Question 1
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
The steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
Question 2
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
ANSWER
1
,C. Keeping a PA log is associated w/ higher level of self efficacy
Question 3
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
ANSWER
A. 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.
Question 4
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
2
,D. Printed handout w/ pics depicting steps of insulin admin, followed by verbal
acknowledgement of understanding.
ANSWER
B. Demonstration and return demonstration of insulin admin
Question 5
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
ANSWER
C. Cultural characteristics/barriers of the population
Question 6
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%
3
, ANSWER
B. 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
Question 7
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
ANSWER
A. Providing materials and experiences that enhance her knowledge and skills
Question 8
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
4
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
The steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
Question 2
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
ANSWER
1
,C. Keeping a PA log is associated w/ higher level of self efficacy
Question 3
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
ANSWER
A. 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.
Question 4
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
2
,D. Printed handout w/ pics depicting steps of insulin admin, followed by verbal
acknowledgement of understanding.
ANSWER
B. Demonstration and return demonstration of insulin admin
Question 5
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
ANSWER
C. Cultural characteristics/barriers of the population
Question 6
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%
3
, ANSWER
B. 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
Question 7
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
ANSWER
A. Providing materials and experiences that enhance her knowledge and skills
Question 8
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
4
