Hypertension and hyperlipidemia are two of the most common chronic conditions managed in the community pharmacy setting, acting as major drivers of cardiovascular disease. The modern pharmacist’s role has evolved far beyond dispensing, requiring proactive engagement in patient care to mitigate these risks. As detailed in the PharmD curriculum in courses like Patient Care 3 and Professional Skills Lab 3 , pharmacists are integral to performing health screenings , assessing cardiovascular risk , and counseling patients on both medications and crucial lifestyle modifications . This quiz will test your knowledge on applying evidence-based guidelines to provide exceptional cardiovascular care in the community, a cornerstone of your future practice.
1. According to the 2017 ACC/AHA guidelines, Stage 1 Hypertension is defined as a blood pressure of:
- a. 120-129/<80 mmHg
- b. 130-139/80-89 mmHg
- c. ≥140/≥90 mmHg
- d. <120/80 mmHg
Answer: b. 130-139/80-89 mmHg
2. A patient’s 10-year ASCVD risk is calculated to be 8.5%. According to the 2018 cholesterol guidelines, this places them in which risk category?
- a. Low Risk
- b. Borderline Risk
- c. Intermediate Risk
- d. High Risk
Answer: c. Intermediate Risk
3. Which of the following is considered a high-intensity statin therapy?
- a. Atorvastatin 20 mg
- b. Rosuvastatin 40 mg
- c. Simvastatin 20 mg
- d. Pravastatin 40 mg
Answer: b. Rosuvastatin 40 mg
4. A persistent, dry cough is a well-known side effect of which class of antihypertensive medications?
- a. Angiotensin II Receptor Blockers (ARBs)
- b. Calcium Channel Blockers (CCBs)
- c. ACE Inhibitors
- d. Beta-Blockers
Answer: c. ACE Inhibitors
5. The primary purpose of an ASCVD risk assessment is to:
- a. Diagnose a patient with heart failure.
- b. Guide the intensity of statin therapy for primary prevention of cardiovascular events.
- c. Determine the patient’s blood pressure goal.
- d. Select the appropriate non-statin therapy.
Answer: b. Guide the intensity of statin therapy for primary prevention of cardiovascular events.
6. Which class of antihypertensives is known to cause peripheral edema, particularly in the ankles?
- a. Thiazide diuretics
- b. Dihydropyridine Calcium Channel Blockers
- c. ACE Inhibitors
- d. Beta-Blockers
Answer: b. Dihydropyridine Calcium Channel Blockers
7. A key objective for student pharmacists is to be able to defend a therapeutic plan for a patient with hypertension or hypercholesterolemia using guidelines.
- a. True
- b. False
Answer: a. True
8. For a patient with diabetes and hypertension, which class of antihypertensive agents is often preferred due to its renal-protective benefits?
- a. Beta-Blockers
- b. Non-dihydropyridine CCBs
- c. ACE Inhibitors or ARBs
- d. Loop diuretics
Answer: c. ACE Inhibitors or ARBs
9. Statin-associated muscle symptoms (SAMS) are a potential side effect of statin therapy. What is the most severe form of SAMS?
- a. Myalgia
- b. Myopathy
- c. Rhabdomyolysis
- d. Arthralgia
Answer: c. Rhabdomyolysis
10. Which of the following is a key component of Therapeutic Lifestyle Changes (TLC) for managing hyperlipidemia?
- a. Reducing intake of saturated fat and cholesterol.
- b. Increasing intake of trans fats.
- c. A sedentary lifestyle.
- d. A high-sodium diet.
Answer: a. Reducing intake of saturated fat and cholesterol.
11. A community pharmacist performing a blood pressure screening is an example of what type of service?
- a. Dispensing
- b. Health and wellness promotion
- c. Compounding
- d. Therapeutic drug monitoring
Answer: b. Health and wellness promotion
12. When should a lipid panel be checked after initiating or changing a statin dose?
- a. Within one week
- b. In 4-12 weeks
- c. In one year
- d. It does not need to be rechecked.
Answer: b. In 4-12 weeks
13. Hydrochlorothiazide can cause which of the following electrolyte abnormalities?
- a. Hyperkalemia
- b. Hypokalemia
- c. Hypernatremia
- d. Hypocalcemia
Answer: b. Hypokalemia
14. A patient taking simvastatin should be counseled to avoid large quantities of what food/drink item?
- a. Milk
- b. Grapefruit juice
- c. Green leafy vegetables
- d. Coffee
Answer: b. Grapefruit juice
15. Counseling a patient on lifestyle modifications is a key part of managing a cardiovascular patient in the community.
- a. True
- b. False
Answer: a. True
16. The DASH diet, recommended for hypertension, emphasizes the intake of:
- a. Red meat and processed foods.
