CDCES study practice questions &
answers with rationales.,
What is the first step in the process of diabetes self management education?
a. assessment
b. goal setting
c. diagnosis
d. referral - CORRECT ANSWER>>a. assessment
the steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
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 - CORRECT ANSWER>>c. keeping a PA log is associated w/ higher
level of self efficacy
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 -
CORRECT 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.
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
d. printed handout w/ pics depicting steps of insulin admin, followed by
verbal acknowledgement of understanding. - CORRECT ANSWER>>b.
demonstration and return demonstration of insulin admin
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 - CORRECT ANSWER>>c. cultural
characteristics/barriers of the population
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%
- CORRECT 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
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 - CORRECT
ANSWER>>a. providing materials and experiences that enhance her
knowledge and skills
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 - CORRECT ANSWER>>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 patient's typical s/s w/ hypos
, b. current pt physical/glycemic status (wt, BMI, A1c)
c. timing and content of meals (ie carbs) in relation to activity
d. med regimen- types, dosing, timing - CORRECT ANSWER>>d. med regimen-
types, dosing, 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. pt becomes tearful as the educator explains how to keep a food diary
b. pt watches a demo but does not say anything
c. pt volunteers to answer a review question at the end of class but gets the
answer wrong
d. pt denies dm dx and disagrees w/ the dr's referral for DSME - CORRECT
ANSWER>>d. pt denies dm dx and disagrees w/ the dr's referral for DSME
according to ADA standards, which statement is not true regarding MNT and
diabetes?
a. MNT is recommended only for those w/ dm who are over/underwt or
obese
b. MNT is recommended for anyone w/ dm, regardless of nutritional status
c. children w/ dm and celiac disease should consult w/ a RD familiar w/ both
conditions
d. bc nutrition in the hospital setting is complex, an RD should be part of the
inpatient dm care team to provide MNT - CORRECT ANSWER>>a. MNT is
recommended only for those w/ dm who are over/underwt or obese
a dm educator is assessing a patient's BG monitoring technique by having
them demo a BG test. Which of the following actions is indicative of
improper technique?
a. cleaning hands w/ warm water and soap instead of etoh
b. setting lancet to her preference
c. milking lanced finger at the tip to acquire sufficient blood sample
answers with rationales.,
What is the first step in the process of diabetes self management education?
a. assessment
b. goal setting
c. diagnosis
d. referral - CORRECT ANSWER>>a. assessment
the steps in order are: assessment, goal setting, planning, implementation,
evaluation/monitoring
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 - CORRECT ANSWER>>c. keeping a PA log is associated w/ higher
level of self efficacy
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 -
CORRECT 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.
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
d. printed handout w/ pics depicting steps of insulin admin, followed by
verbal acknowledgement of understanding. - CORRECT ANSWER>>b.
demonstration and return demonstration of insulin admin
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 - CORRECT ANSWER>>c. cultural
characteristics/barriers of the population
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%
- CORRECT 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
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 - CORRECT
ANSWER>>a. providing materials and experiences that enhance her
knowledge and skills
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 - CORRECT ANSWER>>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 patient's typical s/s w/ hypos
, b. current pt physical/glycemic status (wt, BMI, A1c)
c. timing and content of meals (ie carbs) in relation to activity
d. med regimen- types, dosing, timing - CORRECT ANSWER>>d. med regimen-
types, dosing, 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. pt becomes tearful as the educator explains how to keep a food diary
b. pt watches a demo but does not say anything
c. pt volunteers to answer a review question at the end of class but gets the
answer wrong
d. pt denies dm dx and disagrees w/ the dr's referral for DSME - CORRECT
ANSWER>>d. pt denies dm dx and disagrees w/ the dr's referral for DSME
according to ADA standards, which statement is not true regarding MNT and
diabetes?
a. MNT is recommended only for those w/ dm who are over/underwt or
obese
b. MNT is recommended for anyone w/ dm, regardless of nutritional status
c. children w/ dm and celiac disease should consult w/ a RD familiar w/ both
conditions
d. bc nutrition in the hospital setting is complex, an RD should be part of the
inpatient dm care team to provide MNT - CORRECT ANSWER>>a. MNT is
recommended only for those w/ dm who are over/underwt or obese
a dm educator is assessing a patient's BG monitoring technique by having
them demo a BG test. Which of the following actions is indicative of
improper technique?
a. cleaning hands w/ warm water and soap instead of etoh
b. setting lancet to her preference
c. milking lanced finger at the tip to acquire sufficient blood sample
