Ifeoma Monye - Lifestyle Medicine

14 Thomas is considering becoming more active within the next 30 days to tackle his obesity. Which of these will be the most appropriate action?Check his level of confidence in his ability to carry out his plansDiscuss health risk associated with specific behaviourGive him a lifestyle prescriptionUse CBT to reframe unhealthy thought patterns

15 You are worried that Gabriel still smokes heavily despite his COPD. However, he tells you categorically that he is not willing to give up this habit. Which of these is the most appropriate action for his stage of readiness?You ask the patient to write down his unwillingness to change despite medical adviceYou provide a general healthy lifestyle adviceYou try some CBT techniques to see if you might change his mindYou try to problem‐solve his barriers to stopping smoking

16 Mike tells you that he is already making a change to tackle his unhealthy eating habits. Which of these is the most appropriate next step in his management?Develop a relapse prevention plan if he has been making the change for three monthsDiscuss health risks associated with his unhealthy eating habitGive him an action plan if he is not meeting his goal yetUse CBT to reframe any unhealthy thought patterns

17 Which of the following best describes the stages of readiness?CBT methods work best when started earlyPatients need one month of coaching to complete each stagePositive psychology is counterproductive at the beginning stageThe goal is to move the patient from his current level of readiness to the next stage

18 Which of the following would be most appropriate to include in Health Behaviour Change Readiness tool which a patient could fill while in the waiting room?An assessment of the patient’s confidence that he can improve his nutritionAn assessment of the patient’s marital status and political inclination An assessment of the patient’s perceived importance of lifestyle medicineAn assessment of the patient’s perceived importance of their intellectual abilities

19 Readiness for a change in health behaviour is best determined by which of the following?The doctor’s track record skill of motivational interviewingThe government’s motivations for recommending the changeThe importance the society attaches to the changeThe patient’s confidence level in making the change

20 Which of these is the most appropriate feature of a health behaviour change assessment tool?Patient’s cultural backgroundPatient’s literacy levelPatient’s marital statusPatient’s responses prioritize areas for discussion

21 To facilitate the ‘Coach’ mindset of the Physician, which of the following is the most appropriate recommendation?Be open and compassionateCompel the patient to write his goals downOffer a congratulatory hug to patients for each goal achievedSend a copy of his action plan to his spouse for accountability

22 Which one of these was best demonstrated in the study by Hojat published in the Academic Medicine 2011 on Provider–Patient relationship and illustrated that patients valued empathy from their physician?Improved HbA1c controlImproved literacy levelsImproved social skillsImproved spousal engagement

23 Which statement best summarizes the findings of the study on Provider–Patient relationship Cochrane systematic review (Dwamena et al. 2012)?10‐hour training of providers on attentiveness and empathy did not yield any positive effect on the consultation process10‐hour training on empathy skills achieved the same result as longer trainingLonger training was favoured by most physiciansThe skills had a negligible effect on the consultation process

24 Which of the following best describes key component of good Patient–Provider relationship?Empathetically dwelling on the patient’s negative feelingsIdentifying the patient’s concerns and applying positive psychologyInstructive criticism and goal settingListening carefully and encouraging self‐criticism

25 Which of these approaches is best used in applying the Physician ‘Coach’ Mindset?Discourage family involvement as the patient should not be distractedEncourage patients to take careful note of their weaknessesExplain that obstacles and setbacks on the behaviour change path signals’ poor outcomeShare personal examples where disclosure would support the patient

26 Which of these sets of approaches are most appropriate in the 5 As approach to health behaviour counselling?Advise, agree, approachArrange, amend, acknowledgeAssess, advise, agreeAssist, amend, arrange

27 Which one of these is the most appropriate statement about the 5 As approach to health counselling?Confrontational approach works well in stubborn patientsIt can be used as a brief health behaviour counsellingMotivational speeches are necessary to suppress the patient’s opposition to changePositive psychology should be done by trained psychologists

28 Facilitating behaviour change is best achieved by which of the following?Cognitive behaviour techniques at earlier stages of changeMotivational interviewing at the later stages of changePositive psychology at all stagesWriting down treatment goals

29 It is most appropriate during Motivational Interviewing to do which of the following?Develop discrepancy between where the patient is and what the patient wantsEnsure that the physician sits on the green coaching chair Roll with repentance by remaining non‐judgementalSupport self‐criticism of the patient’s ability to succeed

30 Motivational Interviewing techniques are useful when discussing weight and lifestyle interventions with patients. It’s most helpful to do which of the following?Acknowledge the patient’s prior effortsEmphasize that the cause of obesity is simply overeatingEnsure that obese patients all line up to check their weight in the waiting roomRealize that most obese people have never attempted to lose weight

31 Which of these patterns most represents a type of non‐productive thinking harmful to the patient?All or nothing thinkingCatastrophe avoidingMind mappingUndergeneralization

32 Which of these most suitably describes a feature of unproductive thinking useful to identify in Cognitive Behavioural Therapy (CBT)?Catastrophe avoidingHappiness acting‘Should’ and ‘must’ statementsUndergeneralization

33 Which one of these options best explains how Cognitive Behavioural Therapy (CBT) helps patients?Decrease awareness of their upsetting emotionsDiscourage parental inputMask underlying beliefs that can interfere with behaviour changeReframe thoughts to support behaviour change

34 Cognitive Behavioural Therapy (CBT) is best used in what stages of change?Contemplation and precontemplation stagesMaintenance and precontemplation stagesPrecontemplation and action stagesPreparation and action stages

35 Which of these best explains the role of the clinician during the clinic visit?Encourage more realistic interpretations of thoughtsFacilitate the patient in examining evidence for and against his thoughts Insistence on homework assignments for the patient to practise new thinking strategiesMonitor and explore all thoughts that the patient has

36 Which of the following is the most accurate interpretation of the acronym ABCD in the ABCD method of identifying underlying beliefs that can interfere with behaviour change?Assess the patient’s readiness for changeBerate self about what has occurredConsequences of those beliefs should be exploredDeal with those beliefs

37 Which of the following is the best description of a successful relapse prevention plan?Focusing on self‐criticism when you notice a lapseIdentifying people to blame for a lapseKnowing what to do when a lapse occursTaking steps to write down your action plan

38 Which of the following is a key step in Positive Psychology?Building on dreamsDiscouraging thoughtsEncouraging criticismReinforcing self‐efficacy