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Action Plan forDiabetes

CORRESPONDENCE EDUCATION PROGRAM # 2013-102

This course will expire on December 31, 2014.After that date no credit will be awarded for this program.


How to Complete this ProgramThank you for choosing an Exercise ETC correspondence program for yourcontinuing education needs. To earn your CECs/CEUs you will need to read theenclosed book. After you have completed the book, take the test that is includedwith your program. Remember to choose the best or most correct answer.

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LEARNING OBJECTIVES FOR ACTION PLAN FOR DIABETES

After completing this course participants will be able to:

1. Identify which organ in the body produces insulin.

2. Explain the purpose of insulin in the body.

3. Describe the condition of type 1 diabetes.

4. Explain the difference between type 1 DM and type 2 diabetes.

5. Identify the classic symptoms of both type 1 and type 2 diabetes.

6. Identify the risk factors for diabetes.

7. Identify a normal fasting glucose test result.

8. Explain the normal treatment for gestational diabetes.

9. Identify the prime goal for women with gestational diabetes.

10. Explain what effects high glucose levels can have on the kidneys for someone with diabetes.

11. Identify an alternate test to glucose testing that can be used to initially diagnose diabetes.

12. Explain how diabetes can effect the health of the heart.

13. Explain why people with diabetes and vascular disease are at increased risk of infections.

14. Explain neuropathy and peripheral neuropathy.

15. Explain why proper foot care is so important for people with diabetes.

16. Explain how a lifestyle-assessment form can be used to help a person learn to make healthy choicesin creating a personal action plan.

17. Understand and explain the importance of long term goals and short term goals.

18. Explain the importance and effect of exercise on people with type 1 diabetes and people with type 2diabetes.

19. Explain what dislipidemia is.

20. Explain what a hemoglobin A1C test measures and identify what the ideal level should be.


21. Identify how often a person’s blood pressure should be checked.

22. Explain intermittent claudication and identify the disease it is a symptom for.

23. Identify the exam every person diagnosed with type 2 diabetes should have at the onset of theirdiagnosis.

24. Explain the purpose of a pre-exercise consultation and exam with a physician.

25. Explain the acute effects of exercise on glucose control.

26. Explain the primary risk factor in the active person with diabetes.

27. Identify the two categories of exercise.

28. Identify the components of exercise and explain the purpose of each component.

29. Explain what a MET is.

30. Explain the purpose of an exercise warm-up.

31. Identify the safest form of stretching for a person to do on their own.

32. Identify the most common, simple method of assessing the impact of a person’s weight on theiroverall health.

33. Identify how many calories are equal to a pound.

34. Explain the importance of eating a low fat diet.

35. Explain why fad diets shouldn’t be used to lose weight.

36. Explain low glycemic index diets.

37. Identify the amount of saturated fat that should be in the diet.

38. Identify the amount of fiber required for significant benefits to occur from fiber for people with type 2diabetes.

39. Explain the effect of protein in the diet for a person with diabetes.

40. Identify the plant substances that can be used to restrict the absorption of cholesterol from thegastrointestinal tract.

41. Identify what is considered moderate caloric restriction for men and for women.

42. Explain the exchange system eating plan developed by the American Diabetes Association.

43. Explain the recommended exercise intensity level for people who have not exercised regularly andare just starting an exercise program.

44. Explain the purpose of keeping a health diary.

45. Explain when persons with diabetes should check their blood glucose levels while exercising.


46. Identify the blood glucose level at which a person should not exercise.

47. Identify when it is recommended a person with type 1 diabetes should not exercise.

48. Identify what a rescue plan is and why the use of a contract is important to prevent relapse.


CEC/CEU Test for Action Plan for Diabetes

Please choose the BEST answer for each question

1. Exercise plays an important role in the prevention and treatment of diabetes, but exercise alsoplays a major role in ________.

A. Preventing the weight gain associated with diabetesB. Preventing the complications associated with diabetesC. Curing diabetes for persons recently diagnosedD. Management of the stress associated with a diagnosis of diabetes

2. Diabetes is characterized by ________.

A. Elevated blood glucose level in the bodyB. Elevated levels of insulin in the bodyC. Elevated sugar level in the bodyD. Both A and C

3. Which organ in the body produces insulin?

A. The liverB. The gall bladderC. The pancreasD. The thyroid

4. The purpose of insulin in the body is to _______.

A. Act as a key to open the cell door of cells in the peripheral tissues, so that glucose can enter these cells

B. Speed up a person’s metabolismC. Absorb glucose and reduce glucose levels in the bloodD. Prevent the body from turning carbohydrates into sugar

