1. Which of the following people is most likely to smoke a cigarette for the first time?
A. A young child
B. An adolescent
C. A young adult
D. A middle-aged adult
E. Unsure
2. One of your patients is interested in using a medication to help her quit smoking. She inquires about which medications have been found to help the most smokers quit. What do you tell her?
A. Nicotine patches and varenicline are the most effective options
B. Varenicline is more effective than bupropion
C. The combination of varenicline and nicotine patches is the most effective option
D. Dual nicotine replacement is more effective than varenicline
E. Unsure
3. KC is interested in using varenicline to stop smoking. You notice she has a history of generalized anxiety disorder in her medical record, but she denies current symptoms. What do you suggest?
A. Varenicline is likely to exacerbate neuropsychiatric symptoms, so KC should avoid it
B. Quitting smoking causes anxiety anyway, so her diagnosis should not be a factor in medication choice
C. Varenicline is contraindicated in anyone with a history schizophrenia and mania but not anxiety
D. Varenicline is considered safe in patients with stable neuropsychiatric disorders
E. Unsure
4. CY had a myocardial infarction 8 months ago. When he came in to fill his prescriptions after he was discharged from the hospital, you advised him to quit smoking. He tells you today that he has successfully decreased his use to 8 cigarettes per day and feels that should be sufficient since he was previously a 2 pack-per-day smoker. What do you tell him?
A. Smoking reduction undermines eventual quit attempts
B. Smoking reduction prior to quitting results in more successful abstinence
C. He should drop his use to 5 cigarettes per day because doing so decreases the risk of heart disease from smoking to less than 10%
D. A reduction in cigarette consumption is not considered an appropriate end goal
E. Unsure
5. Which of the following statements about vaping is true?
A. It is more likely to help smokers quit than other types of smoking cessation aids
B. Vaping has never been demonstrated to help people stop smoking
C. Fruit-flavored e-juice is safest because food-grade flavorings are used
D. Data demonstrate that daily vaping doubles the risk of myocardial infarction
E. Unsure
6. BW is a 15-year-old non-tobacco user who has just taken up vaping. According to research, which of the following is true?
A. BW is not at risk for becoming a cigarette smoker as long as he chooses nicotine-free e-juice
B. BW will be exposed to the same serum level of nicotine as a smoker if he uses “high-concentration” nicotine e-juice
C. BW is more likely to become a cigarette smoker if he vapes with nicotine-containing e-juice
D. BW is likely to stop vaping in young adulthood since this is a phenomenon associated primarily with adolescence
E. Unsure
7. What are the 5 A's of smoking cessation?
A. Ask, advise, assess, assist, arrange
B. Ask, admonish, advise, assist, arrange
C. Ask, advise, assess, assist, abstain
D. Ask, assess, advise, accept, adhere
E. Unsure
8. LT is a 62-year-old woman interested in quitting her cigarette habit. She wants to know if adding counseling to her nicotine replacement will increase the likelihood that she will be successful. She states that she is a busy person and does not have time to attend group classes. What information can you offer her?
A. Pharmacologic therapy and counseling are equally effective, but the addition of one to the other does not increase quit rates
B. Counseling has been found to be more beneficial for younger persons since they are less likely to understand the risks associated with smoking
C. For counseling to influence a quit attempt, a smoker must commit to at least 6 months of weekly contact
D. Even brief counseling can be effective in helping people quit smoking
E. Unsure
9. Which of the following correctly describes the “righting reflex”?
A. It is a self-help method for quitting smoking
B. It is a method of counseling for resistant patients
C. It is the last step of the “5 R's”
D. It may cause a patient to become defensive
E. Unsure
10. TN previously managed a period of abstinence from cigarette smoking for 15 weeks using varenicline. He discontinued the medication after 12 weeks, and he relapsed 3 weeks later. He said the medication worked well to control his cravings and he experienced no side effects. What do you suggest to help him remain abstinent?
A. Use varenicline with nicotine gum for 12 weeks
B. Take the varenicline an additional 12 weeks for a total of 24 weeks
C. Increase the dose to 2 mg 2 times daily
D. Try a different therapy since varenicline therapy already failed
E. Unsure
Evaluation Questions
11. How confident are you in your decision about treatment for TN in the question above?
A. Not at all confident
B. Somewhat confident
C. Confident
D. Highly confident
