Deck 7: Making Behavior Change Last

Question 1

Which of the following has been found to be a major predictor of relapse, overeating, and dysfunctional eating patterns?

A) Heart disease
B) Type 2 diabetes
C) Stress
D) Social network
E) Sleep hygiene

Answer 1

C

Question 2

Stress management strategies such as planning ahead, cue management, and social support address which of the following?

A) Cognitive factors
B) Environmental factors
C) Financial factors
D) Interpersonal factors
E) Physiological factors

Answer 2

B

Question 3

Which of the following tools can clients use to deal with difficult issues related to dietary behavior change?

A) Goal setting
B) Journaling
C) Countering
D) Role-playing
E) DASH food plan

Answer 3

D

Question 4

Your client reported she ate chicken fingers, French fries, and a margarita when she went out to dinner with friends because everyone else was eating fried foods and margaritas. She expressed she is really upset because she has been "doing so well." What is likely the reason your client ate chicken fingers, French fries, and a margarita instead of grilled chicken, a sweet potato, green beans, and an unsweet iced tea?

A) Negative emotional state
B) Positive emotional state
C) Interpersonal conflict
D) Social pressures
E) Stress level

Question 5

Some factors that precede a relapse are not obvious and are referred to as which of the following?

A) Covert antecedents
B) High-risk situations
C) Immediate determinants
D) Social pressures
E) Positive outcome expectancies

Question 6

How can clients use mental imagery for developing new behaviors?

A) Clients can set SMART goals and plan to carry out the goal during the actual scenario.
B) Clients can act out a scenario with the nutrition counselor to practice how the actual scenario may go.
C) Clients can imagine themselves thinking, feeling, and behaving in precisely the way they would like to in the actual situation.
D) Clients can talk through an anticipated experience, identify as many contingencies as possible, and then decide on the best response to employ.
E) Clients can imagine the anticipated results of changing a behavior.

Question 7

Which of the following are true of sleep and sleep counseling?

A) Nutrition counselors should refer clients to sleep specialists if they suspect sleep hygiene issues.
B) Sleep quality and duration have an effect on weight and health.
C) Most U.S. adults get seven to eight hours of sleep each night.
D) It is a myth that alcohol and caffeine can effect sleep habits.
E)   Inadequate sleep is associated with healthy body weights.

Question 8

Why is social support essential for clients to make behavior change last?

A) Social support can prevent clients from engaging in positive dietary behavior changes.
B) Social support can serve as encouragement and emotional support to help clients sustain dietary behavior changes.
C) Social support can prevent clients from making and sustaining dietary behavior changes.
D) Social support can encourage clients to eat high-fat, high-sodium meals and sustain this dietary behavior change.
E) Social support can encourage clients to dispel positive feelings and sustain dietary behavior changes.

Question 9

How can significant others support clients to sustain positive nutrition-related behavior changes?

A) Significant others can keep candy and cookies in the house.
B) Significant others can agree to go out to eat for burgers and fries every Friday.
C) Significant others can agree to exercise with the client three times per week.
D) Significant others can nag clients when they are not meeting their nutrition-related goals.
E) Significant others can hide their snack foods in the house, so the client is not tempted to eat them.

Question 10

You are working with a client who appears to be overeating due to stress, but the client is resistant to trying to understand what factors are contributing to her stress. She is refusing to address the topic of stress management during the counseling session. What could you say to this client to attempt to address your client's stress levels?

A) You need to stop being resistant. If you are not honest with me about what is causing your stress, you will never be able to make changes.
B) OK, what is really going on here?
C) It appears that stress is hampering your ability to make changes. Would you be interested in looking at some self-help books or Internet sites?
D) If you refuse to address this issue, I will no longer be able to work with you.
E) It appears that stress is hampering your ability to make changes. Would you like to explore ways to reduce the amount of stress you are experiencing?

Question 11

If a client expresses sleep issues, why is it important for the nutrition counselor to assess the size and types of meals?

A) Heavy meals increase body temperature significantly, which can disrupt sleep.
B) Heavy meals disrupt the maintenance of circadian rhythms, which can disrupt sleep.
C) Heavy meals cause voluntary and involuntary arousal, which can disrupt sleep.
D) Heavy meals right before bed tend to cause indigestion, which can disrupt sleep.
E) Heavy meals suppress the release of melatonin, which can disrupt sleep.

Question 12

Which of the following is considered a covert antecedent, which could potentially impact a client's eating behavior?

A) Dining out with friends who like to eat high-fat foods
B) Buying snack foods for the children to keep in the house
C) Going to the Chinese buffet
D) Going to a birthday party
E) Negative self-talk

Question 13

Which of the following is a stress reduction strategy that can be used to address a physiological response?

A) Planning ahead
B) Cue management
C) Cognitive restructuring
D) Breathing exercises
E) Self-acceptance

Question 14

Sally disclosed to her nutrition counselor that she is ready to cook more meals at home, and even reported she only eats out (e.g., fast or restaurant food) four times per week instead of seven. How will social disclosure likely effect Sally's goal of eating more meals at home?

