NHWBC Exam Flashcards
(137 cards)
1
Q
The Non-Violent Communication Model for expressing empathy assumes four important distinctions. What are they?
A
- Make Observations, not evaluations
- Express Feelings, not thoughts.
- Identify needs, not strategies.
- Make requests, not demands
2
Q
What are the 6 Stages of Change in the TTM
A
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- Termination
3
Q
What TTM Stage is a client in when they do not intend to take action in the near future.
A
Precontemplation
4
Q
What are the “3 D’s” of Precontemplation
A
- Don’t know how.
- Demoralized.
- Defensive
5
Q
In the Precontemplation Stage of TTM what are 8 ways “Defending” can present?
A
- Turning Inward
- Withdrawing
- Going Silent
- Disattending
- Internalizing
- Turning outward
- Projecting
- Displacing
6
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “turning inward”. What does this mean?
A
There are several ways people “turn inward.” They “turn inward” by withdrawing, going silent, dis-attending, and internalizing.
7
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Withdrawing”. What does this mean?
A
When an individual feels pressured to take action before they are ready, they may distance themselves from the pressure before they are ready by dropping out.
8
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Going Silent”. What does this mean?
A
To stay silent
9
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Dis-Attending”. What does this mean?
A
Tuning out - the most common way people stay stuck in Precontemplation.
10
Q
In TTM when in the Precontemplation Phase, your client is “Internalizing”. What does this mean?
A
We blame all of our problems on ourselves.
11
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Turning Outward”. What does this mean?
A
There are several ways people defend themselves by “Turning Outward” such as projecting and displacing.
12
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Projecting”. What does this mean?
A
Blaming others for our problems
13
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Displacing”. What does this mean?
A
We redirect our distress to a substitute object or person who is safe to attack.
14
Q
In TTM when in the Precontemplation Phase, your client is “Defending” by “Explaining away risky behaviors”. What does this mean?
A
People may try to rationalize or intellectualize their risky behaviors or harmful habits to avoid facing the consequence.
15
Q
In the TTM model of change individuals in the state of “Contemplation” usually take action within _______.
A
6 months
16
Q
In the TTM model during the stage of contemplation, the pro’s and cons become more apparent. This is the source of the first “2 D’s” of contemplation. What are they?
A
Doubt and Delay
17
Q
In the TTM Model stage of “Contemplation” what are the forces that keep contemplators from moving ahead?
A
- Chronic contemplation.
- Their search and need for certainty.
- A rush to action.
18
Q
In the TTM model of change in the “Preparation Stage” individuals are prepared to act within what time frame.
A
1 month
19
Q
In the TTM model of change in the “Preparation Phase” where can people become stuck?
A
Dread of failing
20
Q
In the TTM Model of Change what is “Action” defined as?
A
Making a change during the past 6 months that, according to public health criteria, removes one or more of the highest risks behaviors.
21
Q
In the “Action Phase of TTM” what must you have in place before beginning?
A
An action plan
22
Q
In TTM which is the most controversial stages of change?
A
Maintenance
23
Q
In the “Maintenance Phase” of the TTM Model, we strive to keep our new change in good condition. How long must an individual continue to do this to move from maintenance to the Termination Phase?
A
Maintaining a behavior change for 5 years without relapse.
24
Q
In the “Maintenance Phase” of TTM what are 3 ways you can deal with distress?
A
- Walking
- Talking
- Praying
25
In the TTM model, when is a person ready for "Termination"
1. They have previous temptation to return to their previous problem.
2. They have full confidence or self-efficacy that they will not relapse to old behaviors no matter how challenging the situation.
3. That they are so comfortable with the change they no longer have to make any effort to keep from relapsing.
26
What is Blood Pressure?
Blood Pressure is the force of blood as it pulses against the arteries as they carry blood from your heart to nourish your body.
27
How is Blood Pressure measured
Blood Pressure is measured in units of mercury (mmHG) using a stethoscope and inflatable cuff or an automated machine.
28
What is Systolic BP?
Systolic BP is the top number - is the pressure in the arteries when your heart beats.
29
What is Diastolic Blood Pressure
Diastolic Blood Pressure is the bottom number - is the pressure in your arteries when your heart rests.
30
What is normal blood pressure according to the 2017 Guidelines?
<120/<80
31
What is (At Risk or elevated) Pre-hypertension Blood Pressure (2017 guidelines)?
<120-129/<80
32
What is Hypertension (elevated) High Blood Pressure (2017 guidelines)?
