CDCES study practice questions and
answers
What is the first step in the process of diabetes self management education?
a. assessment
b. goal setting
c. diagnosis
d. referral - ANSa. assessment
the steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
Which option is an outcome of personal record keeping in relation to physical activity, according
to recent studies?
a. those who keep logs of PA are more adherent to other elements of tx (ie diet, meds)
b. those who keep PA logs are more likely to enroll in organized exercise programs (ie classes,
gym memberships)
c. keeping a PA log is associated w/ higher level of self efficacy
d. the obligation of record keeping has been identified as a barrier to exercise - ANSc. keeping a
PA log is associated w/ higher level of self efficacy
consider the following pt- male, 46 yo, prev sedentary, mild HTN and HLD (both controlled w/
meds), T2DM, BMI 26. If this pt wishes to start a moderate intensity exercise regimen, what
additional assessment may be warranted?
a. stress test w/ ECG
b. DEXA scan to assess bone density and strength
c. ankle-brachial index to rule out PAD
d. none as BP and chol are controlled and exercise is only mod intensity - ANSa. stress test w/
ECG
stress test is not mandated prior to exercise for pt's w/ dm, clinical judgement recommended
based on hx and comorbidities.
Stress test may be warranted in this case d/t pt being >40 yo w/ prev hx of sedentary, cvd risk
factors, and beginning a program that is more intense than brisk walking.
,a diabetes educator assess and instructs pts on a variety of of self care skills. Which teaching
strategy provides the best opportunity to both assess and instruct on self administration of
insulin?
a. written quiz in which the pt puts insulin admin steps in order.
b. demonstration and return demonstration of insulin admin
c. video viewed and reviewed on proper insulin technique
d. printed handout w/ pics depicting steps of insulin admin, followed by verbal acknowledgement
of understanding. - ANSb. demonstration and return demonstration of insulin admin
The following policies are apart of a DSME program: asking pt's if there are any dietary
restrictions or preferences, inviting family members to participate, being sensitive to ones rate of
speech and tone of voice. These policies address which specific type of consideration?
a. readiness for change variation among pt's
b. potential low literacy/numeracy levels
c. cultural characteristics/barriers of the population
d. poor family and social support - ANSc. cultural characteristics/barriers of the population
according to the ADA consensus statement on managing preexisting dm for pregnancy, what is
the optimal glycemic target for pregnant women w/ preexisting dm (assuming target may be
reached w/o excessive hypoglycemia)?
a. premeal fasting <90 and either 1 hr pp <120 OR 2 hr pp <100; hbA1c <5.5%
b. premeal fasting <95 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <6%
c. premeal fasting <90 and either 1 hr pp <120 OR 2 hr pp <100; hbA1c <6%
d. premeal fasting <100 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <7% - ANSb. premeal
fasting <95 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <6%
also note for pregnancy, BG not considered hypoglycemia until <60
during the initial assessment process, the patient answers the question "how important is it for
you to make this change right now?" with a 9 out 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.
In customizing her DSME plan, what should the focus be?
a. providing materials and experiences that enhance her knowledge and skills
b. addressing psychosocial needs, such as accepting her dx
c. highlighting benefits of good dm mngmnt to encourage behavior change
d. explaining the questions further to confirm understanding - ANSa. providing materials and
experiences that enhance her knowledge and skills
,it is important to address potential barriers to self monitoring of BG, esp for patients who are not
adhering to their plan of care. Which of the following barriers was not one cited by patients in
recent studies?
a. cost of testing supplies
b. discomfort of fingersticks
c. lack of instruction and support
d. misplacement of small items - ANSd. misplacement of small items
when assessing for risk of hypoglycemia in relation to exercise, which element of the patient
record is most important to consider?
a. the patient's typical s/s w/ hypos
b. current pt physical/glycemic status (wt, BMI, A1c)
c. timing and content of meals (ie carbs) in relation to activity
d. med regimen- types, dosing, timing - ANSd. med regimen- types, dosing, timing
Which of the following behaviors is the most likely indication that the pt is at a very low level of
readiness to change?
a. pt becomes tearful as the educator explains how to keep a food diary
b. pt watches a demo but does not say anything
c. pt volunteers to answer a review question at the end of class but gets the answer wrong
d. pt denies dm dx and disagrees w/ the dr's referral for DSME - ANSd. pt denies dm dx and
disagrees w/ the dr's referral for DSME
according to ADA standards, which statement is not true regarding MNT and diabetes?
