CDE Patient Education 4 — Questions and Answers
Question 1: A patient who has had diabetes for 15 years says they 'know everything already' and resists education. The best approach is to:
- Agree and skip the education session
- Acknowledge their experience, ask what concerns them most, and identify any knowledge gaps collaboratively (Correct answer)
- Insist they complete the full standardized curriculum
- Document their refusal and take no further action
Correct answer: Acknowledge their experience, ask what concerns them most, and identify any knowledge gaps collaboratively
Validating the patient's experience while exploring their current concerns and gaps opens a respectful dialogue and may reveal outdated beliefs or new educational needs.
Question 2: When teaching carbohydrate counting to a patient with type 1 diabetes, the educator should FIRST assess:
- Whether the patient owns a food scale
- The patient's current understanding of carbohydrates and their reading/math skills (Correct answer)
- The patient's preference for a specific meal plan
- Whether the patient's insurance covers nutrition counseling
Correct answer: The patient's current understanding of carbohydrates and their reading/math skills
Carbohydrate counting requires numeracy and literacy skills; assessing baseline knowledge and abilities allows the educator to tailor the approach appropriately.
Question 3: Which behavior is the MOST important to teach a patient newly started on basal-bolus insulin therapy?
- How to adjust their basal insulin dose independently based on meals
- How to recognize and treat hypoglycemia (Correct answer)
- How to skip bolus doses when not hungry
- How to reduce insulin during periods of stress
Correct answer: How to recognize and treat hypoglycemia
Hypoglycemia recognition and treatment is a critical safety skill for any patient on insulin, especially when initiating complex regimens.
Question 4: A patient with diabetes says they cannot afford their glucose meter strips. The most appropriate educator response is:
- Tell the patient monitoring is optional if they feel well
- Explore financial assistance programs, manufacturer coupons, and lower-cost testing options (Correct answer)
- Recommend they monitor only monthly to conserve strips
- Suggest they estimate glucose levels by how they feel
Correct answer: Explore financial assistance programs, manufacturer coupons, and lower-cost testing options
Addressing financial barriers through assistance programs and alternative options supports continued self-monitoring without dismissing the patient's concern.
Question 5: During education on alcohol and diabetes, the educator should teach the patient that alcohol consumption can cause:
- Immediate hyperglycemia in all patients with diabetes
- Delayed hypoglycemia, especially in patients taking insulin or sulfonylureas (Correct answer)
- Improved insulin sensitivity for up to 24 hours
- No significant effect on blood glucose if consumed with food
Correct answer: Delayed hypoglycemia, especially in patients taking insulin or sulfonylureas
Alcohol inhibits hepatic glucose production and can cause delayed hypoglycemia, particularly in patients on insulin or sulfonylureas, sometimes hours after drinking.
Question 6: Which of the following BEST demonstrates the teach-back method?
- 'Do you understand how to take your insulin?'
- 'Can you show me how you would draw up and inject your insulin dose?' (Correct answer)
- 'Here is a pamphlet that explains insulin injection technique'
- 'Your nurse will review insulin technique with you at home'
Correct answer: 'Can you show me how you would draw up and inject your insulin dose?'
Asking the patient to demonstrate the skill (return demonstration) confirms actual competency rather than self-reported understanding.
Question 7: A patient with diabetes who works night shifts reports difficulty managing blood glucose. The educator's BEST response is to:
- Advise the patient to change to a daytime work schedule
- Collaboratively develop a schedule-adapted meal and monitoring plan that accounts for shift timing (Correct answer)
- Simplify their regimen by eliminating bolus insulin
- Refer the patient directly to an endocrinologist without further discussion
Correct answer: Collaboratively develop a schedule-adapted meal and monitoring plan that accounts for shift timing
Adapting the management plan to the patient's real-world schedule improves adherence and glucose control without requiring unrealistic lifestyle changes.
CDE Patient Education 4
A patient who has had diabetes for 15 years says they 'know everything already' and resists education.
The best approach is to: