This is Part 1 of the Certified Diabetes
Care and Education Specialist (CDCES)
Exam Prep Seventh Edition
Comprehensive Test Bank by ADCES.
TABLE OF CONTENTS - PART 1 of 5
Domain 1: Assessment - Questions 1-40
Domain 2: Care and Education Intervention - Questions 41-80
Domain 3: Standards and Practices - Questions 81-100
DOMAIN 1: ASSESSMENT
Q1. A patient with type 2 diabetes has an A1C of 8.9% and reports checking blood glucose
"sometimes." What is the MOST appropriate assessment approach?
A. Tell the patient that A1C is the only number that matters
B. Explore the patient's understanding of glucose patterns and barriers to monitoring
C. Recommend increasing the insulin dose
D. Schedule the patient for a retinal exam
Correct Answer: B
Rationale: The patient's statement reveals a gap in understanding and a potential motivational
barrier. The CDCES must assess knowledge, beliefs, and psychosocial context before recommending
changes. Option A dismisses the concern, Option C exceeds scope, and Option D does not address
the assessment need.
Q2. A patient newly diagnosed with type 1 diabetes asks why blood sugar must be checked before
meals if they already know what they are eating. Which domain of assessment does this question
PRIMARILY address?
A. Physical assessment
B. Psychosocial assessment
,C. Self-management knowledge
D. Learning style
Correct Answer: C
Rationale: The question reflects a knowledge gap about pre-meal glucose levels and insulin
dosing. The CDCES must assess understanding of monitoring and insulin timing. Option A is incorrect
because the issue is knowledge. Option B is incorrect because no emotional distress is indicated.
Option D is incorrect because learning preference is not yet revealed.
Q3. A patient on metformin has an eGFR of 38 mL/min/1.73 m2 and asks whether the medication
should continue. What is the CDCES MOST appropriate response?
A. "Metformin is safe at any kidney function level."
B. "I cannot answer that; you must ask your prescriber."
C. "Metformin dosing requires adjustment at this eGFR, so your prescriber will need to review it."
D. "You should stop taking metformin immediately."
Correct Answer: C
Rationale: Metformin requires dose adjustment when eGFR falls below 45. Option A is factually
wrong. Option B is dismissive and withholds accurate information within scope. Option D exceeds the
CDCES role by directing discontinuation without prescriber input.
Q4. A patient with type 1 diabetes says they have been "eating whatever I want" because they
"finally got the insulin pump." What is the PRIORITY assessment?
A. The patient's insulin pump settings
B. The patient's understanding of carbohydrate counting and pump therapy
C. The patient's A1C from three months ago
D. The patient's blood pressure
Correct Answer: B
Rationale: The statement suggests a misconception that pump therapy removes the need for
dietary management. The CDCES must assess understanding of carbohydrate intake and pump
settings. Option A addresses the device only. Option C is retrospective. Option D is not the priority in
this scenario.
Q5. A patient reports "feeling shaky and sweaty" in the afternoons but has never checked glucose
during these episodes. What is the MOST appropriate action?
A. Tell the patient to eat more at lunch
,B. Assess the patient's knowledge of hypoglycemia symptoms and treatment
C. Recommend reducing the insulin dose
D. Schedule a neurology consult
Correct Answer: B
Rationale: The symptoms suggest hypoglycemia but are unconfirmed without glucose data. The
CDCES must assess recognition and treatment knowledge first. Option A is premature. Option C
exceeds scope. Option D is unnecessary before metabolic causes are assessed.
Q6. A patient with type 2 diabetes has an A1C of 6.8% but reports frequent shakiness relieved by
food. What is the MOST important assessment question?
A. "What did you eat for breakfast today?"
B. "Do you check your blood glucose when you feel shaky?"
C. "Have you been exercising more than usual?"
D. "Are you taking your metformin with meals?"
Correct Answer: B
Rationale: The low A1C with symptoms suggests possible unrecognized hypoglycemia. The
CDCES must assess whether the patient monitors during symptoms. Option A addresses diet only.
Option C is secondary. Option D addresses metformin, which rarely causes hypoglycemia alone.
Q7. A patient with type 1 diabetes is planning a pregnancy. What is the PRIORITY assessment?
