CDE EXAM #3 UPDATED ACTUAL QUESTIONS AND
CORRECT ANSWERS
Question:
What is the first step in the process of diabetes self management education?
A. Assessment
B. Goal setting
C. Diagnosis
D. Referral
Answer:
A. Assessment
Question:
Which of the following options is an outcome of personal record keeping in
relation to physical activity, according to recent studies?
A. Those who keep logs of physical activity are more adherent to other
elements of therapy (ie diet, medication)
B. Those who keep exercise logs are more likely to enroll in organized exercise
programs (ie gym memberships, classes)
C. Keeping a physical activity log is associated with a higher level of self
efficacy
D. The obligation of record keeping has been identified as a barrier to exercise
by study participants
Answer:
C. Keeping a physical activity log is associated with a higher level of self
efficacy
Question:
Consider the following pt: male, age 46, previously sedentary, mild HTN and
hyperlipidemia (both adequately controlled with medications), T2DM, and a
BMI of 26. If this pt wishes to begin a moderate-intensity exercise regimen,
what additional assessment may be warranted?
A. Stress test with ECG
B. DEXA scan to assess bone density and strength
C. Ankle-Brachial index to rule out peripheral arterial disease
D. None, as BP and cholesterol are being controlled and exercise is only
moderate intensity
Answer:
A. Stress test with ECG A stress test with ECG may be warranted, as this person
is over 40, previously sedentary, has risk factors for CVD, and is beginning a
program that is more intense than brisk walking, which is mild intensity.
Question:
In your role as a diabetes educator for a clinic, you both assess and instruct pts
on a variety of self-care skills. Which teaching strategy provides the best
opportunity to both assess and instruct on self-administration of insulin?
A. A written quiz in which the patient puts insulin administration steps in
order
,B. A demonstration and return demonstration of insulin administration
C. A video that can be viewed and reviewed on proper insulin administration
technique
D. A printed handout with pictures depicting steps of insulin administration,
followed by verbal acknowledgement of understanding
Answer:
B. A demonstration and return demonstration of insulin administration
Question:
The following policies are part of your DSME program: asking pts if there are
any dietary preferences or re-strictions; inviting family members to
participate; and being sensitive to your rate of speech and tone of voice. These
policies address which specific type of consideration?
A. Readiness to change variation among your patients
B. Potential low literacy/numeracy levels among your patients
C. Cultural characteristics/barriers of your population
D. Poor family and social support
Answer:
C. Cultural characteristics/barriers of your population
Question:
According to the ADA consensus statement on managing preexisting diabetes
for pregnancy (2008), what is the optimal glycemic target for pregnant women
with preexisting diabetes (assuming the target may be reached without
excessive hypoglycemia)?
A. Pre-meal/fasting glucose: 60 to 90 mg/dL; peak postprandial <120 mg/dL;
A1C <5.5%
B. Pre-meal/fasting glucose: 60 to 99 mg/dL; peak postprandial <129 mg/dL;
A1C <6%
C. Pre-meal/fasting glucose: 70 to 100 mg/dL; peak postprandial <120 mg/dL;
A1C <6.5%
D. Pre-meal/fasting glucose: 70 to 110 mg/dL; peak postprandial <140 mg/dL;
A1C <7%
Answer:
B. Pre-meal/fasting glucose: 60 to 99 mg/dL; peak postprandial <129 mg/dL;
A1C <6%
UPDATED 2019: Fasting <95 mg/dL; 1 hr post prandial <140 mg/dL; 2 hr post
prandial <120 mg/dL; A1C <6%
Question:
During the initial assessment process, your pt answers the question, "How
important is it for you to make this change right now?" with a 9 our of 10 (very
important) and answers the question, "How confident are you that you will be
able to make this change?" with a 2 out of 10 (not very confident). In
customizing hr DSME plan, what should your focus be?
