A. HEALTH PROMOTION AND DISEASE PREVENTION

1. A research study focuses on smoking cessation among a specific target population. This group’s research is focusing on _________ prevention.

1. Primary
2. Secondary
3. Tertiary
4. Integrated

2. You educate Miss Smith about the prevention of cervical cancer and risk-reducing behaviors. Which of the following is a primary preventive strategy?

1. Use barrier contraceptives.
2. Exercise regularly.
3. Have a Pap test at appropriate intervals.
4. Have human papillomavirus (HPV) testing.

3. Which of the following lifestyle factors is the most important risk factor of oral cancer?

1. Poor oral hygiene
2. Habitual use of alcohol and tobacco
3. Vitamin A deficiency
4. Human papillomavirus (HPV)

4. After her father’s death from colon cancer, Ellen takes the initiative in preventing colon cancer for herself by eating less fat and more fruits and vegetables and by taking up running. She is engaged in:

1. Illness behavior
2. High-risk behavior
3. Health-protective behavior
4. Information-seeking behavior

5. Which of the following best describes primary prevention of skin cancers?

1. Removal of a dysplastic nevi
2. Reduce ultraviolet radiation (UVR) exposure between 10 a.m. and 3 p.m. and use sunscreens.
3. Annual professional skin examination
4. Practice monthly skin self-examination

6. Which of the following statements regarding environmental tobacco smoke or involuntary inhalation of tobacco smoke is accurate?

1. Environmental tobacco smoke is estimated to lead to 1,000 deaths of nonsmokers from lung cancer per year.
2. There is no evidence to support the idea that involuntary inhalation of tobacco smoke increases the risk of lung cancer in nonsmokers.
3. Secondhand smoke does not pose an elevated risk of lung cancer for smokers.
4. There is a 25% increased risk of lung cancer in women who have never smoked and are married to a smoker.

7. According to research, which of the following statements best describes the breast health of African American women of lower socioeconomic status (SES) compared to age-adjusted Caucasian women?

1. Breast cancer outcomes in minority women with a lower SES are worse than those women with a higher SES.
2. Premature deaths from breast cancer in African American women are similar to premature deaths from breast cancer in non-Hispanic white women.
3. Survival of breast cancer was improved with higher SES for members of all racial and ethnic groups.
4. African American women are more commonly diagnosed with triple-negative breast cancer.

8. Which of the following scenarios represents secondary prevention of cancer?

1. A woman at high risk for breast cancer decides to have prophylactic bilateral mastectomies.
2. Referral of women for cervical Pap tests
3. The Great American Smokeout is promoted to a group of individuals who want to stop smoking.
4. Celecoxib is prescribed for a patient with familial adenomatous polyposis for the reduction of colorectal adenomas.

9. Physical activity is one of the few known modifiable lifestyle factors for the development of cancer, and increased exercise plays a key role in primary prevention against which of the following cancers?

1. Colon, breast, endometrial
2. Colon, breast, ovarian
3. Prostate, kidney, colon
4. Pancreatic, endometrial, ovarian

10. Moderate to heavy alcohol intake has been linked to which of the following cancers?

1. Prostate, renal, stomach
2. Oral cavity, liver, prostate
3. Stomach, ovarian, esophagus
4. Breast, colorectal, esophagus

11. Ms. Jones recently read a report from the World Cancer Research Fund and the American Institute for Cancer Research (WCRF/AICR) that made recommendations to decrease cancer risk. She has decided to modify her lifestyle and follow their recommendations. Which of the following is a recommendation by the WCRF/AICR?

1. Use supplements to protect against cancer.
2. Increase the consumption of energy-dense foods.
3. Eat a healthy diet and be physically active for at least 30 minutes/day.
4. Consume 50% of energy from fat and avoid sugary drinks.

12. The most important factors that appear to have a protective effect against the development of endometrial cancer are:

1. Pregnancy, physical activity, weight management
2. Physical activity, nulliparous, weight management
3. Oral contraceptives, cigarette smoking, pregnancy
4. Nulliparous, oral contraceptives, weight management

13. Which of the following is the most successful approach to smoking cessation in adults?

1. Smoking cessation interventions using nicotine patches and gum
2. Smoking cessation programs using multiple recruitment strategies
3. Increased excise taxes for tobacco products, smoke free laws, and local cessation and abstinence programs
4. Smoking cessation programs that provide psychosocial support and life management skills

14. The Breast Cancer Prevention Trial tested the ability of which of the following to prevent breast cancer in healthy women at high risk for the disease?

