CPC Preventive Care and Education 3 — Questions and Answers
Question 1: 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 2: 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 3: 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 4: 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 5: 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 6: 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 7: 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.
CPC Preventive Care and Education 3
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?