ACE Study Companion

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Omar is a new client who is working with a health coach to improve his health after a recent diagnosis of hypertension and metabolic syndrome. He states that both parents had heart attacks in their 50s and that his twin brother has type 2 diabetes. He says he is concerned that he is heading down a similar path and he is very worried he will have a serious health event, particularly because he is divorced with two young children. Omar reports having a stressful job as a computer engineer, working the night shift in the financial industry. Due to the stress of his job, he purchases food from the vending machine, eats at his desk, and does not have time to exercise. Although he says that he knows the importance of eating better and exercising, he states that he does not have time to do either because after work he goes home and sleeps until it is time to go back to work. Omar states that although it is going to be difficult, he wants to change his behaviors and is asking the health coach for help with eating better to improve his health. Which of the following statements BEST reflects a directing style of communication? A. "I see you are concerned about your health, and you should be, as your children need you. I can help by providing you with some eating suggestions and ways to get some movement in at work. How does that sound?" B. "I see you are concerned about your health. Can you tell me more about the vending machine at work as well as your work environment so I can better understand?" C. "I understand how worried you are about your health, especially since both of your parents experienced heart attacks in their 50s. How do you feel about talking more about your concerns?" D. "I understand how worried you are about your health, especially since your recent diagnosis of hypertension and metabolic syndrome. What do you know about hypertension and metabolic syndrome?"

A. "I see you are concerned about your health, and you should be, as your children need you. I can help by providing you with some eating suggestions and ways to get some movement in at work. How does that sound?"

Suong is a new client seeking assistance with weight loss. She states that her physician recently told her she has metabolic syndrome, wants her to seek help, and needs her to lose weight in order to improve her health and decrease the risk of developing type 2 diabetes. Suong says that she met with a dietitian but was unhappy with many of the vegetables listed on the dietitian's approved food list due to her religious food restrictions. Suong states she understands eating more vegetables will help with weight loss but refuses to eat against her religious food restrictions. Which statement BEST reflects the health coach showing respect and establishing rapport? A. "I understand that you are unhappy with many of the vegetables and support you in avoiding them for religious reasons. Can you tell me about the food suggestions you were happy with and how you think you could use them in your diet?" B. "I don't really understand why you are unhappy with many of the vegetables listed. Can you explain? You know that the dietitian is the food expert and that not following her advice might deter your weight loss." C. "I understand that you are unhappy with many of the vegetables listed, but I respect your religious restrictions. Would you be willing to see a different dietitian?" D. I understand that you are unhappy with many of the vegetables listed and I would be unhappy as well. I can provide you with some dietary information from some of my other clients who also have metabolic syndrome."

A. "I understand that you are unhappy with many of the vegetables and support you in avoiding them for religious reasons. Can you tell me about the food suggestions you were happy with and how you think you could use them in your diet?"

John is working with a health coach to control his newly diagnosed hypertension. He states that his physician told him to lose some weight and improve his eating as initial lifestyle strategies and to return in three months to determine whether hypertension medications are indicated. John states that he is committed to eating better and losing weight to avoid having to take medication. According to the GROW model, which question BEST reflects exploring options for achieving the client's goal of eating better? A. "If you could do anything, what would you do?" B. "How often do you think you can eat healthy meals?" C. "What type of support system is available to help you?" D. "What is the most important reason you have decided to develop a plan to eat better>"

A. "If you could do anything, what would you do?"

Barbara is a new client who was referred to a health coach by her best friend. Barbara states she has had diabetes for more than three years but has not been diligent about following up with her endocrinologist, has not been checking her blood sugar regularly, and sometimes forgets to take her oral medications for her diabetes. Barbara states that her diabetes has been challenging, as it is not well controlled, and she has bouts of hypoglycemia and fainting. Barabara's friend has been controlling her diabetes through lifestyle changes, which she attributes, in part, to her working with the health coach. Barabara states she would like to control her diabetes in the same way as her friend. Which of the following statements reflects the heath coach using a "labeling trap"? A. "Since you are diabetic, I think health coaching is very important for your success." B. "I see you are concerned about controlling your diabetes and feel health coaching would be helpful." C. "Since you friend has had success controlling her diabetes through health coaching, I can see it would help you too. " D. "I see you have diabetes and hear you are struggling to get it under control."

A. "Since you are diabetic, I think health coaching is very important for your success."

Brooke works as an administrative assistant and has recently participated in a health-risk appraisal at her office. Her results surprised her, as they indicated she was at high risk for having a heart attack in the next 10 years, which is something she wants to avoid. Although she states she is a weekend smoker, she feels that she eats well and walk her dog nightly, which she thought would protect her from heart disease. Which of the following questions BEST reflects the spirit of motivational interviewing? A. "What does 'eating well' look like to you?" B. "What unhealthy foods are you eating now?" C. "What are you willing to avoid in order to decrease your risk of heart attack?" D. "What do you think you can do more of in order to decrease your risk of a heart attack?"

A. "What does 'eating well' look like to you?"

During a recent health coaching session, Dimetrius explains that he feels that he is a failure because he can never stick with anything he starts. He says he is struggling with controlling his hypertension and knows that a regular exercise routine would be extremely beneficial. Dimetrius states he does not have time to exercise because his work schedule is very unpredictable, and he does not seem to have time to get home, change clothes, and head to the gym. Which of the following questions might help challenge this client's assumption that he doesn't have time to exercise? A. "When do you think you could add some physical activity into your workday?" B. "Why do you think exercise is important in controlling hypertension?" C. "How late is your gym open?" D. "Do you think your workplace might be interested in building an on-site exercise facility?"

A. "When do you think you could add some physical activity into your workday?"

Roberta is attending her first coaching session and discloses that she is struggling with maintaining a consistent exercise program due to extreme fatigue and pain flare-ups from a car accident she endured over a year ago. She states that although her physician has cleared her for exercise as tolerated, she just lacks motivation. According to the taxonomy of stressors, which type of stressor is BEST reflected in this scenario? A. Chronic stressors B. Brief naturalistic stressors C. Acute time-limited stressors D. Distant stressors

A. Chronic stressors

During a recent health coaching session, Dimetrius explains that he feels that he is a failure because he can never stick with anything he starts. He says he is struggling with controlling his hypertension and knows that a regular exercise routine would be extremely beneficial. Dimetrius states he does not have time to exercise because his work schedule is very unpredictable, and he does not seem to have time to get home, change clothes, and head to the gym. Which of the following is BEST categorized as a simple reflection? A. "You feel you do not have time to exercise." B. "Exercise is very important in controlling hypertension, especially 150 minutes of cardiovascular exercise per week." C. "Can you tell me more about why you feel you are a failure?" D. "You feel that you are never going to improve your hypertension because you are not exercising?"

A. "You feel you do not have time to exercise."

Antwon is a client who has had two months of health coaching after his wife purchased a six-month package for him for his birthday. He states that he feels he is a "big guy" and, although he agrees that he has gained a bit of weight since he got his new "desk job", he thinks his wife is exaggerating his condition. Antwon agreed to have the health coach gather some biometric information, which revealed the following: Heigh: 73 inches (190.5 cm) Weight: 310 lb (140.6 kg) BMI: 40.9 kg/m^2 % fat-free mass: 64% % fat mass: 36% Target % fat-free mass: 70% Target % fat: 30% After reviewing this information, Antwon states he was unaware of how his weight is putting him at a health risk and that he is ready to begin an exercise program, although he presently does not do any physical activity or formal exercise. He used to like walking and hiking long distances, but heard that to lose weight, he has to do shorter, faster power walks. He has a target of achieving a 70% fat-free body mass and agrees that he will reduce his daily caloric intake by 250 kcal and increase his caloric expenditure by 250 kcal/day by adding walking to his routine. How long will it take this client to achieve a 70% fat-free mass, assuming the weight loss will be from fat and using estimate of 1 pound of body fat containing 3500 kcal? A. 27 weeks B. 45 weeks C. 93 weeks D. 70 weeks

A. 27 weeks

Patrick, who is a computer programmer, has been working with a health coach for three months and making healthier food and drink choices in an effort to lose 20 pounds (9.1kg) over the next 5 months, per the recommendation from his physician. Patrick states he is planning his meals during the week, sticking with a 2,000-calorie/day target, down from 2,500 calories/day. However, he says he struggles on the weekends, as he enjoys eating out, going to nightclubs, and socializing with friends. He states he has hit a plateau after losing 10 pounds (4.5 kg) and has heard that a diet that is high in protein and low in fat and carbohydrate is the best way to lose his last pounds (4.5 kg). If Patrick reduces his calorie intake by 500 calories per day, what is MOST accurate timeline estimate for achieving his goal of a 10-pound (4.5 kg) weight loss? A. 70 days B. 65 days C. 60 days D. 55 days

A. 70 days

Ruby has type 2 diabetes and is taking metformin to control her blood sugar. She has received medical clearance and has started a physical-activity program per her endocrinologist's recommendation. She says she is completely committed to exercising more, but fears developing hypoglycemia and passing out. How can the health coach BEST help this client overcome the fear of hypoglycemia? A. Ask the client what she already knows about exercise and hypoglycemia, then, with permission, collaboratively explore practical strategies to employ if any symptoms are present during exercise B. Provide a support system for the client by connecting her with other individuals with diabetes who are successful exercisers C. Ask the client about her hypoglycemic experiences and strategies she used to return her blood sugar to normal ranges D. Provide educational information and glucose tablets that can be used during future hypoglycemic episodes

A. Ask the client what she already knows about exercise and hypoglycemia, then, with permission, collaboratively explore practical strategies to employ if any symptoms are present during exercise

Jamal is a new client who states he is extremely worried about his health, as his recent physician visit identified new diagnoses for hypertension, type 2 diabetes, and hypercholesterolemia. He believes that he will most likely have a heart attacks in the near future, as his father and older brother had all three conditions and suffered heart attacks within a year of those diagnoses. Jamal states that he tried to start eating healthier and exercising but, despite his excessive worrying about his health, he lacks motivation and energy. He is interested in learning stress-management techniques. The health coach has Jamal participate in few mindfulness activities, including diaphragmatic breathing, affirmations, and meditation. Which of the following factors may be contributing to Jamal's personal stress response? A. Biological predisposition B. Protective factors C. Personality traits D. Life experiences

A. Biological predisposition

Lionel, a forklift operator, is interested in working with a health coach to help prevent an escalating blood pressure issue, which a nurse practitioner identified during an employee wellness screening. Over the past 3 months, his blood pressure has averaged 128/82 mmHg. Lionel wants to avoid taking blood pressure medications and instead modify his lifestyle. An entry from his food journal is provided here: Morning: -coffee; egg mcmuffin from mcdonald's Mid-morning: -coffee; donut Lunch: -diet soda; chicken salad with ranch dressing from Wendy's Dinner: -diet soda; frozen dinner Night snack: -white cheddar popcorn; diet coke Which of the following is MOST appropriate for this client? A. Blood pressure self-monitoring, aerobic exercise, and adoption of the DASH eating plan B. Blood pressure self-monitoring, strength-training exercise, and adoption of the DASH eating plan C. Blood pressure self-monitoring, aerobic exercise, and adoption of a Mediterranean-style eating plan D. Blood pressure self-monitoring, strength-training exercise, and adoption of a Mediterranean-style eating

A. Blood pressure self-monitoring, aerobic exercise, and adoption of the DASH eating plan

Jasmine, a long-standing client, has been working with a health coach on mindfulness techniques to aid in managing her work stress. At a recent session, she explains that she has received a work promotion that requires frequent presentations to customers. Although she states that she has strong writing skills, she shares that she has significant anxiety speaking to groups. She says that her heart rate increases, her stomach becomes jittery, and her hands become clammy. Jasmine feels her anxiety stems from a traumatic failed public speaking engagement she has in high school that caused her much embarrassment and ridicule from her peers. Which type of stress is BEST reflected in this scenario? A. Chronic B. Professional demands C. Physical environment D. Acute

A. Chronic

At a health coaching sessions, Malina shares that her osteoarthritis has flared up and she has been in chronic pain for the past few weeks. She states that she was doing well with eating healthy and having more energy and motivation. However, during these flare-ups, she overeats to help deal with the pain, even though she knows it will sabotage her weight-loss efforts and prevent her from getting her body mass index under 35 kg/m^2, which is one of her goals. After the client gives permission to learn more about the most optimal approach to manage osteoarthritis, which of the following statements would be MOST accurate to share? A. Combining exercise and weight loss is the optimal approach, as it can relieve symptoms and improve function B. Following a DASH eating plan can solely aid in reducing inflammation associated with arthritis C. Following a Mediterranean-style eating plan can solely aid in reducing inflammation associated with arthritis D. Losing 5-10% body weight is the optimal approach to improving strength, mobility, and functionality

A. Combining exercise and weight loss is the optimal approach, as it can relieve symptoms and improve function

Roberta is attending her first coaching session and discloses that she is struggling with maintaining a consistent exercise program due to extreme fatigue and pain flare-ups from a car accident she endured over a year ago. She states that although her physician has cleared her for exercise as tolerated, she just lacks motivation. Which type of stress is BEST reflected in this scenario? A. Distress B. Professional demands C. Physical environment D. Eustress

A. Distress

A long-time client shares with his health coach information about the death of a family member and what a significant impact it has had on his ability to stay consistent with his exercise and healthy eating plan. The health coach states, "I feel terrible for you and am so sad to hear of your loss. Please know that I'll be keeping you and your family in my thoughts." This statement BEST reflects which of the following "person-centered care" characteristics? A. Empathy B. Respect C. Autonomy D. Beneficence

A. Empathy

Rose, a non-smoker, has successfully completed a 12-week cardiac rehabilitation program after having a mild heart attack and coronary balloon angioplasty procedure. She states that she feels relieved that the angioplasty has unclogged her blocked arteries and she's "good as new." She also says that her cardiologist approved her to continue exercising and has indicated that she needs to be eating a heart-healthy diet and managing her stress. She is taking a low-dose aspirin as well as an ACE inhibitor and is ready to make the necessary behavior changes to get healthy and avoid a second event. Which of the following statements BEST supports the "arrange" component of the 5 A's evidence-based approach to improve health behaviors? A. Establish a system of accountability and method for self-monitoring B. Identify barriers, leverage social support, and enhance self-management C. Co-create an action plan that aligns with the client's self-directed goals D. Explore attitudes, beliefs, experiences, current behaviors, and knowledge

A. Establish a system of accountability and method for self-monitoring

Serena has a successful coaching business, the growth of which has plateaued. Her strategy for gaining new clients has been primarily word of mouth and some local print advertising in her community. Many of her clients have chronic issues and are travelling business professionals who have asked her to offer a blog, increase her social media presence, and incorporate video-based coaching for additional information and convenience. What is the BEST strategy for having a presence on a social media platform? A. Focus on consistently creating and posting content that is value-rich B. Figure out the current social media algorithm for best results C. Avoid the use of hashtags, as they can negatively impact brand awareness D. Use social media services that allow you to load content for scheduled posts

A. Focus on consistently creating and posting content that is value-rich

Charley is a new client who was referred to a health coach by his primary care physician. He states that he is a "big man," having played middle linebacker for his college football team 20 years ago. Although his physician states that his 52-inch waist, unhealthy eating habits, and lack of regular physical activity are contributing factors to his chronic back pain, Charley feels that his pain is due to years of playing football and that playing with his dog is sufficient physical activity. Charley told his physician he would give health coaching a try. Which of the following would be the MOST appropriate exercise strategy for a client with low-back pain who has been cleared to return to full physical activity? A. Focus on core function and fundamental movement patterns B. Begin with non-impact activities and gradually return to high-impact activities C. Focus on abdominal strengthening exercises that work the rectus abdominis and transverse abdominis musculature D. Begin with aquatic activities in a warm-water pool to increase range of motion, gradually progressing to land-based impact activities

A. Focus on core function and fundamental movement patterns

Cecelia, who is employed as an investment banker, has been a consistent client for the past 3 months. She reports a recent diagnosis of uncontrolled hypertension and is taking a beta blocker. She says she has difficulty remembering to take her medication and knows this is not helping her uncontrolled hypertension. She states that she wants to be consistent with her medications and work on controlling her blood pressure through exercise and improved nutrition, but her stressful job, long hours, and unpredictable work requirements makes it nearly impossible to be consistent with her walking program and regularly prepare healthy meals. She says that both her parents have had heart attacks and she is worried that the stress of her job and inconsistency with taking her medication will put her on this same path. She has two young children and wants to be healthy so she can enjoy them and be around for them in the future. Which of the following statements about hypertension is MOST accurate? A. Inadequate sleep is associated with a higher risk of developing hypertension B. There is not a significant genetic contribution to the development of hypertension C. There is no association between having obesity and the development of hypertension D. Hypertension is the most important risk factors for obstructive sleep apnea

A. Inadequate sleep is associated with a higher risk of developing hypertension

Jasmine has been working with an ACE Certified Health Coach for three months and states she has been making progress with reducing her eating at fast-food restaurants and decreasing her sedentary behaviors. She reports that she has been bringing her lunch and eating at work four days a week and taking a walk around the office building daily. What is the BEST initial strategy to use with this client? A. Support the client in establishing a system of self-monitoring B. Plan for potential lapses and set a reward system C. Explore the client's personal value and commitment D. Identify and assist the client with finding social support and defining goals

A. Support the client in establishing a system of self-monitoring

A health coach receives an email from a potential client who is interested in online coaching but is not sure it is right for him. The email states that he is unfamiliar with the work of a health coach, but at a recent physician visit received a new diagnosis of hypertension, was told his body mass index (BMI) has increased to 39kg/m^2 and learned that his osteopenia has worsened. Which of the following BEST represents a high level of professionalism during an online coaching session? A. Initiating the call on time, minimizing background noise, having a well-organized environment, and dressing professionally B. Initiating the call on time, minimizing background noise, and sharing success stories of previous clients C. Sending a reminder email, having the client call at his convenience, minimizing background noise, and sharing success stories of previous clients D. Sending a reminder email, initiating the call on time, and sharing your background credentials, and number of successful clients

A. Initiating the call on time, minimizing background noise, having a well-organized environment, and dressing professionally

Alyssa is a long-standing client who sees a mental health professional for her depression. Although she is taking medication to help stabilize her mood, she reports frequent mood swings and often lacks motivation, causing her to watch movies for excessive amounts of time and indulge in unhealthy overeating. She reports that she has reduced for fast food intake by 50% and has been exercising three times a week, which seems to help, but says she is concerned because her lack of motivation is increasing, making it more difficult to resist fast foods and exercise regularly. Which of the following terms BEST describes the client's excessive TV watching and overeating? A. Maladaptive coping behaviors B. Behavioral strategies for mood enhancement C. Behavioral strategies for depressive compensation D. Adaptive coping behaviors

A. Maladaptive coping behaviors

Juanita is a new client who has recently been diagnosed with hyperlipidemia. She is interested in improving her diet to lower her total cholesterol and low-density lipoprotein levels, per her physician's recommendation. Which of the following action plans BEST supports the principles of adult learning? A. Meet her at the grocery store for a tour and learning activities. B. Provide her with handouts and adult educational resource materials. C. Connect her with other adults clients with hyperlipidemia for support. D. Suggest she watch more cooking channel shows to get ideas.