5. Type 1 diabetes mellitus (simply type1DM) is also referred to as _______.

A. Non-insulin dependent diabetesB. Negative pancreatic diabetesC. Childhood onset diabetesD. Insulin dependent diabetes


6. Which of the following statements best describes type 1 DM?

A. A diabetic condition in which people are not required to take insulin since their bodies produce insulin, and some produce more insulin than is normal

B. A diabetic condition in which the cells in the body are more resistant to insulin and a high concentration of glucose builds up outside the cells

C. A diabetic condition in which the blood sugar levels are elevated because people with type 1 DM produce no insulin and have to rely on an external source of insulin

D. A diabetic condition in which people produce only a small amount of insulin which their cells are resistant to

7. Around 95 percent of people who have diabetes have _______.

A. Type 1 DMB. Type 2 diabetes mellitusC. Non-insulin dependent diabetes (NIDDM)D. Both B and C

8. What percentage of people with type 2 diabetes are obese?

A. 25 percentB. 50 percentC. 60 percentD. 70 percent

9. Which of the following statements regarding type 2 diabetes is false?

A. People with type 2 diabetes typically do not need to take insulinB. Type 2 diabetes is usually diagnosed in people in their 30sC. Around 50 percent of people who have diabetes have type 1D. People with type 2 diabetes always have to take insulin to live

10. People are typically screened for diabetes starting at _______ if they are not in a high risk group.

A. PubertyB. Age 45C. Age 60D. Birth

11. The classic symptoms for both type 1 and type 2 diabetes is _______ and _______.

A Excessive hunger; slow heart rateB. Excessive thirst; slow heart rateC. Excessive urination; thirstD. Excessive hunger; thirst

12. Which of the following is NOT a risk factor for diabetes?

A. ObesityB. Member of a high-risk group (African American, Asian, Latino, Native American)C. Low blood pressureD. First degree relative with diabetes


13. Which of the following is considered a normal fasting glucose test result?

A. 200 mg/dl or higherB. 110 mg/dlC. Between 110 and 126 mg/dlD. 126 mg/dl or higher

14. When does a physician prefer to administer a fasting glucose test?

A. Late in the evening after the patient has eaten dinnerB. In the morning before the patient has eatenC. One hour after the patient drinks 75 milligrams of glucoseD. In the evening after the patient has fasted for 8 hours

15. Which of the following is indicative of diabetes mellitus?

A. A non-fasting glucose test that shows a blood glucose level above 200 mg/dlB. A single test result of levels above 126 mg/dlC. Fasting blood glucose levels above 126 mg/dl on two separate occasionsD. Both A and B

16. Which of the following tests can be used to differentiate between type 1 and type 2 diabetes?

A. Glucose tolerance testB. Hemoglobin A1CC. The presence of C-peptide in the bloodD. Fasting glucose test

17. Gestational diabetes occurs in what percentage of pregnant women?

A. Up to 25 percentB. Up to 6 percent of women immediately after delivery of their babyC. Up to 6 percent of women during pregnancyD. Up to 80 percent of women in the third trimester

18. Gestational diabetes is caused by _______.

A. A overproduction of insulinB. An increase in glucose uptake by muscles and increases in liver production of glucoseC. Insulin insensitivity or resistanceD. Insufficient production of insulin by the liver

19. When a woman with diabetes gets pregnant, the pregnancy _______.

A. Causes a severe depletion of insulin in type 2 diabetesB. Alters glucose metabolismC. Increases uptake of glucose by muscles and increases liver production of glucoseD. Raises fasting blood glucose and decreases blood glucose levels after meals

20. Which of the following statements regarding treatment for gestational diabetes is NOT true?

A. Some patients with gestational diabetes take insulin to control their glucose levelsB. Oral hypoglycemic agents are often used for treatment because they do not enter the placentaC. Insulin does not enter the placenta and therefore does not directly affect the fetusD. All of the above are true


21. In relation to exercise, the prime goal for women with diabetes or who develop gestationaldiabetes is ________.

A. Glucose controlB. Weight controlC. Control the risk of developing hypoglycemiaD. Liver production of glucose

22. Regarding glucose control, the generally accepted fasting glucose levels are _______,

A. Between 100 mg/dl and 110 mg/dlB. Between 95 mg/dl and 105 mg/dlC. Greater than 110 mg/dlD. Between 110 mg/dl and 120 mg/dl

23. Diabetes is a leading cause of _______ in the United States because diabetes can damage the_______ and this damage is called _______.

A. Deafness; inner ear; diabetic deafnessB. Blindness; cornea; corneal retinopathyC. Blindness; retina; diabetic retinopathyD. Osteoporosis; bones; diabetic osteoporosis

24. The condition where too many new blood vessels form in the retina, block out light and causeblindness is called ________.

