CDE Practice Exam 1
"Record food intake, physical activity, and blood glucose results in a logbook 5 days a
week for 6 weeks" is an example of a:
A. assessment
B. learning objective
C. behavioral objective
D. goal - ANS-C. behavioral objective
SMART goal is a behavior objective or planned change. A learning objective relates to
the completion of a teaching session, although learning objectives are also measurable.
A goal is a big-picture directional guide, the focal point for and the end results of
meeting the learning and behavioral objectives.
A 12 year-old girl, accompanied by her mother, presents to the registered dietitian for
meal planning. Which of the following is the most important consideration when
developing her meal plan?
A. Use the term "diet" instead of "meal plan" to emphasize weight loss urgency
B. Schedule a separate session with the mother to review grocery selection
C. Adjust the meal plan to meet energy requirements for growth and activity
D. Suggest a plan that avoids intake of nutrient-dense foods - ANS-C. Adjust the meal
plan to meet energy requirements for growth and activity
A 14 year-old girl with T1DM presents accompanied by her mother. The girl sits quietly
while her mother expresses concerns about her daughter's rising A1C. She adds that
her daughter is tired all the time. "Instead of talking with her friends on the telephone,
she just sleeps on the couch after school since not being selected for the school
cheerleading squad 2 months ago." Which of the following best supports the diagnosis
of adjustments disorder with depressed mood in this patient?
A. Unintentional changes in weight or appetite
B. Continuation of symptoms for more than 2 months
C. Early morning awakening for at least 1 week
D. Presence of manic symptoms (excessive euphoria) - ANS-B. Continuation of
symptoms for more than 2 months
Adjustment disorder with depressed mood is defined by the American Psychiatric
Association as the development of depressive symptoms (eg sleeping after school,
withdrawing from friends) within a 3 months period time following a stressor (eg not
making cheer squad). With this disorder, depressive symptoms cause impairment in
social, occupational, or other areas of functioning OR are in excess of what would be
,expected from exposure to the stressor. Symptoms are expected to remit within 6
months of the time of onset.
A 19 year-old patient complains of unexplained weight loss and extreme hunger over
the past month. Which of the following is the MOST useful information to confirm
diagnosis of diabetes?
A. Reports of polyuria
B. An A1C of 5.1-6.4%
C. Fasting plasma glucose 100-125 mg/dL
D. Random plasma glucose >200 mg/dL with polyuria - ANS-D. Random plasma
glucose >200 mg/dL with polyuria
According to the ADA's 2015 Clinical Practice Recommendations: Diagnosis and
Classification of DM, the criteria for diagnosis of diabetes are as follows:
Fasting plasma glucose >126 mg/dL OR
Symptoms of hyperglycemia and a casual plasma glucose >200 mg/dL OR
2-hour plasma glucose >200 mg/dL during a 75g oral GTT.
Polyuria is a symptom of hyperglycemia, but cannot be used as diagnostic criteria, A1C
5.1-6.4% would be prediabetes, and a fasting plasma glucose of 100-125 mg/dL would
indicate impaired fasting glucose.
A 24 year-old college student with T1DM presents to the pharmacist educator for insulin
dose adjustments. She reports injecting the same amount of rapid-acting insulin with
each meal and never making any changes. Her recent A1c was 8.7%. Which of the
following is the most appropriate approach for this patient?
A. Advise the patient to search the internet for information on meal planning
B. Consult a registered dietitian to educate the patient about carbohydrate counting
C. Telephone the patient's family to enlist their help and support
D. Provide the patient with written materials to take home - ANS-B. Consult a RD to
educate the patient on carbohydrate counting
This patient could benefit from a consult with an RD for education on carbohydrate
counting and using insulin to carbohydrate ratios.
A 32 year-old woman with polycystic ovarian syndrome and newly diagnosed T2DM
begins pioglitazone plus metformin. Which of the following should be included in her
initial medication counseling?
A. Use of contraception
B. Hypoglycemia risk
C. Risk for diabetic ketoacidosis
D. Potential for disulfiram-like reaction - ANS-A. Use of contraception
, Resolution of hyperglycemia with metformin in patents with PCOS often restores
menstruation and ability to become pregnant. TZDs and biguanides are not associated
with hypoglycemia. Disulfiram-like reactions are associated with first generation
sulfonylureas, bot not with the patient's regimen.
A 35 year-old woman with T1DM present to the clinic for f/u of self monitoring blood
glucose. Her A1c is 12%, and during the interview she reports that she thinks her
boyfriend is interested in a younger, thinner woman. Which of the following is the best
f/u question related to this patient's concerns?
A. Do you think that your boyfriend might stay with you if you become blind?
B. Are you afraid that insulin might cause you to gain weight?
C. Do your parents know that your blood glucose levels are poorly controlled?
D. What time of the day do you check your glucose? - ANS-B. Are you afraid that insulin
might cause you to gain weight?
The question's focus is on assessment and screening for eating disorders, of which
intentional insulin omission is one. Effective assessments reveal lifestyle issues and
facts, are patient centered, and facilitate honest self-disclosure.
A 40 year-old man with T2DM for 3 years presents on his lunch break for diabetes
education. Which of the following is MOST important for the diabetes educator to review
with the patient at this initial visit?
A. Economic impact of diabetes on the healthcare system
B. Patient's family history of diabetes
C. Patient expectations and personal education goals
D. Pathophysiology of diabetes and its complications - ANS-C. Patient expectations and
personal education goals
Assessment is the first step in the process of providing diabetes education. By
understanding what the interests, needs, and problems of the person with diabetes are,
the educator is more likely to provide appropriate and useful information that will assist
the individual to meet desired outcomes.
A 45 year old Hispanic man with T2DM for 10 years refuses to start insulin after failing
oral agents. Which of the following is the MOST appropriate response for the educator?
A. Educate the patient on the increased risk of microvascular complications
B. Ask the patient why he does not want to start insulin
C. Reassure the patient that insulin injections won't hurt
D. Ask the patient if he has any family members with diabetes complications - ANS-B.
Ask the patient why he does not want to start insulin
The educational process always begins with assessment, ie, in this case understanding
why the patient does not want to start insulin. The other choice assumed what the
"Record food intake, physical activity, and blood glucose results in a logbook 5 days a
week for 6 weeks" is an example of a:
A. assessment
B. learning objective
C. behavioral objective
D. goal - ANS-C. behavioral objective
SMART goal is a behavior objective or planned change. A learning objective relates to
the completion of a teaching session, although learning objectives are also measurable.
A goal is a big-picture directional guide, the focal point for and the end results of
meeting the learning and behavioral objectives.
A 12 year-old girl, accompanied by her mother, presents to the registered dietitian for
meal planning. Which of the following is the most important consideration when
developing her meal plan?
A. Use the term "diet" instead of "meal plan" to emphasize weight loss urgency
B. Schedule a separate session with the mother to review grocery selection
C. Adjust the meal plan to meet energy requirements for growth and activity
D. Suggest a plan that avoids intake of nutrient-dense foods - ANS-C. Adjust the meal
plan to meet energy requirements for growth and activity
A 14 year-old girl with T1DM presents accompanied by her mother. The girl sits quietly
while her mother expresses concerns about her daughter's rising A1C. She adds that
her daughter is tired all the time. "Instead of talking with her friends on the telephone,
she just sleeps on the couch after school since not being selected for the school
cheerleading squad 2 months ago." Which of the following best supports the diagnosis
of adjustments disorder with depressed mood in this patient?
A. Unintentional changes in weight or appetite
B. Continuation of symptoms for more than 2 months
C. Early morning awakening for at least 1 week
D. Presence of manic symptoms (excessive euphoria) - ANS-B. Continuation of
symptoms for more than 2 months
Adjustment disorder with depressed mood is defined by the American Psychiatric
Association as the development of depressive symptoms (eg sleeping after school,
withdrawing from friends) within a 3 months period time following a stressor (eg not
making cheer squad). With this disorder, depressive symptoms cause impairment in
social, occupational, or other areas of functioning OR are in excess of what would be
,expected from exposure to the stressor. Symptoms are expected to remit within 6
months of the time of onset.
