CDN CDN Nutrition Counseling & Behavioral Change 1 — Questions and Answers
Question 1: In motivational interviewing (MI), which technique involves reflecting back what a client has said to encourage deeper exploration?
- Open-ended questioning
- Affirmation
- Reflective listening (Correct answer)
- Summarizing
Correct answer: Reflective listening
Reflective listening involves paraphrasing or mirroring the client's statements to demonstrate empathy and promote self-exploration.
Question 2: According to the Transtheoretical Model (Stages of Change), a patient who acknowledges a dietary problem but is not planning to change within the next 30 days is in which stage?
- Precontemplation
- Contemplation (Correct answer)
- Preparation
- Action
Correct answer: Contemplation
Contemplation is characterized by awareness of the problem and ambivalence about change, without commitment to action within 30 days.
Question 3: Which counseling approach is most evidence-based for changing dietary behaviors in patients with chronic disease?
- Didactic nutrition education lectures
- Cognitive-behavioral therapy (CBT) adapted for nutrition (Correct answer)
- Strict meal plans with no patient input
- Supplement-based interventions
Correct answer: Cognitive-behavioral therapy (CBT) adapted for nutrition
CBT for nutrition addresses thought patterns, beliefs, and behaviors that influence food choices, with strong evidence in chronic disease management.
Question 4: A dietitian sets a SMART goal with a client. Which example best illustrates a SMART nutrition goal?
- 'Eat healthier foods every day'
- 'Try to reduce sugar intake'
- 'Replace one sugary beverage with water 5 days per week for the next month' (Correct answer)
- 'Improve overall diet quality'
Correct answer: 'Replace one sugary beverage with water 5 days per week for the next month'
SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound — replacing one sugary drink with water 5 days/week for a month meets all criteria.
Question 5: Which communication style is most likely to increase a patient's resistance to dietary change?
- Asking open-ended questions
- Providing unsolicited advice in a directive tone (Correct answer)
- Affirming the patient's efforts
- Exploring ambivalence collaboratively
Correct answer: Providing unsolicited advice in a directive tone
Unsolicited directive advice creates reactance (psychological resistance), making patients less likely to engage with recommended changes.
Question 6: What does the term 'change talk' refer to in motivational interviewing?
- The dietitian explaining why change is necessary
- The client's own statements about desire, ability, reasons, or commitment to change (Correct answer)
- Written educational materials about dietary change
- Setting a structured meal plan timeline
Correct answer: The client's own statements about desire, ability, reasons, or commitment to change
Change talk refers to client statements that favor change, including desire, ability, reasons, need, and commitment — a key predictor of behavior change outcomes.
CDN CDN Nutrition Counseling & Behavioral Change 1
In motivational interviewing (MI), which technique involves reflecting back what a client has said to encourage deeper exploration?