A. Proliferative diabetic retinopathyB. Vascular retinopathyC. Diabetic ocular vessel proliferationD. Diabetic ocular degeneration

25. Kidney disease caused by diabetes is referred to as ________, and occurs in ________ percent ofpeople with diabetes.

A. Diabetic neuropathy; 10 to 21B. Diabetic renal disorder; 20 to 25C. Diabetic nephropathy; 10 to 21D. Renal neuropathy; 20 to 25

26. For someone with diabetes, high glucose levels affects the kidneys by _______.

A. Allowing the kidneys to filter out unnecessary products from the bloodstream and retain such necessary elements as proteins and electrolytes

B. Causing an abnormality, called proteiuria, that allows necessary elements in the blood, such as proteins, to be wasted into the urine.

C. Causing frequent multiple urinary tract infections that spread to the kidneys and don’t respond to treatment with antibiotics

D. Causing pyelonephritis, or an infection localized in the urinary tract

27. If blood glucose readings are not available, people with diabetes may be initially diagnosed with_______.

A. The 24-hour urine testB. Urine protein analysis testC. Urine test for elevated glucose levelsD. Blood pressure checks on a regular basis


28. How does diabetes affect the health of the heart?

A. Diabetes can cause harm to the coronary vessels and this leads to coronary artery diseaseB. Diabetes can cause an irregular rhythm in the heart beatC. Diabetes causes plaque build-up on the inside of the vessels and this impairs blood flowD. Too much insulin causes damage to the heart muscle

29. The condition that results when the larger vessels in the body have narrowed or have plaque build-up that decreases the blood flow and causes tissue damage, is classified as _________.

A. Carotid artery diseaseB. HypertensionC. Peripheral vascular diseaseD. Cerebrovascular accident

30. Which of the following statements best explains why people with diabetes and vascular diseasehave an increased risk of infections?

A. When blood flow is decreased, the cells that identify and destroy invading organisms can’t function normally and the rate of infection increases

B. Diabetes depresses the immune system and people with diabetes are more susceptible to becoming ill

C. Too much insulin prevents the cells that identify and destroy invading organisms from functioning normally, therefore persons with diabetes are more prone to infections

D. None of the above

31. Problems in the nervous system caused by diabetes is termed _________.

A. NephropathyB. NeuropathyC. Neurological diabetic diseaseD. Diabetic neural disorder

32. Which of the following is NOT a nervous system problem caused by diabetes?

A. Increased pain sensationB. Abnormal heart rhythmsC. Decreased muscle control and functionD. All of the above are problems

33. The condition where people with diabetes have problems sensing pressure pain (such as in thesoles of the feet) that can cause skin breakdown and ulcers which can lead to infection is ______.

A. Epidermal neuropathyB. Peripheral neuropathyC. Peripheral nephropathyD. Autonomic neuropathy

34. Which of the following is a test that a doctor can perform to look at peripheral nerve function andhealth?

A. MRIB. Ultrasound testC. ElectromyelogramD. Electrocardiogram


35. Which of the following statements best explains why proper foot care (including daily foot exams)is so important for people with diabetes?

A. People with diabetes have very dry skin on their feet which can sometimes crack and open and bacteria and viruses can get it

B. Improperly drying the feet after bathing can cause moisture to build up between the toes and this may cause the skin to breakdown which can lead to infection

C. Uncontrolled diabetes can cause poor circulation, leading to nerve damage that prevents a person from feeling pain in their feet which may be an indication of a foot problem that needs to be addressed as soon as possible

D. All of the above

36. Which of the following is NOT a valid recommendation for good foot care?

A. Conduct a daily foot check, and use a mirror to help see any areas that are difficult to seeB. Tell the physician about all cuts that do not start to heal within 24 hours and all swollen, red, or

warm areas.C. Wash the feet every day with warm water and nondrying soapD. Use a moisturizing cream or lotion on the feet making sure to put lotion between the toes to

prevent dry skin

37. A(n) ________ can be used to help a person work through the process of learning to make healthychoices in creating a personal action plan for diabetes.

A. Exercise logB. Meal planC. Lifestyle-assessment formD. Health history form

38. Which of the following is NOT one of the principles a person must abide by to help them recognizechanges they need to make in their lifestyle?

A. If a person has type 2 diabetes, then they must do some form of exerciseB. A person must control their food consumptionC. A person must allow themselves to make mistakes and then learn from these mistakesD. All of the above are valid principles

39. When making changes in lifestyle in order to improve health, which of the following points shouldbe followed?

A. A person should create a lifestyle that will meet their health goals based on choices that are compatible to them

B. One easy way to make healthy lifestyle changes is to find a healthy, fit person and emulate their choices and lifestyle habits

C. Once a person chooses an exercise, they should stick with this exercise and never change itD. All of the above

40. In order to achieve long term goals, a person should ________.

A. Immediately start working on the long term goalsB. Set up a plan or series of short-term goals to achieve the ultimate, or long term goalsC. Set a timeline for reaching the long term goalD. Modify their goals if they seem incompatible with their current lifestyle so they wont’ have to give

up what they enjoy doing or eating


41. If a person increases their food intke and decreases their physical activity, they will ________, andtheir body will ________.