A. Providing materials and experiences to enhance her knowledge and skills
B. Addressing psychosocial needs, such as accepting her diagnosis and
managing stress levels
C. Highlighting the benefits of good diabetes management as a way to
encourage behavior change
,D. Explaingin the two questions further to confirm understanding, as it is very
uncommon for a pt to rate the readiness to change elements this far apart
Answer:
A. Providing materials and experiences to enhance her knowledge and skills
Question:
It is important to assess potential barriers to self-monitoring of bg, especially
for pts who are not adhering to their plan of care recommendations. Which of
the following barriers was NOT one cited by patients in recent studies?
A. Cost of testing supplies
B. Discomfort of finger sticks
C. Lack of instruction and support
D. Misplacement of small items
Answer:
D. Misplacement of small items
Question:
When assessing for risk of hypoglycemia in relation to exercise, which
element of the patient record is most important to consider?
A. The patients typical signs and symptoms with hypoglycemia
B. Current patient physical/glycemic status (wt, BMI, A1C)
C. Timing and content (ie carb content) of meals in relation to activity
D. Medication regimen: types, dose, and timing
Answer:
D. Medication regimen: types, dose, and timing
Question:
Which of the following behaviors is the MOST likely indication that the pt is at
a very low level of readiness to change?
A. The pt becomes tearful as you explain how to keep a food diary
B. The pt watches your demonstration but does not say anything
C. The pt volunteers to answer a review question at the end of class but gets
the answer wrong
D. The pt denies that she has diabetes and disagrees with the doctor's referral
to DSME
Answer:
D. The pt denies that she has diabetes and disagrees with the doctor's referral
to DSME
Question:
According to ADA Standards, which statement is NOT true regarding medical
nutrition therapy and diabetes?
A. MNT is recommended for only those person with diabetes who are
underweight, overweight, or obese
B. MNT is recommended for anyone who has diabetes, regardless of
nutritional status
C. Children with diabetes and celiac disease should consult with a registered
dietitian familiar with both conditions
D. Because nutrition in the hospital setting is complex, a registered dietitian
should be part of the inpatient diabetes care team to provide MNT
, Answer:
A. MNT is recommended for only those person with diabetes who are
underweight, overweight, or obese
Question:
You are assessing a pt's bg monitoring technique b having her demonstrate a
bg test. Which fo the following actions is indicative of improper technique?
A. Cleaning her hands with warm water and soap instead of alcohol
B. Setting the lancet device to her preference
C. Milking the lanced finger at the tip to acquire a sufficient blood sample
D. Recording the reading in her notebook rather than on the clinic-provided
sheet
Answer:
C. Milking the lanced finger at the tip to acquire a sufficient blood sample A pt
should milk the finger closer to the base of the finger and move towards the tip
or milk the finger before lancing.
Question:
Your pt suffers from obesity, T2DM, HTN, and hyperlipidemia. He recalls his
dinner from last night: a low-fat turkey and cheese sandwich with mustard, a
side salad with low-fat Italian dressing, pickles, a small serving of baked chips,
and one can of club soda. Based on your assessment, which of the pt's
conditions is at the greatest risk due to his food choices?
A. Hyperlipidemia
B. T2DM
C. Obesity
D. HTN
Answer:
D. HTN
Question:
A pt with GDM is convinced she developed GDM from eating too much of her
favorite food - popcorn - early in her pregnancy. She insists that if she does not
eat any again during her pregnancy, she will not have to start insulin and her
bg values will return to normal. What emotional stage associated with chronic
disease diagnosis (similar to Kubler-Ross stages of grief) do you assess in your
pt?
A. Denial
B. Anger
C. Bargaining
D. Frustration and depression
Answer:
C. Bargaining The bargaining stage is characterized by inaccurate
explanations and /or erroneous cures. The pt "makes a deal" with self,
provider, God, or others to get rid of the diabetes. Denial is characterized by
disbelief in the diagnosis, anger is characterized by irritation, rage, anxiety, or
guilt. Frustration and depression can occur at any time and are characterized
by feelings of hopelessness and trouble establishing or maintaining good
self-care habits.
