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CDE Practice Exam Questions #3
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CDE Practice Exam Questions #3
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CDE Practice Exam Questions #3"I just can't stand testing my bg, although I have to admit that when I do and the number
is high, I act on it right away." Which of the following is the best example of "developing
discrepancy" by the educator?
A. "Just be glad that we have the meters we do today. Back in the day, it took more than
a minute to get the result and you needed a much bigger drop of blood, which meant a
much more painful finger poke!"
B. "It sounds like you are dealing with some serious obstacles when it comes to self
monitoring, yet I also sense that when you do test, you are able to use the information
to help you correct high bg when needed. What effect do you think those corrections will
have on your health in the long run?"
C. "It is just one of those things that people with diabetes have to deal with. Trust me,
you are not alone - almost none of my pts enjoy testing their bg, and I tell them the
same thing I'm telling you."
D. " Gr - ANS-B. "It sounds like you are dealing with some serious obstacles when it
comes to self monitoring, yet I also sense that when you do test, you are able to use the
information to help you correct high bg when needed. What effect do you think those
corrections will have on your health in the long run?"
"The systematic process by which the worth or value of something, in the case of DSME
teaching or learning is judged" is known as which of the following?
A. Evaluation
B. Documentation
C. Planning
D. Implementation - ANS-A. Evaluation
A 59 year old single female with T2DM admits that she only takes half of her
recommended Januvia (sitagliptin) tablet, but does take her full metformin tablet. She
later tells you that she has added more vegetables to her meals, but only canned
vegetables. Based on these brief statements, what barrier do you believe is MOST likely
a concern for this pt?
A. Transportation
B. Cultural
C. Cognitive ability
D. Financial - ANS-D. Financial
,A member of the DMSE class group asks a specific question about food choices during
session one. You typically address healthy eating in session two. What is the best way
to handle the situation?
A. In order to capitalize on the apparent interest, abandon the present order of classes.
Talk about food today and discuss the session one material next time
B. Take a few minutes to briefly answer the question; acknowledge that many in the
group likely have questions about food, and promise that this will be addressed in
greater detail as part of the next session
C. Tell the client that if he will be patient and remember his question for next session,
you will promise to address it first thing
D. Politely explain that there is a specific order in which the information needs to be
presented to make the most sense. Ask him to limit his questions to the topic at hand
but let him know that he may ask you one on one after class - ANS-B. Take a few
minutes to briefly answer the question; acknowledge that many in the group likely have
questions about food, and promise that this will be addressed in greater detail as part of
the next session
A new pt reports that she is not sure what type of diabetes she has because no one has
ever giver her a clear answer. She is 46 year old and Caucasian with a BMI of 20. She
states that she has always been thin and active, and that no one in her family has
diabetes that she knows of. With the exception of her father, who has rheumatoid
arthritis and psoriasis, her family history is unremarkable. She was diagnosed with
diabetes two years ago and claims she is able to keep her bg in the normal range with a
careful low carb diet. When you check her labs, you see that her last A1c was 6.4% and
her c-peptide level was on the low end of normal. Labs are also positive for GAD and
islet cell antibodies. What type of diabetes does this pt most likely have?
A. T2DM
B. T1DM
C. Latent autoimmune diabetes of adulthood (LADA)
D. Maturity onset diabetes of the young - ANS-C. Latent autoimmune diabetes of
adulthood (LADA)
LADA is characterized by positive GAD/islet cell antibodies, a normal to low c-peptide
level, and can often be managed with diet in the beginning months or years.
A pt comes into your clinic to sign up for diabetes education classes. He tells you that
he has had diabetes for 12 years but did not want to face his diagnosis. Now, after
seeing how he is unable to keep up with his grandchildren, he has realized the need to
make some changes and control his bg. What stage of change most accurately
describes the pt's state?
A. Precontemplation
,B. Contemplation
C. Preparation
D. Action - ANS-C. Preparation
A pt in your DSME group asks why a person cannot use oral medication to treat T1DM.