>130/>80
33
According to the 2003 guidelines, what is normal blood pressure>
<120/<80
34
According to the 2003 guidelines, what is PREHYPERTENSION or at risk blood pressure?
120-139/80-89
35
According to the 2003 guidelines, what is HYPERTENSION or at risk blood pressure.
>140/>90
36
What is the result of HYPERTENSION (Silent Killer) x3
1. Hardness and narrowing of arteries (known as arteriosclerosis) because of plaque buildup and clots forming.
2. Makes the heart work harder.
3. Decreases blood flow to the heart.
37
What are the risks of HYPERTENSION x5
1. Can lead to TIA or Transient Ischemic Attacks - mini-strokes.
2. Stroke ("Brain Attack") - Burst or blocked arteries in the brain.
3. Heart Failure because of the left-side of the heart becomes thicker.
4. Heart Attack, also known as CAD.
5. Kidney Disease - increase blood pressure in kidneys damages tissues - kidneys help regulate blood pressure
38
What are 3 types of risk for developing HYPERTENSION?
1. Conditions
2. Behaviors
3. Family History
39
What behaviors contribute to developing HYPERTENSION x 5?
1. Unhealthy diet (high in salt, low in Potassium)
2. Inactivity
3. Obesity
4. High Alcohol Intake. 1 per day for women, 2 per day for men.
5. Tobacco/Smoking
40
What conditions contribute to HYPERTENSION x2 ?
1. Prehypertension
2. Diabetes
41
What Family Histories contribute to HYPERTENSION x3?
1. Other family members have hypertension.
2. Older age.
3. African American
42
So let's say you are reviewing the health risk assessment of your new client
Charlene. She's a 58-year-old African American woman who has Type 2 diabetes and is overweight. Charlene is concerned about her health because her mother had high blood pressure and died of an ischemic stroke. Her vision for herself includes managing her diabetes better and avoiding high blood pressure so she can live a longer, healthier life and spend time in the future traveling and enjoying her grandchildren.
So the question is, what kinds of SMART goals
might she set to decrease her likelihood of developing hypertension?
So, number one, might be, "I will eat a turkey sandwich for lunch every day instead of having a fast-food lunch." Number two is, "Three times a week after work, I will get off my bus stop one stop before I usually do and walk the rest of the way home." Number three. "I will drink more soda in order to increase my intake of fluids." And number four is, number 1 only. And number five is numbers 1 and 2. So let's see what is the answer here. So for this scenario the kinds of SMART goals that Charlene might set to decrease her likelihood of developing hypertension would be 1 and 2. Eating a turkey sandwich for lunch every day instead of having a fast-food lunch might help her reduce her intake of salty foods. Processed fast foods. And three times a week after work getting off her bus one stop earlier and walking the rest of the way home will increase her physical activity, helping her blood pressure to hopefully stay lower, because her blood vessels, her arteries, will be a little bit more relaxed. And it may actually help contribute to losing a little bit of weight. So those changes would be the ones to make, 1 and 2. TranscribeMe 2 / 8S1: 15:16Let's take a look at a coaching scenario. So let's say you are reviewing the health risk assessment of your new client Charlene. She's a 58-year-old African American woman who has Type 2 diabetes and is overweight. Charlene is concerned about her health because her mother had high blood pressure and died of an ischemic stroke. Her vision for herself includes managing her diabetes better and avoiding high blood pressure so she can live a longer, healthier life and spend time in the future traveling and enjoying her grandchildren. So the question is, what kinds of SMART goals might she set to decrease her likelihood of developing hypertension? 1. "I will eat a turkey sandwich for lunch every day instead of having a fast-food lunch."
2. "Three times a week after work, I will get off my bus stop one stop before I usually do and walk the rest of the way home."
3. "I will drink more soda in order to increase my intake of fluids."
4. Is number 1 only.
5. is numbers 1 and 2.
5
43
What does the acronym S.M.A.R.T. stand for?
1. Specific
2. Measurable
3. Attainable
4. Realistic
5. Time-Bound
44
What does CAD stand for? What does CVD stand for?
1. CAD - CORONARY ARTERY DISEASE. Cardiovascular disease is the most common type of heart disease in the United States.
2. CVD - CORONARY VASCULAR DISEASE
45
What does CARDIOVASCULAR DISEASE affect?
Cardiovascular disease affects the blood vessels of the heart and body.
46
What is CARDIOVASCULAR DISEASE or CAD?
