Review Question - QID 102742

Action	Numeric Key	Letter Key	Function Key
Choose 1	1
Choose 2	2
Choose 3	3
Choose 4	4
Choose 5	5
Submit Response			Enter
Previous Question			Left Arrow
Next Question		N	Right Arrow
Open/Close Bookmode		C
Open Image			Spacebar

Smoking Cessation Introduction Therapies for smoking cessation include: QID: 102742 (M3.PY.13.10)

QID 102742 (Type "102742" in App Search)

A 44-year-old woman presents to her primary care physician for a wellness visit. She states she is generally healthy and currently has no complaints. She drinks 1 alcoholic beverage daily and is currently sexually active. Her last menstrual period was 1 week ago and it is regular. She smokes 1 pack of cigarettes per day and would like to quit. She describes her mood as being a bit down in the winter months but otherwise feels well. Her family history is notable for diabetes in all of her uncles and colon cancer in her mother and father at age 72 and 81, respectively. She has been trying to lose weight and requests help with this as well. Her diet consists of mostly packaged foods. His temperature is 98.0°F (36.7°C), blood pressure is 122/82 mmHg, pulse is 80/min, respirations are 12/min, and oxygen saturation is 98% on room air. Her BMI is 23 kg/m^2. Physical exam reveals a healthy woman with no abnormal findings. Which of the following is the most appropriate initial intervention for this patient?

Type & Select Correct Answer

Type in at least one full word to see suggestions list

Alcohol cessation

0/5

Bupropion

40%

2/5

Colonoscopy

0/5

Varenicline and nicotine gum

40%

2/5

Weight loss, exercise, and nutrition consultation

20%

1/5

Select Answer to see Preferred Response

Review TC In New Tab

This patient is presenting for a wellness visit and notably has a significant smoking history and would like to quit. Varenicline and nicotine replacement are highly effective treatments for smoking cessation.

Smoking is a highly addictive habit that increases mortality significantly. One of the best ways to reduce mortality and the risk of other diseases is to aid patients in smoking cessation. Treatment options include varenicline, nicotine replacement, and bupropion (for depressed patients). Using multiple smoking cessation aids (such as varenicline and nicotine replacement) in combination with cognitive behavioral therapy has been shown to be the most effective in achieving long-term abstinence.

Incorrect Answers:
Answer 1: Alcohol cessation is appropriate in patients who drink excessively. According to current data, 1 drink per day is not harmful to women and may actually lower mortality when compared to abstinence.

Answer 2: Bupropion is an antidepressant that is not sedating, does not have sexual side effects, lowers the seizure threshold, and is effective for smoking cessation. This patient does not necessarily have depression (her symptoms seem to be seasonal affective disorder) and varenicline/nicotine replacement is more effective in smoking cessation, comparatively.

Answer 3: Colonoscopy is indicated at the age of 45 or 10 years before the year in which family members had colon cancer.

Answer 5: Weight loss, exercise, and nutrition consultation would be appropriate for this patient in general; however, her smoking is a greater risk to her health and her BMI is normal.

Bullet Summary:
Smoking cessation is one of the most effective methods of lowering mortality and multiple agents including varenicline and nicotine are highly effective in aiding patients in cessation.

Rating

Please Rate Question Quality

4.3

(7)