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CDE exam question and answers
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CDE exam question and answers14.3% of people with diabetes only successfully achieve target values in which 3 target
areas - ANS-glycemic control, blood pressure, and lipid control
4 critical times to assess, provide, and adjust DSME-s(support), when PCP should refer.
- ANS-1: At diagnosis
2: Annual assessment of education, nutrition, and emotional needs (needs review of
skills, A1c out of target, support for sustained needs, new life situation, changes in
nutrition, activity, meds)
3: When new complicating factors influence self-management (physical limitations
occur, emotional factors such as dep/anx, new health conditions)
4: when transition in care occur (change in living situation, medical care team,
insurance, age-related changes affecting self-care, cognition, etc)
5 Standards for outcomes measurement of DSME - ANS-1) Behavior change is the
unique outcome measurement of DSME (are behaviors changing)
2) 7 diabetes self-care behavior measures determine the effectiveness of DSME at
individual, participant, and population levels (are these behaviors improving/changing)
3) Diabetes self-care behaviors should be evaluated at baseline and then at regular
intervals after the education program.
4) The continuum of outcomes, including learning, behavioral, clinical, and health status
should be assessed to demonstrate the interrelationship between DSME and behavior
change in the care of the pt with diabetes (are outcomes due to DSME or lack of DSME)
5) Pt outcomes are used to guide the intervention and improve care for the patient.
Aggregate population outcomes are used to guide programmatic services and for
continuous quality improvement activities for the DSME and the population it serves
(pt's guide the intervention)
5 step process of DSME - ANS-1: Assessment (arguably the most important step)
2: goal setting
3: planning
4: implementation
5: Evaluation/monitoring
A1c whith combined group and individual education - ANS-Greater A1c reduction when
group and individual ed combined. Even more when education time was more than 10
hours.
, AADE self-care behaviors goal sheet - ANS-tool for tracking knowledge and skills.
Helps address the 7 critical self-care behaviors and keep track of goals and
achievements.
AADE7 Self-Care Behaviors - ANS-Healthy Eating
Being Active
Monitoring
Taking Medication
Problem Solving
Healthy Coping
Reducing Risks
According to the AADE Competencies document, the education plan includes the
following: - ANS-specific outcomes, measurable/behaviorally focused terms, specific
instructional strategies honoring the individual cultural/lifestyle/health beliefs, evaluation
of the plan's effectiveness.
Action PLanning - ANS-Able to decide what steps are needed to achieve particular
goals and then implement these.
ADA A1C goal - ANS-<7% for nonpregnant adult, <7.5 for older/healthy adults, <8% for
complex/intermediate health, <8.5% for very complex/poor health
ADA BP goals - ANS-<140/90
ADA lipid goals - ANS-trigs <150
HDL >40 (M), >50 (W)
LDL goals individualized
Addressing barriers - ANS-Ask the pt, "what is standing in the way of taking care of your
diabetes?
Advantage of group over individual learning - ANS-Group education offered better level
of treatment satisfaction at 1 year with similar glycemic control. Many studies show
group improve metabolic and behavioral measures.
Areas of focus and action in assessment - ANS-1 At Diagnosis: assess cultural
influences, health beliefs, current knowledge, family support, financial status, med
history to provide info on meds, glucose monitoring, physical activity,
preventing/detecting acute/chronic complications, nutrition, risk reduction,
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