A. Maintain their weight; raise their metabolism and burn the excess caloriesB. Gain weight; store the excess calories mainly as fatC. Gain weight; store the excess calories mainly as muscleD. Lose weight; store the excess calories mainly as fat

42. Keeping the calories consumed (food eaten) equal to the calories used for exercise and normalbody functions in order to maintain a stable weight is known as ________.

A. Eating a balanced dietB. Strict dietingC. Energy balanceD. Counting calories

43. One study that showed that middle-aged women who exercised vigorously at least ________ havea lower risk of developing diabetes.

A. Three times per weekB. Five times per weekC. One time per weekD. Two times per week

44. Exercise not only helps lower the risk of diabetes, it also ________

A. Decreases heart disease riskB. Improves blood pressureC. Reduces body fatD. All of the above

45. People with type 1 diabetes should exercise to _________, and people with type 2 diabetesshould exercise to ________.

A. Maintain a healthy weight; improving overall healthB. Improve overall health; maintain a healthy weightC. Improve body composition; relieve depressionD. Both A and C

46. When the blood levels of LDL cholesterol and triglycerides are too high and levels of HDL are toolow, is a condition referred to as ________.

A. High cholesterolB. HypercholesterolC. DyslipidemiaD. Hypoglycemia


47. Which of the following statements regarding diabetes and exercise is NOT true?

A. Persons with type 1 diabetes have higher risks with exercise than those with type 2 diabetesB. If a person has type 1 diabetes they must consult with their physician before starting an exercise

programC. If a person has type 2 diabetes, they do not need to consult with their physician before starting an

exercise programD. Even if a person not experienced any noticeable symptoms, if they have been diagnosed with

diabetes (either type 1 or type 2) they should consult with their physician before they start an exercise program

48. The three main targets to strive for to prevent complications from diabetes that have beenidentified by the American Diabetes Association are ________, ________, and ________.

A. Hemoglobin A1C; blood pressure; cholesterolB. Autonomic neuropathy; blood pressure; cholesterolC. Hemoglobin A1C; body composition; cholesterolD. Autonomic neuropathy; body composition; carotid artery disease

49. The hemoglobin A1C test measures a person’s average glucose level over three months, and theideal level is ________ and should be evaluated ________.

A. Over 7 percent; at least twice per yearB. Less than 7 percent; at least once a yearC. Less than 7 percent; at least twice per yearD. None of the above

50. How often should a person’s blood pressure be checked, and what should it measure?

A. Every 6 months; no higher that 140/90 mmHgB. Each visit to their physician or nurse should include a blood pressure check; less than 138/80

mmHgC. Every year; less than 120/80mmHgD. Once a month; less than 140/90mmHg

51. One of the symptoms of peripheral vascular disease includes pain in the legs while walking whichis known as _______.

A. Intermittent clottingB. Exercise induced claudicationC. Peripheral claudicationD. Intermittent claudication

52. All people with type 2 diabetes should have an ________ at the onset of their diagnosis.

A. Hearing testB. Eye exam by an opthalmologistC. Bone scanD. Blood pressure check


53. The purpose of a preexercise consultation and exam with a physician is to __________.

A. Establish a baseline of current health in order to measure changes after starting a regular exercise program

B. Provide a complete list of recommended as well as contra-indicated exercises to be included or omitted from the person’s exercise program

C. Determine whether a person has conditions (diabetes-related or not) that can interfere with an exercise program

D. Provide a recommended weight loss to be achieved by the exercise program

54. Which of the following are questions patients should ask their physician during their preexerciseexamination?

A. Do I have peripheral vascular diseaseB. Do I have peripheral neuropathyC. Do I have eye diseaseD. All of the above

55. Which of the following statements regarding exercise and glucose control is NOT true?

A. The CDC and ACSM recommend 40 minutes of moderate intensity exercise on most or all days of the week

B. Three 10 minute sessions of moderate intensity exercise per day gives similar benefits in controlling glucose as one 30 minute session

C. The CDC and ACSM recommend 30 minutes of high intensity exercise at lease 3 days per weekD. Both A and C are not true

56. Which of the following statements best explains the acute effects of exercise on glucose control?

A. Over time, more exercise produces more active muscles, which in turn use more glucose, keeping the blood level in control

B. When a muscle is exercising, it uses the glucose stored within it, when the glucose is depleted, the muscle restores this loss by taking glucose out of the blood, which reduces the blood glucoselevel

C. Consistent exercise helps a person lose weight, and with less weight and body fat, the body produces more insulin which is key to controlling blood glucose levels

D. None of the above

57. ________ is the storage form of glucose.