A) Sally will be less likely to eat more meals at home.
B) Sally will be more likely to eat more meals at home.
C) Sally will be more likely to eat more meals out.
D) This self-disclosure will likely have no effect on Sally's ability to eat more meals at home.
E) This self-disclosure will likely have no effect on Sally's ability to eat fewer meals out.

Question 15

Which of the following are a single act, a slip, and a momentary return to previous behavior?

A) High-risk situation
B) Lapse
C) Relapse
D) Urges and cravings
E) Apparently irrelevant decision

Question 16

Traveling, snacking, and eating out are examples of

A) unhealthy behaviors.
B) apparently irrelevant decisions.
C) urges and cravings.
D) high-risk situations.
E) physiological focuses.

Question 17

High-risk situations, a person's lack of coping skills, overly positive outcome expectancies, and a negative reaction to a lapse are all categorized as which of the following?

A) Immediate determinants
B) Covert antecedents
C) Apparently irrelevant decisions
D) Cognition
E) Urges and cravings

Question 18

How can nutrition counselors investigate what is causing stress among their clients?

A) They could assume it is related to eating healthy foods.
B) They could have their client keep a record of when they are feeling stressed.
C) They could assume it is related to purchasing healthy foods.
D) They could diagnose the client during the counseling session.
E) Investigating what is causing stress among their clients is outside the scope of a nutrition counselor.

Question 19

Which of the following is the first step in stress management counseling?

A) Provide client with community resource options related to stress management.
B) Discuss methods and resources for stress reduction.
C) Explain the reactions individuals can have to stress.
D) Investigate what is causing stress among your client.
E) Explain the impact of stress on food behaviors.

Question 20

Which of the following are true of stress?

A) Individuals find eating healthy to be extremely stressful.
B) Individuals find exercising to be somewhat stressful.
C) Stress rarely leads to overeating.
D) Stress often leads to healthy eating patterns.
E) Individuals have different perceptions of what is stressful.

Question 21

How can nutrition counselors end a counseling relationship?

Question 22

Your client recently disclosed that she has depression and this negatively affects her eating behaviors. She said she "has it all under control" and still wants to come to nutrition counseling and improve her nutrition. However, she continually cites her mental health as the primary reason for nonadherence. What would you say to this client?

A) Are you sure you have your depression under control? It seems like it is still affecting your eating behaviors.
B) Have you thought about taking medicine for your depression? I think it might help you feel better. Then you can focus on setting nutrition-related goals.
C) I would recommend following MyPlate. It is a flexible plan, and you should still be able to follow it even when you are feeling depressed.
D) It sounds like your depression is interfering with your nutrition goals. Have you even thought about meeting with a psychotherapist to address your depression?
E) Do you think there are other reasons you aren't sticking to your goals? You look fine to me.

Question 23

Nutrition counselors provide stress management counseling during nutrition interventions. List and describe the five major categories nutrition counselors should address.

Question 24

Which of the following are the last steps when attempting to smoothly end a counseling relationship?

A) Discuss future involvement, provide contact information, and offer directions for follow-up.
B) Provide and elicit feedback concerning the significance of the relationship.
C) Summarize current status and explore the future.
D) Review beginnings and discuss progress.
E) Emphasize success.

Question 25

Why should nutrition counselors assess sleep habits during the nutrition assessment?

Question 26

Women often use food to reduce stress.

Question 27

Inadequate sleep is associated with weight gain and type 2 diabetes.

Question 28

Which of the following are true of ending the counseling relationship?

A) Termination typically occurs after four to six visits over a twelve-month period.
B) Nutrition counseling may end when a referral is placed to another specialist.
C) The nutrition counselor is not required to disclose the reason for termination of the counseling relationship.
D) Clients decide when to end the counseling relationship.
E) Most often, the counseling relationship continues indefinitely.

Question 29

Increases in blood sugar can be an indicator of stress.

Question 30

How can social disclosure affect behavior change among clients?

Question 31

If your client does not have readily available support in their immediate environment, what are some possible alternatives that can be explored?

Question 32

How can nutrition counselors increase a client's self-efficacy during relapse prevention counseling?

Question 33

Why is it important for nutrition counselors to evaluate their effectiveness, and how can counselor effectiveness be evaluated?

Question 34

What is mindful eating, and how can this strategy be used to improve eating behaviors?

Question 35

How can a nutrition counselor evaluate his or her counseling effectiveness?

A) If a client loses weight, it signifies that the counselor was effective.
B) If the client adheres to the recommended goals, it signifies that the counselor was effective.
C) Counselors can use a checklist to compare what they did to their counseling plan.
D) Nutrition counselors are only required to evaluate their clients.
E) The counselor can compare the client's pre- and post-weights and lab values.

Question 36

If a client fails to meet their goals, the nutrition counselor is thought to be ineffective.

Question 37

You have been working with your client for six months to lower his cholesterol. He has made behavioral changes such as increasing his fiber intake, decreasing his saturated fat intake, and walking five days per week. What would be the best parameter(s) to evaluate your client's progress?

A) Behavioral and biochemical
B) Functional
C) Weight and BMI
D) Blood pressure
E) Waist circumference

Question 38

An individual's social network can have a significant impact on attempts to change eating behaviors.