PEBC Health Promotion and Disease Prevention — Questions and Answers
Question 1: A 55-year-old patient asks a pharmacist about colorectal cancer screening. Which recommendation aligns with current Canadian cancer screening guidelines for average-risk adults?
- Colonoscopy every 5 years starting at age 40
- Fecal immunochemical test (FIT) every 1–2 years starting at age 50 (Correct answer)
- CT colonography every 10 years starting at age 45
- No screening is recommended unless symptoms are present
Correct answer: Fecal immunochemical test (FIT) every 1–2 years starting at age 50
Canadian guidelines recommend fecal immunochemical testing (FIT) every 1–2 years for average-risk adults aged 50–74. This is the first-line non-invasive screening method recommended in most provincial programs.
Question 2: A pharmacist is counselling a patient who wants to quit smoking. The patient smokes 1 pack per day and scores 7 on the Fagerström Test for Nicotine Dependence. Which first-line pharmacotherapy is MOST appropriate?
- Nicotine replacement therapy (NRT) patch alone at a low dose
- Bupropion SR as monotherapy
- Varenicline (Champix) due to highest efficacy for highly dependent smokers (Correct answer)
- Nortriptyline as a first-line option given its proven efficacy
Correct answer: Varenicline (Champix) due to highest efficacy for highly dependent smokers
Varenicline (Champix) is considered the most efficacious single pharmacotherapy for smoking cessation and is particularly recommended for highly nicotine-dependent smokers (Fagerström score ≥ 6). Nortriptyline is a second-line option, not first-line.
Question 3: Which vaccine is recommended by the National Advisory Committee on Immunization (NACI) for ALL adults aged 65 years and older in Canada?
- Live attenuated influenza vaccine (LAIV)
- High-dose or adjuvanted inactivated influenza vaccine (Correct answer)
- Herpes zoster live vaccine (Zostavax) annually
- Pneumococcal polysaccharide vaccine (PPSV23) only if immunocompromised
Correct answer: High-dose or adjuvanted inactivated influenza vaccine
NACI preferentially recommends high-dose (Fluzone High-Dose) or adjuvanted (FLUAD) inactivated influenza vaccines for adults ≥65 years, as these formulations produce stronger immune responses in older adults compared to standard-dose vaccines. LAIV is contraindicated in adults ≥50 years.
Question 4: A pharmacist is calculating a patient's BMI as part of a cardiovascular risk assessment. The patient weighs 90 kg and is 1.70 m tall. What is the BMI, and how is it classified?
- BMI = 31.1 kg/m²; classified as Obesity Class I (Correct answer)
- BMI = 28.4 kg/m²; classified as Overweight
- BMI = 31.1 kg/m²; classified as Overweight
- BMI = 52.9 kg/m²; classified as Obesity Class III
Correct answer: BMI = 31.1 kg/m²; classified as Obesity Class I
BMI = weight(kg) / height(m)² = 90 / (1.70)² = 90 / 2.89 = 31.1 kg/m². According to Health Canada classification, BMI 30.0–34.9 is Obesity Class I. Overweight is BMI 25.0–29.9.
Question 5: A parent asks a pharmacist when their healthy 2-month-old infant should receive their first dose of the pneumococcal conjugate vaccine (PCV13) according to the routine Canadian immunization schedule.
- At 2 months of age (Correct answer)
- At 6 months of age
- At 12 months of age
- At 4 years of age (school entry)
Correct answer: At 2 months of age
The routine Canadian immunization schedule recommends the first dose of PCV13 (Prevnar 13) at 2 months of age, with subsequent doses at 4 months and a booster at 12 months, for a standard 3-dose series.
Question 6: Which of the following best describes the role of the pharmacist in the '5 A's' model for brief health promotion interventions (e.g., smoking cessation)?
- Ask, Advise, Assess, Assist, Arrange — a structured counselling framework for behaviour change (Correct answer)
- Analyse, Administer, Assess, Adjust, Audit — a pharmacovigilance framework
- Accept, Acknowledge, Advise, Administer, Arrange — a consent-based model
- Alert, Advise, Assign, Assess, Accomplish — an emergency triage protocol
Correct answer: Ask, Advise, Assess, Assist, Arrange — a structured counselling framework for behaviour change
The 5 A's framework (Ask about behaviour, Advise change, Assess readiness, Assist with a plan, Arrange follow-up) is a validated, widely-used brief intervention model for health behaviour counselling including smoking cessation, recognized by Health Canada and NACI.
PEBC Health Promotion and Disease Prevention
A 55-year-old patient asks a pharmacist about colorectal cancer screening.
Which recommendation aligns with current Canadian cancer screening guidelines for average-risk adults?