A. InsulinB. GlucophageC. GlycogenD. Gluconeogenesis

58. Improvements in glucose controls can typically be seen within ________ of starting aerobicexercise activities.

A. Three monthsB. One weekC. Four weeksD. Six months


59. The primary risk factor in the active person with diabetes is ________, and people with ________are at greater risk.

A. Hypoglycemia; type 1 diabetesB. Hyperglycemia; type 1 diabetesC. Hypoglycemia; type 2 diabetesD. Hyperglycemia; type 2 diabetes

60. Which of the following statements best describes hypoglycemia?

A. High blood glucose levels associated with diabetic ketoacidosisB. Problems with the nervous system that can cause decreased sensation or burning sensation in

the extremitiesC. Low blood glucose than can cause weakness, dizziness, shaking, sweating, blurred vision, and

even loss of consciousness or deathD. Restricted blood flow to the extremities that can cause pain in the legs while walking

61. Delayed-onset hypoglycemia is a phenomena that typically occurs ________ after cessation ofexercise.

A. 48 hoursB. Between 6 and 15, possibly up to 30 hoursC. Between 1 and 2 hoursD. Between 30 minutes and 2 hours

62. Persons with type 2 diabetes must consult their doctor before doing any significant exercise if theyhave a blood glucose greater than ________.

A. 200 mg/dlB. 300 mg/dlC. 400 mg/dlD. 100 mg/dl

63. Persons with diabetes can decrease their risk for developing neuropathy by ________.

A. Eating only a high protein dietB. Making sure they stay well hydratedC. Keeping their glucose at or near normal levelsD. Increasing their dosage of insulin every time they exercise

64. Persons with type 2 diabetes have almost a ________ increase in cardiovascular risk factors,therefore it is important they know what their risk factors for exercise are and the extent of anyunderlying heart disease before starting an exercise program

A. FourfoldB. ThreefoldC. TwofoldD. Triple


65. Both the American Heart Association and ACSM guidelines suggest that if a person with diabeteswould like to start an exercise program, that person should have a _________ first.

A. Strength testB. Medical examC. Exercise stress testD. Blood pressure check-up

66. Which of following statements regarding an exercise stress test and people with diabetes is NOTtrue? “All people with diabetes should have an exercise stress test before starting an exerciseregimen if ________.”

A. They are over 25 years of ageB. They have had type 1 diabetes for more than 15 yearsC. They have had type 2 diabetes for more than 10 yearsD. They have diabetes with other cardiovascular risk factors

67. The two categories of exercise are ________ and ________.

A. Aerobics; strength trainingB. Flexibility; strength and enduranceC. Aerobic; anaerobicD. Anaerobic; weight lifting

68. Which of the following statements best describes aerobic exercise?

A. Activities that last longer than two minutesB. Relies on energy that is immediately available and not dependent on oxygenC. Examples of aerobic exercise include running, cycling, and swimmingD. Both A and C

69. Which of the following statements best explains how weightlifting helps control blood sugar?

A. Weight lifting increases muscle cell size which makes the cells more receptive to insulinB. Weight lifting increases muscle mass, which increases glucose utilization and results in enhanced

blood sugar controlC. Weight lifting increase ft mass, which increases glucose utilization and results in enhanced blood

sugar controlD. Weight lifting increases muscle mass, which increases production of insulin and results in

enhanced blood sugar control

70. Exercise has ________ different components

A. ThreeB. FourC. FiveD. Six

71. Which of the following is NOT a component of exercise?

A. ModeB. RepetitionC. IntensityD. Progression


72. ________ is the component used to identify the type of exercise being done.

A. ProgressionB. IntensityC. ModeD. Duration

73. The total calories burned by an exercise is determined by the ________ of the exercise.

A. IntensityB. ProgressionC. ModeD. Frequency

74. Exercise intensity is measured by calculating ________.

A. How long the exercise can be maintained before fatigue sets inB. The type of exerciseC. A person’s maximal heart rate and using a percentage of itD. How hard a person feels like they are exercising

75. The simplest method of calculating a person’s maximum heart rate is ________.

A. Measuring the heart rate at the end of an exercise stress testB. Subtract their age from 220C. Calculate 60 percent of a person’s age and subtract that from 220D. Subtract their age from 200

76. Which type of medication could affect a person’s heart rate?

A. Some blood pressure medicationsB. AspirinC. Beta-blockersD. Both A and C

77. If a person can’t use their heart rate to determine exercise intensity, they can use ________.

A. A blood pressure machineB. 45 to 50 percent of their maximal heart rateC. The Rating of Perceived Exertion methodD. Both B and C

78. The progression component of an exercise program is divided into three general stages, the________, the ________, and the ________.