a. MNT is recommended only for those w/ dm who are over/underwt or obese
b. MNT is recommended for anyone w/ dm, regardless of nutritional status
c. children w/ dm and celiac disease should consult w/ a RD familiar w/ both conditions
d. bc nutrition in the hospital setting is complex, an RD should be part of the inpatient dm care
team to provide MNT - ANSa. MNT is recommended only for those w/ dm who are over/underwt
or obese
a dm educator is assessing a patient's BG monitoring technique by having them demo a BG
test. Which of the following actions is indicative of improper technique?
a. cleaning hands w/ warm water and soap instead of etoh
b. setting lancet to her preference
c. milking lanced finger at the tip to acquire sufficient blood sample
d. recording the reading in notebook rather than on clinic provided sheet - ANSc. milking lanced
finger at the tip to acquire sufficient blood sample
, finger should be milked from the based not the tip to avoid skewing result
pt suffers from obesity, T2DM, HTN, and HLD. He recalls lastnights dinner- low fat turkey and
cheese sandwich w/ mustard, side salad w/ low fat italian dressing, pickles, a small serving of
baked chips, and one can club soda. Based on assessment, which of his conditions is at
greatest risk d/t his food choices?
a. HLD
b. T2DM
c. obesity
d. HTN - ANSd. HTN
Which instructional strategy is most likely to be most effective in terms of patient retention?
a. slide show presentation w. funny visuals and bullet list of main points
b. current, well-referenced booklets w/ colored diagrams, written at a patients optimal reading
level, that can be reviewed as desired
c. one on one convo over the phone where educator presents info and then rephrases the info
using analogies to ensure understanding
d. small group discussion around a table where pt's teach each other a skill after seeing it
explained and demo'ed by the educator - ANSd. small group discussion around a table where
pt's teach each other a skill after seeing it explained and demo'ed by the educator
a pt w/ GDM is convinced she developed GDM from eating to much popcorn early in her
pregnancy. She insists that if she does not eat any again she will not have to start insulin and
her BG will return to normal. What emotional stage associated w/ chronic disease dx does the
educator assess in this pt?
a. denial
b. anger
c. bargaining
d. frustration and depression - ANSc. bargaining
of the choices below, what is the strongest predictor of health status?
a. ethnic group
b. literacy skill
c. income level
d. age - ANSb. literacy skill
determines their ability to understand health related topics
answers
What is the first step in the process of diabetes self management education?
a. assessment
b. goal setting
c. diagnosis
d. referral - ANSa. assessment
the steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
Which option is an outcome of personal record keeping in relation to physical activity, according
to recent studies?
a. those who keep logs of PA are more adherent to other elements of tx (ie diet, meds)
b. those who keep PA logs are more likely to enroll in organized exercise programs (ie classes,
gym memberships)
c. keeping a PA log is associated w/ higher level of self efficacy
d. the obligation of record keeping has been identified as a barrier to exercise - ANSc. keeping a
PA log is associated w/ higher level of self efficacy
consider the following pt- male, 46 yo, prev sedentary, mild HTN and HLD (both controlled w/
meds), T2DM, BMI 26. If this pt wishes to start a moderate intensity exercise regimen, what
additional assessment may be warranted?
a. stress test w/ ECG
b. DEXA scan to assess bone density and strength
c. ankle-brachial index to rule out PAD
d. none as BP and chol are controlled and exercise is only mod intensity - ANSa. stress test w/
ECG
stress test is not mandated prior to exercise for pt's w/ dm, clinical judgement recommended
based on hx and comorbidities.
Stress test may be warranted in this case d/t pt being >40 yo w/ prev hx of sedentary, cvd risk
factors, and beginning a program that is more intense than brisk walking.
,a diabetes educator assess and instructs pts on a variety of of self care skills. Which teaching
strategy provides the best opportunity to both assess and instruct on self administration of
insulin?
a. written quiz in which the pt puts insulin admin steps in order.
b. demonstration and return demonstration of insulin admin
c. video viewed and reviewed on proper insulin technique
d. printed handout w/ pics depicting steps of insulin admin, followed by verbal acknowledgement
of understanding. - ANSb. demonstration and return demonstration of insulin admin
The following policies are apart of a DSME program: asking pt's if there are any dietary
restrictions or preferences, inviting family members to participate, being sensitive to ones rate of
speech and tone of voice. These policies address which specific type of consideration?
a. readiness for change variation among pt's
b. potential low literacy/numeracy levels
c. cultural characteristics/barriers of the population
d. poor family and social support - ANSc. cultural characteristics/barriers of the population
according to the ADA consensus statement on managing preexisting dm for pregnancy, what is
the optimal glycemic target for pregnant women w/ preexisting dm (assuming target may be
reached w/o excessive hypoglycemia)?