1. Plaque builds up in the walls of the coronary and other arteries.
2. Plaque is made up of deposits of cholesterol and other substances.
3. Inside the arteries narrow over time (atherosclerosis), which can partially or totally block blood flow.
47
What is ATHERIOSCLEROSIS?
When the inside of the arteries narrows over time because of plaque build-up, which can partially or totally block blood flow.
Atherosclerosis makes it harder for blood to pump through your body.
When your heart doesn't get enough blood, chest pain or discomfort can develop - called Angina.
48
What tests are used to diagnose CVD/CAD? x 9
1. Blood Pressure
2. Cholesterol
3. Blood Glucose levels
4. EKG/ECG
5. Echocardiogram
6. Exercise Stress Test
7. Chest X-Ray
8. Cardiac Catheterization
9. Coronary Angiogram
49
What is an EKG/ECG
Electrocardiogram - Used to help diagnose CVD/CAD. Measures electrical activity, rate, and regularity of the heartbeat.
50
What is an Echocardiogram?
Uses ultrasound to create a picture of the heart. Used in diagnosing CVD/CAD.
51
What is an Exercise Stress Test?
Measures heart rate while walking on a treadmill. Used to help diagnose CVD/CAD.
52
What is a Cardiac Catheterization?
Checks the inside of the arteries for blockage by inserting a thin, flexible tube through an artery. Used to help diagnose CVD/CAD.
53
What is a Coronary Angiogram?
Monitors blockage and flow of blood through coronary arteries. Uses X-rays to detect dye injected via Cardiac Catheterization. Used to help diagnose CVD/CAD.
54
What are the 5 major signs of a heart attack?
1. Chest pain or discomfort
2. Nausea, feeling lightheaded, or unusually tired.
3. Pain or discomfort in the jaw, neck, or back.
4. Pain or discomfort in the arm or shoulder.
5. Shortness of breath.
55
What is a stroke (A brain attack)
When the flow of blood in the brain is disrupted, brain cells die within minutes because they don't get oxygen.
56
Name the 2 types of strokes.
1. Ischemic
2. Hemorrhagic
57
What is an Ischemic stroke?
Blood clots or plaque block blood vessels in or to the brain.
58
What is a hemorrhagic stroke?
A blood vessel busts in the brain and damages surrounding brain tissue.
59
What are the signs of a stroke? x 5
1. Numbness or weakness in the face, arm, or leg, especially on one side of the body.
2. Confusion, trouble speaking, or difficulty understanding speech.
3. Trouble seeing in one or both eyes.
4. Trouble walking, dizziness, loss of balance, or lack of coordination.
5. Severe headache with no known cause.
If symptoms go away after a few minutes, it may be a TIA.
60
What is does the acronym F.A.C.E. stand for?
F - Face: Ask the person to smile. Does one side of the face drop.
A-Arms - Ask the person to raise both arms. Does one arm drift downward?
S - Speech - Ask the person to repeat a simple phase. Is the speech slurred or strange.
T - Time: If you see any of these signs call 9-1-1 right away.
61
What conditions are conducive to a stroke?
Hypertension, high cholesterol, diabetes, Sickle Cell Disease, and a previous stroke or TIA.
62
What behaviors contribute to a stroke?
Unhealthy diets, physical inactivity, Obesity, high alcohol intake, Tobacco/smoking.
63
What family history or other factors are conducive to a stroke?
1. Genetics, older age, female, and race/ethnicity.
2. Blacks, Hispanics, American Indians, and Alaska Natives may be more likely to have a stroke than non-Hispanics or whites.
3. African Americans have twice as many strokes as whites and are twice as likely to die from a stroke.
64
What is Metabolic Syndrome?
Metabolic Syndrome is a group of 5 risk factors that raises your risk for heart disease, diabetes, and stroke.
Three or more of these are:
Large waistline
High triglyceride level
Any of the following or taking medicine for any of the following:
Hypertension
Low High-Density Lipoprotein (HDL) level.
High blood glucose
65
What individuals are at a greater risk for developing Metabolic Syndrome?
Individuals with:
Abdominal obesity
An active lifestyle
Insulin resistance
Race Ethnicity - Mexican Americans have the highest rate than whites or blacks.
Other factors:
Diabetes or sibling or parent with diabetes.
Women, especially with polycystic Ovarian Syndrome (PCOS).
66
How do you treat Metabollic Syndrome?
The major goal of treating Metabollic Syndrome is to reduce the risk of CVD/CAD.
Lower LDL cholesterol and High Blood Pressure
Manage Diabetes (If present)
The second goal is to prevent the onset of type 2 diabetes. This can be accomplished through medications and heart-healthy lifestyle changes such as: Diet, physical activity, weight-loss, managing stress, not smoking.
67
What are the Biometrics used to diagnose Biometric Syndrome?
Wasteline - Male > = 40; Female - >= 35
Low HDL - Male < 50 mg/dl; Female <40 mg/dl
High Triglycerides >= 150 mg/dl
High Blood Pressure >= 130/ >=85 mmHg
High Fasting Blood Glucose >100 mg/dl
Prediabetes or diabetes
Or taking medicine for any of the above
68
What is arthritis?
Arthritis is the inflammation or swelling of one or more joints. Specific symptoms may vary but usually include joint pain and stiffness.
69
What is Osteoarthritis?
So osteoarthritis is the most common form of arthritis. It's sometimes called a degenerative joint disease or wear and tear arthritis. It most frequently occurs in the hands, hips, and knees. And we often call this OA.
Unfortunately, about 30 million US adults have OA.
It's diagnosed through a physical exam and review of symptoms, X-rays, and lab tests.
1. Cartilage and bones break down.
2. These changes usually develop slowly and get worse over time.
3. Pain, swelling, and stiffness can occur and can cause disability.
70
What are some treatments for OA
And treatment for OA includes:
1. Self-management
2. physical activity
3. losing weight, if needed, because weight stresses the joints.
4. medications
5. physical therapy with muscle strengthening exercises that strengthen the muscles around joints. 6. Supportive devices, such as crutches or canes.
6. sometimes surgery.
71
What are the risks factors for developing OA.
1. joint injury or overuse.
2. Being older. It increases with age.
3. Being female. Especially after the age of 50, we tend to develop more arthritis.
4. Being obese because extra weight does put stress on joints. Especially, our weight-bearing joints, like our hips and our knees.
5. And genetics. People who have a family history are more likely to develop OA.
And fortunately for people who are Asian, Asian people have a lower risk of OA.
72
What is Rheumatoid Arthritis?
Autoimmune disease and inflammation are involved in RA.
73
What are the effects of RA
1. RA mainly attacks the hands, wrists, and knees, but it can also affect other tissues.
2. RA can cause problems in the lungs, heart, and the eyes.
3. RA has flare-ups and remissions where it gets better.
4. RA has a lot of physical and social consequences and can really affect the quality of life.
5. With RA, the lining of affected joints becomes inflamed and damages the joint tissue.
People can have long-lasting or chronic pain. They can have unsteadiness and problems with balance. And their joints actually can become misshapen over time.
Signs and symptoms include pain, aching, stiffness, similar to OA, tenderness, and swelling in more than one joint on both sides of the body. And it can also have fatigue, fever, tiredness, weakness. And actually, people who have RA can die an early death.
74
Who is at risk for RA?
1. Older adults. Usually in their 60s. And it can begin at any age, though, but it is higher as people get older. 2. Genetics. There are specific genes that, when present, mean that a person is more likely to develop RA. These are called HLA class II genotypes. These are the Human Leukocyte Antigen, HLA, and genes. Which can also make arthritis worse if people have this gene.
3. Obesity
4. Smoking
And interestingly, some early life exposures, for instance, people who were-- as children who were-- had mothers who smoked have double the risk of developing RA.
5. Children of lower-income parents are in an increased risk of developing RA as well.
6. Women have 2 to 3x the risk more than men.
7. Women who have never given birth may be at higher risk of developing RA.
And those who have breastfed their infants have a decreased risk of developing RA.
75
How is RA diagnosed?
1. by reviewing the symptoms.
2. conducting a physical exam.
3. doing X-rays
4. Doing lab tests.
76
What is Fibromyalgia?
1. Fibromyalgia causes widespread pain, sensitivity to pain, and some other symptoms.
2. People with fibromyalgia have some sort of abnormal pain perception processing.
3. Fibromyalgia affects 4 million US adults. About 2% of the adult population.
And the cause is really unknown but it can be effectively treated and managed.
4. With fibromyalgia, people have pain and stiffness.
5. A lot of sleep problems, so then they're tired.
6. And often depressed and sometimes have anxiety 7. brain fog with problems with thinking memory and concentration.
8. can get headaches, including migraines.
9. And often have tingling or numbness in their hands and feet,
10. can have temporomandibular joint syndrome, which causes pain in their face or jaw in particular.