A. Initial stage; change stage; maintenance stageB. Initial stage; improvement stage; maintenance stageC. Beginning stage; intermediate stage; advanced stageD. Initial stage; moderate stage; maintenance stage


79. “Usually lasts four to six weeks and involves low impact aerobic activity and light muscularactivity,” describes which stage of the progression exercise component?

A. BeginningB. MaintenanceC. ModerateD. Initial

80. In order to achieve the goals of controlling glucose level, controlling weight and improving overallhealth, a person should ________.

A. Select the most challenging type of exercise they can doB. Calculate the number of calories they need to burn each week while exercisingC. Keep their food consumption under 1000 calories a dayD. All of the above

81. A MET is ________, and can be used to help a person determine how much they need to exercisein one week to meet their caloric expenditure goal.

A. An estimate of the amount of energy that a particular exercise consumes when done for 30 minutes

B. A unit of calorie measurement only used by physicians and dieticiansC. A metabolic equivalent unit of measurement of how much oxygen is consumed per unit of body

weight per minute (ml/O2/kg/min,) or the energy cost of a specific activityD. Used as a guide in selecting appropriate exercises for people who have never exercised before

82. When the body quickly goes from a resting state to a physically active state (for example, movingquickly to get out of the way of a perceived danger,) this is known as the ________.

A. Fight-or-flight responseB. Adrenaline surgeC. Rescue responseD. Defense mechanism

83. The purpose of a warm-up is to ________.

A. Practice sport moves before competitionB. Allow the body to gradually adjust to the new physiological stress of exercise or physical activityC. To quickly stimulate the body and quickly increase the blood flow to the musclesD. To increase the body’s temperature when exercising in a cold environment

84. Which of the following is considered the safest form of stretching for a person to do on their own?

A. StaticB. BallisticC. PNFD. Active


85. Which of the following statements best describes static stretching?

A. Stretching that consists of bouncing movesB. Alternating contraction and relaxation of the musclesC. Slowly placing a muscle in a stretched position to the point of mild pain and then holding it for 5 to

10 secondsD. Slowly placing a muscle in a stretched position to the point of mild discomfort and then holding it

for 10 to 30 seconds

86. Which of the following is NOT a tip for stretching safely?

A. Relax and breath normally throughout each stretchB. Do not bounce as you stretchC. Inhale into each stretchD. Stretch to a position of discomfort, not pain

87. Nearly ________of people with ________ diabetes are obese because of minimal exercise andovereating.

A. 90 percent; type 2B. 80 percent; type 2C. 90 percent; type 1D. 80 percent; type 1

88. Which of the following is NOT a question a person should ask him/herself when assessing theireating habits?

A. Why do I eat?B. What do I eat?C. When do I eat?D. All of the above are questions to ask

89. If a person has diabetes they must understand their individual health situation and consult a________ in order to create the best individualized nutritional plan for their lifestyle.

A. A cookbook for diabeticsB. A nutritionist who specializes in herbal supplementsC. A registered dietician with skills in nutrition for people with diabetesD. All of the above

90. The most common and simple method of measuring body composition is the ________.

A. Skin fold measurementsB. Weighing on a scaleC. Body Mass Index (BMI)D. Underwater weighing


91. Which of the following statements best describes the use of Body Mass Index in determining if aperson is overweight?

A. BMI uses a person’s weight in kilograms divided by their height and estimates percentage body fat

B. BMI calculation results in a number, or “score” that relates a person’s body weight to their overall health

C. BMI gives comparison of a person’s fat tissues to the lean or nonfat tissues of their bodyD. The higher the resulting number from BMI calculations, the less a person’s health risk is due to

their weight

92. One pound is equal to ________ calories.

A. 1200B. 1500C. 3000D. 3500

93. If a person with type 2 diabetes attains long term weight loss of ________ of his/her startingweight, he/she will realize benefits such as improved insulin sensitivity, improved glucose control,improved cholesterol, and reduced blood pressure.

A. 5 to 7 percentB. 10 to 20 percentC. 25 percentD. 25 to 30 percent

94. Which of the following statements explains why a person should eat a low fat diet?

A. Fat has more calories per gram than protein or carbohydrate, therefore a low-fat diet with the same amount of calories as a high-fat diet will be higher in volume and more satisfying and less likely to trigger overeating

B. Some types of fat are responsible for increasing cholesterol levels and other substances in the blood that raise the risk of cardiovascular disease and stroke

C. Since fat is higher in calories, portion sizes must be smaller in order to reduce total calories consumed

D. Both A and B

95. Which of the following is a good reason not to use a fad diet to lose weight?

A. All fad diets usually include exercise plans and some can be too intense for beginnersB. Some fad diets require certain food products that are expensiveC. Fad diets are difficult to continue for a lifetimeD. Fad diets often offer a variety of easy to prepare meals to keep the food plans interesting

96. Sugar, starch, and fiber are all considered ________.

A. FatsB. ProteinsC. CarbohydratesD. Cholesterol


97. Diets that incorporate certain kinds of carbohydrates that have been shown to minimize glucoselevel in the blood are referred to as ________.