A. Meet her at the grocery store for a tour and learning activities.

Nijah is employed as an administrative assistant and has lived with type 2 diabetes and hypertension for more than 10 years. She reports having recently gained 10 pounds due to stress eating and her sedentary job. She is interested in beginning a physical-activity program and working with a health coach to change her stress-eating behaviors. However, she states that her work schedule is unpredictable and she struggles with childcare issues, so she is not sure how successful she will be. She also states that even though she has tried physical activity and stress reduction in the past, she has never been able to control her blood sugar and feels like nothing is ever going to work for her. Which of the following cognitive distortions is exhibited in this scenario? A. Overgeneralizing B. Personalization and blame C. Magnification and minimization D. Labeling

A. Overgeneralizing

During an initial consultation, Miguel states that at his last physical exam, his blood pressure was categorized as "elevated" and that he has recently been experiencing shortness of breath while at rest. In addition, Miguel says that his 55-year-old father had a heart attack. According to the health belief model, which variable is BEST described in this scenario? A. Perceived susceptibility B. Perceived benefits C. Perceived seriousness D. Perceived barriers

A. Perceived susceptibility

Charley is a new client who was referred to a health coach by his primary care physician. He states that he is a "big man," having played middle linebacker for his college football team 20 years ago. Although his physician states that his 52-inch waist, unhealthy eating habits, and lack of regular physical activity are contributing factors to his chronic back pain, Charley feels that his pain is due to years of playing football and that playing with his dog is sufficient physical activity. Charley told his physician he would give health coaching a try. What stage of change is BEST reflected in this scenario? A. Precontemplation B. Contemplation C. Preparation D. Action

A. Precontemplation

Nijah is employed as an administrative assistant and has lived with type 2 diabetes and hypertension for more than 10 years. She reports having recently gained 10 pounds due to stress eating and her sedentary job. She is interested in beginning a physical-activity program and working with a health coach to change her stress-eating behaviors. However, she states that her work schedule is unpredictable and she struggles with childcare issues, so she is not sure how successful she will be. She also states that even though she has tried physical activity and stress reduction in the past, she has never been able to control her blood sugar and feels like nothing is ever going to work for her. Which of the following is the BEST next step prior to beginning a physical-activity program with this client? A. Provide a PAR-Q+ screening and request a medical clearance B. Refer the client to a certified personal trainers or medical exercise specialist C. Request a blood sugar log to assess whether diabetes is well controlled D. Provide a PAR-Q+ screening and refer to a certified diabetes educator

A. Provide a PAR-Q+ screening and request a medical clearance

Jackson is a long-standing client who has been successfully losing weight and exercising regularly with a goal of reducing his blood pressure. At his final coaching session, he states that he is continuing to eat healthy foods, has come off his blood pressure medications, and is continuing to lose about 1 pound per week. Jackson states that, unfortunately, he has started working shift work and is finding it difficult to stop home, walk the dogs, change his clothes, and get to the gym for a workout. During the session, Jackson states he could pack his gym bag, put it in his car, and ask a neighbor to walk his dogs a few times a week so he could go straight to the gym before heading home. Which technique does Jackson packing his gym bag and putting it in his car BEST display? A. Stimulus control B. Disengagement C. Discord D. Self-reliance

A. Stimulus control

At a recent coaching session, Paul shares that although he has been working on exercising regularly (3-4 times/week) and taking a healthy lunch to work, he finds it extremely difficult and lacks motivation to continue with the plan. He states that exercising causes him soreness and his "bagged lunches" are making him crave fast food, so he reports having lapses back to eating fast food on many occasions. Which of the following BEST demonstrates acceptance-based strategies? A. The client views the discomfort of exercise as a subjective experience that eventually subsides B. The client accepts that he is unable to tolerate the plan and sets more realistic goals C. The client reflects on his values and desires and discusses the pros and cons of eating fast food D. The client tracks his feelings using a mood-monitoring log in order to become aware of his intolerances

A. The client views the discomfort of exercise as a subjective experience that eventually subsides

Catherine is a health coach who works at an inner-city outpatient clinic. She facilitates a prenatal support group focusing on healthy eating and physical activity. The group consists of women originally from India who have migrated to the United States over the past three years to raise their families. They all speak English and have assimilated into American culture while maintaining their Hindu religion and dietary considerations. When coaching these prenatal women on healthy eating, what is the MOST important consideration? A. The religious factors impacting dietary choices specific to Hinduism B. The feasibility of the women being able to prepare home-cooked meals to increase the nutritional value of their food selections C. The commitment of the women to eating healthy and being physically active during their pregnancies D. The trimester of their pregnancies, as individual caloric needs will vary depending on gestational age of the fetus

A. The religious factors impacting dietary choices specific to Hinduism

Emily is a corporate wellness coach who provides one-on-one coaching at the workplace. At a recent session, one of the clients disclosed being bullied and harassed by a coworker to the point that the client is seeking mental health support. What is the MOST important reasons health coaches should be prepared for emergency situations? A. To ensure safety and minimize liability B. To empower the client and minimize liability C. To empower the client and assure confidentiality D. To ensure privacy and the best troubleshooting practice

A. To ensure safety and minimize liability

Vinnie is a new client interested in running a 5k in six months. He states he has a stressful and sedentary job but walks over a mile to work each day. He states that he is ready to begin a formal running program but also wants to make sure he is eating well, dealing with his stress, and sleeping enough to perform well. Which of the following is the BEST initial strategy? A. Use agenda mapping to help decide what to work on first B. Devise a detailed behavior-change plan C. Use OARS skills to help identify the client's stage of readiness D. Ask open-ended questions in order to identify change talk

A. Use agenda mapping to help decide what to work on first

Karen has been working with a health coach for the past year to improve her consistency with exercise and participation in stress-reducing activities to manage chronic back pain. Although she states she had been making good progress, she recently went through a difficult divorce. She is not interested in seeking additional help but wants to get back on track. Karen has reported the following symptoms, which are making things difficult: -Lack of energy and motivation -Desire to stay in bed all weekend -Difficulty concentrating at work -Increased difficulty in maintaining a regular exercise schedule -Feeling restless most of the day Which of the following is the BEST next step for the health coach to take? A. Use the PHQ-9 to screen the client for depression B. Use the GAD-7 scale to screen the client for anxiety C. Use the perceived stress scale to screen the client for depression D. Use the PHQ-9 to screen the client for anxiety

A. Use the PHQ-9 to screen the client for depression

Indira is a new coaching client who states that her physician mandated she change her eating habits to improve her lipid panel and address a recent diagnosis of hypertension. Her most recent lab and blood pressure indicate the following: -Total cholesterol: 230 mg/dL -HDL cholesterol: 51 mg/dL -LDL cholesterol: 173 mg/dL -Blood pressure: 146/88 mmHg Indira states that she has a strict cultural eating regimen and consumes a large amount of vegetables and chicken. She states that she enjoys samosas (deep fried potato and lentil bean-stuffed pastry puff), pakoras (deep fried vegetables), grilled lamb, and chicken with masala sauce, which is made with ghee (clarified butter). She also states that due to her busy work schedule, she get much of this food from a local Indian grocery market that accepts food orders and then packages the pre-made items for purchase. Which of the following dietary suggestions would be MOST appropriate to assist the client in reducing her hypertension? A. When ordering food from the local Indian grocery market, request that no salt be added B. When ordering food from the local Indian grocery market, request that the items be baked when possible C. When ordering food from the local Indian grocery market, request to see a list of ingredients D. When ordering food from the local Indian grocery market, limit consumption to no more than 3 times/week

A. When ordering food from the local Indian grocery market, request that no salt be added

Sylvia is a new health coaching client interested in quitting her 10-year tobacco-smoking habit because her sister, who also smokes, was recently diagnosed with emphysema. She states that she feels like a failure because she has tried quitting many times before but always gains weight because she would use food to replace the cigarettes. She states that another difficult issue she faces is the regular smoking break she and her colleagues enjoy daily. Sylvia states that, though she really enjoys smoking, she would like to discuss smoking cessation, knows living a smoke-free life is what she need to do, and is seeking help to quit. Which of the following BEST reflects the use of open-ended questions? A. "Smoking cessation can work this time if you completely commit to changing." B. "Can you tell me why smoking cessation is important to you right now?" C. "Smoking cessation is critical for you, especially since your sister has emphysema." D. "Can I give you information about the benefits of smoking cessation and improved health?"

B. "Can you tell me why smoking cessation is important to you right now?"

Suong is a new client seeking assistance with weight loss. She states that her physician recently told her she has metabolic syndrome, wants her to seek help, and needs her to lose weight in order to improve her health and decrease the risk of developing type 2 diabetes. Suong says that she met with a dietitian but was unhappy with many of the vegetables listed on the dietitian's approved food list due to her religious food restrictions. Suong states she understands eating more vegetables will help with weight loss but refuses to eat against her religious food restrictions. Which of the following questions is open-ended? A. "Do you think you will be able to use the other food items the dietitian recommended?" B. "How will you use the other food items in your daily menu planning?" C. "Would you consider seeing a dietitian who is more understanding of your religious food restrictions?" D. "Have you incorporated any of the food recommendations into your menu planning?"

B. "How will you use the other food items in your daily menu planning?"

Millie is a long-standing client who has been making progress with a consistent exercise program over the past six months. At her recent health coaching session, she explains that over the past month, she has been inconsistent with her exercise, begun eating at night, gained 10 pounds, and is having trouble sleeping. She states she has been spending more time caring for her mother, who has had dementia for the past five years. Her mother's health is rapidly declining and Millie is faced with the difficult decision to place her mother in a nursing home, which is the recommendation from her mother's physician and other family members. Although Millie states the facility has an exceptional reputation for caring for patients with dementia and is only 2 miles from her home, she feels like she is a loser and a complete failure despite the support from her family members. Which of the following client statements BEST supports the cognitive restructuring process? A. "I know I'm not a complete failure because I do good things at work, but I am failing as a caregiver for my mother." B. "I know I have helped my mother the past five years and I need to stay healthy myself, as it is just as important as my caregiving." C. "I know I have helped my mother over the past five years, but if she only has a short time left in life, I need to do everything I can, even if I sacrifice my own health." D. "I know I'm not a complete failure because the physician and my family support the decision, but I am a perfectionist and am always in control."

B. "I know I have helped my mother the past five years and I need to stay healthy myself, as it is just as important as my caregiving."

Ruby has type 2 diabetes and is taking metformin to control her blood sugar. She has received medical clearance and has started a physical-activity program per her endocrinologist's recommendation. She says she is completely committed to exercising more, but fears developing hypoglycemia and passing out. Which of the following statement BEST reflects a SMART goals for this client? A. "I want to exercise more, feel better, and reduce my fear of having a hypoglycemic event" B. "I want to walk after dinner three days a week and monitor my blood sugar before and after my walk" C. "I want to exercise after dinner and monitor my blood sugar to reduce my fear of having a hypoglycemic event" D. "I want to exercise more and check my blood sugar regularly to better control my type 2 diabetes"

B. "I want to walk after dinner three days a week and monitor my blood sugar before and after my walk"

Brooke works as an administrative assistant and has recently participated in a health-risk appraisal at her office. Her results surprised her, as they indicated she was at high risk for having a heart attack in the next 10 years, which is something she wants to avoid. Although she states she is a weekend smoker, she feels that she eats well and walk her dog nightly, which she thought would protect her from heart disease. Which of the following questions would BEST identify the client's values to guide her behavior-change efforts? A. "How confident are you that you would be able to quit smoking?" B. "What matters most to you in your overall life?" C. "Do you know how eating, exercise, and smoking affect heart health?" D. "What one thing would you like to change?"

B. "What matters most to you in your overall life?"

Tasha is seeing a health coach after many months of contemplation. She also says that a recent physician visit her weight was at its highest and although she has no additional health issues, her physician warned her that her increased weight puts her at high risk for developing diabetes. She works from home and rarely leaves her house due to her embarrassment about her weight. Which of the following BEST reflects the utilization of motivational interviewing? A. "Tell me about the time in your life when you were not overweight?" B. "What steps do you feel would be best to take to improve your health?" C. 'What steps do you feel are realistic to reduce your obesity?" D. "Tell me about how being obese has affected the quality of your life?"

B. "What steps do you feel would be best to take to improve your health?"

Francesca is seeking the assistance of a health coach due to her struggles with obesity since giving birth to twins two years ago. Francesca states that she has always struggled with being 10 to 20 pounds over her ideal body weight, but now it's upwards of 40 pounds and is starting to take a toll on her joints, energy level, and sleep. The first coaching session was devoted to creating a relationship, developing trust, identifying Francesca's stage of change, and using motivational interviewing and active listening to learn her goals and level of commitment. At a subsequent session, Francesca asked the health coach to provide some baseline biometric information so she can better understand her starting point for weight loss. The following biometrics were gathered: Age: 28 Height: 67 inches (170 cm) Weight: 290 lb (131.8 kg) Waist circumference: 47 inches (119 cm) Hip circumference: 50 inches (127 cm) What is Francesca's waist-to-hip ratio and classification of metabolic and cardiovascular disease risk? A. 1.06; at risk B. 0.94; at risk C. 0.85; average D. 0.87; average

B. 0.94; at risk

Dylan is a long-standing client who has recently lost his job as a financial analyst. He reports that his wife just had their third child and they purchased a new home three months ago. Although he states that his college degree and five years of experience in the financial industry will help him secure a new position, Dylan states that he is stressed out and has quit exercising and started smoking again. The health coach administers the perceived stress scale assessment and finds the client's score to be a 28. Which of the following statements about medications is MOST accurate? A. Benzodiazepines are typically recommended for long term management of anxiety disorders B. Anti-depressants are the first-line treatment for anxiety disorders and must be prescribed by a healthcare provider C. Cognitive behavioral therapies are not very effective for long term management of anxiety disorders D. Brain-stimulation therapies are typically used for severe cases of anxiety and must be prescribed by a healthcare provider

B. Anti-depressants are the first-line treatment for anxiety disorders and must be prescribed by a healthcare provider

Antwon is a client who has had two months of health coaching after his wife purchased a six-month package for him for his birthday. He states that he feels he is a "big guy" and, although he agrees that he has gained a bit of weight since he got his new "desk job", he thinks his wife is exaggerating his condition. Antwon agreed to have the health coach gather some biometric information, which revealed the following: Heigh: 73 inches (190.5 cm) Weight: 310 lb (140.6 kg) BMI: 40.9 kg/m^2 % fat-free mass: 64% % fat mass: 36% Target % fat-free mass: 70% Target % fat: 30% After reviewing this information, Antwon states he was unaware of how his weight is putting him at a health risk and that he is ready to begin an exercise program, although he presently does not do any physical activity or formal exercise. He used to like walking and hiking long distances, but heard that to lose weight, he has to do shorter, faster power walks. He has a target of achieving a 70% fat-free body mass and agrees that he will reduce his daily caloric intake by 250 kcal and increase his caloric expenditure by 250 kcal/day by adding walking to his routine. What is this client's target body weight based on achieving 70% fat-free mass? A. 217 lb (98.6 kg) B. 283 lb (129 kg) C. 265 lb (121 kg) D. 240 lb (109 kg)

B. 283 lb (129 kg)

Robert is an inconsistent exerciser interested in running his first 5k in 6 months. Twenty years ago, he was a cross-country runner in high school, but he has not run regularly since then. At his first health coaching session, he discloses that his father, who was a heavy smoker, died of a heart attack at the age of 50. Although Robert reports he is not a smoker, he is wonder whether if it is safe to start an exercise program. He states that he is a sales representative and alternates between being sedentary in the office and walking from site to site when on sales calls. His job requires weekly travel, which is why he feels he becomes inconsistent with his exercise. He states that he is interested in the best training program as well as help with his consistency. What is the BEST aerobic (cardiovascular endurance) exercise volume for this client? A. 10,000 steps per day B. >500 to 1,000 MET minutes/week C. 80-85% of heart rate reserve D. 150 minutes of vigorous weekly aerobic exercise

B. >500 to 1,000 MET minutes/week

Indira is a new coaching client who states that her physician mandated she change her eating habits to improve her lipid panel and address a recent diagnosis of hypertension. Her most recent lab and blood pressure indicate the following: -Total cholesterol: 230 mg/dL -HDL cholesterol: 51 mg/dL -LDL cholesterol: 173 mg/dL -Blood pressure: 146/88 mmHg Indira states that she has a strict cultural eating regimen and consumes a large amount of vegetables and chicken. She states that she enjoys samosas (deep fried potato and lentil bean-stuffed pastry puff), pakoras (deep fried vegetables), grilled lamb, and chicken with masala sauce, which is made with ghee (clarified butter). She also states that due to her busy work schedule, she get much of this food from a local Indian grocery market that accepts food orders and then packages the pre-made items for purchase. In a follow-up session, the health coach, supports the client's desire to consume ethnic cuisine, asks open-ended questions, and uses active listening to understand the eating pattern of the client's home country. To what is the health coach paying special attention? A. Healthy food access B. Acculturation C. Socio-ecological eating D. Assimilation

B. Acculturation

Lester, a long-standing client who was recently diagnosed with type 2 diabetes, asks the health coach to give him a six-week health transformation program because he wants to improve his health and get rid of his type 2 diabetes. What is the MOST appropriate response an ACE Certified Health Coach could give? A. Acknowledge his request, display empathy, share your credentials, and provide education about type 2 diabetes and lifestyle-change benefits. B. Acknowledge his request, ask him to discuss what specific area he is interested in improving, commend him for taking charge of his health, and ask permission to speak with his diabetes healthcare provider. C. Acknowledge his request, display empathy, ask him to discuss what specific area he is interested in improving, and ask permission to give him a six-week low-glycemic menu plan. D. Acknowledge his request, display empathy, share your credentials, and provide a referral to diabetes education classes at a local hospital.