11. Can have digestive problems, including bloating, constipation, or even irritable bowel syndrome, which we can also call IBS
77
A 26-year-old man comes to the coach's office for his ninth weekly session. He was diagnosed with metabolic syndrome 7 months ago. He has been
working earnestly on his goal to decrease his BMI from 32 kg/m to less than 27 kg/m. He made steady progress in the first 7 weeks, but his weight has plateaued during the past 2 weeks. The client decided to further decrease his caloric intake by 200 calories daily. When the coach assesses the client's
confidence about decreasing his caloric intake this week, using a 10-point scale, in which 0 is "not at all confident" and 10 is "extremely confident," the
client rates his confidence as a 6. Which of the following is the most appropriate next step by the coach?
Explore with the client what it would take to increase his confidence.
78
A 49-year-old man meets with the coach at the clinic for his first session. The client says, "My doctor sent me for diabetes healthbecause my blood sugar level was up a bit, but I think everything is fine right now. I do not have a family history of diabetes, andgreat." This client is most likely in which of the following stages of change?
Precontemplation
79
A 32-year-old woman comes to the coach's office for her third session. The client is eager to start losing weight and decreasing hlevel related to her new job, and she wants the coach to provide immediate guidance on how she can accomplish these goals. Dusession, the coach gives the client an exercise to help her distinguish between which of her goals are important and which of her urgent. Which of the following best describes the purpose of this exercise?
Define the client's long-term goals that will lead to her desired outcomes
80
A 46-year-old woman comes to the coach's office for her twenty-first weekly session. She has improved her sleep hygiene and decreased her level of stress. She is now focusing on weight loss. A section of their conversation is shown:
Client: I have struggled with my weight all my life. I gain it, lose it, and gain it again.
Coach: That must be very frustrating.
Which of the following skills is the coach most likely demonstrating?
Empathizing
81
A 45-year-old woman comes to the coach's office for her eighth session. She began coaching after relocating for her job to workstart." In her early sessions, the client was positive and made significant progress. After the client was laid off from her job, the cnoticed that her mood has shifted from upbeat and optimistic to sad and unhappy. Today, her posture is visibly slumped, and heappearance is disheveled. The coach reflects these observations, and the client responds, "Life is too hard right now, and I do ngetting better." Which of the following is the most appropriate next step by the coach?
Advise the client that her situation is outside of the coach's scope of practice and offer to connect her with a mental health
professional
82
According to the Centers for Disease Control and Prevention, which of the following is the most common preventable cause of disease in the United States?
Tobacco use
83
A 42-year-old woman comes to the coach's office for her first session. She wants to go back to school, but she is worried about would find time for it. She works full-time and has four teenage children. Which of the following is the most appropriate initial resthe coach?
"What do you hope to gain from coaching that would support you to make this decision?"
84
After undergoing a biometric screening at his company’s annual health fair, a 38-year-old man meets with the nurse-coach for a laser coaching session to review his results. He is 188 cm (6 ft 2 in) tall and weighs 84.8 kg (187 lb); his BMI is 24 kg/m . His blood pressure is 134/84 mm Hg. His fasting blood sugar level is 81 mg/dL. Which of the following findings is outside of the normal range?
Blood pressure
85
A 30-year-old woman speaks with the coach on the phone as part of a lifestyle management program to decrease her level of stoday's session, the client sets a goal of practicing relaxation exercises that consist of deep breathing, light stretching, and visuaat least 20 minutes daily. Based on this goal, the coach asks the client to rate her confidence on a 10-point scale, in which 0 is "confident" and 10 is "extremely confident." The client responds with a rating of 7. Which of the following is the most appropriate response from the coach?
"Why did you rate your confidence as a 7 and not a 5?"
86
A coach is also a well-trained aromatherapist and a distributor for a particular brand of essential oils. When the coach established coaching agreement with her clients, she discloses her training in aromatherapy and informs clients that she may make relevant aromatherapy recommendations. She does not mention her investment as a distributor of essential oils. In her practice, her recommendations almost always involve her own brand of essential oils. According to the NBHWC Code of Ethics, which of the ethical principles is most likely being violated by this coach’s actions?
Conflict of interest
87
A 79-year-old man meets with the coach at his primary care provider's office for his second session. He was recently diagnose cardiovascular disease and wants to make lifestyle changes to decrease his risk factors. Today, he is ready to set small, manageable goals. He wants to start making a grocery list so he can prepare more meals at home. The coach asks the client what might get on the way of the goal. The client responds, "I am afraid I will forget to make the list over the weekend." Which of the following is the most response by the coach?
"You are worried about not following through with your goal because you might forget."
