Page 1 of 90
ABFM HEALTH COUNSELING AND PREVENTIVE CARE exam
COMPLETE NEWEST 100 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
QUESTION: You see a 45-year-old male who has smoked cigarettes for 25 years. He is very
interested in quitting but has not been able to do so despite many attempts. He is interested in
using medications to help.Which one of the following would likely be most effective?
Calling the QUIT LINE and using over-the-counter nicotine patches
Bupropion (Wellbutrin SR, Zyban)
Nortriptyline (Pamelor)
Varenicline (Chantix)
Varenicline plus nicotine replacement therapy - ANSWER-E
Not only are tobacco cessation treatments effective clinically, they are also cost-effective in
comparison to treatments for other medical disorders (SOR A). Several analyses have found
that the cost of treatment per patient who quits ranges from several hundred to a few
thousand dollars. Insurance coverage of medications and counseling to stop smoking increases
success rates (SOR A). Bupropion, varenicline, and five forms of nicotine replacement (gum,
1
, Page 2 of 90
inhaler, lozenge, nasal spray, and patch) have all been shown to be effective in helping adults
quit smoking (SOR A).For every 10 smokers who quit while taking a placebo nearly 30 could be
expected to quit when taking varenicline as a single agent. Varenicline as a single agent has also
been shown to help about 50% more people quit smoking compared to nicotine replacement
therapy (NRT). Varenicline has been shown to be more effective than the nicotine patch (odds
ratio [OR] 1.510), nicotine gum (OR 1.72), and other forms of NRT including inhalers, sprays,
tablets, or lozenges (OR 1.42). However, varenicline was not shown to be more effective than
combination NRT (OR 1.06). Combination NRT using a nicotine patch plus an additional form
such as a lozenge also outperformed single NRT. A systematic review demonstrated that a
combination of NRT and varenicline appears to have the highest quit rates.A meta-analysis of
the bupropion and varenicline trials found no difference between the active drugs and placebo
arms (risk ratio 1.06) with regard to neuropsychiatric events. Nortriptyline nearly doubles the
chances of quitting but may have more side effects such as dry mouth. Unlike varenicline,
neither nortriptyline nor bupropion was shown to enhance the effect of NRT compared with
NRT alone.Telephone quit lines are also effective for tobacco cessation (SOR A). They reach a d
QUESTION: Which one of the following is true regarding screening for drug abuse?
The benefits of screening adolescents for drug abuse are clear
2
, Page 3 of 90
Counseling adolescents and young adults about drug abuse has been shown to prevent them
from abusing drugs
Screening is most effective when done in the context of a preventive services visit
The U.S. Preventive Services Task Force recommends screening all adults for unhealthy drug use
- ANSWER-D
Drug use is one of the most common causes of preventable injuries, disability, and death. Data
from 2018 showed that an estimated 12% of U.S. residents 18 years or older reported current
unhealthy drug use. Unhealthy drug use was reported by 24% of adults age 18-25, 10% of older
adults, and 8% of adolescents age 12-17. The U.S. Preventive Services Task Force (USPSTF) now
recommends screening by asking questions about unhealthy drug use in adults age 18 years or
older. Screening with written or verbal questions should be implemented when services for
accurate diagnosis, effective treatment, and appropriate care can be offered in the practice or
referred. The USPSTF does not recommend drug testing as a form of screening.The USPSTF
states that there is currently insufficient evidence to assess the balance of benefits and harms
of broad-based screening of adolescents. The data on counseling adolescents on drug use is
mixed. Some smaller trials show some benefit from brief intervention for low-risk drug use such
as cannabis and alcohol. Other studies fail to demonstrate a consistent benefit and can be
difficult to interpret due to the complexity of meta-analyses and comparisons.The USPSTF does
not make any recommendations on the timing or setting of screening. Screening is appropriate
3
, Page 4 of 90
at any visit at clinics where care or referral for unhealthy drug use can occur. Practices may
consider brief tools such as the National Institute on Drug Abuse (NIDA) Quick Screen, which
asks four questions about use of alcohol, tobacco, and illegal drugs, along with nonmedical use
of prescription drugs, in the past year. Longer tools like the eight-item Alcohol, Smoking, and
Substance Involvement Screening Test (ASSIST), which assess risks associated with unhealthy
drug use or comorbid conditions, may reveal information signaling the need
QUESTION: A 3-year-old male is brought to your office by his parents for a well child
examination. His family recently moved to the area. His father says that both he and his wife
have always had problems controlling their weight, and he asks if their son is likely to have the
same problem as he gets older.Factors associated with obesity in adulthood include which one
of the following?