A 19 year-old patient complains of unexplained weight loss and extreme hunger over
the past month. Which of the following is the MOST useful information to confirm
diagnosis of diabetes?
A. Reports of polyuria
B. An A1C of 5.1-6.4%
C. Fasting plasma glucose 100-125 mg/dL
D. Random plasma glucose >200 mg/dL with polyuria - ANS-D. Random plasma
glucose >200 mg/dL with polyuria
According to the ADA's 2015 Clinical Practice Recommendations: Diagnosis and
Classification of DM, the criteria for diagnosis of diabetes are as follows:
Fasting plasma glucose >126 mg/dL OR
Symptoms of hyperglycemia and a casual plasma glucose >200 mg/dL OR
2-hour plasma glucose >200 mg/dL during a 75g oral GTT.
Polyuria is a symptom of hyperglycemia, but cannot be used as diagnostic criteria, A1C
5.1-6.4% would be prediabetes, and a fasting plasma glucose of 100-125 mg/dL would
indicate impaired fasting glucose.
A 24 year-old college student with T1DM presents to the pharmacist educator for insulin
dose adjustments. She reports injecting the same amount of rapid-acting insulin with
each meal and never making any changes. Her recent A1c was 8.7%. Which of the
following is the most appropriate approach for this patient?
A. Advise the patient to search the internet for information on meal planning
B. Consult a registered dietitian to educate the patient about carbohydrate counting
C. Telephone the patient's family to enlist their help and support
D. Provide the patient with written materials to take home - ANS-B. Consult a RD to
educate the patient on carbohydrate counting
This patient could benefit from a consult with an RD for education on carbohydrate
counting and using insulin to carbohydrate ratios.
A 32 year-old woman with polycystic ovarian syndrome and newly diagnosed T2DM
begins pioglitazone plus metformin. Which of the following should be included in her
initial medication counseling?
A. Use of contraception
B. Hypoglycemia risk
C. Risk for diabetic ketoacidosis
D. Potential for disulfiram-like reaction - ANS-A. Use of contraception
, Resolution of hyperglycemia with metformin in patents with PCOS often restores
menstruation and ability to become pregnant. TZDs and biguanides are not associated
with hypoglycemia. Disulfiram-like reactions are associated with first generation
sulfonylureas, bot not with the patient's regimen.
A 35 year-old woman with T1DM present to the clinic for f/u of self monitoring blood
glucose. Her A1c is 12%, and during the interview she reports that she thinks her
boyfriend is interested in a younger, thinner woman. Which of the following is the best
f/u question related to this patient's concerns?
A. Do you think that your boyfriend might stay with you if you become blind?
B. Are you afraid that insulin might cause you to gain weight?
C. Do your parents know that your blood glucose levels are poorly controlled?
D. What time of the day do you check your glucose? - ANS-B. Are you afraid that insulin
might cause you to gain weight?
The question's focus is on assessment and screening for eating disorders, of which
intentional insulin omission is one. Effective assessments reveal lifestyle issues and
facts, are patient centered, and facilitate honest self-disclosure.
A 40 year-old man with T2DM for 3 years presents on his lunch break for diabetes
education. Which of the following is MOST important for the diabetes educator to review
with the patient at this initial visit?
A. Economic impact of diabetes on the healthcare system
B. Patient's family history of diabetes
C. Patient expectations and personal education goals
D. Pathophysiology of diabetes and its complications - ANS-C. Patient expectations and
personal education goals
Assessment is the first step in the process of providing diabetes education. By
understanding what the interests, needs, and problems of the person with diabetes are,
the educator is more likely to provide appropriate and useful information that will assist
the individual to meet desired outcomes.
A 45 year old Hispanic man with T2DM for 10 years refuses to start insulin after failing
oral agents. Which of the following is the MOST appropriate response for the educator?
A. Educate the patient on the increased risk of microvascular complications
B. Ask the patient why he does not want to start insulin
C. Reassure the patient that insulin injections won't hurt
D. Ask the patient if he has any family members with diabetes complications - ANS-B.
Ask the patient why he does not want to start insulin
The educational process always begins with assessment, ie, in this case understanding
why the patient does not want to start insulin. The other choice assumed what the