B. Acknowledge his request, ask him to discuss what specific area he is interested in improving, commend him for taking charge of his health, and ask permission to speak with his diabetes healthcare provider.

Jasmine has been working with an ACE Certified Health Coach for three months and states she has been making progress with reducing her eating at fast-food restaurants and decreasing her sedentary behaviors. She reports that she has been bringing her lunch and eating at work four days a week and taking a walk around the office building daily. Which stage of change BEST reflects the client's current situation? A. Maintenance B. Action C. Contemplation D. Precontemplation

B. Action

Omar is a new client who is working with a health coach to improve his health after a recent diagnosis of hypertension and metabolic syndrome. He states that both parents had heart attacks in their 50s and that his twin brother has type 2 diabetes. He says he is concerned that he is heading down a similar path and he is very worried he will have a serious health event, particularly because he is divorced with two young children. Omar reports having a stressful job as a computer engineer, working the night shift in the financial industry. Due to the stress of his job, he purchases food from the vending machine, eats at his desk, and does not have time to exercise. Although he says that he knows the importance of eating better and exercising, he states that he does not have time to do either because after work he goes home and sleeps until it is time to go back to work. Omar states that although it is going to be difficult, he wants to change his behaviors and is asking the health coach for help with eating better to improve his health. Which of the following BEST describes Omar's statement about his ability to improve his eating and exercise habits? A. Evocation B. Ambivalence C. Affirmation D. Engagement

B. Ambivalence

Jamal is a new client who states he is extremely worried about his health, as his recent physician visit identified new diagnoses for hypertension, type 2 diabetes, and hypercholesterolemia. He believes that he will most likely have a heart attacks in the near future, as his father and older brother had all three conditions and suffered heart attacks within a year of those diagnoses. Jamal states that he tried to start eating healthier and exercising but, despite his excessive worrying about his health, he lacks motivation and energy. He is interested in learning stress-management techniques. The health coach has Jamal participate in few mindfulness activities, including diaphragmatic breathing, affirmations, and meditation. Which of the following BEST describes Jamal's mindset? A. Stress-is-debilitating mindset B. Fixed mindset C. Growth mindset D. Stress-debilitating mindset

B. Fixed mindset

Taj is a consistent health coach client who has made good progress in improving his sleeping habits since his diagnosis of obstructive sleep apnea more than six months ago. At a recent coaching session, Taj explains that his physician has directed him to see a pulmonologist for continued monitoring of his condition, but he is apprehensive since he has never seen any other physicians and states he believes his primary care physician can take care of him. Which of the following suggestions would BEST improve Taj's health literacy? A. Provide him with the name of a well-respected local pulmonologist. B. Ask him what he knows about a pulmonologist's role in managing patients with obstructive sleep apnea, then provide education as necessary. C. Tell him that a primary care physician does not have the education to treat obstructive sleep apnea, then provide a list of reasons. D. Ask him for permission to allow you to speak with his primary care physician about your apprehension.

B. Ask him what he knows about a pulmonologist's role in managing patients with obstructive sleep apnea, then provide education as necessary.

Susan has been working with a health coach for the past month and has had a recent diagnosis of osteopenia. She is concerned about the increased risk of osteoporosis, as both her grandmother and mother have the disease. Susan is a regular participant in water exercise classes 5 to 7 days/week. After she received this diagnosis, she started deep-water running, but her healthcare provider told her she had to run on land to receive any protective benefits. Susan stated that she does not like to run on land and is concerned that since she will not be consistent she will end up with osteoporosis. She states she is ready to change her behavior but is struggling doing something she does not enjoy. What is the BEST next step for the health coach to take with this client? A. Discuss a variety of alternative exercises that can assist in bone strengthening and reduce the client's risk of osteoporosis B. Ask the client what she knows about physical activity and osteoporosis risk reduction, if she would like to learn about alternative exercises for bone strengthening, and if agreeable, discuss modalities like resistance training and walking on land C. Discuss the need for the client to see a dietitian to determine whether a lack of calcium could be the root cause of her osteopenia D. Ask the client if you can share some experiences of other clients you have worked with and, if agreeable, discuss success stories of other women who have improved their bone density

B. Ask the client what she knows about physical activity and osteoporosis risk reduction, if she would like to learn about alternative exercises for bone strengthening, and if agreeable, discuss modalities like resistance training and walking on land

Niko, a health coaching client, reports his recent physician visit revealed an increased body mass index of 36kg/m^2 and an ALC of 7.0%. Over the past month, the health coach has been using motivational interviewing to assist with the client's desire to change his eating behaviors to lose weight, despite challenges of working shift work at this cybersecurity job. Which of the following BEST reflects use of the elicit-provide-elicit model? A. Ask the client how he feels about this information, share information about the relationship between elevated body mass index and diabetes (with client permission), and provide information about blood sugar control B. Ask what the client know about diabetes, share additional information to fill in gaps (with client permission), then ask what the client understands from the shared information C. Ask what the client knows about diabetes, provide a low-glycemic eating plan to assist in blood sugar stability (with client permission), then ask what the client understands regarding this type of eating D. Ask the client how he feels about this information, allow the client to discuss his feelings, acknowledge his feelings, and demonstrate sympathy and understanding by stating your ability to help

B. Ask what the client know about diabetes, share additional information to fill in gaps (with client permission), then ask what the client understands from the shared information

Felipe is a new client who states he is a "workaholic" who is searching for a new job and is training to complete his first half-marathon. He is looking to work with a health coach to assist in managing the stress associated with his job situation so he can do his best at the event. Felipe states that eh has been following a "marathon runner's eating plan," which was suggested by a sports dietitian. He says that the event is in two weeks and he is excited but very nervous about performing well. According to the taxonomy of stressors, which type of stressor is BEST reflected by his nervousness about performing well in the half-marathon? A. Chronic sequences B. Brief naturalistic stressors C. Acute time-limited stressors D. Distant stressors

B. Brief naturalistic stressors

Sylvia is a new client interested in beginning an exercise program to help her arthritis. In the first session, she tells the health coach that she bought a new pair of athletic shoes and took a tour of a local health club but feels she is too old to exercise and is considering returning her athletic shoes. The health coach offers to introduce Sylvia to a few of her older clients and states that if she is interested she can be a guest at the health club where they are members. According to the stages of change, what should be the initial focus of the client's program? A. Maintain a support system for best outcome and success B. Co-create an action plan with frequent positive feedback C. Increase awareness about the benefits of exercise for older adults D. Maintain interest to avoid boredom and burnout

B. Co-create an action plan with frequent positive feedback

Cassandra has just begun her health coaching sessions and states that even though she knows exercise will be helpful with achieving her weight-loss goal, she knows she is not going to be consistent with it because she is always sore after she exercises and is in pain for days. Which of the following coaching techniques would be BEST to use with Cassandra? A. Motivational interviewing coaching B. Cognitive behavioral coaching C. Positive psychology coaching D. Self-empowerment coaching

B. Cognitive behavioral coaching

A health coach receives an email from a potential client who is interested in online coaching but is not sure it is right for him. The email states that he is unfamiliar with the work of a health coach, but at a recent physician visit received a new diagnosis of hypertension, was told his body mass index (BMI) has increased to 39kg/m^2 and learned that his osteopenia has worsened. What is the health coach's BEST next step? A. Send the potential new client a lifestyle questionnaire and set up time for consultation B. Set up a time for a 15 minute session to determine if the coach and client are a good fit for one another C. Send the potential new client a brochure detailing the coach's credentials, services, and pricing D. Set up the initial consultation and payment schedule

B. Set up a time for a 15 minute session to determine if the coach and client are a good fit for one another

Alyssa is a long-standing client who sees a mental health professional for her depression. Although she is taking medication to help stabilize her mood, she reports frequent mood swings and often lacks motivation, causing her to watch movies for excessive amounts of time and indulge in unhealthy overeating. She reports that she has reduced for fast food intake by 50% and has been exercising three times a week, which seems to help, but says she is concerned because her lack of motivation is increasing, making it more difficult to resist fast foods and exercise regularly. Which of the following behavior-change plans can prove MOST beneficial for this client? A. Develop a SMART goal strategy based on the client's previous success B. Collaborate with the client, define metrics of success, and build in numerous opportunities for successful experiences C. Register the client for a local support group that focused on healthy lifestyle behaviors D. Collaborate with the client and her mental health professional to discuss the possibility of medication adjustment due to the recent client mood swings and lack of motivation

B. Collaborate with the client, define metrics of success, and build in numerous opportunities for successful experiences

A health coach is working in a clinical setting with a new client interested in losing weight and beginning an exercise program in order to manage her diabetes. The initial session identified the client as being in the preparation stage of change and having basic knowledge of exercise and health eating for weight loss. The client says she lacks consistency and has difficulty sticking to a program due to a hectic work schedule, three young children, and a chronically ill parent. The health coach uses agenda mapping to uncover options for discussion. Which of the following represents the MOST appropriate steps for after the coaching session? A. Reconcile any client paperwork, process the transaction for session payment, and prepare the area for the next client B. Complete session documentation per clinic guidelines, update the healthcare provider if required, and prepare the area for the next client C. Reconcile any client paperwork, send a "homework reminder" email, and prepare the area for the next client D. Complete session documentation, create a new file, and process the transaction for session payment

B. Complete session documentation per clinic guidelines, update the healthcare provider if required, and prepare the area for the next client

Frank is a new client who states that he wants to get back in the shape he was in college. He says that as a college athlete he was strong and had a very lean body. Frank reports having multiple injuries from his sport that caused him to have a knee replacements nearly a year age. He received opioid prescriptions for his pain, which he says have become an addiction because they make him "feel good." His physician has told him to stop taking the opioids and has criticized him for continuing to take them. Frank has learned that his prescriptions will expire one year from the surgery, which is fast approaching. Frank states he feels better when he takes them and that he needs help. What is the BEST next step to take with this client? A. Inform the client that you are unable to discuss this situation because he is a drug addict B. Confirm the client's interest in getting help, collaborate with other professionals, and privately explain that the situation is beyond the scope of a health coach, but that with his permission you would like to refer to a substance-use disorder specialist C. Confirm the client's interest in getting help and suggest educational information to help him learn more about opioid addiction and treatment options D. Inform the client that you would like to speak with his physician and offer suggestions regarding behavior change

B. Confirm the client's interest in getting help, collaborate with other professionals, and privately explain that the situation is beyond the scope of a health coach, but that with his permission you would like to refer to a substance-use disorder specialist

Nijah is employed as an administrative assistant and has lived with type 2 diabetes and hypertension for more than 10 years. She reports having recently gained 10 pounds due to stress eating and her sedentary job. She is interested in beginning a physical-activity program and working with a health coach to change her stress-eating behaviors. However, she states that her work schedule is unpredictable and she struggles with childcare issues, so she is not sure how successful she will be. She also states that even though she has tried physical activity and stress reduction in the past, she has never been able to control her blood sugar and feels like nothing is ever going to work for her. Which stage of change is BEST reflected by this scenario? A. Precontemplation B. Contemplation C. Preparation D. Action

B. Contemplation

Sylvia is a new health coaching client interested in quitting her 10-year tobacco-smoking habit because her sister, who also smokes, was recently diagnosed with emphysema. She states that she feels like a failure because she has tried quitting many times before but always gains weight because she would use food to replace the cigarettes. She states that another difficult issue she faces is the regular smoking break she and her colleagues enjoy daily. Sylvia states that, though she really enjoys smoking, she would like to discuss smoking cessation, knows living a smoke-free life is what she need to do, and is seeking help to quit. At a subsequent coaching session, Sylvia comments that she has started her plan by not smoking at work. She states that she has started a walking group during work breaks and her "smoking" colleagues have joined to support her. Sylvia states she is glad they are supporting her efforts, as it is helping her to not smoke at work. Which of the following behavior-change approaches is BEST reflected in this scenario? A. Structured self-help program B. Coping skills C. Cognitive behavioral therapy D. Normative skills

B. Coping skills

Catherine is a health coach who works at an inner-city outpatient clinic. She facilitates a prenatal support group focusing on healthy eating and physical activity. The group consists of women originally from India who have migrated to the United States over the past three years to raise their families. They all speak English and have assimilated into American culture while maintaining their Hindu religion and dietary considerations. Which of the following would BEST create an environment of inclusion for these women? A. Assume that all group members, who are of the Hindu religion, have the same backgrounds and cultural food preferences B. Demonstrate cultural competence and treat each group member as an individual even though they are all from India C. Conduct a survey of the participants to determine their goals and plan for their success D. Consult with a colleague who practices the Hindu religion in order to learn skills to provide an inclusive support group experience

B. Demonstrate cultural competence and treat each group member as an individual even though they are all from India

Nijah is employed as an administrative assistant and has lived with type 2 diabetes and hypertension for more than 10 years. She reports having recently gained 10 pounds due to stress eating and her sedentary job. She is interested in beginning a physical-activity program and working with a health coach to change her stress-eating behaviors. However, she states that her work schedule is unpredictable and she struggles with childcare issues, so she is not sure how successful she will be. She also states that even though she has tried physical activity and stress reduction in the past, she has never been able to control her blood sugar and feels like nothing is ever going to work for her. Which of the following strategies may be MOST helpful in addressing this client's cognitive distortion? A. Tell the client that working with a health coach will help hold her accountable, so changes will occur and she will not fail this time B. Empower the client to rephrase negative self-talk by challenging her irrational thinking and coaching her to reframe her perspective C. Empower the client by providing detailed information about evidence-based strategies that can prove to be more helpful than those tried in the past D> Tell the client you can help her feel better and she should visualize herself succeeding and use positive affirmations to delete negative thoughts

B. Empower the client to rephrase negative self-talk by challenging her irrational thinking and coaching her to reframe her perspective

Omar is a new client who is working with a health coach to improve his health after a recent diagnosis of hypertension and metabolic syndrome. He states that both parents had heart attacks in their 50s and that his twin brother has type 2 diabetes. He says he is concerned that he is heading down a similar path and he is very worried he will have a serious health event, particularly because he is divorced with two young children. Omar reports having a stressful job as a computer engineer, working the night shift in the financial industry. Due to the stress of his job, he purchases food from the vending machine, eats at his desk, and does not have time to exercise. Although he says that he knows the importance of eating better and exercising, he states that he does not have time to do either because after work he goes home and sleeps until it is time to go back to work. Omar states that although it is going to be difficult, he wants to change his behaviors and is asking the health coach for help with eating better to improve his health. What is the BEST strategy the health coach can employ at this point? A. Provide educational material and applaud the client's desire to change. B. Engage the client in OARS to empower him to talk himself into change. C. Provide motivation and reflective listening techniques to guide client change. D. Engage the client, using a directing style, to identify specific areas of change.

