Hello William,
Your understanding is correct: if you select "Yes" for both Include ITTO Exam and Include Exam questions, you may see the same questions again when you take Exams 1, 2, 3, 4, and ITTO Exam 5. Unless you have a good reason for doing that, our recommendation is to start with short quizzes excluding ITTO and Exam questions, identify your gaps, study the topics you answered incorrectly, take more quizzes, repeat the cycle of gap identification and closure as many times as needed (you have enough questions in the quiz pool to do that without touching any of the exam questions), and only then, when you feel ready, take the full-length exams.
I hope this makes sense and helps with your preparations.