CDCES 2026 Mock Exam – Certified Diabetes Care and
Education Specialist Practice Test
SECTION 1: ASSESSMENT OF THE DIABETES CONTINUUM
(Questions 1-25)
Question 1
Which screening tool is most appropriate for identifying depression in patients with
diabetes?
A) Beck Depression Inventory (BDI)
B) Patient Health Questionnaire-9 (PHQ-9)
C) Generalized Anxiety Disorder-7 (GAD-7)
D) Diabetes Distress Scale (DDS)
Correct Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is designed to screen for
depression and is validated for use in patients with chronic illnesses, making it suitable
for diabetes patients . The PHQ-9 is a 9-item questionnaire that assesses the frequency
of depressive symptoms over the past two weeks. While the Diabetes Distress Scale
(DDS) measures diabetes-specific distress, the PHQ-9 is the standard tool for depression
screening. The GAD-7 screens for anxiety, not depression.
Question 2
Which psychosocial factor is most commonly associated with poor diabetes
management outcomes?
A) Social support
B) Chronic stress
C) Financial stability
D) Family history of diabetes
Correct Answer: B
,Rationale: Chronic stress is most commonly associated with poor diabetes
management outcomes . Chronic stress affects blood glucose levels through hormonal
pathways, including increased cortisol and catecholamines, and impairs the individual's
capacity to engage in effective self-care behaviors such as monitoring blood glucose,
adhering to medication regimens, and making healthy food choices.
Question 3
A patient with type 2 diabetes presents with increasing glycemic variability. Which
assessment finding should be the priority for further evaluation?
A) Hemoglobin A1c of 7.5%
B) Fasting glucose of 180 mg/dL
C) Positive urine ketones
D) Total cholesterol of 240 mg/dL
Correct Answer: C
Rationale: Positive urine ketones indicate that the patient may be experiencing diabetic
ketoacidosis (DKA), which is a critical condition requiring immediate intervention . The
HbA1c and fasting glucose are concerning but do not demand urgent action, and
elevated cholesterol, while important, is not immediately life-threatening. Ketones
indicate insulin deficiency and the breakdown of fat for energy, which can rapidly
progress to metabolic acidosis and medical emergency.
Question 4
What should be included in a comprehensive diabetes assessment?
A) Only laboratory values
B) Only physical examination
C) Physical and psychosocial assessment, diabetes-relevant health history, and social
determinants of health
D) Only medication history
Correct Answer: C
Rationale: A comprehensive diabetes assessment includes physical and psychosocial
assessment, diabetes-relevant health history, social determinants of health, general
health history, diabetes measures and laboratory data, and mental health wellbeing .
,This holistic approach ensures that all factors affecting the patient's diabetes
management are identified and addressed.
Question 5
A patient reports difficulty affording their diabetes supplies. What is the most
appropriate assessment question for the diabetes care and education specialist to ask?
A) "Have you considered applying for a new job?"
B) "What are your food preferences?"
C) "Are you having trouble affording your medications, testing supplies, or food?"
D) "Do you have a family history of diabetes?"
Correct Answer: C
Rationale: The most appropriate question is to ask directly about affordability of
medications, testing supplies, and food . Food insecurity is a critical social determinant
of health that directly impacts diabetes management. The diabetes care and education
specialist should assess economic stability, healthcare access, social supports, and food
and housing insecurity as part of the comprehensive assessment.
Question 6
Which characteristic of the individual with diabetes should be assessed as part of
learning considerations?
A) Only age
B) Physical abilities, language preferences, cultural factors, and developmental stage
C) Only educational level
D) Only vision status
Correct Answer: B
Rationale: Learning considerations should include developmental stage, physical
abilities, language preferences, cultural factors, spiritual beliefs, psychosocial factors,
economic status, family and caregiver dynamics, and learning disabilities . This
comprehensive approach ensures that education is tailored to the individual's unique
needs and circumstances.
, Question 7
A patient with diabetes has a history of reading glasses use and difficulty reading small
print. The diabetes care and education specialist should include assessment of:
A) Dietary habits only
B) Health literacy, numeracy, and digital literacy
C) Exercise preferences only
D) Medication history only
Correct Answer: B
Rationale: Assessment should include health literacy, numeracy, and digital literacy .
Patients with visual impairment may struggle with reading medication labels,
interpreting glucose meters, or using insulin pens. The specialist should assess whether
the patient can read food labels, count carbohydrates, interpret blood glucose numbers,
and use technology such as continuous glucose monitors.
Question 8
A 65-year-old patient with type 2 diabetes is experiencing frequent episodes of
nocturnal hypoglycemia. Which assessment question should the specialist ask to identify
the cause?
A) "Are you checking your blood glucose before bed?"
B) "What time do you take your evening medication?"
C) "Do you drink alcohol in the evenings?"
D) "All of the above"
Correct Answer: D
Rationale: All of the above questions are relevant assessments for nocturnal
hypoglycemia. The specialist should assess medication timing (particularly insulin or
sulfonylureas), alcohol consumption (which can cause delayed hypoglycemia), and
bedtime glucose monitoring practices .
Question 9
Which of the following is an example of a psychosocial screening tool used in diabetes
care?