B. Engage the client in OARS to empower him to talk himself into change.

At a health coaching sessions, Malina shares that her osteoarthritis has flared up and she has been in chronic pain for the past few weeks. She states that she was doing well with eating healthy and having more energy and motivation. However, during these flare-ups, she overeats to help deal with the pain, even though she knows it will sabotage her weight-loss efforts and prevent her from getting her body mass index under 35 kg/m^2, which is one of her goals. Which of the following is the MOST accurate statement regarding exercise considerations for individuals with arthritis? A. During acute, painful flare-ups, all exercise should be avoided and the client should seek attention and advice B. Exercising in water that is between 83 and 88 F (28 and 31 C) can assist in providing relaxation and reduced pain C. Incorporating strenuous exercise will help the client get back on track during a flare-up D. The client should be encouraged to reduce the duration of her exercise during flare-ups and push through the pain

B. Exercising in water that is between 83 and 88 F (28 and 31 C) can assist in providing relaxation and reduced pain

Barbara is a new client who was referred to a health coach by her best friend. Barbara states she has had diabetes for more than three years but has not been diligent about following up with her endocrinologist, has not been checking her blood sugar regularly, and sometimes forgets to take her oral medications for her diabetes. Barbara states that her diabetes has been challenging, as it is not well controlled, and she has bouts of hypoglycemia and fainting. Barabara's friend has been controlling her diabetes through lifestyle changes, which she attributes, in part, to her working with the health coach. Barabara states she would like to control her diabetes in the same way as her friend. Barbara's assessments indicate that she is in contemplation, smokes three or four cigarettes daily, has diabetes, has been diagnosed with hypertension but is not taking her medications, and works at a local hospital requiring shift work. Which of the following is the BEST next step? A. Require a physical exam prior to progressing, based on the additional diagnosis of hypertension B. Explain the health coach's scope of practice and recommend a referral to her physician to get the diabetes and hypertension controlled before progressing C. Prepare and present the contractual coaching agreement, which outlines coaching session procedures and fees D. Offer partner coaching sessions with her friend in order to provide a support system and increase accountability

B. Explain the health coach's scope of practice and recommend a referral to her physician to get the diabetes and hypertension controlled before progressing

A health coach receives a phone call from a self-described "obese woman with diabetes" who recently received a diagnosis of obstructive sleep apnea. The client states that her physician told her she needs to lose weight and exercise in order to avoid continued degradation of her health. She works as a cashier in a local restaurant, which she says makes it difficult to eat healthy. She states that after work she is responsible for caring for two children and making dinner for the family. The client says that she is unable to enjoy life due to all of her physical health ailments and is ready to make a change but does not know where to begin. Which of the following BEST represents a health coach tailoring the first session according to the awareness-choice-executions cycle of change framework? A. Identify the client's goals, teach the necessary skills, designs an accountability plan, and implement a reward system B. Explore gaps between client behaviors and desired goals, support the client in selecting goals, and co-create a personalized plan and system for accountability C. Identify client goals and barriers, collaborate with allied health providers, and develop a realistic plan and system for accountability D. Explore the client's past successes and her understanding of medical conditions, administer intake questionnaires to gather additional information, and develop client goals and a feedback system

B. Explore gaps between client behaviors and desired goals, support the client in selecting goals, and co-create a personalized plan and system for accountability

Antwon is a client who has had two months of health coaching after his wife purchased a six-month package for him for his birthday. He states that he feels he is a "big guy" and, although he agrees that he has gained a bit of weight since he got his new "desk job", he thinks his wife is exaggerating his condition. Antwon agreed to have the health coach gather some biometric information, which revealed the following: Heigh: 73 inches (190.5 cm) Weight: 310 lb (140.6 kg) BMI: 40.9 kg/m^2 % fat-free mass: 64% % fat mass: 36% Target % fat-free mass: 70% Target % fat: 30% After reviewing this information, Antwon states he was unaware of how his weight is putting him at a health risk and that he is ready to begin an exercise program, although he presently does not do any physical activity or formal exercise. He used to like walking and hiking long distances, but heard that to lose weight, he has to do shorter, faster power walks. He has a target of achieving a 70% fat-free body mass and agrees that he will reduce his daily caloric intake by 250 kcal and increase his caloric expenditure by 250 kcal/day by adding walking to his routine. Which of the following is the MOST accurate statement regarding the quantity of exercise needed for inactive clients to gain health benefits? A. Moderate-intensity exercise for 150-250 minutes each week is needed for inactive clients to see health benefits B. Gradual increases in frequency, duration, and/or intensity over a longer period are needed for inactive clients to see health benefits C. Vigorous-intensity exercise for 75 minutes each week is needed for inactive clients to see health benefits D. Gradual decreases in frequency, duration, and/or intensity in a reverse pyramid fashion over a shorter period are needed for inactive clients to see health benefits

B. Gradual increases in frequency, duration, and/or intensity over a longer period are needed for inactive clients to see health benefits

Maya works as a flight attendant for an international airline and is struggling with constant fatigue, low energy, low motivation, and inconsistency with her eating and exercise. Due to long transatlantic flights, she finds herself struggling with erratic sleep patterns (getting less than 6 hours per night), overconsumption of airline foods and caffeine, inconsistency with exercise, and significant amounts of time spent on her cell phone and tablet playing games and connecting with loved ones. Maya states that she thinks she has many issues going on but has a very demanding work schedule and isn't sure if anything can help. Which of the following BEST reflects coaching to this client's stage of change? A. Implement self-directed behavior-change strategies, assuming the journey through the steps will be linear B. Guide the client so she sees the importance of change and help her link behavior change with personal goals C. Teach the client about the advantages of change so she learns the negative impact her current lifestyle is having on her personal goals D. Design an action plan using the 12-step model of behavior change to overcome difficult addictions

B. Guide the client so she sees the importance of change and help her link behavior change with personal goals

Roberto is a new health coach and has decided to begin his career by offering group-coaching sessions in the basement of his church. He is well known in his church community and has already begun marketing his services by advertising in the church bulletin and has his first five coaching clients. Which of the following would be MOST appropriate to ensure client privacy and confidentiality? A. Have coaching clients sign contracts stating that all personal information is allowed to be shared at group coaching sessions for best coaching outcomes B. Have coaching clients develop a set of ground rules for the group so all members feel safe, will interact with each other, and maintain respect for each other's privacy C. Have coaching clients support each other and encourage openness by inviting each other to their social media sites D. Have coaching clients use fake names during group coaching sessions in order to protect their personal identities

B. Have coaching clients develop a set of ground rules for the group so all members feel safe, will interact with each other, and maintain respect for each other's privacy

Emily is a corporate wellness coach who provides one-on-one coaching at the workplace. At a recent session, one of the clients disclosed being bullied and harassed by a coworker to the point that the client is seeking mental health support. To best ensure client privacy, which of the following statements is MOST accurate? A. Health coaches are allowed to share confidential client information with allied healthcare providers via email or text if the information is pertinent to the client's health and well-being B. Health coaches can share client confidential information with allied healthcare professionals as long as the client provides written consent for this to occur C. Health coaches must uphold the HIPAA laws and guidelines by encrypting any text, voice, or email messages to allied healthcare professionals D. Health coaches are exempt from documenting verbal communication in order to expedite transmission of client information among providers

B. Health coaches can share client confidential information with allied healthcare professionals as long as the client provides written consent for this to occur

Rose, a non-smoker, has successfully completed a 12-week cardiac rehabilitation program after having a mild heart attack and coronary balloon angioplasty procedure. She states that she feels relieved that the angioplasty has unclogged her blocked arteries and she's "good as new." She also says that her cardiologist approved her to continue exercising and has indicated that she needs to be eating a heart-healthy diet and managing her stress. She is taking a low-dose aspirin as well as an ACE inhibitor and is ready to make the necessary behavior changes to get healthy and avoid a second event. Which of the following statement BEST supports the "assist" component of the 5 A's evidence-based approach to improve health behaviors? A. Establish a system of accountability and method for self-monitoring B. Identify barriers, leverage social support, and enhance self-management C. Co-create an action plan that aligns with the client's self-directed goals D. Explore attitudes, beliefs, experiences, current behaviors, and knowledge

B. Identify barriers, leverage social support, and enhance self-management

Karen has been working with a health coach for the past year to improve her consistency with exercise and participation in stress-reducing activities to manage chronic back pain. Although she states she had been making good progress, she recently went through a difficult divorce. She is not interested in seeking additional help but wants to get back on track. Karen has reported the following symptoms, which are making things difficult: -Lack of energy and motivation -Desire to stay in bed all weekend -Difficulty concentrating at work -Increased difficulty in maintaining a regular exercise schedule -Feeling restless most of the day Which of the following statements about individuals with depression is MOST accurate? A. Individuals with depression are not likely to benefit from working with a health coach and need to be referred to a mental health provider B. Individuals with depression are likely to benefit from working with a health coach, as it provides an added layer of support C. Individuals with depression need to address their mental health issues before progressing with any healthy lifestyle habit changes D. Individuals with depression need to be screened, diagnosed, and referred to a mental health provider for best outcomes

B. Individuals with depression are likely to benefit from working with a health coach, as it provides an added layer of support

Carlita has been sedentary most of her life, but her mother's recent type 2 diabetes diagnosis, along with her own struggle with having peripheral vascular disease and metabolic syndrome, is causing serious concern. The following information was revealed at her annual physician visit: -Waist circumference: 38 inches -Triglycerides: 187 mg/dL -HDL cholesterol: 47 mg/dL -Fasting glucose: 110 mg/dL -Blood pressure: 132/88 mmHg -Body mass index: 35 kg/m^2 Her insurance plan allows for three visits with a registered dietitian, who is teaching her how to make healthier food choices, but the dietitian suggested she work with a health coach to assist in additional behaviors changes, like adding physical activity and decreasing sedentary time. According to the American College of Sports Medicine preparticipation guidelines, which of the following is MOST accurate regarding this client's participation in an exercise program? A. Vigorous-intensity exercises requires medical clearance only if symptoms are present B. Light-to-moderate intensity exercise requires medical clearance C. Light-to-moderate intensity exercise does not require medical clearance D. Vigorous-intensity exercise does not require medical clearance

B. Light-to-moderate intensity exercise requires medical clearance

Latrice is attending her second health coach session and is excited to further her knowledge of selecting healthy foods in an effort to lose weight. She states that since her first session, she has reduced her fast-food consumption by 50% and is trying to prepare more meals at home but is not a good cook. She says she would rather purchase prepared foods at the local grocery store by is confused about what packaged foods are healthy, as she states she get frustrated when reading food labels. Which of the following would be one the MOST effective strategies for helping this client learn about healthier shopping and eating? A. Provide a list of healthy cooking classes offered in the client's community B. Offer to provide a grocery store tour at the client's favorite store C. Provide a referral to a registered dietitian who can offer additional education D. Offer a list of websites, books, videos, or TV shows that highlight healthy eating

B. Offer to provide a grocery store tour at the client's favorite store

Delonda is a newly certified health coach interested in structuring her health coach practice. She is deciding between offering in-person sessions or online sessions. She has developed a business name, marketing plan, and website, and has already received inquiries from a few potential clients. In addition, she intends to operate her coaching business alone, as she wants to be able to take advantage of the flow-through taxation. What is one of the BEST ways to build an interpersonal relationship with coaching clients? A. Offering telephonic coaching sessions B. Offering in-person coaching services C. Offering coaching services via text message D. Offering email coaching services

B. Offering in-person coaching services

Robert is an inconsistent exerciser interested in running his first 5k in 6 months. Twenty years ago, he was a cross-country runner in high school, but he has not run regularly since then. At his first health coaching session, he discloses that his father, who was a heavy smoker, died of a heart attack at the age of 50. Although Robert reports he is not a smoker, he is wonder whether if it is safe to start an exercise program. He states that he is a sales representative and alternates between being sedentary in the office and walking from site to site when on sales calls. His job requires weekly travel, which is why he feels he becomes inconsistent with his exercise. He states that he is interested in the best training program as well as help with his consistency. According to the Physical Activity Guidelines for Americans, which of the following suggestions is MOST appropriate? A. Participate in physical activity at a low intensity for at least 150 minutes per week or at a high intensity for at least 75 minutes per week (or an equivalent combination) B. Participate in physical activity at a moderate intensity for at least 150 minutes per week or at a vigorous intensity for at least 75 minutes per week (or equivalent combination) C. Participate in physical activity at a high intensity for at least 150 minutes per week or at a vigorous intensity for at least 75 minutes per week (or equivalent combination) D. Participate in physical activity at a low intensity for at least 150 minutes per week or at a moderate intensity for at least 75 minutes per week (or equivalent combination combination combination)

B. Participate in physical activity at a moderate intensity for at least 150 minutes per week or at a vigorous intensity for at least 75 minutes per week (or equivalent combination)

Frank is a new client who states that he wants to get back in the shape he was in college. He says that as a college athlete he was strong and had a very lean body. Frank reports having multiple injuries from his sport that caused him to have a knee replacements nearly a year age. He received opioid prescriptions for his pain, which he says have become an addiction because they make him "feel good." His physician has told him to stop taking the opioids and has criticized him for continuing to take them. Frank has learned that his prescriptions will expire one year from the surgery, which is fast approaching. Frank states he feels better when he takes them and that he needs help. Which of the following MOST accurately describes Frank's continued use of opioids even though his physician has criticized him and told him to discontinue use? A. Relapse B. Reactance C. Reflection D. Reversal

B. Reactance

A health coach is working in a clinical setting with a new client interested in losing weight and beginning an exercise program in order to manage her diabetes. The initial session identified the client as being in the preparation stage of change and having basic knowledge of exercise and health eating for weight loss. The client says she lacks consistency and has difficulty sticking to a program due to a hectic work schedule, three young children, and a chronically ill parent. The health coach uses agenda mapping to uncover options for discussion. Which of the following is the BEST strategy to use next? A. Allow the client to select SMART goals and identify potential barriers B. Review the agenda map and narrow in on an area of focus C. Use OARS skills to help identify the client's stage of readiness D. Ask open-ended questions to identify change talk and barriers

B. Review the agenda map and narrow in on an area of focus

John is working with a health coach to control his newly diagnosed hypertension. He states that his physician told him to lose some weight and improve his eating as initial lifestyle strategies and to return in three months to determine whether hypertension medications are indicated. John states that he is committed to eating better and losing weight to avoid having to take medication. What is one question the health coach might ask to help the client form more specific goals? A. "Why do you have an aversion to medication that might be helpful?" B. "How often do you think you will eat healthy meals?" C. "Can you tell me exactly what eating better looks like to you?" D. "What type of support system is available to you?"

C. "Can you tell me exactly what eating better looks like to you?"

Dannika is a long-standing client who works as an emergency room nurse in a busy hospital. She reports that she recently took a manager role and that she is having difficulty adjusting to the longer hours and added stress. She states that she rarely gets lunch breaks and unfortunately finds herself eating from the vending machine. In addition, she is no longer consistent with exercise, has trouble sleeping at night, and lacks energy. She thinks that if she had better stress-reduction skills, she might have more energy, which would help her get back on her exercise routine, which she is ready to do. She also argues that she is unable to change her job, so even if she became better at handling stress, her job is a big challenge. Which part of the scenario represents the client exhibiting change talk? A. She states that she has changed jobs and is now a manager working longer hours B. She states that if she had better stress-reduction skills she might have the energy she needs to get back on track with her exercise C. She states that her job is a big challenge and does not know if health coaching can work D. She states that she has trouble sleeping at night and lacks energy

B. She states that if she had better stress-reduction skills she might have the energy she needs to get back on track with her exercise

During an initial coaching session, Tanya reports that she is a long-time smoker of three or four cigarettes daily, has difficulty sleeping, and has been experiencing significant stress. She tells the ACE Certified Health Coach that she is actively involved in a community group where they volunteer at a homeless shelter weekly, and she regularly attends book club meetings and vegetarian cooking classes. She shares that last month she joined a weekly mall working group, but she is having trouble attending with consistency. In addition, the health coach learns that a competitor has recently bought the company where Tanya has been employed for 15 years, where her job has involved significant telephone and computer use. Now, she is concerned about her financial future and job security to the point that it is interfering with her life. Which of the dimensions of wellness is BEST represented by this client's present lifestyle activities? A. Intellectual wellness B. Social wellness C. Environmental wellness D. Physical wellness

B. Social wellness

Sylvia is a new health coaching client interested in quitting her 10-year tobacco-smoking habit because her sister, who also smokes, was recently diagnosed with emphysema. She states that she feels like a failure because she has tried quitting many times before but always gains weight because she would use food to replace the cigarettes. She states that another difficult issue she faces is the regular smoking break she and her colleagues enjoy daily. Sylvia states that, though she really enjoys smoking, she would like to discuss smoking cessation, knows living a smoke-free life is what she need to do, and is seeking help to quit. Which of the following BEST identifies the antecedent for the client's smoking behavior at work? A. Working with coworkers who smoke B. Taking a work break with coworkers C. Grabbing food instead of a cigarettes D. Learning of her sister's emphysema diagnosis

B. Taking a work break with coworkers

Jackson is a long-standing client who has been successfully losing weight and exercising regularly with a goal of reducing his blood pressure. At his final coaching session, he states that he is continuing to eat healthy foods, has come off his blood pressure medications, and is continuing to lose about 1 pound per week. Jackson states that, unfortunately, he has started working shift work and is finding it difficult to stop home, walk the dogs, change his clothes, and get to the gym for a workout. During the session, Jackson states he could pack his gym bag, put it in his car, and ask a neighbor to walk his dogs a few times a week so he could go straight to the gym before heading home. What is the MOST appropriate way to close this client-coach relationship? A. Thank the client for attending the sessions and tell him about your referral program B. Thank the client, ask him about what he has learned, and celebrate his growth C. Offer continued services to assure that the client reduces the risk of a relapse D. Offer the client some marketing materials to distribute to others in need of health coaching

B. Thank the client, ask him about what he has learned, and celebrate his growth

During an initial coaching session, Tanya reports that she is a long-time smoker of three or four cigarettes daily, has difficulty sleeping, and has been experiencing significant stress. She tells the ACE Certified Health Coach that she is actively involved in a community group where they volunteer at a homeless shelter weekly, and she regularly attends book club meetings and vegetarian cooking classes. She shares that last month she joined a weekly mall working group, but she is having trouble attending with consistency. In addition, the health coach learns that a competitor has recently bought the company where Tanya has been employed for 15 years, where her job has involved significant telephone and computer use. Now, she is concerned about her financial future and job security to the point that it is interfering with her life. Which of the following approaches by the health coach BEST represents a person-centered approach to coaching? A. Telling the client that she has risk factors for chronic disease and without significant lifestyle improvements may encounter serious health issues in the near future. B. Thanking the client for sharing her lifestyle information, as well as concerns about the impact her company's buyout will have on her future, and asking what she would like her initial coaching session's goal to be. C. Telling the client that there have been other clients in the same situation and conveying a complete understanding of why she feels the way she does, while reassuring her that things will get better. D. Thanking the client for sharing her lifestyle information, as well as her concerns about her financial and employment future, while relaying a plan to help her work through this difficult time and to achieve her goal.

B. Thanking the client for sharing her lifestyle information, as well as concerns about the impact her company's buyout will have on her future, and asking what she would like her initial coaching session's goal to be.