88
A 50-year-old man speaks with the coach on the phone for his eighth weekly session. His goal is to do aerobic activity for 30 minutes 3 times weekly. The client mentions that his son is always reminding him to get up off of the couch and exercise, which annoys his client. How can the coach reframe the client's perception?
"Your son seems to care about your health."
89
Which of the following is mandatory to include in any coaching agreement?
Client and coach responsibilities
90
A 28-year-old woman speaks with the coach on the phone for her third session. The client has a goal to improve her health and appearance; she is not satisfied with her appearance due to weight gain. She went through a difficult divorce five years ago which has left her feeling resentful and cautious about relationships. She also "generally feels run down" because of work. Prior to this session, she took
a strengths assessment. Her top five strengths were fairness, creativity, integrity, humility, and prudence. Her five lowest categories were perseverance, zest, bravery, capacity to love, and gratitude. Which of the following is the most appropriate approach for this client?
Explore the client's strengths to find creative ways to meet her goals
91
Explore the client's strengths to find creative ways to meet her goals
Body mass index
92
A 39 year old male client, Josh, is really struggling with this habit of exercising regularly. He landed on going for 3 thirty minutes walks per week in the previous session, but when the coach followed up in the next session he had only gone on 1 ten minute walk.
Which of the following would NOT be an appropriate coach response?
Active listening - The coach is listening for what the client is saying behind her words, and inferring what the client's emotions might be in order to get clarity about what she means in the situation.
93
Monique, a 29 year old female, is experiencing a lot of stress as she’s in the midst of a custody battle for her son. She knows that when she’s grounded and centered she’s a better version of herself, and she wants to be the best version of herself when she testifies in court. She set a goal of meditating each day and her coach gave her the resource of mentally going to a safe place when she feels stressed. She comes into her fourth session very disgruntled.
Client: I’ve tried everything and I’m still so stressed! It’s like as soon as my meditation ends it just all comes back. Coach: That is very frustrating.
Client: I feel like I’ve done everything I can and nothing works. Can’t you just tell me what to do? What am I even paying you for?
Which of the following is the most appropriate response from the coach?
I know it’s frustrating to feel like what you’ve been trying isn’t working, however, it does work best when goal-setting is a collaborative process between the two of us. I can see you’re feeling stuck, would it be helpful if I gave you a few suggestions and we could talk about which one would work best?
94
Jamal, a 28 year old male, has been working on the same goal for four weeks, getting two twenty minute runs in per week. He comes into his fourth session and says the following: Once again I didn’t hit my goal. I didn’t do any exercise this past week. I’m such a failure.
Which of the following is the most appropriate response from the coach?
I can see how not hitting a goal a few times now could feel really discouraging, you feel like you won’t ever be able to do it. What do you think might be getting in the way of you achieving your goal?
95
Joshua, a 41 year old male, has come to health coaching to help himself get out of a rut after his divorce. He spends most of his free time playing video games and rarely feels the energy to cook for himself.
Client: I just feel stuck. I have no energy or motivation to make a change.
E. Why do you think you haven’t made a change yet?
96
Client: I just hate taking pills. I mean, don’t get me wrong I understand that I need them right now, I don’t want to have another episode again, but they’re so big they’re hard for me to swallow. And I have to take them after each meal, it can be hard to remember especially when I’m on the go. At heart I’m really a naturalist, I’d like to be able to solve things the natural way like with exercise or changing my eating habits, I don’t want my body to be filled with chemicals.
In which of the following coach responses is the coach reflecting back the client’s change talk?
D.You recognize that it’s important to take these pills, you really don’t want to have another episode again
97
Which of the following is NOT one of the six dimensions of wellness?
C. Mindfulness
98
What are the six dimensions of wellness?
1. Occupational
2. Physical
3. Social
4. Intellectual
5. Spiritual
6. Emotional
99
Coach: How are you feeling today?
Client: Fine, everything’s going pretty ok.
Coach: So everything’s ok right now.
Client: Yeah, I mean I just wish I could find work that feels meaningful to me. Working in finance can feel pretty pointless sometimes.
Coach: Leading a meaningful life is important
Client: Very important
Which stage of the 5D cycle is the conversation currently in?
Define
100
What are the 5 Dimensions (Principles) of Appreciative Inquiry?
1. Define
2. Discover
3. Dream
4. Design
5. Destiny
101
Define what the first principle of Appreciative Inquiry is?
"What is the focus?" Affirmative topic choice. Clarifying.
102
Define what the 2nd phase of Appreciative Inquiry is?
Discover "What gives life meaning" Appreciating.
