pneumococcal
D. Shingles
Answer: B. Influenza
Rationale: Annual influenza vaccination is recommended for all adults to
reduce morbidity and mortality.
4. For a patient with heart failure with reduced ejection fraction (HFrEF),
which therapy improves mortality?
,A. Furosemide
B. Metoprolol succinate
C. Digoxin
D. Hydrochlorothiazide
Answer: B. Metoprolol succinate
Rationale: Beta-blockers (metoprolol succinate, carvedilol, bisoprolol) reduce
mortality and hospitalizations in HFrEF.
5. Which statin is most appropriate for high-intensity therapy in a 55-year-old
patient with atherosclerotic cardiovascular disease (ASCVD)?
A. Pravastatin 40 mg
B. Simvastatin 20 mg
C. Atorvastatin 80 mg
D. Lovastatin 20 mg
Answer: C. Atorvastatin 80 mg
Rationale: High-intensity statins (atorvastatin 40–80 mg or rosuvastatin 20–40
mg) lower LDL by ≥50% in high-risk patients.
6. A patient presents with uncontrolled asthma despite low-dose inhaled
corticosteroid. The next step is:
A. Add a long-acting beta-agonist (LABA)
B. Increase ICS dose to high
C. Add montelukast
D. Discontinue ICS
Answer: A. Add a long-acting beta-agonist (LABA)
Rationale: Stepwise therapy recommends adding a LABA to low-dose ICS for
better asthma control before increasing ICS dose.
7. Which laboratory test is most sensitive for monitoring warfarin therapy?
A. PT/INR
B. aPTT
C. Platelet count
D. Fibrinogen
Answer: A. PT/INR
Rationale: INR standardizes PT and is used to monitor warfarin anticoagulation
and reduce risk of bleeding or thrombosis.
, 8. A patient with chronic stable angina is already on a beta-blocker. Which
agent is appropriate to add for symptom control?
A. Nitroglycerin PRN
B. Ranolazine
C. Aspirin
D. Atorvastatin
Answer: B. Ranolazine
Rationale: Ranolazine is used as add-on therapy when beta-blockers are
insufficient, improving exercise tolerance and reducing angina.
9. Which medication is contraindicated in pregnancy?
A. Lisinopril
B. Insulin
C. Acetaminophen
D. Labetalol
Answer: A. Lisinopril
Rationale: ACE inhibitors are teratogenic, especially in the second and third
trimesters, and should be avoided in pregnancy.
10. For a patient with chronic pain and opioid therapy, which risk mitigation
strategy is recommended?
A. Routine MRI
B. Urine drug screening
C. Daily CBC
D. Monthly ECG
Answer: B. Urine drug screening
Rationale: Regular urine drug screens help detect misuse and improve safety in
chronic opioid therapy.
11. Which drug class reduces mortality in post-MI patients with reduced
ejection fraction?
A. Calcium channel blockers
B. ACE inhibitors
C. Nitrates
D. Antiplatelets only
Answer: B. ACE inhibitors