Education Specialist Practice Test
SECTION 1: ASSESSMENT OF THE DIABETES CONTINUUM
(Questions 1-25)
Question 1
Which screening tool is most appropriate for identifying depression in patients with
diabetes?
A) Beck Depression Inventory (BDI)
B) Patient Health Questionnaire-9 (PHQ-9)
C) Generalized Anxiety Disorder-7 (GAD-7)
D) Diabetes Distress Scale (DDS)
Correct Answer: B
Rationale: The Patient Health Questionnaire-9 (PHQ-9) is designed to screen for
depression and is validated for use in patients with chronic illnesses, making it suitable
for diabetes patients . The PHQ-9 is a 9-item questionnaire that assesses the frequency
of depressive symptoms over the past two weeks. While the Diabetes Distress Scale
(DDS) measures diabetes-specific distress, the PHQ-9 is the standard tool for depression
screening. The GAD-7 screens for anxiety, not depression.
Question 2
Which psychosocial factor is most commonly associated with poor diabetes
management outcomes?
A) Social support
B) Chronic stress
C) Financial stability
D) Family history of diabetes
Correct Answer: B
,Rationale: Chronic stress is most commonly associated with poor diabetes
management outcomes . Chronic stress affects blood glucose levels through hormonal
pathways, including increased cortisol and catecholamines, and impairs the individual's
capacity to engage in effective self-care behaviors such as monitoring blood glucose,
adhering to medication regimens, and making healthy food choices.
Question 3
A patient with type 2 diabetes presents with increasing glycemic variability. Which
assessment finding should be the priority for further evaluation?
A) Hemoglobin A1c of 7.5%
B) Fasting glucose of 180 mg/dL
C) Positive urine ketones
D) Total cholesterol of 240 mg/dL
Correct Answer: C
Rationale: Positive urine ketones indicate that the patient may be experiencing diabetic
ketoacidosis (DKA), which is a critical condition requiring immediate intervention . The
HbA1c and fasting glucose are concerning but do not demand urgent action, and
elevated cholesterol, while important, is not immediately life-threatening. Ketones
indicate insulin deficiency and the breakdown of fat for energy, which can rapidly
progress to metabolic acidosis and medical emergency.
Question 4
What should be included in a comprehensive diabetes assessment?
A) Only laboratory values
B) Only physical examination
C) Physical and psychosocial assessment, diabetes-relevant health history, and social
determinants of health
D) Only medication history
Correct Answer: C
Rationale: A comprehensive diabetes assessment includes physical and psychosocial
assessment, diabetes-relevant health history, social determinants of health, general
health history, diabetes measures and laboratory data, and mental health wellbeing .
,This holistic approach ensures that all factors affecting the patient's diabetes
management are identified and addressed.
Question 5
A patient reports difficulty affording their diabetes supplies. What is the most
appropriate assessment question for the diabetes care and education specialist to ask?
A) "Have you considered applying for a new job?"
B) "What are your food preferences?"
C) "Are you having trouble affording your medications, testing supplies, or food?"
D) "Do you have a family history of diabetes?"
Correct Answer: C
Rationale: The most appropriate question is to ask directly about affordability of
medications, testing supplies, and food . Food insecurity is a critical social determinant
of health that directly impacts diabetes management. The diabetes care and education
specialist should assess economic stability, healthcare access, social supports, and food
and housing insecurity as part of the comprehensive assessment.
Question 6
Which characteristic of the individual with diabetes should be assessed as part of
learning considerations?
A) Only age
B) Physical abilities, language preferences, cultural factors, and developmental stage
C) Only educational level
D) Only vision status
Correct Answer: B
Rationale: Learning considerations should include developmental stage, physical
abilities, language preferences, cultural factors, spiritual beliefs, psychosocial factors,
economic status, family and caregiver dynamics, and learning disabilities . This
comprehensive approach ensures that education is tailored to the individual's unique
needs and circumstances.
, Question 7
A patient with diabetes has a history of reading glasses use and difficulty reading small
print. The diabetes care and education specialist should include assessment of:
A) Dietary habits only
B) Health literacy, numeracy, and digital literacy
C) Exercise preferences only
D) Medication history only
Correct Answer: B
Rationale: Assessment should include health literacy, numeracy, and digital literacy .
Patients with visual impairment may struggle with reading medication labels,
interpreting glucose meters, or using insulin pens. The specialist should assess whether
the patient can read food labels, count carbohydrates, interpret blood glucose numbers,
and use technology such as continuous glucose monitors.
Question 8
A 65-year-old patient with type 2 diabetes is experiencing frequent episodes of
nocturnal hypoglycemia. Which assessment question should the specialist ask to identify
the cause?
A) "Are you checking your blood glucose before bed?"
B) "What time do you take your evening medication?"
C) "Do you drink alcohol in the evenings?"
D) "All of the above"
Correct Answer: D
Rationale: All of the above questions are relevant assessments for nocturnal
hypoglycemia. The specialist should assess medication timing (particularly insulin or
sulfonylureas), alcohol consumption (which can cause delayed hypoglycemia), and
bedtime glucose monitoring practices .
Question 9
Which of the following is an example of a psychosocial screening tool used in diabetes
care?