Serena has a successful coaching business, the growth of which has plateaued. Her strategy for gaining new clients has been primarily word of mouth and some local print advertising in her community. Many of her clients have chronic issues and are travelling business professionals who have asked her to offer a blog, increase her social media presence, and incorporate video-based coaching for additional information and convenience. Which of the following statements is MOST accurate regarding blogging? A. Blogging as a marketing tool has hit its peak and is at a plateau B. The traffic to a blog has a compounding effect and over time can increase the website's search engine optimization C. Blogs have a short-term return on investment when compared to traditional marketing efforts D. The cost of a blog can be incremental but effective at recruiting new clients

B. The traffic to a blog has a compounding effect and over time can increase the website's search engine optimization

Mateo lives in a rural area and has established a telephonic health coaching business to best meet the needs of his sprawling community. Although he has five consistent clients who has reported significant health improvements, he is struggling to grow his business and has decided to develop a formal marketing plan, which includes designing a website. What is one of the biggest challenges a coach faces when using telephonic coaching? A. There is significant potential for dropped calls and poor signals, which interrupts the coaching session B. There is risk of potential miscommunication due to the lack of nonverbal communication C. Unscripted telephonic coaching sessions have limited impact on improving health behaviors and self-efficacy D. Unscripted telephonic coaching sessions make it difficult to connect with new clients who live in less populated areas

B. There is risk of potential miscommunication due to the lack of nonverbal communication

Emily is a long-time client who had been making progress with her hypertension. However, at her last health coaching session, she stated that her physician has increased the dosage of her blood-pressure medication due to recurring elevated readings. Emily shares that she has gained 10 pounds over the past 3 months due to her need to assume caregiver duties for her ill mother and her increased fast-food intake. She states that she is interested in modifying her lifestyle to get back on track and reduce her blood pressure. Which of the following represent a suitable SMART goal for this client? A. To purchase a gym membership and eat more fruit to lose 10 pounds B. To lose 10 pounds in the next 3 months by reducing fast-food intake to once per week C. To lose 10 pounds by eating better and exercising on a regular bas D. To purchase a stationary cycle, decrease fast-food intake, and make better choices

B. To lose 10 pounds in the next 3 months by reducing fast-food intake to once per week

A health coach receives a phone call from a self-described "obese woman with diabetes" who recently received a diagnosis of obstructive sleep apnea. The client states that her physician told her she needs to lose weight and exercise in order to avoid continued degradation of her health. She works as a cashier in a local restaurant, which she says makes it difficult to eat healthy. She states that after work she is responsible for caring for two children and making dinner for the family. The client says that she is unable to enjoy life due to all of her physical health ailments and is ready to make a change but does not know where to begin. During the first session, the health coach asks the client to share what really matters most to her and to describe the rules she lives by. What type of interview technique is the health coach using? A. Lifestyle interview B. Values interview C. Goal-based interview D. Change talk interview

B. Values interview

Serena has a successful coaching business, the growth of which has plateaued. Her strategy for gaining new clients has been primarily word of mouth and some local print advertising in her community. Many of her clients have chronic issues and are travelling business professionals who have asked her to offer a blog, increase her social media presence, and incorporate video-based coaching for additional information and convenience. Which of the following statements is MOST accurate regarding video-based coaching? A. Video conferencing is very effective, but can be expensive and requires specialized equipment to be most beneficial B. Video conferencing is cost- and time-effective for both the coach and client C. Video conferencing has an initial start-up cost and significant overhead with diminishing returns D. Video conferencing is impersonal but extremely convenient for busy individuals

B. Video conferencing is cost- and time-effective for both the coach and client

Indira is a new coaching client who states that her physician mandated she change her eating habits to improve her lipid panel and address a recent diagnosis of hypertension. Her most recent lab and blood pressure indicate the following: -Total cholesterol: 230 mg/dL -HDL cholesterol: 51 mg/dL -LDL cholesterol: 173 mg/dL -Blood pressure: 146/88 mmHg Indira states that she has a strict cultural eating regimen and consumes a large amount of vegetables and chicken. She states that she enjoys samosas (deep fried potato and lentil bean-stuffed pastry puff), pakoras (deep fried vegetables), grilled lamb, and chicken with masala sauce, which is made with ghee (clarified butter). She also states that due to her busy work schedule, she get much of this food from a local Indian grocery market that accepts food orders and then packages the pre-made items for purchase. Which of the following dietary suggestions would be MOST appropriate to assist the client in reducing her lipid profile? A. When ordering food from the local Indian grocery market, request the no salt be added B. When ordering food from the local Indian grocery market, request items that are baked, not fried C. When ordering food from the local Indian grocery market, request to see a list of ingredients D. When ordering food from the local Indian grocery market, limit consumption to no more than 3 times/week

B. When ordering food from the local Indian grocery market, request items that are baked, not fried

Patrick, who is a computer programmer, has been working with a health coach for three months and making healthier food and drink choices in an effort to lose 20 pounds (9.1kg) over the next 5 months, per the recommendation from his physician. Patrick states he is planning his meals during the week, sticking with a 2,000-calorie/day target, down from 2,500 calories/day. However, he says he struggles on the weekends, as he enjoys eating out, going to nightclubs, and socializing with friends. He states he has hit a plateau after losing 10 pounds (4.5 kg) and has heard that a diet that is high in protein and low in fat and carbohydrate is the best way to lose his last pounds (4.5 kg). Which of the following statements from the health coach is BEST supported by the 2015-2020 Dietary Guidelines for Americans? A. "An emphasis on protein can aid in weight loss and is a strategy many individuals feel is beneficial" B. "In addition to a high-protein meal plan, it is recommended to seek the advice of a dietitian, as providing general nutrition guidance is beyond my scope" C. "An emphasis should be placed on overall eating patterns more than individual nutrients, like protein" D. "In addition to a high-protein meal plan, consideration should be given to portion sizes as well as timing of food ingestion, particularly eating after 6 pm"

C. "An emphasis should be placed on overall eating patterns more than individual nutrients, like protein"

Omar is a new client who is working with a health coach to improve his health after a recent diagnosis of hypertension and metabolic syndrome. He states that both parents had heart attacks in their 50s and that his twin brother has type 2 diabetes. He says he is concerned that he is heading down a similar path and he is very worried he will have a serious health event, particularly because he is divorced with two young children. Omar reports having a stressful job as a computer engineer, working the night shift in the financial industry. Due to the stress of his job, he purchases food from the vending machine, eats at his desk, and does not have time to exercise. Although he says that he knows the importance of eating better and exercising, he states that he does not have time to do either because after work he goes home and sleeps until it is time to go back to work. Omar states that although it is going to be difficult, he wants to change his behaviors and is asking the health coach for help with eating better to improve his health. What questions BEST reflect a motivational interviewing approach to health coaching? A. "Can we talk about the work vending machine? Why do you think you keep eating from the vending machine instead of bringing healthier foods?" B. "Is it ok to discuss nutrition and exercise with you? Do you think that if I provide some menu plans and desk exercises you will be able to do them?" C. "Can you tell me specifically what 'eating better' means to you? Is it okay to share some additional information with you?" D. "Do you have a support system? Is this something you would like to do with your brother, since he has diabetes?"

C. "Can you tell me specifically what 'eating better' means to you? Is it okay to share some additional information with you?"

Manuel is an inactive new client who has been diagnosed with cardiovascular disease (CVD) and is considering improving his dietary habits. He states that he is on medications, which he feels will cure his disease. However, his cardiologist strongly recommended he improve his eating and begin a walking program. In a follow-up session, Manuel stated that he has been enjoying walking and it has helping him feel better. He is still struggling with healthy eating but says he wants to improve his dietary habits. Using a motivational interviewing approach, what is the next BEST question to ask? A. "How much are you walking and what is your walking goal?" B. "Where do you think you are failing with your healthy eating?" C. "How does improving your dietary habits fit into the bigger picture of your life?" D. "Where do you think you can find support for improving your dietary habits?"

C. "How does improving your dietary habits fit into the bigger picture of your life?"

Susan has been working with a health coach for the past month to assist with reducing her sedentary activity and increase her physical activity. She reports being a new mom with a 9-month-old child and lacking the time and energy to participate in a formal exercise program 3 to 5 times per week, which was her physician's recommendation. She states that she is interested in getting her pre-pregnancy muscles back by doing resistance training for muscular endurance exercise and losing 20 pounds over the next 6 months by attending kickboxing aerobic exercise classes, but she states that she does not want to waste her time and wants to know what the best exercise program is for her. What is the MOST appropriate follow-up statement? A. "I heard you say you don't have the time or energy to exercise 3 to 5 times per week. What about doing a split-routine resistance-training program at home once or twice a week?" B. "So, your goal is to lose 20 pounds and tone your muscles. I have some great program resources and client success stories I'd like to share with you. Would that be okay?" C. "I heard you say you don't have the time or energy to exercise 3 to 5 times per week. Can you tell me more about your interest in resistance training, how committed you are, the type of exercise you find enjoyable, and how you feel it can fit into your schedule?" D. "So, your goal is to lose 20 pounds and tone your muscles, which is understandable after pregnancy. How about if we look at your schedule and I develop a resistance program that can fit?"

C. "I heard you say you don't have the time or energy to exercise 3 to 5 times per week. Can you tell me more about your interest in resistance training, how committed you are, the type of exercise you find enjoyable, and how you feel it can fit into your schedule?"

Tasha is seeing a health coach after many months of contemplation. She also says that a recent physician visit her weight was at its highest and although she has no additional health issues, her physician warned her that her increased weight puts her at high risk for developing diabetes. She works from home and rarely leaves her house due to her embarrassment about her weight. Which of the following statements BEST reflects weight bias and stigma? A. "I understand your concern and would like your permission to work with you." B. "Let's talk about how you would like to move forward in improving your health." C. "I understand how important it is for you to not be obese and I can help." D. "Let's talk about the things you feel are important in your life."

C. "I understand how important it is for you to not be obese and I can help."

An ACE Certified Health Coach is conducting a first health coaching session with Theo, who is interested in weight loss. Theo appears reserved and non-talkative, as she provides one-word responses to the health coach's initial queries. In an effort to learn more about Theo, as well as build rapport and trust, the health coach engages in the following conversation: Health coach: "Can you tell me more about not having positive feelings about participating in an exercise program as part of the plan to help you reach your weight-loss goal?" Theo: "Ok. When I was a college athlete, I played second string on the softball team. We had a mediocre team and whenever our team lost, our coach would punish us with tough drills, timed lap running, and additional high-intensity workouts. Mid-season, I suffered a number of overuse injuries that my orthopedic physician stated were due to the excessive training. Whenever I reported pain to my coach, I was still required to participate and started to develop a negative attitude toward exercise, as it just was not fun. Now, I've gained 30 pounds since graduating college five years ago and have anxiety just thinking about having to exercise to reach my weight-loss goal. I know a lot about the importance of exercise to assist with weight loss, but I am just not feeling I will be successful." Heath Coach: "Thanks for sharing that. So you are saying that those 'workout punishments' after your team suffered a loss are really contributing to how you are feeling about participating in an exercise program to help you reach your weight-loss goal. Did I get that right?" Theo: "Yes." Which of the following statements by the health coach would BEST reflect the principle of autonomy? A. "Well, I have had clients with negative feelings about exercise and I know why you feel the way you do. Honestly, if I plan your workout to focus on doing things that are fun, like kettlebells, I think that that will help you get over those feelings." B. "I heard you say that you know a lot about the importance of exercise and weight loss, but there are new studies out regarding high-intensity training that you might not be familiar with. I'm sure with the right combination of my program design and your commitment to your goal, you will have good success." C. "That is great that you know a lot about the importance of exercise and weight loss. I would like to hear more about your knowledge so we can discuss how that information can help you with your goal. Then, I would like you to talk about any physical activity that does not cause negative emotions." D. "Well, you know that without exercise, your weight-loss goal is probably not going to be achieved. If you tell me some of your favorite music selections, I can make you a playlist that you can play during your workouts, as music is very motivating and has been proven to aid in exercise motivation and adherence."

C. "That is great that you know a lot about the importance of exercise and weight loss. I would like to hear more about your knowledge so we can discuss how that information can help you with your goal. Then, I would like you to talk about any physical activity that does not cause negative emotions."

Rose, a non-smoker, has successfully completed a 12-week cardiac rehabilitation program after having a mild heart attack and coronary balloon angioplasty procedure. She states that she feels relieved that the angioplasty has unclogged her blocked arteries and she's "good as new." She also says that her cardiologist approved her to continue exercising and has indicated that she needs to be eating a heart-healthy diet and managing her stress. She is taking a low-dose aspirin as well as an ACE inhibitor and is ready to make the necessary behavior changes to get healthy and avoid a second event. What is an effective motivational interviewing-based question you might ask this client? A. "Can you tell me more about the heart attack so I can better understand?" B. "Can you tell me more about the exercise program you completed at cardiac rehabilitation?" C. "What does 'getting healthy' look like to you?" D. "How long have you been in poor health?"

C. "What does 'getting healthy' look like to you?"

A health coach receives a phone call from a self-described "obese woman with diabetes" who recently received a diagnosis of obstructive sleep apnea. The client states that her physician told her she needs to lose weight and exercise in order to avoid continued degradation of her health. She works as a cashier in a local restaurant, which she says makes it difficult to eat healthy. She states that after work she is responsible for caring for two children and making dinner for the family. The client says that she is unable to enjoy life due to all of her physical health ailments and is ready to make a change but does not know where to begin. Which of the following is the BEST example of a health coach asking a "curious question"? A. "Can you tell me how you are managing you diabetes right now?" B. "Which goal is most important to you right now?" C. "What needs to change in order to turn your goal into reality?" D. "When do you think you will be able to begin working on this goal?"

C. "What needs to change in order to turn your goal into reality?"

Francesca is seeking the assistance of a health coach due to her struggles with obesity since giving birth to twins two years ago. Francesca states that she has always struggled with being 10 to 20 pounds over her ideal body weight, but now it's upwards of 40 pounds and is starting to take a toll on her joints, energy level, and sleep. The first coaching session was devoted to creating a relationship, developing trust, identifying Francesca's stage of change, and using motivational interviewing and active listening to learn her goals and level of commitment. At a subsequent session, Francesca asked the health coach to provide some baseline biometric information so she can better understand her starting point for weight loss. The following biometrics were gathered: Age: 28 Height: 67 inches (170 cm) Weight: 290 lb (131.8 kg) Waist circumference: 47 inches (119 cm) Hip circumference: 50 inches (127 cm) What is Francesca's body mass index and classification of overweight/obesity? A. 35.4 kg/m^2; overweight B. 30.4 kg/m^2; obesity C. 45.4 kg/m^2; obesity D. 40.4 kg/m^2; overweight

C. 45.4 kg/m^2; obesity

Latrice is attending her second health coach session and is excited to further her knowledge of selecting healthy foods in an effort to lose weight. She states that since her first session, she has reduced her fast-food consumption by 50% and is trying to prepare more meals at home but is not a good cook. She says she would rather purchase prepared foods at the local grocery store by is confused about what packaged foods are healthy, as she states she get frustrated when reading food labels. At a follow-up coaching session, the client brings a food label from a food she felt was healthy and asks the health coach to assist in deciphering the food label, which contains the following information: -130 calories per serving -4 servings per package -Carbohydrates - 15 grams/serving -Protein - 4 grams/serving -Fat - 6 grams/serving How many calories would your client consume if she ate the entire package? A. 130 calories B. 430 calories C. 520 calories D. 260 calories

C. 520 calories

Latrice is attending her second health coach session and is excited to further her knowledge of selecting healthy foods in an effort to lose weight. She states that since her first session, she has reduced her fast-food consumption by 50% and is trying to prepare more meals at home but is not a good cook. She says she would rather purchase prepared foods at the local grocery store by is confused about what packaged foods are healthy, as she states she get frustrated when reading food labels. At a follow-up coaching session, the client brings a food label from a food she felt was healthy and asks the health coach to assist in deciphering the food label, which contains the following information: -130 calories per serving -4 servings per package -Carbohydrates - 15 grams/serving -Protein - 4 grams/serving -Fat - 6 grams/serving How many calories came from carbohydrate, protein, and fat per serving? A. 135 calories from carbohydrates, 16 calories from protein, 54 calories from fat B. 60 calories from carbohydrates, 16 calories from protein, 24 calories from fat C. 60 calories from carbohydrates, 16 calories from protein, 54 calories from fat D. 60 calories from carbohydrates, 36 calories from protein, 54 calories from fat

C. 60 calories from carbohydrates, 16 calories from protein, 54 calories from fat

Joshua is a college senior whose grade have started slipping since he turned 21. He states that although he is focused on school during the week and abstains from alcohol, he and his friends play video games and drink all weekend long. He says he does not particularly enjoy drinking but wants to be social with his peers, even though he feels it is taking a toll on him. He states that he pushes some of his schoolwork to the weekend with the intention of completing it but is tired and lacks motivation. Joshua states that he is seeking the help of a health coach to change his drinking behavior, as he wants to end his college career on a positive path for his future. Which of the following statements BEST reflects coaching to this client's stage of change? A. Refer the client to an alcohol rehabilitation center to assist with his alcohol use disorder B. Teach the client about the negative long-tern effects of binge drinking so he learns the negative impact his current lifestyle will have on his future C. Ask the client to specify the quantity of drinking he wants to change, identify and address barriers to change, and support him in making self-directed behavior-change strategies D. Design an action plan that includes a weekly study plan that allows for more freedom on weekends

C. Ask the client to specify the quantity of drinking he wants to change, identify and address barriers to change, and support him in making self-directed behavior-change strategies

Juanita is a new client who has recently been diagnosed with hyperlipidemia. She is interested in improving her diet to lower her total cholesterol and low-density lipoprotein levels, per her physician's recommendation. What is the BEST next step for the health coach? A. Provide a list of resources and education to improve her health literacy. B. Provide a copy of the Mediterranean eating plan, which can improve her hyperlipidemia. C. Ask what she knows about hyperlipidemia and what she would like to learn. D. Ask for her permission to provide information about hyperlipidemia.