- b. Fruits, vegetables, and low-fat dairy products.
- c. Sugar-sweetened beverages.
- d. High-sodium snacks.
Answer: b. Fruits, vegetables, and low-fat dairy products.
17. What is the primary mechanism of action of ezetimibe?
- a. It inhibits HMG-CoA reductase in the liver.
- b. It inhibits the absorption of cholesterol from the small intestine.
- c. It increases the breakdown of triglycerides.
- d. It is a PCSK9 inhibitor.
Answer: b. It inhibits the absorption of cholesterol from the small intestine.
18. Beta-blockers should be used with caution in patients with:
- a. Heart failure
- b. Asthma or COPD
- c. Previous myocardial infarction
- d. Angina
Answer: b. Asthma or COPD
19. Shared decision-making in dyslipidemia management involves:
- a. The pharmacist making the decision for the patient.
- b. A conversation between the clinician and patient to reach a healthcare choice together, considering risks, benefits, and patient preferences.
- c. The patient deciding on their therapy without clinical input.
- d. The insurance company dictating the therapy.
Answer: b. A conversation between the clinician and patient to reach a healthcare choice together, considering risks, benefits, and patient preferences.
20. A patient’s blood pressure reading is 125/82 mmHg. How would this be classified?
- a. Normal
- b. Elevated Blood Pressure
- c. Stage 1 Hypertension
- d. Stage 2 Hypertension
Answer: b. Elevated Blood Pressure
21. A patient with a history of hypertriglyceridemia should be counseled to limit their intake of:
- a. Water
- b. Fiber
- c. Alcohol and refined carbohydrates
- d. Lean protein
Answer: c. Alcohol and refined carbohydrates
22. Which class of antihypertensives is generally less effective as monotherapy in African American patients?
- a. Thiazide diuretics
- b. Calcium Channel Blockers
- c. ACE Inhibitors and ARBs
- d. They are all equally effective.
Answer: c. ACE Inhibitors and ARBs
23. The most common side effect of niacin therapy is:
- a. Constipation
- b. Flushing and itching
- c. Cough
- d. Drowsiness
Answer: b. Flushing and itching
24. The Professional Skills Lab 3 curriculum includes a session on “Cardiovascular Care in the Community: Hypertension and Hyperlipidemia.”
- a. True
- b. False
Answer: a. True
25. A patient on lisinopril presents with swelling of the lips and tongue. This is a medical emergency known as:
- a. Peripheral edema
- b. Anaphylaxis
- c. Angioedema
- d. Statin-associated muscle symptoms
Answer: c. Angioedema
26. For a patient with clinical ASCVD (e.g., history of heart attack or stroke), what intensity of statin therapy is recommended for secondary prevention?
- a. Low-intensity
- b. Moderate-intensity
- c. High-intensity
- d. No statin is needed.
Answer: c. High-intensity
27. When taking a patient’s blood pressure, the cuff should be placed:
- a. On the forearm.
- b. Over thick clothing.
- c. On the bare upper arm with the artery marker over the brachial artery.
- d. As loosely as possible.
Answer: c. On the bare upper arm with the artery marker over the brachial artery.
28. Which of the following is NOT a first-line agent for hypertension?
- a. Amlodipine
- b. Lisinopril
- c. Chlorthalidone
- d. Clonidine
Answer: d. Clonidine
29. The main goal of statin therapy is to lower which lipoprotein value?
- a. HDL (High-Density Lipoprotein)
- b. LDL (Low-Density Lipoprotein)
- c. VLDL (Very Low-Density Lipoprotein)
- d. Triglycerides
Answer: b. LDL (Low-Density Lipoprotein)
30. Which diuretic is generally preferred for hypertension due to its longer half-life and proven trial data?
- a. Furosemide
- b. Spironolactone
- c. Chlorthalidone
- d. Triamterene
Answer: c. Chlorthalidone
31. A community pharmacist can improve patient adherence to cardiovascular medications by:
- a. Setting up 90-day supplies.
- b. Using pill boxes or blister packs.
- c. Providing education and managing side effects.
- d. All of the above.
Answer: d. All of the above.