Which is the most accurate and appropriate response?
A. "Because T2DM is brought on by wt, and weight gain is a side effect of insulin, we
avoid using insulin in those with T2DM while we prefer it for those with T1DM, who are
typically underweight."
B. "Everyone needs insulin to live. In T2DM, the insulin producing cells (beta cells) may
still be working somewhat but not well enough to keep bg normal. Oral medications help
the body's insulin to work better. In T1DM, the body has destroyed its own beta cells
and so we must use insulin from an outside source."
C. "T1DM is a more severe form of diabetes, and therefore, we go straight for the most
potent medication. T2DM, on the other hand, is less severe and can be minimized by
lifestyle changes, and so there are "less drastic" medication options."
D. "Because T2DM is characterized by in - ANS-B. "Everyone needs insulin to live. In
T2DM, the insulin producing cells (beta cells) may still be working somewhat but not
well enough to keep bg normal. Oral medications help the body's insulin to work better.
In T1DM, the body has destroyed its own beta cells and so we must use insulin from an
outside source."
A pt states that he has a goal of getting his A1C to below 7% by the end of the year. He
worries that having is high as it is now (7.9%) puts him at risk for complications. You
notice his weight has been increasing. He admits that with his new job, he has not had
time to work out at the gym and has been snacking a lot, due to stress. Which of the
following actions would be a BEST next step with this pt?
A. Discuss the increased risks of having an A1C above 7%
B. Ask open-ended questions that may help the pt identify some short-term goals that
will help lower his A1C
C. Lay out a daily schedule for the pt that facilitates his return to exercising, which will
be sufficient to lower bg w/o increasing his medication
D. Explore why he eats when stressed and suggest some stress reduction exercises
that he can do at work - ANS-B. Ask open-ended questions that may help the pt identify
some short-term goals that will help lower his A1C
A pt tells you that she is very worried about "dropping too low" at night and therefore
eats a bowl of ice cream every night and only takes a half dose of her nighttime basal
insulin. Because this results in high fasting AM bgs, she has quit testing in the morning
, because she is not willing to increase her basal insulin anyway. What mental health
issue does this pt exhibit?
A. Depression
B. Eating disorder
C. Denial
D. Anxiety - ANS-D. Anxiety
Anxiety is manifested by taking extreme measures to avoid a feared outcome.
A pt who has identified himself as a visual learner would likely most prefer which
method of instruction?
A. Role-playing a scenario in which he orders a balanced meal at a restaurant
B. Seeing pictures of food portions followed by booklets on meal planning
C. A spoken explanation of how to adjust insulin depending on pre-meal glucose
D. Group discussion on challenges relating to dealing with the stress of diabetes -
ANS-B. Seeing pictures of food portions followed by booklets on meal planning
A pt who is reluctant to attend DSME class states the reason as, "I already know all this
stuff." In light of his learning readiness, what would be the MOST appropriate action?"
A. Tell him that if he changes his mind, he may call you at anytime. Document his
refusal to participate.
B. Give him a pop quiz with challenging diabetes knowledge questions to help him see
that he does not know everything
C. Acknowledge his reluctance and ask if he might be willing to share some of his
knowledge and experiences with the other class members
D. Change the subject to minimize conflict and then speak with his wife to see if she
might have better luck convincing him - ANS-C. Acknowledge his reluctance and ask if
he might be willing to share some of his knowledge and experiences with the other
class members
A pt with GDM is convinced she developed GDM from eating too much of her favorite
food - popcorn - early in her pregnancy. She insists that if she does not eat any again
during her pregnancy, she will not have to start insulin and her bg values will return to
normal. What emotional stage associated with chronic disease diagnosis (similar to
Kubler-Ross stages of grief) do you assess in your pt?
A. Denial
B. Anger
C. Bargaining
D. Frustration and depression - ANS-C. Bargaining
The bargaining stage is characterized by inaccurate explanations and /or erroneous
cures. The pt "makes a deal" with self, provider, God, or others to get rid of the
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