A. The patient's current A1C and glucose control
B. The patient's insurance coverage
C. The patient's exercise routine
D. The patient's family history of diabetes
Correct Answer: A
Rationale: Preconception glycemic control is the strongest predictor of pregnancy outcomes.
Option B affects access but is not clinical priority. Option C and Option D are relevant but secondary
to glucose control in this context.
Q8. A patient reports they "can't afford" test strips and checks glucose only once a week. What is the
MOST appropriate initial response?
A. Tell the patient to check less often to save strips
B. Assess insurance coverage and explore cost-reduction options
, C. Recommend a continuous glucose monitor
D. Refer to a financial counselor only
Correct Answer: B
Rationale: Cost directly affects self-management. The CDCES must assess coverage and explore
options such as manufacturer programs or pharmacy discounts. Option A reduces necessary
monitoring. Option C requires coverage assessment. Option D is incomplete without immediate
solutions.
Q9. A patient with a BMI of 38 reports "eating because I'm stressed." What is the PRIORITY
assessment?
A. The patient's daily calorie intake
B. The patient's emotional relationship with food and stressors
C. The patient's blood pressure
D. The patient's lipid panel
Correct Answer: B
Rationale: The statement reveals a psychosocial driver of eating. The CDCES must assess
emotional and behavioral patterns before recommending dietary changes. Option A addresses
quantity only. Option C and Option D are clinical parameters but do not address the stated behavior.
Q10. A patient with type 1 diabetes has an A1C of 7.2% and reports no lows, but CGM shows glucose
below 70 mg/dL for 4% of the time. What is the MOST appropriate action?
A. Reassure the patient that the A1C is at goal
B. Discuss the CGM data and assess for hypoglycemia unawareness
C. Recommend increasing the insulin dose
D. Schedule follow-up in six months
Correct Answer: B
Rationale: CGM data reveals unrecognized hypoglycemia, suggesting hypoglycemia
unawareness. Option A ignores the safety risk. Option C would worsen hypoglycemia. Option D
delays necessary intervention for a safety concern.
Q11. A patient on insulin reports "checking my sugar whenever I feel like it." What is the MOST
appropriate assessment?
A. Ask the patient to describe their usual monitoring routine
B. Tell the patient they must check at specific times
Care and Education Specialist (CDCES)
Exam Prep Seventh Edition
Comprehensive Test Bank by ADCES.
TABLE OF CONTENTS - PART 1 of 5
Domain 1: Assessment - Questions 1-40
Domain 2: Care and Education Intervention - Questions 41-80
Domain 3: Standards and Practices - Questions 81-100
DOMAIN 1: ASSESSMENT
Q1. A patient with type 2 diabetes has an A1C of 8.9% and reports checking blood glucose
"sometimes." What is the MOST appropriate assessment approach?
A. Tell the patient that A1C is the only number that matters
B. Explore the patient's understanding of glucose patterns and barriers to monitoring
C. Recommend increasing the insulin dose
D. Schedule the patient for a retinal exam
Correct Answer: B
Rationale: The patient's statement reveals a gap in understanding and a potential motivational
barrier. The CDCES must assess knowledge, beliefs, and psychosocial context before recommending
changes. Option A dismisses the concern, Option C exceeds scope, and Option D does not address
the assessment need.
Q2. A patient newly diagnosed with type 1 diabetes asks why blood sugar must be checked before
meals if they already know what they are eating. Which domain of assessment does this question
PRIMARILY address?
A. Physical assessment
B. Psychosocial assessment
,C. Self-management knowledge
D. Learning style
Correct Answer: C
Rationale: The question reflects a knowledge gap about pre-meal glucose levels and insulin
dosing. The CDCES must assess understanding of monitoring and insulin timing. Option A is incorrect
because the issue is knowledge. Option B is incorrect because no emotional distress is indicated.
Option D is incorrect because learning preference is not yet revealed.
Q3. A patient on metformin has an eGFR of 38 mL/min/1.73 m2 and asks whether the medication
should continue. What is the CDCES MOST appropriate response?
A. "Metformin is safe at any kidney function level."
B. "I cannot answer that; you must ask your prescriber."
C. "Metformin dosing requires adjustment at this eGFR, so your prescriber will need to review it."
D. "You should stop taking metformin immediately."
Correct Answer: C
Rationale: Metformin requires dose adjustment when eGFR falls below 45. Option A is factually
wrong. Option B is dismissive and withholds accurate information within scope. Option D exceeds the
CDCES role by directing discontinuation without prescriber input.