A. Low sugar dietsB. Low glycemic index dietsC. High glycemic index dietsD. Low calorie diets

98. Which of the following statements regarding low glycemic index diets is NOT true?

A. There is no significant benefit to a low glycemic index diet for a person with type 1 diabetesB. A low glycemic index diet has not shown any consistent benefits for those with type 2 diabetesC. There has been no evidence to show that a low glycemic index diet has any health benefits for

anyoneD. A low glycemic index diet can require complex meal plans

99. Starches are ________.

A. Simple carbohydrates from plan sourcesB. Simple carbohydrates from animal sourcesC. Complex carbohydrates from plant sourcesD. Complex carbohydrates from animal sources

100. For any significant benefits from fiber containing foods to occur in persons with type 2 diabetes,their dietary fiber intake needs to be ________.

A. Nearly double what is required for the general populationB. 25 to 35 grams of fiber per dayC. 40 to 50 grams of fiber per dayD. Both A and B

101. It is not recommended that fructose be used in place of sucrose in the diet because ________.

A. Studies have shown that when fructose is substituted for sucrose, it may increase cholesterolB. Fructose is much higher in calories than sucroseC. Fructose raises blood glucose level more than sucroseD. Both B and C

102. Which of the following statements regarding the effect of protein on a person with diabetes istrue?

A. Eating a diet high in protein has been shown to cause kidney problems in those with diabetesB. Protein has a direct effect on blood glucose levelsC. Protein stimulates insulin production and this may play a role in decreasing blood glucose levels

in those with type 2 diabetesD. Protein has been shown to have an influence on the rate or amount of glucose that is absorbed

from the gastrointestinal tract into the blood

103. Saturated fats should be limited to less than ________ of the total calories in the diet becausethey are the primary cause of increased ________cholesterol.

A. 25 percent; LDLB. 10 percent; HDLC. 25 percent; HDLD. 10 percent; LDL


104. Which of the following statements regarding a person with diabetes and cholesterol is NOT true?

A. People with diabetes appear to be more affected by dietary cholesterol than those without diabetes

B. A diet low in saturated fats and cholesterol leads to improvements in total cholesterol, a decreasein LDL cholesterol, and a decrease in triglycerides

C. It is recommended that the amount of cholesterol in the daily diet be no more that 150 mg/dlD. All of the above are true

105. ________ and ________ are substances from plants that can be used to restrict the absorption ofcholesterol from your gastrointestinal tract into your blood.

A. Omega 3; steroidsB. Sterols; stanolsC. Omega 3; sterolsD. Stanols; steroids

106. Olestra, which is a nonfat cooking oil approved by the FDA as a fat substitute, has beenassociated with ________.

A. Weight gainB. High blood pressureC. Gastrointestinal problems including crampingD. Increases in LDL cholesterol

107. Which of the following statements is NOT true regarding alcohol use and diabetes?

A. Alcohol has 9 calories per gramB. Mixed drinks have additional sugar in them that increase blood glucoseC. Alcohol consumption may adversely affect lipid profileD. Alcohol can decrease blood glucose by interacting with enzymes, causing sugar to be taken up

the liver, which can lead to hypoglycemia

108. From the Food Guide Pyramid included in the book, more food should be eaten ________.

A. From the middle of the pyramid (milk, yogurt, cheese, meat poultry, fish, dry beans, eggs and nuts)

B. From the top of the pyramidC. From the whole pyramid to get a balanced dietD. From the bottom of the pyramid (fruits, vegetables, and whole grains)

109. The food groups from the bottom of the Food Guide Pyramid are ________.

A. More dense in caloriesB. Less dense in calories and usually contain less fatC. Higher in fat and sugarD. Higher in vitamins and minerals

110. Moderate caloric restriction in the diet for overweight people is typically from ________ calories aday for men, and from ________ calories a day for women.

A. 3,000 to 2,5000; 2,000 to 2,500B. 1,800 to 2,000; 1,200 to 1,500C. 1,200 to 1,500; 1,000 to 1,200D. 4,000 to 3,200; 2,200 to 2,400


111. The American Diabetes Association has created an eating plan, known as the ________, forpeople with diabetes.

A. Food Guide Pyramid for diabetesB. Food Grouping SystemC. Exchange SystemD. Calorie Count System

112. ________ on packaged foods can be used to help control portion size by identifying what theserving size is as well as the percentage of nutrients it contains.