32. Which medication class is known to increase triglyceride levels?
- a. Statins
- b. Bile acid sequestrants
- c. ACE inhibitors
- d. Metformin
Answer: b. Bile acid sequestrants
33. Abrupt discontinuation of which antihypertensive class can lead to rebound hypertension?
- a. ARBs
- b. Thiazide diuretics
- c. Beta-blockers
- d. ACE inhibitors
Answer: c. Beta-blockers
34. The pharmacology of antihyperlipidemic agents like statins is covered in the Patient Care course series.
- a. True
- b. False
Answer: a. True
35. A patient on an ACE inhibitor should have which labs monitored periodically?
- a. Lipid panel and LFTs
- b. Serum potassium and serum creatinine
- c. Complete blood count (CBC)
- d. Thyroid stimulating hormone (TSH)
Answer: b. Serum potassium and serum creatinine
36. For primary prevention in a patient with an LDL-C of 195 mg/dL, what is the recommended first step?
- a. Begin moderate-intensity statin therapy.
- b. Begin high-intensity statin therapy without calculating ASCVD risk.
- c. Recommend lifestyle modifications only.
- d. Add ezetimibe to their current regimen.
Answer: b. Begin high-intensity statin therapy without calculating ASCVD risk.
37. Which of the following is a non-dihydropyridine calcium channel blocker?
- a. Amlodipine
- b. Nifedipine
- c. Verapamil
- d. Felodipine
Answer: c. Verapamil
38. Fibrates are most effective at lowering:
- a. LDL-C
- b. HDL-C
- c. Triglycerides
- d. Total cholesterol
Answer: c. Triglycerides
39. A key counseling point for a patient starting any new antihypertensive medication is:
- a. The medication will cure their hypertension.
- b. To rise slowly from a sitting or lying position to avoid dizziness.
- c. To stop taking it once their blood pressure is normal.
- d. To only take it when they feel like their blood pressure is high.
Answer: b. To rise slowly from a sitting or lying position to avoid dizziness.
40. PCSK9 inhibitors work by:
- a. Increasing the number of LDL receptors on the liver to clear more LDL-C from the blood.
- b. Blocking cholesterol absorption in the gut.
- c. Inhibiting HMG-CoA reductase.
- d. Decreasing VLDL production.
Answer: a. Increasing the number of LDL receptors on the liver to clear more LDL-C from the blood.
41. Which of the following is a potential side effect of spironolactone?
- a. Hypokalemia
- b. Gynecomastia
- c. Cough
- d. Ankle edema
Answer: b. Gynecomastia
42. Interpreting patient data for a cardiovascular patient is a learning objective in the Professional Practice Skills Lab I.
- a. True
- b. False
Answer: a. True
43. A patient with gout should use which class of antihypertensives with caution, as it can increase uric acid levels?
- a. ACE Inhibitors
- b. ARBs
- c. Beta-blockers
- d. Thiazide diuretics
Answer: d. Thiazide diuretics
44. Atorvastatin and rosuvastatin can be taken at any time of day, while some other statins should be taken in the evening because:
- a. They cause drowsiness.
- b. Cholesterol synthesis in the body is highest at night, and those statins have shorter half-lives.
- c. They interact with daytime medications.
- d. They are more likely to cause muscle pain during the day.
Answer: b. Cholesterol synthesis in the body is highest at night, and those statins have shorter half-lives.
45. Which of the following is NOT a component of the ASCVD risk score calculation?
- a. Age
- b. Sex
- c. Blood type
- d. Systolic blood pressure
Answer: c. Blood type
46. Which antihypertensive class can mask the symptoms of hypoglycemia in diabetic patients?
- a. ACE inhibitors
- b. Non-selective Beta-blockers
- c. Thiazide diuretics
- d. Calcium Channel Blockers
Answer: b. Non-selective Beta-blockers
47. Patient education on medication adherence is a critical role for the community pharmacist.
- a. True
- b. False
Answer: a. True
48. Combining a statin with which other lipid-lowering class increases the risk of myopathy the most?
- a. Ezetimibe
- b. PCSK9 inhibitors
- c. Fibrates
- d. Bile acid sequestrants
Answer: c. Fibrates
49. Losartan belongs to which drug class?
- a. ACE Inhibitor
- b. Angiotensin II Receptor Blocker (ARB)
- c. Beta-blocker
- d. Calcium Channel Blocker
Answer: b. Angiotensin II Receptor Blocker (ARB)
50. The ultimate goal of managing hypertension and hyperlipidemia in the community is to:
- a. Sell the most expensive medications.
- b. Lower a patient’s numbers on a lab report.
- c. Prevent long-term cardiovascular morbidity and mortality, such as heart attacks and strokes.
- d. Ensure patients are on at least five medications.
Answer: c. Prevent long-term cardiovascular morbidity and mortality, such as heart attacks and strokes.