AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF
SECTION I: FOUNDATIONS OF HEALTH PROMOTION & PREVENTION
1. A 55-year-old patient with no chronic diseases asks about primary prevention.
Which of the following represents the BEST example of primary prevention in
pharmacology?
• A) Prescribing a statin after a myocardial infarction
• B) Administering the influenza vaccine to a healthy adult
• C) Prescribing metformin for a patient with newly diagnosed diabetes
• D) Ordering a colonoscopy after a positive fecal occult blood test
Correct Answer: B
*Rationale: Primary prevention aims to prevent disease before it occurs.
Vaccination (influenza, pneumococcal, COVID-19) is the classic pharmacological
example of primary prevention. Statins post-MI are secondary prevention
(preventing recurrence). Metformin is treatment of an existing disease (tertiary
prevention).*
2. A 60-year-old patient with hypertension and hyperlipidemia asks about
preventing a stroke. According to the USPSTF, which of the following is a Grade A
recommendation for cardiovascular disease prevention in this patient?
• A) Daily low-dose aspirin for primary prevention
, • B) Statin therapy for primary prevention in adults aged 40-75 with ≥1 CVD
risk factor
• C) Vitamin E supplementation
• D) Omega-3 fatty acid supplements
Correct Answer: B
*Rationale: The USPSTF gives a Grade A recommendation to initiating statin
therapy for primary prevention in adults aged 40-75 with one or more CVD risk
factors (dyslipidemia, diabetes, hypertension, smoking) and a calculated 10-year
CVD risk ≥ 10%. Aspirin for primary prevention is now a Grade C (individualized
decision) in most adults.*
3. A 50-year-old female is concerned about breast cancer. She has no family
history. According to the USPSTF, when should she start screening
mammography?
• A) Age 40
• B) Age 50 (Grade B recommendation for biennial screening)
• C) Age 65
• D) Never, if she is asymptomatic
Correct Answer: B
*Rationale: The USPSTF recommends biennial screening mammography for
women aged 50-74 (Grade B). For women aged 40-49, the decision is
individualized (Grade C). This is a core health promotion knowledge point for
advanced practice.*
4. A 65-year-old patient with a 30-pack-year smoking history is asked about lung
cancer screening. According to the USPSTF, which of the following is the correct
screening recommendation?
, • A) Annual chest X-ray
• B) Annual low-dose computed tomography (LDCT) for adults aged 50-80
with a ≥20 pack-year smoking history, current smokers or quit within the
past 15 years
• C) Sputum cytology annually
• D) No screening is recommended
Correct Answer: B
*Rationale: The USPSTF recommends annual LDCT lung cancer screening for
adults aged 50-80 with a 20+ pack-year smoking history who currently smoke or
have quit within the past 15 years. This is a Grade B recommendation that
significantly reduces lung cancer mortality.*
5. A 45-year-old patient asks about taking daily aspirin to prevent a heart attack.
He has no history of CVD. What is the MOST accurate evidence-based response?
• A) "Yes, all adults over 40 should take daily aspirin."
• B) "Aspirin for primary prevention is no longer routinely recommended. The
bleeding risk often outweighs the benefit. We should discuss your individual
risk factors."
• C) "Aspirin is only for secondary prevention."
• D) "You should take 81 mg daily without discussion."
Correct Answer: B
*Rationale: Updated guidelines (2022) from the USPSTF recommend against
initiating low-dose aspirin for primary prevention in adults over 60. For adults 40-
59 with a 10-year CVD risk ≥10%, the decision is individualized. Bleeding risk (GI,
intracranial) often outweighs the modest benefit.*
, 6. A 70-year-old patient with no history of CVD is taking a statin for primary
prevention. The patient asks, "Do I still need to watch my diet?" What is the
BEST health promotion response?
• A) "No, the statin completely eliminates the need for diet."
• B) "The statin lowers your cholesterol, but a heart-healthy diet, exercise,
and smoking cessation have additive benefits and reduce inflammation
beyond what the pill can do."
• C) "Diet does not matter."
• D) "You should stop all dietary fats."
Correct Answer: B
Rationale: Health promotion emphasizes that pharmacotherapy is an adjunct to,
not a replacement for, lifestyle modification. Combining statins with the
Mediterranean diet, exercise, and smoking cessation provides synergistic risk
reduction.
7. A 55-year-old patient with prediabetes (A1c 6.2%) is concerned about
progressing to Type 2 diabetes. According to the ADA, which pharmacological
intervention is recommended for diabetes prevention in high-risk patients?
• A) Insulin glargine
• B) Metformin (especially in patients with BMI ≥35, age <60, or history of
gestational diabetes)
• C) Sulfonylureas
• D) No medication is ever indicated for prediabetes
Correct Answer: B
*Rationale: The ADA recommends metformin for diabetes prevention in patients
with prediabetes who are at very high risk (BMI ≥35, age <60, history of
gestational diabetes, or rising A1c). Lifestyle modification (weight loss 7%, exercise
150 min/week) is the first-line intervention.*