a. premeal fasting <90 and either 1 hr pp <120 OR 2 hr pp <100; hbA1c <5.5%
b. premeal fasting <95 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <6%
c. premeal fasting <90 and either 1 hr pp <120 OR 2 hr pp <100; hbA1c <6%
d. premeal fasting <100 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <7% - ANSb. premeal
fasting <95 and either 1 hr pp <140 OR 2 hr pp <120; hbA1c <6%
also note for pregnancy, BG not considered hypoglycemia until <60
during the initial assessment process, the patient answers the question "how important is it for
you to make this change right now?" with a 9 out 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.
In customizing her DSME plan, what should the focus be?
a. providing materials and experiences that enhance her knowledge and skills
b. addressing psychosocial needs, such as accepting her dx
c. highlighting benefits of good dm mngmnt to encourage behavior change
d. explaining the questions further to confirm understanding - ANSa. providing materials and
experiences that enhance her knowledge and skills
,it is important to address potential barriers to self monitoring of BG, esp for patients who are not
adhering to their plan of care. Which of the following barriers was not one cited by patients in
recent studies?
a. cost of testing supplies
b. discomfort of fingersticks
c. lack of instruction and support
d. misplacement of small items - ANSd. misplacement of small items
when assessing for risk of hypoglycemia in relation to exercise, which element of the patient
record is most important to consider?
a. the patient's typical s/s w/ hypos
b. current pt physical/glycemic status (wt, BMI, A1c)
c. timing and content of meals (ie carbs) in relation to activity
d. med regimen- types, dosing, timing - ANSd. med regimen- types, dosing, timing
Which of the following behaviors is the most likely indication that the pt is at a very low level of
readiness to change?
a. pt becomes tearful as the educator explains how to keep a food diary
b. pt watches a demo but does not say anything
c. pt volunteers to answer a review question at the end of class but gets the answer wrong
d. pt denies dm dx and disagrees w/ the dr's referral for DSME - ANSd. pt denies dm dx and
disagrees w/ the dr's referral for DSME
according to ADA standards, which statement is not true regarding MNT and diabetes?
a. MNT is recommended only for those w/ dm who are over/underwt or obese
b. MNT is recommended for anyone w/ dm, regardless of nutritional status
c. children w/ dm and celiac disease should consult w/ a RD familiar w/ both conditions
d. bc nutrition in the hospital setting is complex, an RD should be part of the inpatient dm care
team to provide MNT - ANSa. MNT is recommended only for those w/ dm who are over/underwt
or obese
a dm educator is assessing a patient's BG monitoring technique by having them demo a BG
test. Which of the following actions is indicative of improper technique?
a. cleaning hands w/ warm water and soap instead of etoh
b. setting lancet to her preference
c. milking lanced finger at the tip to acquire sufficient blood sample
d. recording the reading in notebook rather than on clinic provided sheet - ANSc. milking lanced
finger at the tip to acquire sufficient blood sample
, finger should be milked from the based not the tip to avoid skewing result
pt suffers from obesity, T2DM, HTN, and HLD. He recalls lastnights dinner- low fat turkey and
cheese sandwich w/ mustard, side salad w/ low fat italian dressing, pickles, a small serving of
baked chips, and one can club soda. Based on assessment, which of his conditions is at
greatest risk d/t his food choices?
a. HLD
b. T2DM
c. obesity
d. HTN - ANSd. HTN
Which instructional strategy is most likely to be most effective in terms of patient retention?
a. slide show presentation w. funny visuals and bullet list of main points
b. current, well-referenced booklets w/ colored diagrams, written at a patients optimal reading
level, that can be reviewed as desired
c. one on one convo over the phone where educator presents info and then rephrases the info
using analogies to ensure understanding
d. small group discussion around a table where pt's teach each other a skill after seeing it
explained and demo'ed by the educator - ANSd. small group discussion around a table where
pt's teach each other a skill after seeing it explained and demo'ed by the educator
a pt w/ GDM is convinced she developed GDM from eating to much popcorn early in her
pregnancy. She insists that if she does not eat any again she will not have to start insulin and
her BG will return to normal. What emotional stage associated w/ chronic disease dx does the
educator assess in this pt?
a. denial
b. anger
c. bargaining
d. frustration and depression - ANSc. bargaining
of the choices below, what is the strongest predictor of health status?
a. ethnic group
b. literacy skill
c. income level
d. age - ANSb. literacy skill
determines their ability to understand health related topics
