Question 1
Which of the following statements is most characteristic of Intensive Therapeutic Lifestyle
Change (ITLC)?
a. Gradual changes are encouraged in one's daily routine, including habits around sleep,
diet, physical activity and stress management.
b. There is a singular focus on one health-related domain to ensure that patients make
substantial change in this area
c. Programs need to be delivered in-person to be effective
d. These utilize multiple modalities and a multidisciplinary team
CORRECT ANSWER
D. These utilize multiple modalities and a multidisciplinary team
ITLCs encourage drastic changes in one's daily routine, not gradual changes. ITLCs produce
the essential induction phase that is needed for people to make the dramatic lifestyle
changes necessary for treating severe disease and precedes the maintenance and support
phases in lifestyle change. ITLC treatment programs are usually administered in a group
setting and typically focus on multiple modalities and generally utilized a multidisciplinary
team. They can be delivered in-person or virtually.
Question 2
Overall annual medical expenditures among people diagnosed with diabetes in the United
States are how much higher compared with people without diabetes?
a. 1.5 times higher
b. 2.3 times higher
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,c. 3.5 times higher
d. 6.2 times higher
CORRECT ANSWER
B. 2.3 times higher
Question 3
What percentage of US adults with diabetes are unaware that they have it?
a. 27%
b. 16%
c. 23%
d. 34%
CORRECT ANSWER
C. 23%
According to the CDC, 23% of US adults who met laboratory criteria for diabetes were not
aware of or did not report having diabetes (undiagnosed diabetes). Approximately 11% of
the US population (adults and children) have diabetes and nearly 15% of US adults have
diabetes.
Question 4
Which of the following is true about positive psychology?
a. It acknowledges the value of negative emotions, alone time, and reflecting on previous
failures
b. It reinforces autonomy and self-efficacy
c. Avoidance of negative thoughts and emotions is preferable as these can serve as
detractors to growth
d. It emphasizes self-improvement by focusing on strengthening areas of weakness
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,CORRECT ANSWER
B. It reinforces autonomy and self-efficacy
Positive psychology reinforces autonomy and self-efficacy (b), and emphasizes current skills
abilities, strengths, and positive actions (d). It acknowledges the value of positive
emotions, engagement, relationships, meaning, and accomplishment (a). Positive
psychology improves attention, open-mindedness, and creativity. It also recognizes that a
healthy ratio of positive to negative emotions (not the avoidance of) builds resilience that
foster adaptation and changes (c).
Question 5
A 45-year-old man wants to make lifestyle changes to reduce his body weight and increase
regular moderate intensity exercise. He wants to address weight loss first but is frustrated
because he feels like his past efforts have failed. His health care provider decides that
supporting his self-efficacy would be useful. Which of the following is the most
appropriate inquiry to make at this point?
a. "Who in your life is most likely to support you to achieve your weight loss goal right now?"
b. "Tell me about a time when you overcame a challenge to accomplish something you really
wanted to achieve."
c. "What factor in your life would most motivate you to work towards weight loss right
now?"
d. "Deciding to improve your health is a great decision - how will you feel when you achieve
this?"
CORRECT ANSWER
B. "Tell me about a time when you overcame a challenge to accomplish something you
really wanted to achieve."
The primary foundation of self-efficacy is mastery experiences. The inquiry inviting the man
to describe a previous experience of overcoming a challenge is a strong invitation to report
a mastery experience. Other options invite him to describe other supportive people or
factors rather than self-efficacy experiences or are likely to negatively impact self-efficacy
due to the practitioner's "cheerleading".
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, Question 6
When asked a scaling question to assess his confidence to make a lifestyle change, a 48-
year-old man responds that he is "4 out of 10 confident." His health care provider
responds with a follow-up inquiry: "What stops you from being 8 or 9 out of 10?" This
response is an example of which of the following?
a. An invitational challenge
b. Setting a stretch goal
c. The righting reflex
d. Rolling with resistance
CORRECT ANSWER
C. The righting reflex
Miller and Rollnick define the righting reflex as attempts to use an expert stance to urge
patients into change. Such challenges are likely to evoke a self-defensive reaction rather
than further discussion about the possibility of change.