C. Ask what she knows about hyperlipidemia and what she would like to learn.

Manuel is an inactive new client who has been diagnosed with cardiovascular disease (CVD) and is considering improving his dietary habits. He states that he is on medications, which he feels will cure his disease. However, his cardiologist strongly recommended he improve his eating and begin a walking program. Which of the following statements is MOST accurate regarding exercise considerations for inactive clients with cardiovascular disease? A. Begin with moderate-to-vigorous intensity physical activity, which corresponds to any activity >3 METS, for most cardioprotective benefits B. Begin with level walking (3.0 to 5.9 METs) and gradually increase speed to a vigorous intensity for most cardioprotective benefits C. Bouts of physical activity less than 10 minutes in duration can produce cardiovascular and metabolic benefits D. High-intensity interval training has been shown to be a superior training method to deliver most cardioprotective benefits

C. Bouts of physical activity less than 10 minutes in duration can produce cardiovascular and metabolic benefits

Millie is a long-standing client who has been making progress with a consistent exercise program over the past six months. At her recent health coaching session, she explains that over the past month, she has been inconsistent with her exercise, begun eating at night, gained 10 pounds, and is having trouble sleeping. She states she has been spending more time caring for her mother, who has had dementia for the past five years. Her mother's health is rapidly declining and Millie is faced with the difficult decision to place her mother in a nursing home, which is the recommendation from her mother's physician and other family members. Although Millie states the facility has an exceptional reputation for caring for patients with dementia and is only 2 miles from her home, she feels like she is a loser and a complete failure despite the support from her family members. Which of the following BEST describes Millie's thought pattern? A. Agenda mapping B. Collaboration C. Cognitive distortion D. Righting reflex

C. Cognitive distortion

Jasmine has been working with an ACE Certified Health Coach for three months and states she has been making progress with reducing her eating at fast-food restaurants and decreasing her sedentary behaviors. She reports that she has been bringing her lunch and eating at work four days a week and taking a walk around the office building daily. Which of the following processes of change is BEST describes by this scenario? A. Stimulus control B. Self-reevaluation C. Counter-conditioning D. Dramatic relief

C. Counter-conditioning

Carlita has been sedentary most of her life, but her mother's recent type 2 diabetes diagnosis, along with her own struggle with having peripheral vascular disease and metabolic syndrome, is causing serious concern. The following information was revealed at her annual physician visit: -Waist circumference: 38 inches -Triglycerides: 187 mg/dL -HDL cholesterol: 47 mg/dL -Fasting glucose: 110 mg/dL -Blood pressure: 132/88 mmHg -Body mass index: 35 kg/m^2 Her insurance plan allows for three visits with a registered dietitian, who is teaching her how to make healthier food choices, but the dietitian suggested she work with a health coach to assist in additional behaviors changes, like adding physical activity and decreasing sedentary time. Which of the following statements regarding the contributions of exercise and diet to weight loss is MOST accurate? A. Exercise alone can produce significantly greater weight loss than diet alone at 12 months, 18 months, and 36 months B. Diet alone can produce significantly greater weight loss than exercise alone at 12 months, 18 months, and 36 months C. Diet plus exercise produces significantly weight loss than either one alone at 12 months, 18 months, or 36 months D. Neither diet nor exercise, alone or in combination, produces significant weight loss at 12 months, 18 months, or 36 months

C. Diet plus exercise produces significantly weight loss than either one alone at 12 months, 18 months, or 36 months

Emily is a corporate wellness coach who provides one-on-one coaching at the workplace. At a recent session, one of the clients disclosed being bullied and harassed by a coworker to the point that the client is seeking mental health support. What is the BEST next step the health coach should take in this situation? A. Develop a protocol for this type of information and distribute to all employees B. Document this information and have the client sign it to validate the information was shared C. Document and report this information to the person responsible for managing this client at work D. To ensure privacy and the best troubleshooting practices

C. Document and report this information to the person responsible for managing this client at work

Nijah is employed as an administrative assistant and has lived with type 2 diabetes and hypertension for more than 10 years. She reports having recently gained 10 pounds due to stress eating and her sedentary job. She is interested in beginning a physical-activity program and working with a health coach to change her stress-eating behaviors. However, she states that her work schedule is unpredictable and she struggles with childcare issues, so she is not sure how successful she will be. She also states that even though she has tried physical activity and stress reduction in the past, she has never been able to control her blood sugar and feels like nothing is ever going to work for her. Which of the following strategies would be MOST appropriate based on the client's stage of change? A. Explore the client's personal values and personalize the risks of uncontrolled diabetes B. Identify and assist with problem-solving obstacles while offering alternative solutions C. Encourage evaluation of the pros and cons of making changes to control blood sugar and stress D. Support the client's need to establish a system of accountability and self-monitoring to control blood sugar and stress

C. Encourage evaluation of the pros and cons of making changes to control blood sugar and stress

Alyssa is a long-standing client who sees a mental health professional for her depression. Although she is taking medication to help stabilize her mood, she reports frequent mood swings and often lacks motivation, causing her to watch movies for excessive amounts of time and indulge in unhealthy overeating. She reports that she has reduced for fast food intake by 50% and has been exercising three times a week, which seems to help, but says she is concerned because her lack of motivation is increasing, making it more difficult to resist fast foods and exercise regularly. Which of the following strategies is the BEST next step to take? A. Develop SMART goals, if the client agrees B. Develop an extrinsic reward system, if the client agrees C. Explore mood-monitoring strategies, if the client agrees D. Explore mindfulness and meditative strategies, if the client agrees

C. Explore mood-monitoring strategies, if the client agrees

Roberto is a new health coach and has decided to begin his career by offering group-coaching sessions in the basement of his church. He is well known in his church community and has already begun marketing his services by advertising in the church bulletin and has his first five coaching clients. Which of the following guidelines BEST establishes clear professional coaching boundaries? A. Focus all coaching sessions on the clients' needs, unless the clients ask about your personal life, at which time you can share B. provide personal social media contact information and invite clients to your public page to increase feelings of inclusiveness C. Focus all coaching sessions on the clients' needs and refrain from discussing your personal life D. Provide a comprehensive, inclusive, non-intimidating coaching experience and exchange personal contact information to make the clients feel supported

C. Focus all coaching sessions on the clients' needs and refrain from discussing your personal life

Charley is a new client who was referred to a health coach by his primary care physician. He states that he is a "big man," having played middle linebacker for his college football team 20 years ago. Although his physician states that his 52-inch waist, unhealthy eating habits, and lack of regular physical activity are contributing factors to his chronic back pain, Charley feels that his pain is due to years of playing football and that playing with his dog is sufficient physical activity. Charley told his physician he would give health coaching a try. What is the MOST appropriate goal to set with this client? A. Co-create an action plan with frequent positive feedback on his progress B. Support cues to action and provide basic structured guidance upon request C. Focus on addressing something relevant to him and have him think about change D. Establish a system of self-monitoring and accountability

C. Focus on addressing something relevant to him and have him think about change

Mateo lives in a rural area and has established a telephonic health coaching business to best meet the needs of his sprawling community. Although he has five consistent clients who has reported significant health improvements, he is struggling to grow his business and has decided to develop a formal marketing plan, which includes designing a website. What is the FIRST step in developing a marketing plan? A. Produce a marketing campaign timeline B. Develop an operating budget C. Identify the ideal customer D. Determine the marketing space

C. Identify the ideal customer

Emily is a long-time client who had been making progress with her hypertension. However, at her last health coaching session, she stated that her physician has increased the dosage of her blood-pressure medication due to recurring elevated readings. Emily shares that she has gained 10 pounds over the past 3 months due to her need to assume caregiver duties for her ill mother and her increased fast-food intake. She states that she is interested in modifying her lifestyle to get back on track and reduce her blood pressure. Which of the following statements about the relationship between body weight and hypertension is MOST accurate? A. Increasing rates of hypertension are minimally correlated with rates of obesity B. It is not well-established that body weight is a risk factor for hypertension C. It is well-established that excess body fat is a risk factors for hypertension D. Increasing rates of hypertension are negatively correlated with rates of obesity

C. It is well-established that excess body fat is a risk factors for hypertension

Chinwa has been working with a health coach for less than a month and reports not having much success eating a more healthful diet. During a recent session, he explains that although he values the health coaching sessions, he has never been good at sticking to a healthy diet and always reverts back to his old unhealthy eating habits because he simply lacks the energy and focus to preplan his meals and snacks. Chinwa states that he is just destined to be unhealthy and knows his attempt will result in failure. Which of the following health behavior theories is BEST represented by Chinwa's statements? A. Locus of control B. Self-perception C. Learned helplessness D. Self-determination

C. Learned helplessness

Susan has been working with a health coach for the past month to assist with reducing her sedentary activity and increase her physical activity. She reports being a new mom with a 9-month-old child and lacking the time and energy to participate in a formal exercise program 3 to 5 times per week, which was her physician's recommendation. She states that she is interested in getting her pre-pregnancy muscles back by doing resistance training for muscular endurance exercise and losing 20 pounds over the next 6 months by attending kickboxing aerobic exercise classes, but she states that she does not want to waste her time and wants to know what the best exercise program is for her. According to the American College of Sports Medicine preparticipation guidelines, which of the following is MOST accurate regarding this client's participation in an exercise program? A. Light-to-moderate intensity exercise requires medical clearance B. Vigorous-intensity exercise requires medical clearance only if symptoms are present C. Light-to-moderate intensity exercise does not require medical clearance D. Vigorous-intensity exercise requires medical clearance

C. Light-to-moderate intensity exercise does not require medical clearance

Sylvia is a new client interested in beginning an exercise program to help her arthritis. In the first session, she tells the health coach that she bought a new pair of athletic shoes and took a tour of a local health club but feels she is too old to exercise and is considering returning her athletic shoes. The health coach offers to introduce Sylvia to a few of her older clients and states that if she is interested she can be a guest at the health club where they are members. Which of the following BEST describes the health coach's technique to influence this client's self-efficacy? A. Stress arousal B. Persuasive message C. Motivational model D. Mastery experience

C. Motivational model

Brooke works as an administrative assistant and has recently participated in a health-risk appraisal at her office. Her results surprised her, as they indicated she was at high risk for having a heart attack in the next 10 years, which is something she wants to avoid. Although she states she is a weekend smoker, she feels that she eats well and walk her dog nightly, which she thought would protect her from heart disease. Which of the following statements about smoking is MOST accurate? A. The most effective smoking-cessation interventions are pharmacologic in nature B. Electronic cigarettes (e-cigarettes), are a healthier smoking alternative and can be used as a cessation aid C. On average, adults cigarette smokers who quit at age 50 decrease their risk of death by half D. Nonsmokers who live with a smoker do not acquire any increased risk of heart disease

C. On average, adults cigarette smokers who quit at age 50 decrease their risk of death by half

Maya works as a flight attendant for an international airline and is struggling with constant fatigue, low energy, low motivation, and inconsistency with her eating and exercise. Due to long transatlantic flights, she finds herself struggling with erratic sleep patterns (getting less than 6 hours per night), overconsumption of airline foods and caffeine, inconsistency with exercise, and significant amounts of time spent on her cell phone and tablet playing games and connecting with loved ones. Maya states that she thinks she has many issues going on but has a very demanding work schedule and isn't sure if anything can help. Which of the following practices can be explored with the client to increase the likelihood of improving sleep? A. encourage the client to eat a large meal just before bed to increase levels of comfort while falling asleep and aid in relaxation B. Participate in vigorous exercise 30 - 60 minutes before bed to ensure tiredness C. Participate in a consistent pre-bedtime routine that includes avoiding exposure to electronic devices and television screens D. Consume warm drinks like green tea and coffee in order to induce the body's natural relaxation response

C. Participate in a consistent pre-bedtime routine that includes avoiding exposure to electronic devices and television screens

Cecelia, who is employed as an investment banker, has been a consistent client for the past 3 months. She reports a recent diagnosis of uncontrolled hypertension and is taking a beta blocker. She says she has difficulty remembering to take her medication and knows this is not helping her uncontrolled hypertension. She states that she wants to be consistent with her medications and work on controlling her blood pressure through exercise and improved nutrition, but her stressful job, long hours, and unpredictable work requirements makes it nearly impossible to be consistent with her walking program and regularly prepare healthy meals. She says that both her parents have had heart attacks and she is worried that the stress of her job and inconsistency with taking her medication will put her on this same path. She has two young children and wants to be healthy so she can enjoy them and be around for them in the future. Which of the following BEST describes using "stimulus control" for behavior change with this client? A. Use the client's children to serve as the necessary social support for lifestyle-change adherence B. Develop a reward system for engaging in healthy behaviors that contribute to blood pressure reduction C. Place medication in a "pill box" to serve as a cue to regularly take her blood pressure medication D. Have the client engage with other who model regularly taking blood pressure medication

C. Place medication in a "pill box" to serve as a cue to regularly take her blood pressure medication

Cecelia, who is employed as an investment banker, has been a consistent client for the past 3 months. She reports a recent diagnosis of uncontrolled hypertension and is taking a beta blocker. She says she has difficulty remembering to take her medication and knows this is not helping her uncontrolled hypertension. She states that she wants to be consistent with her medications and work on controlling her blood pressure through exercise and improved nutrition, but her stressful job, long hours, and unpredictable work requirements makes it nearly impossible to be consistent with her walking program and regularly prepare healthy meals. She says that both her parents have had heart attacks and she is worried that the stress of her job and inconsistency with taking her medication will put her on this same path. She has two young children and wants to be healthy so she can enjoy them and be around for them in the future. What stage of change BEST describes this client's readiness of change as it relates to taking her medication regularly? A. Precontemplation B. Contemplation C. Preparation D. Action

C. Preparation

Sylvia is a new client interested in beginning an exercise program to help her arthritis. In the first session, she tells the health coach that she bought a new pair of athletic shoes and took a tour of a local health club but feels she is too old to exercise and is considering returning her athletic shoes. The health coach offers to introduce Sylvia to a few of her older clients and states that if she is interested she can be a guest at the health club where they are members. What is the client's stage of change? A. Precontemplation B. Contemplation C. Preparation D. Maintenance

C. Preparation

Rafael is a long-standing client who reports having a recent cancer diagnosis. He states that he has been making good progress with his exercise and healthy eating while working with the health coach over the past year and is concerned that he will lose all the gains he has made when he goes through cancer treatment. He is interested in learning more about improving his nutrition to help him through his cancer treatments. What is the BEST next step to assist this client with his nutrition goals? A. Provide information on the best cancer-fighting meal plans B. Provide a list of foods that are high in phytochemicals and that can assist with nausea and vomiting, which are common side effects of cancer treatment C. Provide a referral to a registered dietitian, preferably one who is a certified specialist in oncology D. Provide a support system of other clients who have gone through a similar situation to assist the client in getting through the treatments

C. Provide a referral to a registered dietitian, preferably one who is a certified specialist in oncology

Emily is a long-time client who had been making progress with her hypertension. However, at her last health coaching session, she stated that her physician has increased the dosage of her blood-pressure medication due to recurring elevated readings. Emily shares that she has gained 10 pounds over the past 3 months due to her need to assume caregiver duties for her ill mother and her increased fast-food intake. She states that she is interested in modifying her lifestyle to get back on track and reduce her blood pressure. Which of the following statements is MOST accurate? A. Health coaches are unable to work with clients diagnosed with hypertension B. There is insufficient evidence showing that psychosocial stress is a primary risk factor for hypertension C. Psychosocial stress is associated with a higher risk of hypertension D. Guidelines do not include psychosocial intervention for individuals with hypertension

C. Psychosocial stress is associated with a higher risk of hypertension

Lionel, a forklift operator, is interested in working with a health coach to help prevent an escalating blood pressure issue, which a nurse practitioner identified during an employee wellness screening. Over the past 3 months, his blood pressure has averaged 128/82 mmHg. Lionel wants to avoid taking blood pressure medications and instead modify his lifestyle. An entry from his food journal is provided here: Morning: -coffee; egg mcmuffin from mcdonald's Mid-morning: -coffee; donut Lunch: -diet soda; chicken salad with ranch dressing from Wendy's Dinner: -diet soda; frozen dinner Night snack: -white cheddar popcorn; diet coke What is the BEST next step to take with this client? A. Recheck his blood pressure and develop a daily log sheet for client self-monitoring B. Discuss options for lifestyle modifications that would be most impactful in reducing blood pressure C. Query the client regarding why reducing his blood pressure is important to him D. Provide information on lifestyle modification and blood pressure improvement

C. Query the client regarding why reducing his blood pressure is important to him

Catherine is a health coach who works at an inner-city outpatient clinic. She facilitates a prenatal support group focusing on healthy eating and physical activity. The group consists of women originally from India who have migrated to the United States over the past three years to raise their families. They all speak English and have assimilated into American culture while maintaining their Hindu religion and dietary considerations. Which of the following would be the BEST next step the health coach should take? A. Question the group to determine their short- and long-term goals B. Question the group to determine what they currently know about healthy eating and physical activity C. Question the group about their personal beliefs, attitudes, and values as related to healthy eating and physical activity D. Question the group about their commitment to healthy eating and physical activity during their pregnancies

C. Question the group about their personal beliefs, attitudes, and values as related to healthy eating and physical activity

Susan has been working with a health coach for the past month to assist with reducing her sedentary activity and increase her physical activity. She reports being a new mom with a 9-month-old child and lacking the time and energy to participate in a formal exercise program 3 to 5 times per week, which was her physician's recommendation. She states that she is interested in getting her pre-pregnancy muscles back by doing resistance training for muscular endurance exercise and losing 20 pounds over the next 6 months by attending kickboxing aerobic exercise classes, but she states that she does not want to waste her time and wants to know what the best exercise program is for her. What is the preferred method of monitoring aerobic exercise intensity for this client? A. Maximum heart rate B. Metabolic equivalents C. Ratings of perceived exertion D. Target heart rate

C. Ratings of perceived exertion

Barbara is a new client who was referred to a health coach by her best friend. Barbara states she has had diabetes for more than three years but has not been diligent about following up with her endocrinologist, has not been checking her blood sugar regularly, and sometimes forgets to take her oral medications for her diabetes. Barbara states that her diabetes has been challenging, as it is not well controlled, and she has bouts of hypoglycemia and fainting. Barabara's friend has been controlling her diabetes through lifestyle changes, which she attributes, in part, to her working with the health coach. Barabara states she would like to control her diabetes in the same way as her friend. In addition to a lifestyle and health-history questionnaire and Physical Activity Questionnaire for Everyone (PAR-Q+), which of the following client assessments should be part of the intake process for this client? A. Blood sugar (glucose) and heart-rate readings B. Biometrics and body composition C. Readiness to change questionnaire D. Blood sugar (glucose) and blood pressure readings