A birth weight categorized as low for gestational age
A high socioeconomic level
Being a member of an ethnic minority
An increase in BMI of 2 kg/m2 in 1 year - ANSWER-A
4
ABFM HEALTH COUNSELING AND PREVENTIVE CARE exam
COMPLETE NEWEST 100 QUESTIONS AND VERIFIED
SOLUTIONS LATEST UPDATE THIS YEAR
QUESTION: You see a 45-year-old male who has smoked cigarettes for 25 years. He is very
interested in quitting but has not been able to do so despite many attempts. He is interested in
using medications to help.Which one of the following would likely be most effective?
Calling the QUIT LINE and using over-the-counter nicotine patches
Bupropion (Wellbutrin SR, Zyban)
Nortriptyline (Pamelor)
Varenicline (Chantix)
Varenicline plus nicotine replacement therapy - ANSWER-E
Not only are tobacco cessation treatments effective clinically, they are also cost-effective in
comparison to treatments for other medical disorders (SOR A). Several analyses have found
that the cost of treatment per patient who quits ranges from several hundred to a few
thousand dollars. Insurance coverage of medications and counseling to stop smoking increases
success rates (SOR A). Bupropion, varenicline, and five forms of nicotine replacement (gum,
1
, Page 2 of 90
inhaler, lozenge, nasal spray, and patch) have all been shown to be effective in helping adults
quit smoking (SOR A).For every 10 smokers who quit while taking a placebo nearly 30 could be
expected to quit when taking varenicline as a single agent. Varenicline as a single agent has also
been shown to help about 50% more people quit smoking compared to nicotine replacement
therapy (NRT). Varenicline has been shown to be more effective than the nicotine patch (odds
ratio [OR] 1.510), nicotine gum (OR 1.72), and other forms of NRT including inhalers, sprays,
tablets, or lozenges (OR 1.42). However, varenicline was not shown to be more effective than
combination NRT (OR 1.06). Combination NRT using a nicotine patch plus an additional form
such as a lozenge also outperformed single NRT. A systematic review demonstrated that a
combination of NRT and varenicline appears to have the highest quit rates.A meta-analysis of
the bupropion and varenicline trials found no difference between the active drugs and placebo
arms (risk ratio 1.06) with regard to neuropsychiatric events. Nortriptyline nearly doubles the
chances of quitting but may have more side effects such as dry mouth. Unlike varenicline,
neither nortriptyline nor bupropion was shown to enhance the effect of NRT compared with
NRT alone.Telephone quit lines are also effective for tobacco cessation (SOR A). They reach a d
QUESTION: Which one of the following is true regarding screening for drug abuse?
The benefits of screening adolescents for drug abuse are clear
2
, Page 3 of 90
Counseling adolescents and young adults about drug abuse has been shown to prevent them
from abusing drugs
Screening is most effective when done in the context of a preventive services visit
The U.S. Preventive Services Task Force recommends screening all adults for unhealthy drug use
- ANSWER-D
Drug use is one of the most common causes of preventable injuries, disability, and death. Data
from 2018 showed that an estimated 12% of U.S. residents 18 years or older reported current
unhealthy drug use. Unhealthy drug use was reported by 24% of adults age 18-25, 10% of older
adults, and 8% of adolescents age 12-17. The U.S. Preventive Services Task Force (USPSTF) now
recommends screening by asking questions about unhealthy drug use in adults age 18 years or
older. Screening with written or verbal questions should be implemented when services for
accurate diagnosis, effective treatment, and appropriate care can be offered in the practice or
referred. The USPSTF does not recommend drug testing as a form of screening.The USPSTF
states that there is currently insufficient evidence to assess the balance of benefits and harms
of broad-based screening of adolescents. The data on counseling adolescents on drug use is
mixed. Some smaller trials show some benefit from brief intervention for low-risk drug use such
as cannabis and alcohol. Other studies fail to demonstrate a consistent benefit and can be
difficult to interpret due to the complexity of meta-analyses and comparisons.The USPSTF does
not make any recommendations on the timing or setting of screening. Screening is appropriate
3
, Page 4 of 90
at any visit at clinics where care or referral for unhealthy drug use can occur. Practices may
consider brief tools such as the National Institute on Drug Abuse (NIDA) Quick Screen, which
asks four questions about use of alcohol, tobacco, and illegal drugs, along with nonmedical use
of prescription drugs, in the past year. Longer tools like the eight-item Alcohol, Smoking, and
Substance Involvement Screening Test (ASSIST), which assess risks associated with unhealthy
drug use or comorbid conditions, may reveal information signaling the need
QUESTION: A 3-year-old male is brought to your office by his parents for a well child
examination. His family recently moved to the area. His father says that both he and his wife
have always had problems controlling their weight, and he asks if their son is likely to have the
same problem as he gets older.Factors associated with obesity in adulthood include which one
of the following?
A birth weight categorized as low for gestational age
A high socioeconomic level
Being a member of an ethnic minority
An increase in BMI of 2 kg/m2 in 1 year - ANSWER-A
4
