APEA CEU FNP Exam Prep (2026/2027) –
200 Practice Questions & Answers for
Family Nurse Practitioner Certification
Exam Prep Review (PDF)
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A 62-year-old male presents with a blood pressure of 148/92 mmHg. He has a history of
benign prostatic hyperplasia (BPH). Which antihypertensive might also help his BPH
symptoms?
A) Lisinopril
B) Doxazosin (alpha-blocker)
C) Amlodipine
D) Hydrochlorothiazide
Correct Answer: B) Doxazosin (alpha-blocker)
,Rationale: Alpha-blockers such as doxazosin are used for both hypertension and BPH
by relaxing smooth muscle in blood vessels and the prostate. ACE inhibitors (lisinopril),
calcium channel blockers (amlodipine), and thiazides (HCTZ) do not treat BPH
symptoms .
Question 2
A patient with palpitations has an ECG showing a narrow QRS complex tachycardia at
180 beats per minute. The rhythm is regular. What is the most likely rhythm?
A) Atrial fibrillation
B) Supraventricular tachycardia (SVT)
C) Ventricular tachycardia
D) Atrial flutter with variable block
Correct Answer: B) Supraventricular tachycardia (SVT)
Rationale: SVT presents with a regular, narrow-complex tachycardia. Atrial fibrillation is
irregularly irregular; ventricular tachycardia is wide-complex; atrial flutter with variable
block is irregular .
Question 3
ECG shows a heart rate of 38 beats per minute with a regular rhythm and no relationship
between P waves and QRS complexes. What is the most likely rhythm?
A) Atrial fibrillation with slow ventricular response
B) Complete heart block
C) Sinus bradycardia
D) Ventricular escape rhythm
Correct Answer: B) Complete heart block
Rationale: Complete heart block (third-degree AV block) presents with a slow, regular
rhythm with no relationship between P waves and QRS complexes. Atrial fibrillation has
,irregularly irregular rhythm; sinus bradycardia has P waves; ventricular escape rhythm is
a secondary phenomenon .
Question 4
A 55-year-old male presents with a blood pressure of 165/100 mmHg and a heart rate
of 110 beats per minute. He reports a history of migraine headaches. Which
antihypertensive would be contraindicated?
A) Lisinopril
B) Amlodipine
C) Metoprolol
D) Hydrochlorothiazide
Correct Answer: B) Amlodipine
Rationale: Amlodipine can cause headache as a side effect and may exacerbate
migraines. Beta-blockers (metoprolol) are actually preferred in patients with migraines
for both hypertension and migraine prophylaxis. ACE inhibitors and thiazides are
generally safe options .
Question 5
A patient with hypertension and chronic kidney disease has a blood pressure of 142/90
mmHg on lisinopril 20 mg and hydrochlorothiazide 25 mg. What is the most
appropriate next step?
A) Increase lisinopril to 40 mg
B) Add amlodipine
C) Increase hydrochlorothiazide to 50 mg
D) Switch to losartan
Correct Answer: B) Add amlodipine
, Rationale: The patient is on two agents and remains above goal. Adding a third agent
from a different class (calcium channel blocker) is appropriate. Increasing lisinopril may
be considered but amlodipine is a common third agent for resistant hypertension .
Question 6
What is the target INR for a patient with atrial fibrillation on warfarin?
A) 1.0–1.5
B) 2.0–3.0
C) 3.0–4.0
D) 4.0–5.0
Correct Answer: B) 2.0–3.0
Rationale: INR 2.0–3.0 is the target for DVT, PE, and atrial fibrillation. Higher targets
(3.0–4.0) are for mechanical heart valves .
Question 7
A patient with heart failure with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan (Entresto). What is the mechanism of action?
A) Inhibition of neprilysin and blockade of angiotensin II receptors
B) Selective beta-1 blockade and vasodilation
C) Aldosterone antagonism and potassium sparing
D) Calcium channel blockade and negative inotropy
Correct Answer: A) Inhibition of neprilysin and blockade of angiotensin II
receptors
Rationale: Sacubitril inhibits neprilysin, increasing natriuretic peptides, while valsartan
blocks AT1 receptors. This combination reduces cardiac remodeling and improves
outcomes in HFrEF. Beta-blockade, aldosterone antagonism, and calcium channel
blockade are separate drug classes .
