Avoidable habits and lifestyle modification MCQs With Answer

Avoidable habits and lifestyle modification are fundamental topics for B.Pharm students preparing to counsel patients and optimize pharmacotherapy. This introduction covers key concepts such as smoking cessation, alcohol reduction, healthy diet, physical activity, weight management, sleep hygiene, and medication adherence. Emphasis is placed on pharmacologic aids (nicotine replacement, bupropion, varenicline), drug–lifestyle interactions (CYP induction by smoking), and evidence-based diets (DASH, Mediterranean) for hypertension, diabetes, and cardiovascular risk reduction. Understanding behavior change techniques, brief interventions, and monitoring biomarkers helps pharmacists design preventive strategies and improve therapeutic outcomes. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. Which cigarette component is most directly responsible for nicotine addiction?

• Tar
• Carbon monoxide
• Nicotine
• Formaldehyde

Correct Answer: Nicotine

Q2. Which pharmacotherapy works as a partial agonist at α4β2 nicotinic acetylcholine receptors to aid smoking cessation?

• Bupropion
• Varenicline
• Nicotine patch
• Clonidine

Correct Answer: Varenicline

Q3. Bupropion aids smoking cessation primarily through which mechanism?

• MAO-B inhibition increasing dopamine breakdown
• SERT inhibition to increase serotonin only
• Dopamine and norepinephrine reuptake inhibition
• GABA receptor agonism causing sedation

Correct Answer: Dopamine and norepinephrine reuptake inhibition

Q4. Smoking induces which cytochrome P450 enzyme that can lower plasma levels of some drugs?

• CYP3A4
• CYP2D6
• CYP1A2
• CYP2C9

Correct Answer: CYP1A2

Q5. Which of the following drugs can have increased plasma levels after smoking cessation due to reduced CYP1A2 induction?

• Theophylline
• Levofloxacin
• Metformin
• Enalapril

Correct Answer: Theophylline

Q6. First-line pharmacologic options for alcohol dependence include all EXCEPT:

• Disulfiram
• Naltrexone
• Acamprosate
• Benzodiazepine maintenance therapy

Correct Answer: Benzodiazepine maintenance therapy

Q7. Disulfiram prevents alcohol metabolism at which enzymatic step, causing unpleasant reactions?

• Alcohol dehydrogenase inhibition
• Aldehyde dehydrogenase inhibition
• CYP2E1 inhibition
• Acetaldehyde clearance enhancement

Correct Answer: Aldehyde dehydrogenase inhibition

Q8. Which lifestyle modification most directly lowers blood pressure within weeks?

• Increasing saturated fat intake
• Reducing dietary sodium
• Adding sedentary activities
• Reducing potassium intake

Correct Answer: Reducing dietary sodium

Q9. The DASH diet is specifically designed to reduce which risk factor?

• Hyperthyroidism
• Hypertension
• Osteoporosis
• Infectious disease susceptibility

Correct Answer: Hypertension

Q10. For weight loss, the fundamental principle is:

• Increasing carbohydrate intake only
• Energy deficit (calories out > calories in)
• Taking herbal supplements instead of diet change
• Eliminating protein to reduce muscle mass

Correct Answer: Energy deficit (calories out > calories in)

Q11. Which lifestyle change improves insulin sensitivity most effectively in type 2 diabetes prevention?

• Regular aerobic and resistance exercise
• Skipping meals daily
• High-sugar energy drinks
• Complete bed rest

Correct Answer: Regular aerobic and resistance exercise

Q12. Which counseling model is centered on exploring and resolving ambivalence to change behavior?

• Health Belief Model
• Motivational Interviewing
• Transtheoretical Model (without counseling)
• Classical Conditioning

Correct Answer: Motivational Interviewing

Q13. The “5 A’s” framework for brief tobacco intervention includes all EXCEPT:

• Ask
• Advise
• Arrange
• Autonomy

Correct Answer: Autonomy

Q14. Which biomarker is commonly elevated with chronic heavy alcohol use and can help monitor cessation?

• HbA1c
• Carbohydrate-deficient transferrin (CDT)
• Serum creatinine
• TSH

Correct Answer: Carbohydrate-deficient transferrin (CDT)

Q15. Excessive alcohol combined with acetaminophen increases risk of:

• Renal failure only
• Hepatotoxicity
• Hypoglycemia only
• Improved drug clearance

Correct Answer: Hepatotoxicity

Q16. Sleep hygiene recommendations for better sleep include all of the following EXCEPT:

• Maintaining a consistent sleep schedule
• Using the bed for work and watching TV
• Avoiding caffeine late in the day
• Creating a dark, quiet sleep environment

Correct Answer: Using the bed for work and watching TV

Q17. Which of these is a direct effect of sedentary behavior independent of exercise level?

