NMS Q&A Family Medicine

chapter 39Smoking CessationExamination questions: Unless instructed otherwise, choosethe ONE lettered answer or completion that is BEST ineach case.1 A 45-year-old two-pack-per-day cigarette smokingwoman with diabetes and taking metformin 500 mgtwice daily obtained a prescription for varenicline(Chantix) to assist her in smoking cessation. Her dosagewas 0.5 mg daily for 3 days followed by 0.5 mgdaily for the balance of 1 week; after the first week shefollowed the instructions to increase dosing to 1 mgtwice daily. After a week of the definitive dosing, sherequested a visit and complained of a side effect sufficientto cause the drug to be discontinued. Which ofthe following is the most likely side effect that forcedthe discontinuation of the prescription?(A) Hypoglycemia(B) Uncontrolled diabetes(C) Nausea(D) Disturbance in attention span(E) Anxiety and depression2 A 35-year-old male worker who was employed for thepast 3 years in the field for a company that specializesin asbestos abatement in structures built 60 to80 years ago is now complaining of dyspnea andcough. He is atopic, subject to allergic rhinitis, and hehas smoked cigarettes for 20 pack-years. As smokingis known to increase asbestosis and asbestosis multipliesthe risk of lung cancer, which of the following isthe least likely cause of the recent onset of dyspnea inthis patient?(A) Asthma(B) Mesothelioma(C) Carcinoma of the lung(D) Chronic bronchitis(E) Emphysema3 A 25-year-old woman in her first trimester of pregnancyis seeing you for a prenatal visit. She smokesone pack of cigarettes per day. In advising her to stopsmoking, you tell her that her baby will be at increasedrisk for which of the following, if she continues tosmoke?(A) Preterm birth(B) Macrosomia(C) Transient tachypnea of newborn(D) Spinal cord defects(E) Neonatal hypoglycemia4 You are designing a program for your office to encouragepatients to stop smoking. Which of the followingis correct with respect to physician office efforts toencourage smoking cessation?(A) It may be assumed that smokers have alreadybeen told of the adverse effects of smoking ifthey have seen other physicians recently.(B) Smoking in the physician’s office should only beallowed in partitioned, ventilated smoking areas.(C) Counseling to cease smoking should await atime when a detailed, lengthier discussion ofsmoking cessation can occur.(D) Smoking should be listed on the problem list ofanyone who smokes and on the child’s chart ofany child in a smoking household.(E) If the dangers of smoking are pointed outvigorously, cessation can usually beaccomplished in one office visit.5 A family consisting of mother, father, a 1-year-oldboy, and a 3.5-year-old girl are under your care. Bothparents smoke. The incidence of which of the followingchildhood diseases is increased in householdswith smokers present?(A) Reactive airway disease(B) Epiglotitis(C) Sudden infant death syndrome(D) Lymphatic leukemia(E) Wilms tumor6 A 33-year-old man who has smoked a pack per dayfor 15 years since his first year in college (15 packyears)has discovered that his uncle who smoked30 pack-years has been diagnosed with lung cancer.He is seriously considering quitting but asks youradvice as to whether it is too late to reduce his risk oflung cancer. Which of the following is the bestresponse to this patient in answer to the question?241