C. Readiness to change questionnaire

Dylan is a long-standing client who has recently lost his job as a financial analyst. He reports that his wife just had their third child and they purchased a new home three months ago. Although he states that his college degree and five years of experience in the financial industry will help him secure a new position, Dylan states that he is stressed out and has quit exercising and started smoking again. The health coach administers the perceived stress scale assessment and finds the client's score to be a 28. Which of the following is the BEST next step for the health coach to take with this client? A. Recommend stress-management and smoking-cessation classes B. Identify the client's values and strengths in order to support strengths-based coaching techniques C. Refer the client to a healthcare provider for further evaluation D. Discuss the client's desires, collaborate on a SMART goal, and develop a strategic plan

C. Refer the client to a healthcare provider for further evaluation

Emily is a corporate wellness coach who provides one-on-one coaching at the workplace. At a recent session, one of the clients disclosed being bullied and harassed by a coworker to the point that the client is seeking mental health support. What is the FIRST step the health coach should take when considering creating a professional network? A. Create a professional marketing toolkit that can be distributed to allied healthcare professionals B. Refer to local policies and laws regarding a health coach's relationship with allied professionals C. Refer to the ACE Certified Health Coach's scope of practice as well as the ACE Code of Ethics to understand professional guidelines and scope of practice D. Create a networking event and invite allied healthcare professionals with the goal of developing partnership and collaboration

C. Refer to the ACE Certified Health Coach's scope of practice as well as the ACE Code of Ethics to understand professional guidelines and scope of practice

Jamal is a new client who states he is extremely worried about his health, as his recent physician visit identified new diagnoses for hypertension, type 2 diabetes, and hypercholesterolemia. He believes that he will most likely have a heart attacks in the near future, as his father and older brother had all three conditions and suffered heart attacks within a year of those diagnoses. Jamal states that he tried to start eating healthier and exercising but, despite his excessive worrying about his health, he lacks motivation and energy. He is interested in learning stress-management techniques. The health coach has Jamal participate in few mindfulness activities, including diaphragmatic breathing, affirmations, and meditation. Which of the following factors would be MOST affected by regularly participating in health coaching, cognitive restructuring, social support, exercise, and motivation? A. Mindset B. Flow C. Resilience D. Efficiency

C. Resilience

Dannika is a long-standing client who works as an emergency room nurse in a busy hospital. She reports that she recently took a manager role and that she is having difficulty adjusting to the longer hours and added stress. She states that she rarely gets lunch breaks and unfortunately finds herself eating from the vending machine. In addition, she is no longer consistent with exercise, has trouble sleeping at night, and lacks energy. She thinks that if she had better stress-reduction skills, she might have more energy, which would help her get back on her exercise routine, which she is ready to do. She also argues that she is unable to change her job, so even if she became better at handling stress, her job is a big challenge. Which part of the scenario represents the client exhibiting sustain talk? A. She states she rarely gets lunch breaks and eats from the vending machine B. She thinks she needs better stress-reduction skills which might provide more energy C. She is unable to change her job, so even if she becomes better at handling stress, the challenges of her job remain D. She states she is not consistent with exercise and lacks energy

C. She is unable to change her job, so even if she becomes better at handling stress, the challenges of her job remain

Susan has been working with a health coach for the past month and has had a recent diagnosis of osteopenia. She is concerned about the increased risk of osteoporosis, as both her grandmother and mother have the disease. Susan is a regular participant in water exercise classes 5 to 7 days/week. After she received this diagnosis, she started deep-water running, but her healthcare provider told her she had to run on land to receive any protective benefits. Susan stated that she does not like to run on land and is concerned that since she will not be consistent she will end up with osteoporosis. She states she is ready to change her behavior but is struggling doing something she does not enjoy. Which of the following statements about osteoporosis is MOST accurate? A. Individuals who are at risk for osteoporosis are encouraged to increase their intake of omega 3 and 6 fatty acids, as well as foods containing calcium and magnesium B. Pharmacologic interventions have been proven to be the most beneficial treatment for reversing the deleterious effects of osteoporosis C. Smoking can negatively impact the ability of adolescents and young adults to acquire peak bone mass D. Alcohol intake of any amount is associated with increased risk of bone loss, impaired bone health, and increased risk of falling

C. Smoking can negatively impact the ability of adolescents and young adults to acquire peak bone mass

John is working with a health coach to control his newly diagnosed hypertension. He states that his physician told him to lose some weight and improve his eating as initial lifestyle strategies and to return in three months to determine whether hypertension medications are indicated. John states that he is committed to eating better and losing weight to avoid having to take medication. Which statement is the BEST example of a positive goal for adopting a new habit? A. Thinking about changing you snack habit is a great first step toward achieving your goal of eating better. B. Stopping your habit of snacking on cookies and chips is a great first step toward achieving your goal of eating better. C. Snacking on fruits and vegetables is a great new habit to establish as you work toward your goal of eating better. D. Switching out healthier snack options for unhealthy ones is a great new habit to establish as you work towards achieving your goal of eating better.

C. Snacking on fruits and vegetables is a great new habit to establish as you work toward your goal of eating better.

Delonda is a newly certified health coach interested in structuring her health coach practice. She is deciding between offering in-person sessions or online sessions. She has developed a business name, marketing plan, and website, and has already received inquiries from a few potential clients. In addition, she intends to operate her coaching business alone, as she wants to be able to take advantage of the flow-through taxation. Which of the following BEST represents the business model described in this scenario? A. Limited liability corporation B. S-corporation C. Sole proprietor D. General partnership

C. Sole proprietor

Lionel, a forklift operator, is interested in working with a health coach to help prevent an escalating blood pressure issue, which a nurse practitioner identified during an employee wellness screening. Over the past 3 months, his blood pressure has averaged 128/82 mmHg. Lionel wants to avoid taking blood pressure medications and instead modify his lifestyle. An entry from his food journal is provided here: Morning: -coffee; egg mcmuffin from mcdonald's Mid-morning: -coffee; donut Lunch: -diet soda; chicken salad with ranch dressing from Wendy's Dinner: -diet soda; frozen dinner Night snack: -white cheddar popcorn; diet coke What category BEST represents Lionel's average blood pressure reading? A. Normal blood pressure B. Elevated blood pressure C. Stage 1 hypertension D. Stage 2 hypertension

C. Stage 1 hypertension

A health coach is working in a clinical setting with a new client interested in losing weight and beginning an exercise program in order to manage her diabetes. The initial session identified the client as being in the preparation stage of change and having basic knowledge of exercise and health eating for weight loss. The client says she lacks consistency and has difficulty sticking to a program due to a hectic work schedule, three young children, and a chronically ill parent. The health coach uses agenda mapping to uncover options for discussion. Which of the following represents the MOST appropriate way to end the coaching session? A. Thank the client for coming and share encouragement for her to stick with her goals while establishing the frequency of future sessions B. Thank the client for coming and ask that she identify a support system to help at home C. Thank the client for coming, and collaborate on a plan for accountability, communication, and establishing the frequency of future sessions D. Thank the client for coming and tell her about her homework assignment to optimize accountability and outcomes

C. Thank the client for coming, and collaborate on a plan for accountability, communication, and establishing the frequency of future sessions

Manuel is an inactive new client who has been diagnosed with cardiovascular disease (CVD) and is considering improving his dietary habits. He states that he is on medications, which he feels will cure his disease. However, his cardiologist strongly recommended he improve his eating and begin a walking program. Which of the following statements BEST reflects the "awareness" stage of the awareness-choice-execution (ACE) cycle of change? A. "I agree with your cardiologist, as you need to change your eating habits and begin walking so you do not have a heart attack. I can help." B. "Now that you have chosen to work on this, let me help put a heart-healthy eating plan and walking program together for you." C. "Let's discuss who will be able to support you in eating better and beginning a walking program." D. "Let's discuss your current behaviors and your vision for improved eating and beginning a walking program."

D. "Let's discuss your current behaviors and your vision for improved eating and beginning a walking program."

Niko, a health coaching client, reports his recent physician visit revealed an increased body mass index of 36kg/m^2 and an ALC of 7.0%. Over the past month, the health coach has been using motivational interviewing to assist with the client's desire to change his eating behaviors to lose weight, despite challenges of working shift work at this cybersecurity job. Which of the following statements regarding this client's A1C reading is MOST accurate? A. The A1C reading, which indicates average blood glucose levels over the past 2 to 3 months, is categorized as prediabetes B. The A1C reading, which indicates average blood glucose levels over the past 2 to 3 months, is categorized as prediabetes C. The A1C reading, which indicates average blood glucose levels over the past 2 to 3 months, is categorized as type 2 diabetes D. The A1C reading, which indicates average blood glucose levels over the past 2 to 3 months, is categorized as type 2 diabetes

C. The A1C reading, which indicates average blood glucose levels over the past 2 to 3 months, is categorized as type 2 diabetes

Suong is a new client seeking assistance with weight loss. She states that her physician recently told her she has metabolic syndrome, wants her to seek help, and needs her to lose weight in order to improve her health and decrease the risk of developing type 2 diabetes. Suong says that she met with a dietitian but was unhappy with many of the vegetables listed on the dietitian's approved food list due to her religious food restrictions. Suong states she understands eating more vegetables will help with weight loss but refuses to eat against her religious food restrictions. Which of the following BEST describes the health coach using active listening skills? A. The health coach is taking notes during the conversation, nodding her head, and looking at the clock to ensure the client receives the allotted time for the session. B. The health coach is standing up throughout the session in order to provide education from a food label wall chart. C. The health coach places his silenced cell phone in his desk drawer and sits near the client, nodding his head and listening intently. D. The health coach sets his cell phone's timer to ensure adequate time is allotted and places it on his desk while listening intently.

C. The health coach places his silenced cell phone in his desk drawer and sits near the client, nodding his head and listening intently.

Howie, a new health coaching client, discloses that he is depressed and sad about a family member's recent lung cancer diagnosis. Howie states that he is seeking assistance with smoking cessation, as he is fearful about his own health. During the conversation, he explains that his smoking behavior helps him cope with his anxiety and depression. What is the BEST strategy a health coach can use to assist Howie with smoking cessation? A. Provide smoking-cessation information and design a behavior-change program based on the principles of cognitive psychology. B. Commend him on his desire to stop smoking and refer him to a mental health professional. C. Use open-ended questions and motivational interviewing to gather more information to determine if a referral is warranted. D. Discuss specific behaviors that could replace smoking and work with the client to provide a detailed smoking-cessation plan.

C. Use open-ended questions and motivational interviewing to gather more information to determine if a referral is warranted.

Dannika is a long-standing client who works as an emergency room nurse in a busy hospital. She reports that she recently took a manager role and that she is having difficulty adjusting to the longer hours and added stress. She states that she rarely gets lunch breaks and unfortunately finds herself eating from the vending machine. In addition, she is no longer consistent with exercise, has trouble sleeping at night, and lacks energy. She thinks that if she had better stress-reduction skills, she might have more energy, which would help her get back on her exercise routine, which she is ready to do. She also argues that she is unable to change her job, so even if she became better at handling stress, her job is a big challenge. Which of the following statements BEST reflects the health coaching querying extremes to evoke change talk? A. "On a scale from 1 to 10, how important is it for you to get back to a regular exercise routine?" B. "Can you look ahead and imagine what will happen if you don't make this change and how your life will change?" C. "Can you talk about how your life used to be before you took on this new manager role?" D. "Can you talk about the best-case scenario if this change occurs as well as what would happen if it didn't?"

D. "Can you talk about the best-case scenario if this change occurs as well as what would happen if it didn't?"

A health coach receives an email from a potential client who is interested in online coaching but is not sure it is right for him. The email states that he is unfamiliar with the work of a health coach, but at a recent physician visit received a new diagnosis of hypertension, was told his body mass index (BMI) has increased to 39kg/m^2 and learned that his osteopenia has worsened. At the first online coaching session, which of the following questions is the BEST option to gather information and assist in developing the client-coach relationship? A. "What was your specific blood pressure reading so I can better help you with managing your newly diagnosed hypertension?" B. "On a scale from 1 to 10, how important is reducing your blood pressure and body mass index?" C. "How many days per week are you able to commit to making changes for improved health?" D. "Can you tell me what you would like to get out of these coaching sessions?"

D. "Can you tell me what you would like to get out of these coaching sessions?"

Lionel, a forklift operator, is interested in working with a health coach to help prevent an escalating blood pressure issue, which a nurse practitioner identified during an employee wellness screening. Over the past 3 months, his blood pressure has averaged 128/82 mmHg. Lionel wants to avoid taking blood pressure medications and instead modify his lifestyle. An entry from his food journal is provided here: Morning: -coffee; egg mcmuffin from mcdonald's Mid-morning: -coffee; donut Lunch: -diet soda; chicken salad with ranch dressing from Wendy's Dinner: -diet soda; frozen dinner Night snack: -white cheddar popcorn; diet coke Which of the following BEST represent the client's change talk? A. "I really want to improve my lifestyle, but I love alone and don't cook" B. "I really want to improve my lifestyle, but I need to see if it can fit it into my schedule" C. "I really want to improve my lifestyle, as long as it's not too difficult and I have someone to help me" D. "I really want to improve my lifestyle and not take my medications, so I've hired a personal trainer"

D. "I really want to improve my lifestyle and not take my medications, so I've hired a personal trainer"

Millie is a long-standing client who has been making progress with a consistent exercise program over the past six months. At her recent health coaching session, she explains that over the past month, she has been inconsistent with her exercise, begun eating at night, gained 10 pounds, and is having trouble sleeping. She states she has been spending more time caring for her mother, who has had dementia for the past five years. Her mother's health is rapidly declining and Millie is faced with the difficult decision to place her mother in a nursing home, which is the recommendation from her mother's physician and other family members. Although Millie states the facility has an exceptional reputation for caring for patients with dementia and is only 2 miles from her home, she feels like she is a loser and a complete failure despite the support from her family members. Which of the following statements if MOST appropriate from a strengths-based coaching approach? A. "You are not a failure, as dementia is a debilitating and incurable disease that is best managed from the professionals at a skilled nursing facility." B. "I see you want to be there for you mother, but you are stating that your own health and well-being are suffering, and I'm sure your mother would not want that for you." C. "Although you feel like a loser and a failure, I think you are not looking at all the good things you are doing for her and should focus on that." D. "Tell me more about how you family members would describe the care you've been providing your mother over the past five years."

D. "Tell me more about how you family members would describe the care you've been providing your mother over the past five years."

Jamal is a new client who states he is extremely worried about his health, as his recent physician visit identified new diagnoses for hypertension, type 2 diabetes, and hypercholesterolemia. He believes that he will most likely have a heart attacks in the near future, as his father and older brother had all three conditions and suffered heart attacks within a year of those diagnoses. Jamal states that he tried to start eating healthier and exercising but, despite his excessive worrying about his health, he lacks motivation and energy. He is interested in learning stress-management techniques. The health coach has Jamal participate in few mindfulness activities, including diaphragmatic breathing, affirmations, and meditation. Which of the following statements BEST reflects a mindful approach to health coaching? A. "Thank you for sharing this important information. I understand why you are so worried. I think that yoga or tai chi would be a great way to begin to manage you stress." B. "Thank you for sharing this important information. I heard you say you are lacking energy and motivation due to your worrying. Can you tell me more about that?" C. "Thank you for sharing this important information. To better help you, I'm hoping you can provide additional information about your father and brother." D. "Thank you for sharing. I'd like for you to focus on the here and the now and invite you to talk about how you are feeling in this moment."

D. "Thank you for sharing. I'd like for you to focus on the here and the now and invite you to talk about how you are feeling in this moment."

Tasha is seeing a health coach after many months of contemplation. She also says that a recent physician visit her weight was at its highest and although she has no additional health issues, her physician warned her that her increased weight puts her at high risk for developing diabetes. She works from home and rarely leaves her house due to her embarrassment about her weight. Which of the following is the MOST appropriate question? A. "How much weight are you interested in losing?" B. "When you say you are at your highest weight, what specifically would that amount be?" C. "On a scale of 1 to 10, how committed are you to losing weight?" D. "To make you feel comfortable, what words would you like to use when we talk about weight?"

D. "To make you feel comfortable, what words would you like to use when we talk about weight?"

Roberto is a new health coach and has decided to begin his career by offering group-coaching sessions in the basement of his church. He is well known in his church community and has already begun marketing his services by advertising in the church bulletin and has his first five coaching clients. Which of the following is the MOST appropriate question to ask at the beginning of the first group coaching session to encourage honestly and openness and cultivate a sense of community? A. "What should our group goals and outcomes be, so we can stay focused and on track?" B. "Can we go around the room and share their first and last names as well as reasons for being here today?" C. "Can everyone find a partner and share your personal contact information with them, as they will serve as your support buddy?" D. "What would make this a safe and respectful place for us to work together effectively?"

D. "What would make this a safe and respectful place for us to work together effectively?"

Karen has been working with a health coach for the past year to improve her consistency with exercise and participation in stress-reducing activities to manage chronic back pain. Although she states she had been making good progress, she recently went through a difficult divorce. She is not interested in seeking additional help but wants to get back on track. Karen has reported the following symptoms, which are making things difficult: -Lack of energy and motivation -Desire to stay in bed all weekend -Difficulty concentrating at work -Increased difficulty in maintaining a regular exercise schedule -Feeling restless most of the day Which of the following BEST demonstrates a strengths-based coaching technique? A. "You have worked hard and can't risk losing all that you've gained. Let's talk about a plan to get you back on track" B. "I completely understand how you feel, as I've had other clients with similar situations. I am here for you and will help you get through this" C. "I completely understand how you feel and I'm so sorry. Is it ok for us to talk about this in greater depth so I can help?" D. "You have worked hard this past year and made significant progress. Can you tell me what worked in past that could help you now?"

