Motivating Patients & Lifestyle Changes Post-Test

Question 1 of 14

1. Question

Harry Mason (BMI 30.4 kg/m2) drinks a lot of sodas and eats sugary snacks but skips lunch. Which of
the following would be the best suggestion for improving his diet?

Skip breakfast instead of lunch.
Skip breakfast instead of lunch.
Go on meal replacements.
Switch to diet sodas.

Question 2 of 14

2. Question

38-year-old Fred McMurray was overweight 2 years ago and now is mildly obese (BMI=31 kg/m2). So
far, he has no known obesity-related comorbidities. Does he meet criteria to recommend an intense, 6-
month program to support comprehensive lifestyle change for weight loss?

No, because he only has mild obesity
No, because he does not have a weight-related
comorbidity
No, because he has not been obese for very long
Yes, he meets criteria for this treatment
recommendation

Question 3 of 14

3. Question

Which of the following best describes patients who should, in addition to diet and exercise, be referred for structured weight-loss programs or professional weight-loss supports?

At least moderately overweight or overweight with either a comorbid weight-related condition or
failing to lose weight with diet/exercise changes.
At least obese and failed to lose weight with diet/exercise changes
At least obese or moderately overweight with weight-related comorbidity
At least overweight and failed to respond to diet/exercise changes

Question 4 of 14

4. Question

Roger Thomas achieved his final weight-loss goal of 50 pounds but did not return for follow-up appointments. When he finally returned, he had regained 15 pounds and was upset. Which is the best response to support him in the maintenance stage?

Reassure him that a small weight regain is typical after a large weight loss.
Recommend adjustments in his daily caloric intake, activity level, and behavioral support as
needed.
Add a pharmacological weight loss treatment.
Advise him that a 15 lb gain is not significant for his health.

Question 5 of 14

5. Question

Harry Mason (BMI 30.4 kg/m2) sits on his couch most of the time, but has started to walk 15 minutes per day. If he increases to 22 minutes per day, would he meet all recommendations for a healthy level of physical activity?

Yes, 20 minutes per day of physical activity, even at low intensity, would meet all
recommendations for a healthy level of physical activity.
15 minutes per day was already enough physical activity if it is moderately intense.
No, he would need to add activity to become less sedentary throughout the day, too.
22 minutes per day would be enough, but only if performed at moderate intensity.

Question 6 of 14

6. Question

You have counseled Delonte Stevens about his obesity over the years without long-lasting success. He sounds aggravated when you bring up the topic again. Of the following, which is the best way, following motivational interviewing principles, to respond to the discord?

“I can understand you might feel annoyed that I keep bringing this up, but as your health provider, I’d be remiss if I didn’t.”
“Since the last time we talked, there’s a new treatment that is more likely to work for you.”
“I don’t want to force you to talk about it, so we can skip it if you like.”
“As I’ve been telling you, the health benefits of weight loss are important.”

Question 7 of 14

7. Question

Gregory Walker has been slowly gaining weight in his 40s and now is slightly obese. He also has dyslipidemia, hypertension, and a family history of heart disease. Of the choices listed below, which diet best addresses his comorbid conditions?

Recommend that he count calories carefully and reduce them by around 200 calories per day.
Recommend that he eat smaller portions of what he normally eats.
Recommend that he substitute a low calorie, high protein energy bar for one meal per day.
Recommend that he consider a weight-loss version of the Mediterranean or DASH diets.

Question 8 of 14

8. Question

James Carter has maintained an obese weight while eating 2900 calories per day. He started counting calories using an online diary but wants to know a specific number of calories by which he should reduce his daily caloric intake to lose weight. Which of the following responses is best if he maintains the same level of activity?

Reducing daily calories by 500 per day will typically produce a 2 pound average weight loss per week in the first month or two.
Eat 400 to 800 calories per day for 6 months then gradually increase calories, stopping if he starts to gain weight.
Counting calories is likely to backfire because it will have him thinking about food too much of the time.
The caloric deficit needed per day to lose weight varies significantly with weight and age.

Question 9 of 14

9. Question

Mary is a new patient who is overweight and hypertensive. Which of the following topics are important to include in a motivational approach to discussing weight loss with her?

Importance of losing weight for her health
How confident she is that she can make changes needed to lose weight
How ready she is to make changes needed to lose weight
All of the above

Question 10 of 14

10. Question

After getting patient Anna Stone’s permission to talk about her weight, you explain the health consequences of her excess weight and the benefit for her health of losing weight. The dialogue continues:

Provider:Â Would you be open to trying to lose weight?

Ms. Stone:Â I guess so…

Which of the following statements is the best motivational approach to continuing the dialogue?

“I recommend we set a goal of your losing around 5% of your weight at first.”
“Come on, let’s have some more enthusiasm! I think you can do it.”
“Small changes will make a difference. You could cut back by just 500 calories a day and would lose a pound a week.”
“How confident are you that you could make the changes in your diet that would be needed?”

Question 11 of 14

11. Question

Susan Taylor is overweight. Her diet includes a lot of high-fat fast food and few vegetables because she does not have time to prepare healthy food. She became overwhelmed by counting points in one diet plan. Which of the following recommendations is best tailored to her situation?

Count calories carefully and reduce them by around 400 calories per day.
Make foods on the DASH diet ahead of time in order to readily have them available throughout the week.
Identify relatively healthier substitutions for fast food.
Use very low calorie meal replacements (400 to 800 calories per day) for around 6 weeks.

Question 12 of 14

12. Question

Patient Abby Peterson, explains:

â€œI want to lose weight, but it’s hard to read food labels and takes too much time to calculate my calories everyday. I often go over my calorie count and feel like a failure.â€

Which of the following suggestion is best to support her in her diet attempts?

Educate her about portion control and how to determine portions visually.
Suggest that she look into prepared, nutritious meals with calorie counts on the packages.
Recommend that she plan her meals a day in advance so she can avoid going over her calorie limit.
All of the above

Question 13 of 14

13. Question

Elma Taylor seems resistant to talking about a weight-loss plan. She describes reasons weight-loss attempts would not work. You have tried brainstorming ideas to get around barriers and suggesting small steps to take, but she says, â€œThat won’t work for me.â€ Which of the following techniques best follows motivational interviewing principals to break through her resistance?

“I get frustrated from making suggestions when you reject all of them.”
“That may be. It may not work for you.”
“It seems like you don’t really want to lose weight. Do you?”
“It has worked for countless other patients of mine.”

Question 14 of 14

14. Question

Which patients meet guidelines for having some behavioral support in addition to diet and physical activity modifications to lose weight?

BMI=32 kg/m2, no weight-related comorbidities
BMI=28 kg/m2, controlled hypertension
BMI=29 kg/m2, no weight-related comorbidities
All of the above
None of the above