103
Define what the 3rd dimension of Appreciative Inquiry is?
Envisioning. "What might be" What the world is calling for.
104
Define the 4th dimension of Appreciative Inquiry?
Design (Compelling goals) Co-Constructing
105
Design the 5th dimension of Appreciative Inquiry.
Destiny "What will be?" How to empower, learn, and improvise" Innovating
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What is the definition of the first dimension of Appreciative Inquiry: Define
The process starts by securing an agreement between coach and client as to what the client wants to learn (topic choice) and how the client wants to learn it. (Method)
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What is the definition of the 2nd dimension of Appreciative Inquiry: Discover
Once the learning agreement is clear, the next step is to assist the client in discovering promising outcomes of desired outcomes, both present and past.
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What is the definition of the 3rd Dimension of Appreciative Inquiry: Dream
Once the client has discovered the best of "What is," it is time to encourage them to envision the best of "What might be."
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Coach: " Those 3 wishes are very clear. I'm curious - What is your deeper goal here? How does this fit in with your larger life goal?
Client: "Gosh, if I can live with no regrets on vacation - a time when people usually let their guards down and have no rules-I can do anything in the real world"
What dimension of Appreciative Inquiry is the coach investigating with his client?
Dream
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Define the 4th dimension of Appreciative Inquiry.
The design phase of AI process gives the dream legs by working to align the client's infrastructure with the dream. Client's are asked to make proposals, set goals, as to how the dream might manifest itself in terms of habits, procedures, systems, technology, roles, resources, relationships, finances, structures, and stakeholders.
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Coach: It sounds like your dream of a vacation fits well in your bigger dreams for yourself. Would you like to begin to create a plan for your vacation?
Client: "Absolutely"
Coach: "What is the commitment you are ready to make?"
What dimension of Appreciative Inquiry is the coach supporting the client in?
Design
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What is the 5th dimension of Appreciative Inquiry.
Destiny
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What is the purpose of the 5th Dimension of Appreciative Inquiry: Destiny?
The purpose of AI is to elevate both the positive energy and self-efficacy of clients in order to assist them in realizing their destinies. It is an action process that makes dreams come true and makes dreaming intrinsic to the client's way of being in the world. Client's learn to make the 5-D cycle approach to problems and opportunities in order to fulfill their Destinies.
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What are the risk factors for developing fibromyalgia?
1. Age So it can affect people of all ages, even children, but most people are diagnosed during middle age. And as they get older, it's more likely to be diagnosed.
2. People who have lupus or rheumatoid arthritis are also more likely to develop fibromyalgia.
3. Women are twice as likely to have fibromyalgia as men.
4. Stressful or traumatic events, such as a car accident or posttraumatic stress disorder.
5. Repetitive stress injuries, frequent knee bending, or using hands for keyboarding can often occur in people with fibromyalgia.
6. Viral infections
7. a family history
8. Obesity.
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How is fibromyalgia primarily diagnosed?
It's primarily a diagnosis based on the history and the symptoms.
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How is fibromyalgia primarily treated?
Fibromyalgia can be treated and managed with medications and self-management strategies.
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What are the causes of inflammation?
Infections
chemical irritants
particles such as asbestos and silicone. And they cause oxidative damage and that result from inflammation when white blood cells, our leukocytes, that are signaled to come to the area when we are inflamed secrete substances called cytokines that cause more inflammation.
So it's a real cycle of inflammation and that becomes chronic.
And a big factor is an excess of fatty cells when we are obese that secrete proinflammatory substances, including the cytokines and something called C-reactive protein . These substances have been found in people with cardiovascular disease, type 2 diabetes, cancers, rheumatoid arthritis, multiple sclerosis, Alzheimer's and Parkinson's diseases, as well as amyotrophic lateral sclerosis and even schizophrenia.
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So you're coaching a group of people who have various forms of arthritis and fibromyalgia. Many of the members have shared that they struggle to be physically active and are distressed because it has led to weight gain. Some have even become obese. You ask if they would like to brainstorm ways to, fill in the blank, in order to help self-manage their symptoms of pain and stiffness.
What is the best way to manage their symptoms?
Increase their physical activity
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So metabolic syndrome is diagnosed when someone has any three of these five biometrics.
Large waist size, high blood pressure, high triglycerides, low HDL, and high blood glucose.
Or
It could be the large waist size or medication to treat three or more of the conditions that we just mentioned.
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What is cholesterol?
Cholesterol is a lipid. Lipid is a fat. So cholesterol is a waxy, fat-like substance that travels through the blood on proteins called lipoproteins. We need it to create hormones and to digest fatty foods.
