Lifestyle Medicine. Ifeoma Monye
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
39 Which of the following is the best description of the important role the patient’s social and environmental factors play in their health behaviour change?Can help support accountabilityCan have a negative influence due to scrutinyShould ideally be faith‐basedShould never be electronic social networks due to distractions
40 Which of the following is the most effective at undermining health behaviour change?Faith‐based groupsFamily and friendsPeer modelling strategiesPoor goal setting
41 Positive relationships can help support the patient’s health journey by encouraging which of the following?Self‐accountingSelf‐autonomy Self‐criticismSelf‐effacing
42 Which of the following is the most appropriate way for care providers to empower patients?Encouraging dependency on familyProviding monetary supportProviding social entertainmentSignposting to environmental and social support
43 Which of the following is a key feature of poor counselling techniques on health behaviour change?Encouraging introspection and focus on areas of weaknessEncouraging the involvement of family members in action plansGuiding the patient to do a social support analysisOffer stage‐matched intervention at every visit
44 52‐year‐old Sue has been found to have high cholesterol of 7.2 mmol/l. She says she hates vegetables and would not ever eat them. She is already considering registering with a gym to increase her physical activity but is concerned her bad knee may not allow her exercise much.On the advice of a friend, she has bought a cookery book to explore healthy meals that do not include vegetables. What is the best course of action to facilitate her health behaviour change journey?Cognitive Behavioural Therapy (CBT) to address her concern that her knee would be a limiting factorCognitive Behavioural Therapy (CBT) to counter her hatred of vegetablesMotivational interviewing to address her plans of registering with a gymMotivational interviewing to address her use of the cookery book
45 Lucy has a blood pressure of 173/92. She is adamant that she will not take medication. She is keen to try lifestyle changes and is already cooking with less salt and adding garlic to her meals. She refuses to go for a walk as she is afraid of the youngsters hanging about the street corners and her husband is always too tired to come walking with her.What is the best course of action to address her concerns?Cognitive Behavioural Therapy (CBT) to explore her mindset about taking medicationMotivational Interviewing to address her fear of youngsters in the streetMotivational Interviewing to address the perceived limiting effect that her husband’s tiredness is having on her healthPositive psychology to affirm what she is already doing with her meals
46 Which of