200 Practice Questions & Answers for
Family Nurse Practitioner Certification
Exam Prep Review (PDF)
SECTION 1: CARDIOVASCULAR DISORDERS
Question 1
A 62-year-old male presents with a blood pressure of 148/92 mmHg. He has a history of
benign prostatic hyperplasia (BPH). Which antihypertensive might also help his BPH
symptoms?
A) Lisinopril
B) Doxazosin (alpha-blocker)
C) Amlodipine
D) Hydrochlorothiazide
Correct Answer: B) Doxazosin (alpha-blocker)
,Rationale: Alpha-blockers such as doxazosin are used for both hypertension and BPH
by relaxing smooth muscle in blood vessels and the prostate. ACE inhibitors (lisinopril),
calcium channel blockers (amlodipine), and thiazides (HCTZ) do not treat BPH
symptoms .
Question 2
A patient with palpitations has an ECG showing a narrow QRS complex tachycardia at
180 beats per minute. The rhythm is regular. What is the most likely rhythm?
A) Atrial fibrillation
B) Supraventricular tachycardia (SVT)
C) Ventricular tachycardia
D) Atrial flutter with variable block
Correct Answer: B) Supraventricular tachycardia (SVT)
Rationale: SVT presents with a regular, narrow-complex tachycardia. Atrial fibrillation is
irregularly irregular; ventricular tachycardia is wide-complex; atrial flutter with variable
block is irregular .
Question 3
ECG shows a heart rate of 38 beats per minute with a regular rhythm and no relationship
between P waves and QRS complexes. What is the most likely rhythm?
A) Atrial fibrillation with slow ventricular response
B) Complete heart block
C) Sinus bradycardia
D) Ventricular escape rhythm
Correct Answer: B) Complete heart block
Rationale: Complete heart block (third-degree AV block) presents with a slow, regular
rhythm with no relationship between P waves and QRS complexes. Atrial fibrillation has
,irregularly irregular rhythm; sinus bradycardia has P waves; ventricular escape rhythm is
a secondary phenomenon .
Question 4
A 55-year-old male presents with a blood pressure of 165/100 mmHg and a heart rate
of 110 beats per minute. He reports a history of migraine headaches. Which
antihypertensive would be contraindicated?
A) Lisinopril
B) Amlodipine
C) Metoprolol
D) Hydrochlorothiazide
Correct Answer: B) Amlodipine
Rationale: Amlodipine can cause headache as a side effect and may exacerbate
migraines. Beta-blockers (metoprolol) are actually preferred in patients with migraines
for both hypertension and migraine prophylaxis. ACE inhibitors and thiazides are
generally safe options .
Question 5
A patient with hypertension and chronic kidney disease has a blood pressure of 142/90
mmHg on lisinopril 20 mg and hydrochlorothiazide 25 mg. What is the most
appropriate next step?
A) Increase lisinopril to 40 mg
B) Add amlodipine
C) Increase hydrochlorothiazide to 50 mg
D) Switch to losartan
Correct Answer: B) Add amlodipine
, Rationale: The patient is on two agents and remains above goal. Adding a third agent
from a different class (calcium channel blocker) is appropriate. Increasing lisinopril may
be considered but amlodipine is a common third agent for resistant hypertension .
Question 6
What is the target INR for a patient with atrial fibrillation on warfarin?
A) 1.0–1.5
B) 2.0–3.0
C) 3.0–4.0
D) 4.0–5.0
Correct Answer: B) 2.0–3.0
Rationale: INR 2.0–3.0 is the target for DVT, PE, and atrial fibrillation. Higher targets
(3.0–4.0) are for mechanical heart valves .
Question 7
A patient with heart failure with reduced ejection fraction (HFrEF) is started on
sacubitril/valsartan (Entresto). What is the mechanism of action?
A) Inhibition of neprilysin and blockade of angiotensin II receptors
B) Selective beta-1 blockade and vasodilation
C) Aldosterone antagonism and potassium sparing
D) Calcium channel blockade and negative inotropy
Correct Answer: A) Inhibition of neprilysin and blockade of angiotensin II
receptors
Rationale: Sacubitril inhibits neprilysin, increasing natriuretic peptides, while valsartan
blocks AT1 receptors. This combination reduces cardiac remodeling and improves
outcomes in HFrEF. Beta-blockade, aldosterone antagonism, and calcium channel
blockade are separate drug classes .
