CWP Assessment and Diagnosis 3 — Questions and Answers
Question 1: A practitioner uses the PROMIS (Patient-Reported Outcomes Measurement Information System) framework. What is a key advantage of PROMIS over legacy fixed-length questionnaires?
- It is restricted to physical health domains only
- It uses computerized adaptive testing to reduce item burden (Correct answer)
- It requires physician administration
- It produces diagnoses rather than functional scores
Correct answer: It uses computerized adaptive testing to reduce item burden
PROMIS uses computerized adaptive testing (CAT), which tailors questions to the individual's responses, providing precise scores with fewer items.
Question 2: When assessing a client's social determinants of health (SDOH), which tool is commonly recommended in primary care wellness settings?
- GAD-7 generalized anxiety scale
- PRAPARE (Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences) (Correct answer)
- YMCA step test
- Borg RPE scale
Correct answer: PRAPARE (Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences)
PRAPARE is a standardized SDOH screening tool endorsed by the National Association of Community Health Centers for identifying social needs.
Question 3: In wellness assessment, the term 'allostatic load' refers to which concept?
- The maximum aerobic capacity achievable under ideal conditions
- The cumulative physiological wear and tear from chronic stress adaptation (Correct answer)
- A measure of dietary inflammatory burden
- The threshold at which homeostasis breaks down acutely
Correct answer: The cumulative physiological wear and tear from chronic stress adaptation
Allostatic load quantifies the cumulative physiological toll of chronic stress exposure and failed adaptation across multiple body systems.
Question 4: A client scores 16 on the PHQ-9. How should a wellness practitioner respond to this result?
- Integrate mindfulness exercises and monitor
- Refer to a licensed mental health professional immediately (Correct answer)
- Proceed with standard wellness programming without modification
- Repeat the PHQ-9 in 30 days before acting
Correct answer: Refer to a licensed mental health professional immediately
A PHQ-9 score of 16 indicates moderately severe depression, which is beyond a wellness practitioner's scope and requires referral to a licensed mental health clinician.
Question 5: Which method is considered the criterion standard for measuring body composition in research settings?
- Bioelectrical impedance analysis (BIA)
- Skinfold calipers (Jackson-Pollock)
- Dual-energy X-ray absorptiometry (DEXA) (Correct answer)
- Body mass index (BMI) calculation
Correct answer: Dual-energy X-ray absorptiometry (DEXA)
DEXA is considered the gold standard for body composition assessment, providing precise measures of fat mass, lean mass, and bone mineral density.
Question 6: The 'iceberg profile' in psychological wellness assessment describes which pattern?
- High tension and depression with low vigor
- Elevated vigor with below-average negative mood states (Correct answer)
- Equal scores across all POMS subscales
- High fatigue paired with high motivation
Correct answer: Elevated vigor with below-average negative mood states
The iceberg profile describes mentally healthy individuals who score high in vigor and below the population mean on negative mood states like tension, depression, and fatigue.
Question 7: A wellness practitioner notices a client's resting heart rate has increased by 8 bpm over three consecutive weekly measurements despite consistent training. This finding most likely indicates:
- Improved cardiovascular fitness
- Overtraining or inadequate recovery (Correct answer)
- Normal physiological adaptation
- Measurement error only
Correct answer: Overtraining or inadequate recovery
A sustained elevation in resting heart rate despite regular training is a key indicator of overtraining syndrome or insufficient recovery, warranting program modification.
CWP Assessment and Diagnosis 3
A practitioner uses the PROMIS (Patient-Reported Outcomes Measurement Information System) framework.
What is a key advantage of PROMIS over legacy fixed-length questionnaires?