Q4. A patient with type 1 diabetes says they have been "eating whatever I want" because they
"finally got the insulin pump." What is the PRIORITY assessment?
A. The patient's insulin pump settings
B. The patient's understanding of carbohydrate counting and pump therapy
C. The patient's A1C from three months ago
D. The patient's blood pressure
Correct Answer: B
Rationale: The statement suggests a misconception that pump therapy removes the need for
dietary management. The CDCES must assess understanding of carbohydrate intake and pump
settings. Option A addresses the device only. Option C is retrospective. Option D is not the priority in
this scenario.
Q5. A patient reports "feeling shaky and sweaty" in the afternoons but has never checked glucose
during these episodes. What is the MOST appropriate action?
A. Tell the patient to eat more at lunch
,B. Assess the patient's knowledge of hypoglycemia symptoms and treatment
C. Recommend reducing the insulin dose
D. Schedule a neurology consult
Correct Answer: B
Rationale: The symptoms suggest hypoglycemia but are unconfirmed without glucose data. The
CDCES must assess recognition and treatment knowledge first. Option A is premature. Option C
exceeds scope. Option D is unnecessary before metabolic causes are assessed.
Q6. A patient with type 2 diabetes has an A1C of 6.8% but reports frequent shakiness relieved by
food. What is the MOST important assessment question?
A. "What did you eat for breakfast today?"
B. "Do you check your blood glucose when you feel shaky?"
C. "Have you been exercising more than usual?"
D. "Are you taking your metformin with meals?"
Correct Answer: B
Rationale: The low A1C with symptoms suggests possible unrecognized hypoglycemia. The
CDCES must assess whether the patient monitors during symptoms. Option A addresses diet only.
Option C is secondary. Option D addresses metformin, which rarely causes hypoglycemia alone.
Q7. A patient with type 1 diabetes is planning a pregnancy. What is the PRIORITY assessment?
A. The patient's current A1C and glucose control
B. The patient's insurance coverage
C. The patient's exercise routine
D. The patient's family history of diabetes
Correct Answer: A
Rationale: Preconception glycemic control is the strongest predictor of pregnancy outcomes.
Option B affects access but is not clinical priority. Option C and Option D are relevant but secondary
to glucose control in this context.
Q8. A patient reports they "can't afford" test strips and checks glucose only once a week. What is the
MOST appropriate initial response?
A. Tell the patient to check less often to save strips
B. Assess insurance coverage and explore cost-reduction options
, C. Recommend a continuous glucose monitor
D. Refer to a financial counselor only
Correct Answer: B
Rationale: Cost directly affects self-management. The CDCES must assess coverage and explore
options such as manufacturer programs or pharmacy discounts. Option A reduces necessary
monitoring. Option C requires coverage assessment. Option D is incomplete without immediate
solutions.
Q9. A patient with a BMI of 38 reports "eating because I'm stressed." What is the PRIORITY
assessment?
A. The patient's daily calorie intake
B. The patient's emotional relationship with food and stressors
C. The patient's blood pressure
D. The patient's lipid panel
Correct Answer: B
Rationale: The statement reveals a psychosocial driver of eating. The CDCES must assess
emotional and behavioral patterns before recommending dietary changes. Option A addresses
quantity only. Option C and Option D are clinical parameters but do not address the stated behavior.
Q10. A patient with type 1 diabetes has an A1C of 7.2% and reports no lows, but CGM shows glucose
below 70 mg/dL for 4% of the time. What is the MOST appropriate action?
A. Reassure the patient that the A1C is at goal
B. Discuss the CGM data and assess for hypoglycemia unawareness
C. Recommend increasing the insulin dose
D. Schedule follow-up in six months
Correct Answer: B
Rationale: CGM data reveals unrecognized hypoglycemia, suggesting hypoglycemia
unawareness. Option A ignores the safety risk. Option C would worsen hypoglycemia. Option D
delays necessary intervention for a safety concern.
Q11. A patient on insulin reports "checking my sugar whenever I feel like it." What is the MOST
appropriate assessment?
A. Ask the patient to describe their usual monitoring routine
B. Tell the patient they must check at specific times