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What are the 4 different types of cholesterol?
1. total cholesterol, which is based on the HDL, the high-density lipoproteins, the LDL, the low-density proteins, and triglycerides.
2. LDL - LDL cholesterol makes up the majority of cholesterol. And high LDL, though, can lead to plaque buildup in arteries, heart disease, and stroke.
3. HDL - HDL cholesterol carries LDL cholesterol back to the liver to flush it from the body. So we like HDL. We want our HDL levels to be high so that they can help us reduce heart disease and stroke risk.
4. Triglycerides - And triglycerides are a type of fat that your body uses for energy. But if they're too high, they can be a problem.
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What is LDL?
LDL cholesterol makes up the majority of cholesterol. And high LDL, though, can lead to plaque buildup in arteries, heart disease, and stroke. So this is bad.
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What is HDL?
HDL cholesterol carries LDL cholesterol back to the liver to flush it from the body. S
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What is triglycerides?
And triglycerides are a type of fat that your body uses for energy.
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What numbers make up an optimal lipid profile?
Total cholesterol < 200
LDL, lowdensity lipoprotein, < 100 milligrams per deciliter.
HDL -High-density lipoprotein, > 60.
The non-HDL cholesterol is your total cholesterol - the HDL. < 130.
Triglycerides < 150.
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What are the 5 stages of change?
1. Precontemplation
2. Contemplation
3. Action
4. Maintenance
5. Relapse and Recycle
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In the "stages of change" define the precontemplation phase?
The clients are in precontemplation about a behavior. Not ready to take action.
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What are the "3 D's" of the precontemplation phase in the "stages of change" model?
1. don't know how
2. demoralized - They want to, but they've failed. They have fear. They are uncertain.
3. defensive
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What is the Contemplation phase of "Stages of Change"
n moving from precontemplation to contemplation is the biggest leap of all. It's a leap of faith in one's own ability to change, otherwise known as self-efficacy. In contemplation, the client's more excited about the pros or the reasons for change. But the cons become more evident too which can create some confusion.
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What are the 2 D's in the Contemplation phase in the "Stages of Change" model?
1. Doubt -They ask, "Is the change really worth it?" So they won't act.
2. Delay - Being stuck. They'll research or talk about the change at length, but they won't act on it.
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How many months must a person be actively working on a new behavior to be considered in the "Action Phase" of the Stages of change modedl
6 months. Action is the most demanding stage.
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In the stages of change model what are some principles of progress.
1. Increase your pro's.
2. Consciousness-raising.
3. Get your facts to be informed.
4. Increase your behavior IQ.
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In the stages of change in order to move from contemplation to preparation what must we do.
, we must decrease our cons but only by half as much as we need to increase our pros.
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In the stages of change model what is needed to move from preparation to action?
Self-regulation and self-efficacy
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Client: You must be half my age. How are you going to know what’s best for me? You haven’t even been through menopause I bet. I’m an older woman and I need someone who can understand my struggles. Your metabolism starts to work differently when you’re older, I need advice on how to deal with that. My body hurts and it can’t move like it used to, I need advice on ways I can change my movement routine.
What strength could the coach pull out from this client?
thoughtful, this client has already thought through the specifics of what she needs.
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Bathilda, a 76 year old woman, is in her fourth session with her health coach. She has recently left the range for prediabetes and is very proud of her success! She wants to continue this trend and work on maintaining her healthy habits. Bathilda was a marathon runner when she was younger, running a total of 15 marathons in her lifetime. Swimming currently feels best for her and she would like to maintain her habit of swimming for 50 minutes on Saturday, Wednesday and Friday of each week. On Tuesdays and Thursdays she goes to a calisthenics class with some of her friends. Per the CDC guidelines, what modification might you suggest to her current exercise routine?
Adding in balancing training
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Janet, a 31 year old female, is struggling in her relationship to her husband. She notices how upset she gets when he does something small like not take out the trash without having to be asked. She doesn’t feel the level of her reaction is warranted and always feels bad after being sharp with him about it. She’s concerned something is wrong with her. Upon further questioning Janet explains that her parents didn’t have a good relationship and that she might not even know what one would look like.
Which of the following coach responses helps Janet build her self-efficacy through exploring a vicarious experience?
You don’t feel like you’ve had very many positive examples of a healthy relationship, most notably since you don’t think your parents had one. I’m curious, do any of your friends or their parents have a healthy relationship that you’ve been able to observe?