• Decreased cardiovascular risk regardless of diet
• Increased metabolic risk (insulin resistance)
• Guaranteed muscle hypertrophy
• Improved bone density

Correct Answer: Increased metabolic risk (insulin resistance)

Q18. A pharmacist counseling on lifestyle modification should prioritize which step first?

• Prescribing medication without discussing habits
• Assessing current habits and readiness to change
• Immediately setting long-term goals without patient input
• Ignoring cultural and socioeconomic factors

Correct Answer: Assessing current habits and readiness to change

Q19. Which dietary pattern is associated with reduced cardiovascular events and is recommended as a lifestyle intervention?

• High processed-food, low-fiber diet
• Mediterranean diet
• Zero-fat diet with no fruits
• Extremely high-sodium traditional diet

Correct Answer: Mediterranean diet

Q20. Excessive salt intake increases blood pressure primarily by:

• Decreasing plasma volume
• Increasing vascular resistance and fluid retention
• Directly destroying endothelial cells only
• Lowering sympathetic activity

Correct Answer: Increasing vascular resistance and fluid retention

Q21. Which counseling technique uses short, specific advice and is suitable for brief pharmacy encounters?

• Intensive psychotherapy
• Brief intervention model
• Long-term residential program only
• Ignoring the behavior

Correct Answer: Brief intervention model

Q22. Nicotine replacement therapy (NRT) is contraindicated in which situation?

• Pregnancy (relative caution, weigh risks and benefits)
• Recent myocardial infarction without stabilization (caution)
• Active peptic ulcer disease (no specific contraindication)
• Absolute contraindication in all adolescents

Correct Answer: Pregnancy (relative caution, weigh risks and benefits)

Q23. Which statement about physical activity guidelines is correct?

• Adults need at least 150 minutes of moderate-intensity aerobic activity per week
• Muscle-strengthening is not recommended for adults
• Only high-intensity exercise provides health benefits
• Physical activity increases cardiovascular risk in all adults

Correct Answer: Adults need at least 150 minutes of moderate-intensity aerobic activity per week

Q24. Medication adherence improves when pharmacists do all EXCEPT:

• Provide clear counseling and simplify regimens
• Assess for barriers like cost and side effects
• Use judgmental language to shame nonadherence
• Offer reminders and follow-up

Correct Answer: Use judgmental language to shame nonadherence

Q25. Which habit modification reduces cancer risk most substantially?

• Quitting tobacco use
• Increasing processed meat consumption
• Prolonged UV tanning without protection
• Ignoring regular screening tests

Correct Answer: Quitting tobacco use

Q26. Which is an effective community-level intervention to promote healthy lifestyle behaviors?

• Removing sidewalks to discourage walking
• Implementing workplace wellness programs
• Restricting access to parks
• Promoting sugary drink subsidies

Correct Answer: Implementing workplace wellness programs

Q27. Chronic stress affects health by increasing which physiological mediator connected to cardiovascular risk?

• Serotonin only
• Cortisol and sympathetic nervous system activity
• Insulin production exclusively
• Vitamin D synthesis

Correct Answer: Cortisol and sympathetic nervous system activity

Q28. Which lifestyle change can most rapidly improve fasting glucose and insulin sensitivity in prediabetes?

• Short-term high-sugar dieting
• Modest weight loss with physical activity
• Complete elimination of proteins
• Increasing sedentary time

Correct Answer: Modest weight loss with physical activity

Q29. Stopping smoking may require dose adjustments for which psychotropic medication due to metabolic changes?

• Fluoxetine (no change expected with CYP1A2)
• Clozapine (plasma levels may rise after cessation)
• Metoprolol (affected primarily by CYP2D6)
• Insulin (no CYP interaction)

Correct Answer: Clozapine (plasma levels may rise after cessation)

Q30. When advising patients about alcohol and medications, pharmacists should:

• Assume no interaction exists and do nothing
• Review medications for interactions, counsel on risks, and offer support for reduction
• Recommend doubling the dose of all medications to counteract alcohol
• Tell patients to stop all medications when they drink one drink

Correct Answer: Review medications for interactions, counsel on risks, and offer support for reduction

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