CDE PRACTICE
EXAM
QUESTIONS #3
What is the first step in the process of diabetes self management education?
A. Assessment
B. Goal setting
C. Diagnosis
D. Referral - Answers- A. Assessment
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 - Answers- C. Keeping a physical activity log is associated with a higher
level of self efficacy
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 - Answers- 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.
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 - Answers- B. A demonstration and return
demonstration of insulin administration
The following policies are part of your DSME program: asking pts if there are any
dietary preferences or restrictions; 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 - Answers- C. Cultural characteristics/barriers of your
population
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%
- Answers- 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%
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 - Answers-
A. Providing materials and experiences to enhance her knowledge and skills
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 - Answers- D. 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 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 - Answers- D. Medication regimen:
types, dose, and 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. 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
- Answers- D. The pt denies that she has diabetes and disagrees with the doctor's
referral to DSME
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 - Answers- A. MNT is
recommended for only those person with diabetes who are underweight, overweight, or
obese
, 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 -
Answers- 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.
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 - Answers- D. HTN
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 - Answers- 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.
Which instructional strategy is likely to be MOST effective in terms of pt retention?
A. PowerPoint presentation with funny visuals and bullet list of main points
B. Current, well-referenced booklets with colorful diagrams, written at a patient's optimal
reading level, that can be reviewed if desired
C. One-on-one conversation over the phone where the educator presents information
and then rephrases the information using analogies to ensure understanding
D. Small group discussion around a table where pts teach each other a skill after seeing
it explained and demonstrated by the educator - Answers- D. Small group discussion
around a table where pts teach each other a skill after seeing it explained and
demonstrated by the educator
EXAM
QUESTIONS #3
What is the first step in the process of diabetes self management education?
A. Assessment
B. Goal setting
C. Diagnosis
D. Referral - Answers- A. Assessment
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 - Answers- C. Keeping a physical activity log is associated with a higher
level of self efficacy
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 - Answers- 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.
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 - Answers- B. A demonstration and return
demonstration of insulin administration
The following policies are part of your DSME program: asking pts if there are any
dietary preferences or restrictions; 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 - Answers- C. Cultural characteristics/barriers of your
population
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%
- Answers- 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%
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 - Answers-
A. Providing materials and experiences to enhance her knowledge and skills
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 - Answers- D. 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 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 - Answers- D. Medication regimen:
types, dose, and 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. 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
- Answers- D. The pt denies that she has diabetes and disagrees with the doctor's
referral to DSME
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 - Answers- A. MNT is
recommended for only those person with diabetes who are underweight, overweight, or
obese
, 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 -
Answers- 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.
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 - Answers- D. HTN
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 - Answers- 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.
Which instructional strategy is likely to be MOST effective in terms of pt retention?
A. PowerPoint presentation with funny visuals and bullet list of main points
B. Current, well-referenced booklets with colorful diagrams, written at a patient's optimal
reading level, that can be reviewed if desired
C. One-on-one conversation over the phone where the educator presents information
and then rephrases the information using analogies to ensure understanding
D. Small group discussion around a table where pts teach each other a skill after seeing
it explained and demonstrated by the educator - Answers- D. Small group discussion
around a table where pts teach each other a skill after seeing it explained and
demonstrated by the educator
