CPC Preventive Care and Education — Questions and Answers

Question 1: A community paramedic is conducting a fall risk assessment for a 78-year-old patient. Which standardized tool is MOST appropriate for evaluating fall risk in community-dwelling older adults?

Berg Balance Scale
Timed Up and Go (TUG) test (Correct answer)
Glasgow Coma Scale
AUDIT-C questionnaire

Correct answer: Timed Up and Go (TUG) test

The Timed Up and Go (TUG) test is a validated, widely used tool for assessing fall risk and mobility in older community-dwelling adults.

Question 2: When educating a patient with newly diagnosed hypertension on lifestyle modifications, which dietary approach has the strongest evidence for blood pressure reduction?

Mediterranean diet
DASH diet (Correct answer)
Ketogenic diet
Low-fat dairy-free diet

Correct answer: DASH diet

The DASH (Dietary Approaches to Stop Hypertension) diet is specifically designed and clinically proven to reduce blood pressure.

Question 3: A community paramedic is teaching a diabetic patient about foot care. Which instruction is MOST important to include?

Walk barefoot indoors to strengthen foot muscles
Inspect feet daily for cuts, blisters, and sores (Correct answer)
Soak feet in hot water for 20 minutes daily
Use a heating pad on feet to improve circulation

Correct answer: Inspect feet daily for cuts, blisters, and sores

Daily foot inspection allows early detection of wounds or infections that can rapidly worsen due to diabetic neuropathy and poor circulation.

Question 4: Which vaccine is recommended annually for all adults, especially those with chronic respiratory conditions, as part of a community paramedic's preventive care plan?

Pneumococcal vaccine (PPSV23)
Influenza vaccine (Correct answer)
Tdap booster
Hepatitis B series

Correct answer: Influenza vaccine

The annual influenza vaccine is recommended for all adults and is especially critical for those with chronic respiratory or cardiac conditions.

Question 5: When using the teach-back method during patient education, the community paramedic asks the patient to:

Sign a consent form indicating they understood
Repeat back the information in their own words (Correct answer)
Watch a video about their condition
Read a pamphlet and answer written questions

Correct answer: Repeat back the information in their own words

The teach-back method asks patients to explain information back in their own words, confirming comprehension rather than just verbal acknowledgment.

Question 6: A community paramedic identifies that a patient's A1C is 6.2%. How should the paramedic counsel this patient?

Reassure them their glucose is normal and no action is needed
Counsel on prediabetes prevention strategies to avoid progression to type 2 diabetes (Correct answer)
Begin insulin education immediately
Refer urgently to the ED for diabetic crisis management

Correct answer: Counsel on prediabetes prevention strategies to avoid progression to type 2 diabetes

An A1C of 5.7–6.4% indicates prediabetes, and lifestyle interventions at this stage can significantly reduce or delay progression to type 2 diabetes.

Question 7: Which social determinant of health is MOST directly associated with increased rates of preventable hospitalizations in urban communities?

Ethnicity and cultural background
Food insecurity and limited access to nutritious food (Correct answer)
Educational attainment in childhood
Geographic proximity to hospitals

Correct answer: Food insecurity and limited access to nutritious food

Food insecurity leads to poor nutrition management of chronic conditions like diabetes and hypertension, directly increasing preventable hospitalization rates.

Question 8: A community paramedic is counseling a patient who smokes about cessation. Which pharmacotherapy has the HIGHEST rate of long-term abstinence when combined with behavioral counseling?

Nicotine replacement patch alone
Varenicline (Chantix) (Correct answer)
Bupropion (Wellbutrin) alone
Short-acting nicotine gum alone

Correct answer: Varenicline (Chantix)

Varenicline (Chantix) combined with behavioral support has demonstrated the highest quit rates in clinical trials compared to other cessation medications.

Question 9: When performing a pediatric well-child screening visit as part of a community paramedic program, at what age is developmental surveillance for autism spectrum disorder (ASD) specifically recommended by the AAP?

6 and 12 months
18 and 24 months (Correct answer)
36 and 48 months
9 and 15 months

Correct answer: 18 and 24 months

The AAP recommends specific ASD screening at the 18- and 24-month well-child visits using validated tools such as the M-CHAT.

Question 10: A community paramedic is educating a patient with COPD on pulmonary hygiene. Which technique is MOST effective for mobilizing secretions in this patient population?

Incentive spirometry every 2 hours
Pursed-lip breathing during exertion
Active Cycle of Breathing Technique (ACBT) (Correct answer)
Abdominal breathing exercises only

Correct answer: Active Cycle of Breathing Technique (ACBT)

The Active Cycle of Breathing Technique (ACBT) combines breathing control, thoracic expansion exercises, and forced expiration to effectively clear secretions.

Question 11: During a home visit, a community paramedic notices a patient hoards medications and takes higher doses than prescribed to manage pain. This behavior most likely represents:

Pseudoaddiction due to undertreated pain
Opioid use disorder requiring referral to addiction services (Correct answer)
Normal behavior for chronic pain patients
A need to increase the patient's current prescription

Correct answer: Opioid use disorder requiring referral to addiction services

Hoarding medications and dose escalation without provider guidance are behavioral warning signs consistent with opioid use disorder requiring addiction assessment.

Question 12: A community paramedic is screening a 50-year-old patient with a 25 pack-year smoking history. Which screening is NOW recommended by the USPSTF for this patient?

