BC ADM Psychosocial Support & Care Coordination 4 — Questions and Answers
Question 1: A patient with type 2 diabetes has poorly controlled A1C despite reporting adherence. During the visit, you learn they work night shifts. Which psychosocial and practical factor should be addressed first?
- Recommend the patient change careers for better health
- Explore how shift work affects sleep, meals, and medication timing (Correct answer)
- Add a second oral agent without further assessment
- Refer to endocrinology without gathering more history
Correct answer: Explore how shift work affects sleep, meals, and medication timing
Shift work disrupts circadian rhythms, eating patterns, and medication schedules, all of which can significantly impair glycemic control.
Question 2: When a patient with diabetes and depression is being comanaged, which outcome should the diabetes care specialist monitor in addition to glycemic parameters?
- Serum cortisol levels monthly
- Depression symptom scores and medication adherence (Correct answer)
- Weekly weight measurements exclusively
- Quarterly liver function tests
Correct answer: Depression symptom scores and medication adherence
Depression significantly impairs self-management, so monitoring symptom scores and adherence is essential to integrated diabetes-depression comanagement.
Question 3: In a patient with diabetes who is experiencing grief after a recent loss, the most appropriate psychosocial approach is to:
- Focus exclusively on optimizing A1C until the grief resolves
- Acknowledge the loss, offer support, and adjust short-term self-management goals accordingly (Correct answer)
- Withhold diabetes education until the grief period has passed
- Increase visit frequency only for lab monitoring without addressing emotional needs
Correct answer: Acknowledge the loss, offer support, and adjust short-term self-management goals accordingly
Acute grief can temporarily impair self-management capacity; acknowledging emotional needs and adjusting goals compassionately supports continued engagement.
Question 4: The AADE7 Self-Care Behaviors framework includes which of the following psychosocial domain?
- Optimizing surgical readiness
- Healthy coping (Correct answer)
- Preventing occupational stress
- Improving sleep architecture
Correct answer: Healthy coping
Healthy coping is one of the seven AADE7 Self-Care Behaviors, recognizing that psychological well-being is integral to effective diabetes self-management.
Question 5: A patient declines referral to a mental health professional despite signs of significant diabetes distress. The most appropriate next step is to:
- Document the refusal and take no further action
- Respect the decision while continuing to offer support and revisit at future visits (Correct answer)
- Mandate a mental health evaluation as a condition of continued diabetes care
- Discontinue diabetes education until the patient agrees to counseling
Correct answer: Respect the decision while continuing to offer support and revisit at future visits
Respecting patient autonomy while keeping the door open for future referral maintains the therapeutic alliance and allows for reconsideration over time.
Question 6: Which of the following factors is MOST associated with poor glycemic outcomes in adolescents with type 1 diabetes?
- Excessive physical activity
- Family conflict and lack of parental involvement in diabetes management (Correct answer)
- High socioeconomic status
- Frequent use of continuous glucose monitoring
Correct answer: Family conflict and lack of parental involvement in diabetes management
Family conflict and decreased parental involvement are strongly linked to poorer glycemic control and adherence in adolescents with type 1 diabetes.
Question 7: A community health worker (CHW) is part of the diabetes care team. Their primary role is to:
- Prescribe diabetes medications in underserved communities
- Bridge cultural and logistical gaps between patients and the healthcare system (Correct answer)
- Perform point-of-care A1C testing independently
- Replace the diabetes educator in low-resource settings
Correct answer: Bridge cultural and logistical gaps between patients and the healthcare system
CHWs serve as trusted liaisons who connect patients to resources, address social barriers, and reinforce care team guidance in community settings.
BC ADM Psychosocial Support & Care Coordination 4
A patient with type 2 diabetes has poorly controlled A1C despite reporting adherence.
During the visit, you learn they work night shifts.
Which psychosocial and practical factor should be addressed first?