CORRECT ANSWERS
Question:
What is the first step in the process of diabetes self management education?
A. Assessment
B. Goal setting
C. Diagnosis
D. Referral
Answer:
A. Assessment
Question:
Which of the following options is an outcome of personal record keeping in
relation to physical activity, according to recent studies?
A. Those who keep logs of physical activity are more adherent to other
elements of therapy (ie diet, medication)
B. Those who keep exercise logs are more likely to enroll in organized exercise
programs (ie gym memberships, classes)
C. Keeping a physical activity log is associated with a higher level of self
efficacy
D. The obligation of record keeping has been identified as a barrier to exercise
by study participants
Answer:
C. Keeping a physical activity log is associated with a higher level of self
efficacy
Question:
Consider the following pt: male, age 46, previously sedentary, mild HTN and
hyperlipidemia (both adequately controlled with medications), T2DM, and a
BMI of 26. If this pt wishes to begin a moderate-intensity exercise regimen,
what additional assessment may be warranted?
A. Stress test with ECG
B. DEXA scan to assess bone density and strength
C. Ankle-Brachial index to rule out peripheral arterial disease
D. None, as BP and cholesterol are being controlled and exercise is only
moderate intensity
Answer:
A. Stress test with ECG A stress test with ECG may be warranted, as this person
is over 40, previously sedentary, has risk factors for CVD, and is beginning a
program that is more intense than brisk walking, which is mild intensity.
Question:
In your role as a diabetes educator for a clinic, you both assess and instruct pts
on a variety of self-care skills. Which teaching strategy provides the best
opportunity to both assess and instruct on self-administration of insulin?
A. A written quiz in which the patient puts insulin administration steps in
order
,B. A demonstration and return demonstration of insulin administration
C. A video that can be viewed and reviewed on proper insulin administration
technique
D. A printed handout with pictures depicting steps of insulin administration,
followed by verbal acknowledgement of understanding
Answer:
B. A demonstration and return demonstration of insulin administration
Question:
The following policies are part of your DSME program: asking pts if there are
any dietary preferences or re-strictions; inviting family members to
participate; and being sensitive to your rate of speech and tone of voice. These
policies address which specific type of consideration?
A. Readiness to change variation among your patients
B. Potential low literacy/numeracy levels among your patients
C. Cultural characteristics/barriers of your population
D. Poor family and social support
Answer:
C. Cultural characteristics/barriers of your population
Question:
According to the ADA consensus statement on managing preexisting diabetes
for pregnancy (2008), what is the optimal glycemic target for pregnant women
with preexisting diabetes (assuming the target may be reached without
excessive hypoglycemia)?
A. Pre-meal/fasting glucose: 60 to 90 mg/dL; peak postprandial <120 mg/dL;
A1C <5.5%
B. Pre-meal/fasting glucose: 60 to 99 mg/dL; peak postprandial <129 mg/dL;
A1C <6%
C. Pre-meal/fasting glucose: 70 to 100 mg/dL; peak postprandial <120 mg/dL;
A1C <6.5%
D. Pre-meal/fasting glucose: 70 to 110 mg/dL; peak postprandial <140 mg/dL;
A1C <7%
Answer:
B. Pre-meal/fasting glucose: 60 to 99 mg/dL; peak postprandial <129 mg/dL;
A1C <6%
UPDATED 2019: Fasting <95 mg/dL; 1 hr post prandial <140 mg/dL; 2 hr post
prandial <120 mg/dL; A1C <6%
Question:
During the initial assessment process, your pt answers the question, "How
important is it for you to make this change right now?" with a 9 our of 10 (very
important) and answers the question, "How confident are you that you will be
able to make this change?" with a 2 out of 10 (not very confident). In
customizing hr DSME plan, what should your focus be?
