CDCES Exercise and Physical Activity Management 3

Question 1

A patient planning to exercise for 60 minutes at moderate intensity asks about carbohydrate supplementation.
Approximately how many grams of carbohydrate per hour are generally recommended to prevent hypoglycemia during sustained aerobic exercise in insulin-treated diabetes?

Accepted Answer

15–30 grams per hour

Answer

5–10 grams per hour

Answer

45–60 grams per hour

Answer

70–90 grams per hour

Question 2

Which physical activity recommendation is most appropriate for a patient with diabetic nephropathy (CKD stage 3) who wants to improve fitness?

Accepted Answer

Moderate aerobic and resistance exercise is safe and beneficial, with attention to hydration

Answer

Avoid all exercise to prevent further kidney damage

Answer

Exercise only at sub-maximal intensity above the anaerobic threshold

Answer

High-intensity plyometrics three times per week

Question 3

What is the recommended maximum number of consecutive days without exercise for adults with diabetes, per ADA guidelines, to maintain glycemic benefits?

Accepted Answer

2 days

Answer

1 day

Answer

3 days

Answer

5 days

Question 4

For patients who are sedentary or have mobility limitations, which activity can serve as an effective substitute for traditional aerobic exercise to improve glycemic control?

Accepted Answer

Breaking up prolonged sitting with brief bouts of light walking or leg lifts every 30 minutes

Answer

Controlled deep breathing exercises

Answer

Passive massage therapy

Answer

Meditation for 20 minutes daily

Question 5

A CDCES is helping a patient interpret post-exercise blood glucose readings. The patient reports that blood glucose was 140 mg/dL immediately after exercise but 68 mg/dL two hours later. What is the most likely explanation?

Accepted Answer

Continued glucose uptake by muscles to replenish glycogen stores after exercise

Answer

Insulin resistance caused by the exercise

Answer

A delayed gastric emptying effect from a pre-exercise meal

Answer

Counter-regulatory hormone rebound

Question 6

When counseling a patient about exercising safely in hot weather, which diabetes-specific concern should the CDCES emphasize most strongly?

Accepted Answer

Sweating can be impaired by autonomic neuropathy, increasing the risk of hyperthermia

Answer

Heat causes insulin resistance and high blood glucose

Answer

Sunlight exposure increases vitamin D and lowers blood glucose unpredictably

Answer

Heat causes ketone production similar to illness

Question 7

A CDCES is advising a patient with type 2 diabetes who takes a sulfonylurea and wants to start exercising. What is the most important hypoglycemia-related counseling point specific to this medication class?

Accepted Answer

Sulfonylureas stimulate insulin secretion regardless of blood glucose, increasing hypoglycemia risk with exercise

Answer

Sulfonylureas increase insulin resistance during exercise

Answer

Sulfonylureas must be discontinued before any exercise program

Answer

Sulfonylureas cause rebound hyperglycemia after exercise