CDE Behavioral Strategies 5 — Questions and Answers
Question 1: A patient consistently resists dietary changes despite agreeing in appointments. This pattern is best understood as which concept in behavioral science?
- Motivational deficit
- Intention-behavior gap (Correct answer)
- Cognitive dissonance resolution
- Learned helplessness
Correct answer: Intention-behavior gap
The intention-behavior gap describes the common disconnect between stated intentions and actual behavior, often due to environmental or emotional barriers.
Question 2: In motivational interviewing, when a patient begins to verbalize reasons for making a change on their own, this is referred to as:
- Reflective listening output
- Change talk (Correct answer)
- Readiness signaling
- Autonomy affirmation
Correct answer: Change talk
Change talk is patient-generated language expressing desire, ability, reason, or commitment to change, and is a key predictor of behavior change.
Question 3: Which environmental modification strategy is most effective for improving dietary behavior in patients with diabetes?
- Providing a list of forbidden foods
- Restructuring the home food environment to make healthier options more accessible (Correct answer)
- Encouraging willpower-based resistance to unhealthy foods
- Prescribing a rigid 1,200-calorie meal plan
Correct answer: Restructuring the home food environment to make healthier options more accessible
Environmental restructuring—such as keeping vegetables cut and at eye level—reduces reliance on willpower by making the healthy choice the easy choice.
Question 4: A diabetes educator notices a patient avoids discussing hypoglycemia experiences. The most likely behavioral explanation is:
- The patient believes hypoglycemia is not relevant to their care
- The patient may have hypoglycemia-related anxiety or fear of judgment (Correct answer)
- The patient is unaware hypoglycemia is a concern
- The patient's literacy prevents understanding the topic
Correct answer: The patient may have hypoglycemia-related anxiety or fear of judgment
Fear of hypoglycemia is a recognized psychological barrier that leads to avoidance behaviors, including under-reporting episodes to healthcare providers.
Question 5: Relapse prevention in diabetes behavioral education primarily involves teaching patients to:
- Strictly avoid any lapse in self-management behaviors
- Recognize high-risk situations and develop plans to recover quickly after setbacks (Correct answer)
- Increase medication doses following a behavioral lapse
- Report lapses immediately to their care team for disciplinary review
Correct answer: Recognize high-risk situations and develop plans to recover quickly after setbacks
Relapse prevention focuses on identifying triggers and building recovery plans so patients view setbacks as learning opportunities rather than failures.
Question 6: Which behavioral strategy is most appropriate for a patient who is in the maintenance stage of the Transtheoretical Model?
- Explore ambivalence about change
- Set initial short-term behavior goals
- Provide relapse prevention strategies and reinforce self-efficacy (Correct answer)
- Conduct motivational interviewing to build readiness
Correct answer: Provide relapse prevention strategies and reinforce self-efficacy
Patients in maintenance have already changed their behavior and need strategies to sustain it and prevent relapse over the long term.
Question 7: A patient with diabetes who recently immigrated to the US is having difficulty adhering to dietary recommendations. The educator's most culturally competent approach is to:
- Provide a standard American Diabetes Association meal plan
- Explore the patient's traditional foods and collaboratively adapt recommendations to fit their culture (Correct answer)
- Refer the patient to a dietitian specializing in Western nutrition
- Simplify recommendations to reduce cultural conflict
Correct answer: Explore the patient's traditional foods and collaboratively adapt recommendations to fit their culture
Culturally tailored dietary guidance that incorporates familiar foods improves adherence by respecting the patient's identity and reducing the burden of change.
CDE Behavioral Strategies 5
A patient consistently resists dietary changes despite agreeing in appointments.
This pattern is best understood as which concept in behavioral science?