A. Food guide labelB. Cooking directionsC. Ingredients informationD. Nutrition facts label

113. When planning their exercise program, a person will need to choose the ________, ________,________, ________, and ________.

A. Type; difficulty; duration; frequency; progressionB. Mode; intensity; duration; frequency; progressionC. Type; intensity; duration; frequency; program changesD. Mode; difficulty; duration; frequency; changes

114. A person who is just starting an exercise program or has been exercising up to a moderateintensity can use the ________, an in-home test that can be used to estimate how much intensitythey are able to endure.

A. Five minute step testB. 1-mile walk testC. Three minute step testD. Three mile run test

115. If a person has a low fitness level, they should choose an exercise with a ________, such aswalking.

A. Metabolic equivalent (MET) of more than 8B. Metabolic equivalent (MET) of more than 6C. Metabolic equivalent (MET) of less than 6D. Metabolic equivalent (MET) of more than 10

116. If a person’s physician orders an exercise stress test for them, they should ask to receive theirfitness level, which is a ________.

A. Estimate of their maximum heart rateB. Measure of their oxygen consumption, usually written as V02

C. Estimate of their target heart rateD. Estimate of their minimum intensity level

117. If a person has not exercised regularly, they should exercise at a level that ________.

A. Allows them to have a conversation while working outB. Leaves them breathless at the end of their workoutC. Causes them to breath hard and sweat profuselyD. Leaves them feeling relaxed at the end of their workout


118. After a person has put their action plan for diabetes into motion, they need to document theirhealth status in a ________.

A. Workout logB. Exercise chartC. Personalized health diaryD. Health assessment questionnaire

119. A health diary should include all of the following information except ________.

A. Heart rate and blood pressureB. Weight or BMIC. Food planD. Laboratory test results such as lipid levels

120. When exercising, persons with type 1 diabetes should ________.

A. Drink a soft drink containing sugar before starting to exerciseB. Monitor blood glucose levels to prevent hypoglycemia or hyperglycemiaC. Always eat a full meal before exercisingD. Monitor blood pressure

121. It is recommended that person should test their blood sugar ________ and ________ duringexercise.

A. Immediately after exercise; every 20 minutesB. Just before exercise; every 30 minutesC. 15 minutes after exercise; every 30 minutesD. Both B and C

122. To prevent delayed-onset hypoglycemia, which typically occurs in the early states of a person’sexercise program, he/she should measure their glucose levels ________.

A. 12, 24 and 36 hours after cessation of exerciseB. 6, 12, and 24 hours after cessation of exerciseC. 1, 2, and 5 hours after cessation of exerciseD. 12 hours after cessation of exercise

123. According to ACSM guidelines, if a person’s blood glucose is ________ they should not exercise,and if their blood glucose is between ________, they need medical supervision during exercise.

A. 150 mg/dl; 150 and 200 mg/dlB. Slightly above 100 mg/dl; 200 and 400 mg/dlC. Below 400 mg/dl; 200 and 400 mg/dlD. Greater than 400 mg/dl; 200 and 400 mg/dl

124. People with type 1 diabetes use ________ to control their diabetes.

A. A low sugar dietB. Oral doses of insulinC. Insulin injections just under the skinD. Glucose pills or tablets


125. For persons with type 1 diabetes, it is generally recommended that they do not exercise if________.

A. Their insulin’s activity is low and glucose levels are risingB. Their insulin’s activity is at or near its peak and glucose levels are fallingC. Their insulin’s activity is at or near its peak and glucose levels are risingD. None of the above

126. Which of the following medications may increase blood glucose levels?

A. AlcoholB. Beta-blockersC. SalicylatesD. ACE inhibitors

127. Which of the following is thought to be a benefit of taking the supplement, chromium picolinate?

A. Chromium picolinate is thought to be beneficial in increasing muscle sizeB. Chromium picolinate helps insulin bind to the cells’ receptors, enhancing insulin sensitivityC. Persons with type 2 diabetes who supplement with 500 micrograms of chromium picolinate have

been reported to have significant decreases in hemoglobin A1C and total cholesterol valuesD. Both B and C

128. During the maintenance phase of your exercise program, it is important that you have a________ in place to deal with potential problems that may arise.

A. Alternate action planB. Rescue planC. Restart dateD. Reminder plan

129. One method to help prevent relapse is to devise a ________.

A. Reward systemB. New exercise programC. Contract with your health care teamD. Re-start date

130. Which of the following are recommendations to use to help maintain long term control and keepon track with your action plan?

A. Anticipate problems that could occur that would interrupt your ability to stick to your action plan (such as illness or injury, travel, schedule disruptions, increase in caloric intake)

B. Make a contingency plan for all of the problems so that if they happen, you can minimize disturbance to your plan

C. Find friends who will help you stay committed through encouragement and motivationD. All of the above

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