1. Raloxifene
2. Retinoic acid
3. Tamoxifen
4. Beta-carotene

15. Mr. Smith, a heavy smoker, wants to quit and asks you if vaping with e-cigarettes will help him quit smoking cigarettes. The best response to his question is:

1. Vaping with e-cigarettes is a good reduction tool.
2. Toxic substances in e-cigarettes vapor are lower than conventional cigarettes so may be safe for smoking reduction.
3. Manufacturers state that e-cigarettes decreased smoking-related symptoms and was more efficacious than nicotine gum.
4. Research is needed to determine health hazards of e-cigarettes and efficacy in smoking reduction and cessation.

16. Epidemiology studies have provided compelling evidence that obesity is associated with increased risks of:

1. Colon, endometrial, esophageal cancer
2. Thyroid, ovarian, gallbladder cancer
3. Hepatocellular, gallbladder, cervical cancer
4. Prostate, stomach, kidney cancer

17. Successes in the immunologic approaches to cancer prevention involve vaccines that prevent cancer. Which of the following cancer-causing viruses have vaccines available for prevention?

1. Human papillomavirus (HPV) (type 16), Helicobacter pylori
2. Hepatitis B, hepatitis C
3. Hepatitis B, HPV (type 16 and 18)
4. HPV (type 16 and 18), Helicobacter pylori

18. Once the elements of a cancer risk assessment are collected (e.g., personal medical history, history of exposures to carcinogens, family history) the risk must be interpreted to the individual in understandable terms. This is often accomplished by using various risk terms. Which of the following terms is accurate?

1. Absolute risk measures the occurrence of cancer (incidence or mortality) in a high-risk population.
2. Relative risk measures the incidence or deaths among those with a particular risk factor.
3. Attributable risk is the amount of disease within the population that could be prevented by alteration of a risk factor.
4. Proportional risk factor implicates which disease an individual will eventually develop.

19. Chemoprevention focuses on individuals or subpopulations known to be at increased risk for developing a malignancy. Which of the following best describes chemoprevention?

1. Chemoprevention is the use of natural or synthetic agents to interrupt the carcinogenic process.
2. Chemoprevention is the use of manufactured pills.
3. Chemopreventive agents include food components ingested as part of a regular diet.
4. Chemopreventive agents are not derived from food compounds or supplements.

20. Most chemopreventive agents are administered through a clinical trial. Which of the following individuals most likely would be considered for a chemoprevention trial?

1. An individual who has smoked for 10 years
2. A 40-year-old female with dense breasts
3. A 55-year-old black male whose father died of prostate cancer
4. A 63-year-old woman who has a history of benign breast disease

21. Your patient, Mrs. Smith, who has ovarian cancer and a BRCA1 gene mutation, asks you if her 35-year-old daughter should have risk-reduction surgery to prevent her from developing ovarian cancer. Your best advice to her is which of the following?

1. For your daughter to fully understand her risk, she should go through a formal risk assessment and see a genetic health professional before she makes any decision.
2. She is at risk for ovarian cancer, and it would be worthwhile for her to consider a prophylactic oophorectomy.
3. Your daughter should be followed closely, and she may want to talk to her physician about oral contraceptives to suppress ovulation.
4. Since she is asymptomatic, she should have a yearly physical examination that includes a bimanual rectovaginal examination and discuss tubal ligation with her physician.

22. Which statement is the best reason to recommend risk-reduction bilateral mastectomy for a woman with high genetic risk of breast cancer?

1. Removal of the breasts before cancer detection lowers risk by 90%.
2. Removal of the breasts before cancer detection lowers risk by 80%.
3. Removal of the breasts will decrease the risk of ovarian cancer.
4. Removal of the breasts will decrease the risk of both ovarian and breast cancer.

23. The American Cancer Society recommends that all women who are sexually active or who are 21 years of age or older have a Pap smear performed:

1. Every 3 years with a conventional or liquid-based Pap test
2. Every 2 years with a regular Pap test
3. Biannually
4. Annually with a regular Pap test

24. Colorectal surveillance recommendations for carriers of hereditary nonpolyposis colon cancer–associated mutations (Lynch syndrome) include which of the following?

1. Colonoscopy beginning at age 40; repeat every 2 years
2. Upper gastrointestinal (GI) endoscopy at age 50 every 3–5 years
3. Colonoscopy beginning at ages 20–25; repeat every 1–2 years
4. Screening for gastric, duodenal, and small bowel cancer

25. The most significant reduction in prostate cancer risk is in:

1. Men who take nutritional supplements of selenium and vitamin E
2. Men who take finasteride
3. Men who have an annual digital rectal examination
4. Men who have a high dietary intake of antioxidants

26. The most important risk-reduction behavior for the prevention of cervical cancer is:

1. Limit the number of lifetime sexual partners
2. Regular Pap smear testing
3. Take oral contraceptives
4. Annual human papillamovirus (HPV) testing