A. Providing materials and experiences to enhance her knowledge and skills
B. Addressing psychosocial needs, such as accepting her diagnosis and
managing stress levels
C. Highlighting the benefits of good diabetes management as a way to
encourage behavior change
,D. Explaingin the two questions further to confirm understanding, as it is very
uncommon for a pt to rate the readiness to change elements this far apart
Answer:
A. Providing materials and experiences to enhance her knowledge and skills
Question:
It is important to assess potential barriers to self-monitoring of bg, especially
for pts who are not adhering to their plan of care recommendations. Which of
the following barriers was NOT one cited by patients in recent studies?
A. Cost of testing supplies
B. Discomfort of finger sticks
C. Lack of instruction and support
D. Misplacement of small items
Answer:
D. Misplacement of small items
Question:
When assessing for risk of hypoglycemia in relation to exercise, which
element of the patient record is most important to consider?
A. The patients typical signs and symptoms with hypoglycemia
B. Current patient physical/glycemic status (wt, BMI, A1C)
C. Timing and content (ie carb content) of meals in relation to activity
D. Medication regimen: types, dose, and timing
Answer:
D. Medication regimen: types, dose, and timing
Question:
Which of the following behaviors is the MOST likely indication that the pt is at
a very low level of readiness to change?
A. The pt becomes tearful as you explain how to keep a food diary
B. The pt watches your demonstration but does not say anything
C. The pt volunteers to answer a review question at the end of class but gets
the answer wrong
D. The pt denies that she has diabetes and disagrees with the doctor's referral
to DSME
Answer:
D. The pt denies that she has diabetes and disagrees with the doctor's referral
to DSME
Question:
According to ADA Standards, which statement is NOT true regarding medical
nutrition therapy and diabetes?
A. MNT is recommended for only those person with diabetes who are
underweight, overweight, or obese
B. MNT is recommended for anyone who has diabetes, regardless of
nutritional status
C. Children with diabetes and celiac disease should consult with a registered
dietitian familiar with both conditions
D. Because nutrition in the hospital setting is complex, a registered dietitian
should be part of the inpatient diabetes care team to provide MNT
, Answer:
A. MNT is recommended for only those person with diabetes who are
underweight, overweight, or obese
Question:
You are assessing a pt's bg monitoring technique b having her demonstrate a
bg test. Which fo the following actions is indicative of improper technique?
A. Cleaning her hands with warm water and soap instead of alcohol
B. Setting the lancet device to her preference
C. Milking the lanced finger at the tip to acquire a sufficient blood sample
D. Recording the reading in her notebook rather than on the clinic-provided
sheet
Answer:
C. Milking the lanced finger at the tip to acquire a sufficient blood sample A pt
should milk the finger closer to the base of the finger and move towards the tip
or milk the finger before lancing.
Question:
Your pt suffers from obesity, T2DM, HTN, and hyperlipidemia. He recalls his
dinner from last night: a low-fat turkey and cheese sandwich with mustard, a
side salad with low-fat Italian dressing, pickles, a small serving of baked chips,
and one can of club soda. Based on your assessment, which of the pt's
conditions is at the greatest risk due to his food choices?
A. Hyperlipidemia
B. T2DM
C. Obesity
D. HTN
Answer:
D. HTN
Question:
A pt with GDM is convinced she developed GDM from eating too much of her
favorite food - popcorn - early in her pregnancy. She insists that if she does not
eat any again during her pregnancy, she will not have to start insulin and her
bg values will return to normal. What emotional stage associated with chronic
disease diagnosis (similar to Kubler-Ross stages of grief) do you assess in your
pt?
A. Denial
B. Anger
C. Bargaining
D. Frustration and depression
Answer:
C. Bargaining The bargaining stage is characterized by inaccurate
explanations and /or erroneous cures. The pt "makes a deal" with self,
provider, God, or others to get rid of the diabetes. Denial is characterized by
disbelief in the diagnosis, anger is characterized by irritation, rage, anxiety, or
guilt. Frustration and depression can occur at any time and are characterized
by feelings of hopelessness and trouble establishing or maintaining good
self-care habits.
