CCCP Practice Test

Certifications > CCCP > Practice Test

CCCP Practice Test (V1)

Dive into practice questions

Question 1

A 62-year-old male with type 2 diabetes and established atherosclerotic cardiovascular disease (ASCVD) has an A1c of 7.8% on metformin monotherapy. According to the 2024 ADA guidelines, which of the following medication classes, when added to metformin, offers the most significant benefit in reducing major adverse cardiovascular events (MACE)?

  1. DPP-4 inhibitor (e.g., sitagliptin)
  2. Sulfonylurea (e.g., glipizide)
  3. SGLT2 inhibitor (e.g., empagliflozin)
  4. Thiazolidinedione (e.g., pioglitazone)

Question 2

A patient’s blood pressure remains elevated at 155/95 mmHg despite adherence to maximum tolerated doses of lisinopril, amlodipine, and hydrochlorothiazide. What is the next most appropriate agent to add for management of this resistant hypertension?

  1. Clonidine
  2. Spironolactone
  3. Hydralazine
  4. Propranolol

Question 3

A patient with a history of myocardial infarction has an LDL-C of 110 mg/dL despite adherence to high-intensity atorvastatin 80 mg and ezetimibe 10 mg daily. What is the next guideline-recommended therapy to further lower cardiovascular risk?

  1. Niacin
  2. Gemfibrozil
  3. Evolocumab
  4. Colesevelam

Question 4

A patient with HFrEF (LVEF 30%) is symptomatic on lisinopril 20 mg daily. The provider decides to switch to sacubitril/valsartan (Entresto). What is the most critical instruction to provide regarding the transition from the ACE inhibitor?

  1. Overlap the lisinopril and Entresto for three days to ensure efficacy.
  2. Stop the lisinopril and start Entresto the very next day.
  3. A 36-hour washout period is required after stopping lisinopril before starting Entresto.
  4. The starting dose of Entresto is not dependent on the previous lisinopril dose.

Answer Key

  • Question 1: C. SGLT2 inhibitor (e.g., empagliflozin). (Both SGLT2 inhibitors and GLP-1 RAs have proven cardiovascular benefits in this population, making them the preferred add-on agents over others that are primarily glucose-lowering.)
  • Question 2: B. Spironolactone. (For resistant hypertension, defined as uncontrolled BP on three antihypertensives including a diuretic, a mineralocorticoid receptor antagonist like spironolactone is the recommended fourth-line agent.)
  • Question 3: C. Evolocumab. (For very high-risk secondary prevention patients who do not reach an LDL-C goal of <55-70 mg/dL on a maximally tolerated statin and ezetimibe, adding a PCSK9 inhibitor is the next guideline-directed step.)
  • Question 4: C. A 36-hour washout period is required after stopping lisinopril before starting Entresto. (Due to the increased risk of angioedema from concomitant ACE inhibitor and neprilysin inhibitor use, a 36-hour washout period is mandatory to ensure patient safety.)