Question 7
A 43-year-old man with type 2 diabetes has had unstable and high hemoglobin A1c
(HbA1c) over a number of years. He has recently moved to another city and is seeing a
new primary care provider. Over the past 12 weeks, his HbA1c has decreased from 7.9% to
6.7%. Which of the following physician attributes would most likely explain this?
a. Insightful reflections of adaptive patient behaviors
b. Highly developed capacity for empathy
c. Autonomy-supportive informational approach
d. Curious open inquiry about the reasons behind fluctuations
CORRECT ANSWER
B. Highly developed capacity for empathy
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Which of the following statements is most characteristic of Intensive Therapeutic Lifestyle
Change (ITLC)?
a. Gradual changes are encouraged in one's daily routine, including habits around sleep,
diet, physical activity and stress management.
b. There is a singular focus on one health-related domain to ensure that patients make
substantial change in this area
c. Programs need to be delivered in-person to be effective
d. These utilize multiple modalities and a multidisciplinary team
CORRECT ANSWER
D. These utilize multiple modalities and a multidisciplinary team
ITLCs encourage drastic changes in one's daily routine, not gradual changes. ITLCs produce
the essential induction phase that is needed for people to make the dramatic lifestyle
changes necessary for treating severe disease and precedes the maintenance and support
phases in lifestyle change. ITLC treatment programs are usually administered in a group
setting and typically focus on multiple modalities and generally utilized a multidisciplinary
team. They can be delivered in-person or virtually.
Question 2
Overall annual medical expenditures among people diagnosed with diabetes in the United
States are how much higher compared with people without diabetes?
a. 1.5 times higher
b. 2.3 times higher
1
@THE STUDY VAULT
,c. 3.5 times higher
d. 6.2 times higher
CORRECT ANSWER
B. 2.3 times higher
Question 3
What percentage of US adults with diabetes are unaware that they have it?
a. 27%
b. 16%
c. 23%
d. 34%
CORRECT ANSWER
C. 23%
According to the CDC, 23% of US adults who met laboratory criteria for diabetes were not
aware of or did not report having diabetes (undiagnosed diabetes). Approximately 11% of
the US population (adults and children) have diabetes and nearly 15% of US adults have
diabetes.
Question 4
Which of the following is true about positive psychology?
a. It acknowledges the value of negative emotions, alone time, and reflecting on previous
failures
b. It reinforces autonomy and self-efficacy
c. Avoidance of negative thoughts and emotions is preferable as these can serve as
detractors to growth
d. It emphasizes self-improvement by focusing on strengthening areas of weakness
2
@THE STUDY VAULT
,CORRECT ANSWER
B. It reinforces autonomy and self-efficacy
Positive psychology reinforces autonomy and self-efficacy (b), and emphasizes current skills
abilities, strengths, and positive actions (d). It acknowledges the value of positive
emotions, engagement, relationships, meaning, and accomplishment (a). Positive
psychology improves attention, open-mindedness, and creativity. It also recognizes that a
healthy ratio of positive to negative emotions (not the avoidance of) builds resilience that
foster adaptation and changes (c).
Question 5
A 45-year-old man wants to make lifestyle changes to reduce his body weight and increase
regular moderate intensity exercise. He wants to address weight loss first but is frustrated
because he feels like his past efforts have failed. His health care provider decides that
supporting his self-efficacy would be useful. Which of the following is the most
appropriate inquiry to make at this point?
a. "Who in your life is most likely to support you to achieve your weight loss goal right now?"
b. "Tell me about a time when you overcame a challenge to accomplish something you really
wanted to achieve."
c. "What factor in your life would most motivate you to work towards weight loss right
now?"
d. "Deciding to improve your health is a great decision - how will you feel when you achieve
this?"
CORRECT ANSWER
B. "Tell me about a time when you overcame a challenge to accomplish something you
really wanted to achieve."
The primary foundation of self-efficacy is mastery experiences. The inquiry inviting the man
to describe a previous experience of overcoming a challenge is a strong invitation to report
a mastery experience. Other options invite him to describe other supportive people or
factors rather than self-efficacy experiences or are likely to negatively impact self-efficacy
due to the practitioner's "cheerleading".
3
@THE STUDY VAULT
, Question 6
When asked a scaling question to assess his confidence to make a lifestyle change, a 48-
year-old man responds that he is "4 out of 10 confident." His health care provider
responds with a follow-up inquiry: "What stops you from being 8 or 9 out of 10?" This
response is an example of which of the following?
a. An invitational challenge
b. Setting a stretch goal
c. The righting reflex
d. Rolling with resistance
CORRECT ANSWER
C. The righting reflex
Miller and Rollnick define the righting reflex as attempts to use an expert stance to urge
patients into change. Such challenges are likely to evoke a self-defensive reaction rather
than further discussion about the possibility of change.
Question 7
A 43-year-old man with type 2 diabetes has had unstable and high hemoglobin A1c
(HbA1c) over a number of years. He has recently moved to another city and is seeing a
new primary care provider. Over the past 12 weeks, his HbA1c has decreased from 7.9% to
6.7%. Which of the following physician attributes would most likely explain this?
a. Insightful reflections of adaptive patient behaviors
b. Highly developed capacity for empathy
c. Autonomy-supportive informational approach
d. Curious open inquiry about the reasons behind fluctuations
CORRECT ANSWER
B. Highly developed capacity for empathy
4
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