Lifestyle Medicine Review Questions with
correct answers
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
|| || || || || || || || || ||
ANSWERS ✔✔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.
|| || || || || || ||
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
|| || ||
c. 3.5 times higher
|| || ||
d. 6.2 times higher - CORRECT ANSWERS ✔✔B. 2.3 times higher
|| || || || || || || || || ||
What percentage of US adults with diabetes are unaware that they have it?
|| || || || || || || || || || || ||
a. 27%
||
b. 16%||
c. 23%
||
d. 34% - CORRECT ANSWERS ✔✔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.
|| || || || || || || || || ||
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 - CORRECT ANSWERS ✔✔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).
|| || || || ||
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 ANSWERS ✔✔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".
|| ||
, 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 ANSWERS ✔✔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.
||
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
|| || || || || || || || || ||
ANSWERS ✔✔B. Highly developed capacity for empathy
|| || || || || || ||
correct answers
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
|| || || || || || || || || ||
ANSWERS ✔✔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.
|| || || || || || ||
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
|| || ||
c. 3.5 times higher
|| || ||
d. 6.2 times higher - CORRECT ANSWERS ✔✔B. 2.3 times higher
|| || || || || || || || || ||
What percentage of US adults with diabetes are unaware that they have it?
|| || || || || || || || || || || ||
a. 27%
||
b. 16%||
c. 23%
||
d. 34% - CORRECT ANSWERS ✔✔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.
|| || || || || || || || || ||
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 - CORRECT ANSWERS ✔✔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).
|| || || || ||
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 ANSWERS ✔✔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".
|| ||
, 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 ANSWERS ✔✔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.
||
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
|| || || || || || || || || ||
ANSWERS ✔✔B. Highly developed capacity for empathy
|| || || || || || ||