Annual chest X-ray
Annual low-dose CT (LDCT) scan of the chest (Correct answer)
Sputum cytology every 6 months
Bronchoscopy every 2 years

Correct answer: Annual low-dose CT (LDCT) scan of the chest

USPSTF recommends annual low-dose CT lung cancer screening for adults aged 50–80 with at least a 20 pack-year smoking history who currently smoke or quit within the past 15 years.

Question 13: When educating a hypertensive patient on home blood pressure monitoring, the community paramedic should instruct the patient to:

Measure BP immediately after exercising for the most accurate reading
Avoid caffeine for 30 minutes and rest 5 minutes before measurement (Correct answer)
Take only one reading per session to avoid anxiety
Check BP only when they feel symptoms like headache

Correct answer: Avoid caffeine for 30 minutes and rest 5 minutes before measurement

Avoiding caffeine and resting for at least 5 minutes before measurement eliminates variables that can artificially elevate blood pressure readings.

Question 14: A community paramedic is reviewing immunization records for a 65-year-old patient who has never received a pneumococcal vaccine. Which vaccine(s) should be recommended?

PPSV23 only, one dose is sufficient
PCV15 or PCV20 followed by PPSV23 if PCV15 was used (Correct answer)
PCV13 and PPSV23 simultaneously in one visit
No pneumococcal vaccine is needed at this age

Correct answer: PCV15 or PCV20 followed by PPSV23 if PCV15 was used

Current CDC guidance recommends PCV15 or PCV20 for pneumococcal-naive adults 65+; if PCV15 is used, PPSV23 should follow at least one year later.

Question 15: A community paramedic is performing a mental health screen on a patient using the PHQ-9. A score of 15 indicates:

Mild depression requiring watchful waiting
Moderately severe depression warranting active treatment or referral (Correct answer)
Severe depression requiring immediate psychiatric hospitalization
Normal baseline—no action needed

Correct answer: Moderately severe depression warranting active treatment or referral

A PHQ-9 score of 15–19 indicates moderately severe depression, which typically warrants initiation of treatment and/or mental health referral.

Question 16: When counseling a pregnant patient on prenatal nutrition, which supplement is MOST critical to recommend in the first trimester to prevent neural tube defects?

Iron (ferrous sulfate)
Folic acid (400–800 mcg daily) (Correct answer)
Calcium carbonate
Vitamin D3

Correct answer: Folic acid (400–800 mcg daily)

Folic acid taken before conception and during the first trimester significantly reduces the risk of neural tube defects such as spina bifida.

Question 17: A community paramedic is implementing a medication reconciliation process for a high-risk patient. Which situation is the MOST common source of medication errors in this population?

Filling prescriptions at multiple pharmacies
Discrepancies between what patients report taking and what providers have prescribed (Correct answer)
Patients refusing to take brand-name medications
Outdated medication packaging

Correct answer: Discrepancies between what patients report taking and what providers have prescribed

Discrepancies between patient-reported medications and prescribed medications are the leading source of errors, often due to adherence issues, discontinued meds, or miscommunication.

Question 18: During a community health fair, a paramedic screens a 45-year-old male with BMI 31, sedentary lifestyle, and a father with type 2 diabetes. Using the ADA risk score, this patient should be:

Reassured since he has no symptoms
Referred for a fasting glucose or A1C test to screen for prediabetes/diabetes (Correct answer)
Started on metformin immediately
Re-screened in 10 years at age 55

Correct answer: Referred for a fasting glucose or A1C test to screen for prediabetes/diabetes

Multiple risk factors (overweight, sedentary, family history) indicate this patient should be screened with fasting glucose or A1C per ADA guidelines.

Question 19: When performing a home safety assessment for a patient at risk for falls, which environmental modification has the STRONGEST evidence for fall reduction?

Installing bright fluorescent lights in every room
Removing trip hazards and installing grab bars in the bathroom (Correct answer)
Replacing all carpets with hardwood flooring
Moving the patient to a single-story home

Correct answer: Removing trip hazards and installing grab bars in the bathroom

Removing trip hazards and installing grab bars are the most evidence-supported environmental interventions shown to reduce falls in older adults at home.

Question 20: A community paramedic is using motivational interviewing (MI) with a patient resistant to making lifestyle changes. Which MI technique is used when the paramedic says, 'So on one hand you enjoy smoking with your coffee, but on the other hand you're worried about your lungs—is that right?'

Open-ended questioning
Developing discrepancy
Double-sided reflection (Correct answer)
Affirming autonomy

Correct answer: Double-sided reflection

A double-sided reflection acknowledges both sides of ambivalence simultaneously, helping the patient explore the conflict between current behavior and desired health outcomes.

Question 21: A community paramedic is educating a patient with heart failure on daily self-monitoring. Which symptom should prompt the patient to call their provider before the next visit?

Feeling tired after walking upstairs
Weight gain of 2–3 pounds in one day or 5 pounds in one week (Correct answer)
Occasional ankle swelling at the end of the day
Mild shortness of breath when climbing stairs

Correct answer: Weight gain of 2–3 pounds in one day or 5 pounds in one week

Rapid weight gain (2–3 lbs/day or 5 lbs/week) indicates fluid retention and early decompensation in heart failure, requiring prompt provider notification.

CPC Preventive Care and Education

A community paramedic is conducting a fall risk assessment for a 78-year-old patient.
Which standardized tool is MOST appropriate for evaluating fall risk in community-dwelling older adults?

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