D. "You have worked hard this past year and made significant progress. Can you tell me what worked in past that could help you now?"

Jasmine, a long-standing client, has been working with a health coach on mindfulness techniques to aid in managing her work stress. At a recent session, she explains that she has received a work promotion that requires frequent presentations to customers. Although she states that she has strong writing skills, she shares that she has significant anxiety speaking to groups. She says that her heart rate increases, her stomach becomes jittery, and her hands become clammy. Jasmine feels her anxiety stems from a traumatic failed public speaking engagement she has in high school that caused her much embarrassment and ridicule from her peers. Which of the following factors may be contributing to Jasmine's personal stress response? A. Biological predisposition B. Protective factors C. Personality traits D. Life experiences

D. Life experiences

Suong is a new client seeking assistance with weight loss. She states that her physician recently told her she has metabolic syndrome, wants her to seek help, and needs her to lose weight in order to improve her health and decrease the risk of developing type 2 diabetes. Suong says that she met with a dietitian but was unhappy with many of the vegetables listed on the dietitian's approved food list due to her religious food restrictions. Suong states she understands eating more vegetables will help with weight loss but refuses to eat against her religious food restrictions. Which of the following statements BEST reflects a double-sided reflection response? A. "You are here because your doctor has told you to change your behavior." B. "You have some food restrictions that were on the dietitian's food list." C. "You are ready to make food changes in order to lose weight, but you are not happy about your dietitian visit." D. "You know the importance of increasing vegetable consumption for weight loss but have some religious food restrictions that need to be considered."

D. "You know the importance of increasing vegetable consumption for weight loss but have some religious food restrictions that need to be considered."

At a health coaching sessions, Malina shares that her osteoarthritis has flared up and she has been in chronic pain for the past few weeks. She states that she was doing well with eating healthy and having more energy and motivation. However, during these flare-ups, she overeats to help deal with the pain, even though she knows it will sabotage her weight-loss efforts and prevent her from getting her body mass index under 35 kg/m^2, which is one of her goals. Which of the following BEST demonstrates a double-sided reflection statement? A. "You're frustrated because you overeat to help you deal with pain during your arthritis flare-ups?" B. "It seems like it will be hard for you to maintain your weight-loss achievement during your arthritis flare-ups. Is that correct?" C. "That must be extremely upsetting when that occurs?" D. "You overeat to help you deal with arthritis flare-ups and when you eat healthy you have more energy and motivation."

D. "You overeat to help you deal with arthritis flare-ups and when you eat healthy you have more energy and motivation."

Indira is a new coaching client who states that her physician mandated she change her eating habits to improve her lipid panel and address a recent diagnosis of hypertension. Her most recent lab and blood pressure indicate the following: -Total cholesterol: 230 mg/dL -HDL cholesterol: 51 mg/dL -LDL cholesterol: 173 mg/dL -Blood pressure: 146/88 mmHg Indira states that she has a strict cultural eating regimen and consumes a large amount of vegetables and chicken. She states that she enjoys samosas (deep fried potato and lentil bean-stuffed pastry puff), pakoras (deep fried vegetables), grilled lamb, and chicken with masala sauce, which is made with ghee (clarified butter). She also states that due to her busy work schedule, she get much of this food from a local Indian grocery market that accepts food orders and then packages the pre-made items for purchase. Which of the following is one of the MOST valuable skills the health coach can use with this client? A. Ask curious, open-ended questions to gather information and develop a personalized nutrition plan based on the client's cultural food preferences B. Provide educational information from validated sources regarding the health impact of high cholesterol and hypertension C. Provide information regarding the importance of a support system within her community to assist with the necessary dietary changes D. Ask curious, open-ended questions in order to evoke change talk and elicit the client's desires, abilities, and reasons for improving her dietary intake

D. Ask curious, open-ended questions in order to evoke change talk and elicit the client's desires, abilities, and reasons for improving her dietary intake

Robert is an inconsistent exerciser interested in running his first 5k in 6 months. Twenty years ago, he was a cross-country runner in high school, but he has not run regularly since then. At his first health coaching session, he discloses that his father, who was a heavy smoker, died of a heart attack at the age of 50. Although Robert reports he is not a smoker, he is wonder whether if it is safe to start an exercise program. He states that he is a sales representative and alternates between being sedentary in the office and walking from site to site when on sales calls. His job requires weekly travel, which is why he feels he becomes inconsistent with his exercise. He states that he is interested in the best training program as well as help with his consistency. Which of the following is the BEST next step? A. Ask open-ended questions, engage in active listening to elicit the client's specific goals, and conduct a risk-factors profile to identify level of risk for exercise participation B. Ask open-ended questions, engage in active listening to elicit the client's specific goals, and design a balanced exercise program based on the Physical Activity Guidelines for Americans C. Ask open-ended questions, engage in active listening to elicit the client's in-depth medical history and specific goals, and request a medical clearance D. Ask open-ended questions, engage in active listening to elicit the client's specific goals, and conduct a preparticipation health screening using the PAR-Q+

D. Ask open-ended questions, engage in active listening to elicit the client's specific goals, and conduct a preparticipation health screening using the PAR-Q+

Maya works as a flight attendant for an international airline and is struggling with constant fatigue, low energy, low motivation, and inconsistency with her eating and exercise. Due to long transatlantic flights, she finds herself struggling with erratic sleep patterns (getting less than 6 hours per night), overconsumption of airline foods and caffeine, inconsistency with exercise, and significant amounts of time spent on her cell phone and tablet playing games and connecting with loved ones. Maya states that she thinks she has many issues going on but has a very demanding work schedule and isn't sure if anything can help. Which of the following statements is BEST for talking to this client about sleep? A. Tell the client that six hours of sleep is not enough and that adults need about 8 to 10 hours of sleep per night B. Let the client know that only a small percentage of the US population struggles with sleep disorders to the extent that it affects daily function C. Recognizing the client has issues with sleep, make a referral to a sleep specialist for screening and diagnosis of underlying disorders D. Ask questions to bring sleep into the coaching conversation, exploring caffeine use, levels of fatigue, and connections between sleep quality and exercise

D. Ask questions to bring sleep into the coaching conversation, exploring caffeine use, levels of fatigue, and connections between sleep quality and exercise

During a FIRST health coach session, the following conversation took place: Health coach: "Hi Colin. I'm James. I appreciate you taking time to come in to meet with me today." Colin: "Nice to meet you." Health coach: "It's nice to meet you too. I see on your intake questionnaire that you are interested in weight loss and are looking for a diet that works." Colin: "Yes, that's right. I want to find a diet that works for life, as I've been on many diets before and it's so aggravating to just keep gaining weight when I go off them." Health coach: "You're feeling frustrated by those past diets." Colin: "You got that right." Health coach: "Would you feel comfortable talking about the last diet you tried?" Colin: "Sure. I cut out all added sugar and lost over 20 pounds in six weeks. I looked and felt great, but then after a while, I had a horrible cookie cravings and was irritable often. And one day, I just gave in, ate an entire box of them, and never went back on the diet." Health coach: "Sounds like you really missed having cookies on that diet." Colin: "You have no idea. Once I ate my favorite cookies, I felt terrible about breaking my diet, but I have to tell you I really enjoyed every last crumb." Health coach: "You felt a lot of relief from eating those cookies." Colin: "Yeah, I really did. I know it sounds terrible." Health coach: "You attempted a diet that eliminates something you really enjoy and eventually you acted on a craving for cookies. You listened to your body and were aware of the signal being sent." Colin: "Wait, you're not going to yell at me for eating cookies? Are you saying that you think I can find a diet where cookies and other carbohydrates are allowed? I read they cause weight gain." Health coach: "Would you like to be able to eat carbs and some cookies in reasonable amounts?" Colin: "That would be awesome, but I don't know much about carbohydrates. Can you tell me?" Health coach: "Sure, carbohydrates really help us feel alert and help us function. There are so many good carbohydrates to select from. When you cut out carbs it can cause mental and physical fatigue. Did you know that?" Colin: "Really? Now it makes sense why I kept hitting a slump in the middle of the day and got so irritable. What are you thinking?" Health coach: "I'm wondering if you can think of some strategies where you can eat for weight loss while also making sure your food selection includes things you enjoy?" Colin: "You have really helped me begin to understand how excluding carbs from my diet make me feel awful. I honestly don't think I need to go on another diet, but instead should look at foods I enjoy eating, and keeping an eye on the quantity and quality of my food. It doesn't sound that hard anymore since I can make my own food decisions and improve my eating." Which of the following self-determination theory factors contributed to this client's motivation to improve his food choices? A. Relatedness B. Competence C. Affirmation D. Autonomy

D. Autonomy

Dannika is a long-standing client who works as an emergency room nurse in a busy hospital. She reports that she recently took a manager role and that she is having difficulty adjusting to the longer hours and added stress. She states that she rarely gets lunch breaks and unfortunately finds herself eating from the vending machine. In addition, she is no longer consistent with exercise, has trouble sleeping at night, and lacks energy. She thinks that if she had better stress-reduction skills, she might have more energy, which would help her get back on her exercise routine, which she is ready to do. She also argues that she is unable to change her job, so even if she became better at handling stress, her job is a big challenge. During a follow-up session, Dannika states that she has been very busy at work, but she intends to start bringing her lunch as a first step toward making healthier changes. What type of "change talk" BEST describes this statement? A. Taking steps B. Showing ambivalence C. Activation D. Commitment

D. Commitment

Patrick, who is a computer programmer, has been working with a health coach for three months and making healthier food and drink choices in an effort to lose 20 pounds (9.1kg) over the next 5 months, per the recommendation from his physician. Patrick states he is planning his meals during the week, sticking with a 2,000-calorie/day target, down from 2,500 calories/day. However, he says he struggles on the weekends, as he enjoys eating out, going to nightclubs, and socializing with friends. He states he has hit a plateau after losing 10 pounds (4.5 kg) and has heard that a diet that is high in protein and low in fat and carbohydrate is the best way to lose his last pounds (4.5 kg). Which of the following actions is outside the scope of practice of a health coach? A. Sharing information regarding nutrients contained in the foods he is eating B. Sharing information about the foods that should be included in a balanced daily diet C. Discussing principle of healthy nutrition and ways he can prepare food D. Discussing an individualized nutrition plan to assist with additional weight loss

D. Discussing an individualized nutrition plan to assist with additional weight loss

Felipe is a new client who states he is a "workaholic" who is searching for a new job and is training to complete his first half-marathon. He is looking to work with a health coach to assist in managing the stress associated with his job situation so he can do his best at the event. Felipe states that eh has been following a "marathon runner's eating plan," which was suggested by a sports dietitian. He says that the event is in two weeks and he is excited but very nervous about performing well. Which type of stress is Felipe experiencing regarding his performance in his half-marathon? A. Distress B. Professional demands C. Physical environment D. Eustress

D. Eustress

During an initial coaching session, Tanya reports that she is a long-time smoker of three or four cigarettes daily, has difficulty sleeping, and has been experiencing significant stress. She tells the ACE Certified Health Coach that she is actively involved in a community group where they volunteer at a homeless shelter weekly, and she regularly attends book club meetings and vegetarian cooking classes. She shares that last month she joined a weekly mall walking group, but she is having trouble attending with consistency. In addition, the health coach learns that a competitor has recently bought the company where Tanya has been employed for 15 years, where her job has involved significant telephone and computer use. Now, she is concerned about her financial future and job security to the point that it is interfering with her life. Based on the information gathered during the initial coaching session, which lifestyle factor is of no concern at this time? A. Poor Nutrition B. Lack of physical activity C. Tobacco use D. Excessive alcohol use

D. Excessive alcohol use

Sylvia is a new health coaching client interested in quitting her 10-year tobacco-smoking habit because her sister, who also smokes, was recently diagnosed with emphysema. She states that she feels like a failure because she has tried quitting many times before but always gains weight because she would use food to replace the cigarettes. She states that another difficult issue she faces is the regular smoking break she and her colleagues enjoy daily. Sylvia states that, though she really enjoys smoking, she would like to discuss smoking cessation, knows living a smoke-free life is what she need to do, and is seeking help to quit. Which of the following statements BEST reflects coaching to this client's stage of change? A. Implement self-directed behavior-change strategies for the client and her sister to create a strong support system B. Teach the client about the advantages of smoking cessation so she learns the negative impact her current lifestyle is having on her personal health C. Design an action plan using the 12-step model of smoking cessation D. Guide the client in evaluating the pros and cons of smoking cessation so she sees the importance of change and help her link smoking cessation to improved health

D. Guide the client in evaluating the pros and cons of smoking cessation so she sees the importance of change and help her link smoking cessation to improved health

Delonda is a newly certified health coach interested in structuring her health coach practice. She is deciding between offering in-person sessions or online sessions. She has developed a business name, marketing plan, and website, and has already received inquiries from a few potential clients. In addition, she intends to operate her coaching business alone, as she wants to be able to take advantage of the flow-through taxation. What is the BEST way to assure the laws and regulations of the profession are upheld, and the risk of litigation for the health coach is minimized? A. Access copies of state and local laws related to health and wellness professionals and write a client-coach contractual agreement B. Purchase professional liability insurance to protect the health coach from lawsuits resulting from negligence or grievance claims C. Join a professional health coach network or association to learn about laws and regulations related to the profession D. Hire a lawyer who is familiar with the laws and regulations that apply to the health coach profession

D. Hire a lawyer who is familiar with the laws and regulations that apply to the health coach profession

Mateo lives in a rural area and has established a telephonic health coaching business to best meet the needs of his sprawling community. Although he has five consistent clients who has reported significant health improvements, he is struggling to grow his business and has decided to develop a formal marketing plan, which includes designing a website. What is one of the MOST important elements of having a website? A. Having reader-friendly content and easy navigation B. Using client success stories, quotes, and testimonials C. Gathering demographic information on all website visitors D. Hiring an expert who knows search engine optimization

D. Hiring an expert who knows search engine optimization

Sylvia is a new client interested in beginning an exercise program to help her arthritis. In the first session, she tells the health coach that she bought a new pair of athletic shoes and took a tour of a local health club but feels she is too old to exercise and is considering returning her athletic shoes. The health coach offers to introduce Sylvia to a few of her older clients and states that if she is interested she can be a guest at the health club where they are members. What is the BEST initial strategy to use for working with this client? A. Support the client in establishing a system of self-monitoring B. Plan for potential lapses and set a reward system C. Explore the client's personal value and commitment D. Identify and assist the client with finding social support and defining goals

D. Identify and assist the client with finding social support and defining goals

Serena has a successful coaching business, the growth of which has plateaued. Her strategy for gaining new clients has been primarily word of mouth and some local print advertising in her community. Many of her clients have chronic issues and are travelling business professionals who have asked her to offer a blog, increase her social media presence, and incorporate video-based coaching for additional information and convenience. Which of the following describes how to BEST create an exciting blog? A. Write blog posts that are under 1500 words long for better search engine results B. Post content from shareable, trustworthy sites like Facebook to increase readership C. Develop titles with more than 15 words to attract the most traffic and optimize searches D. Incorporate images in your blogs to increase viewership

D. Incorporate images in your blogs to increase viewership

Antwon is a client who has had two months of health coaching after his wife purchased a six-month package for him for his birthday. He states that he feels he is a "big guy" and, although he agrees that he has gained a bit of weight since he got his new "desk job", he thinks his wife is exaggerating his condition. Antwon agreed to have the health coach gather some biometric information, which revealed the following: Heigh: 73 inches (190.5 cm) Weight: 310 lb (140.6 kg) BMI: 40.9 kg/m^2 % fat-free mass: 64% % fat mass: 36% Target % fat-free mass: 70% Target % fat: 30% After reviewing this information, Antwon states he was unaware of how his weight is putting him at a health risk and that he is ready to begin an exercise program, although he presently does not do any physical activity or formal exercise. He used to like walking and hiking long distances, but heard that to lose weight, he has to do shorter, faster power walks. He has a target of achieving a 70% fat-free body mass and agrees that he will reduce his daily caloric intake by 250 kcal and increase his caloric expenditure by 250 kcal/day by adding walking to his routine. Which of the following statements about energy expenditure is MOST accurate? A. Individuals with overweight or obesity will use less energy if they walk inefficiently due to their size B. Individuals with overweight or obesity will use less energy when moving at the same speed as individuals of normal body weight C. Individuals with overweight or obesity will have the same energy expenditure regardless of biomechanics or walking efficiency D. Individuals with overweight or obesity will use more energy when moving at the same speed as individuals of normal body weight

D. Individuals with overweight or obesity will use more energy when moving at the same speed as individuals of normal body weight

During a recent health coaching session, Jenn shares that she is considering discontinuing her exercise plan at the local gym due to her struggles with obesity and feeling uncomfortable and discriminated against in the changing area. The health coach says, "I hear what you are saying and understand you feel discriminated against. I am sorry you are having that experience and would like your permission to talk about this." Which of the following broad principles of ethics is being displayed by the health coach? A. Autonomy B. Non-maleficence C. Beneficence D. Justice

D. Justice

At a recent coaching session, Paul shares that although he has been working on exercising regularly (3-4 times/week) and taking a healthy lunch to work, he finds it extremely difficult and lacks motivation to continue with the plan. He states that exercising causes him soreness and his "bagged lunches" are making him crave fast food, so he reports having lapses back to eating fast food on many occasions. Which of the following BEST reflects the client's low distress tolerance? A. Lack of motivation for continuing with the plan B. Regular exercise causing client soreness C. Bagging lunches assists with healthy eating adherence D. Lapses back to eating fast foods

D. Lapses back to eating fast foods

Carlita has been sedentary most of her life, but her mother's recent type 2 diabetes diagnosis, along with her own struggle with having peripheral vascular disease and metabolic syndrome, is causing serious concern. The following information was revealed at her annual physician visit: -Waist circumference: 38 inches -Triglycerides: 187 mg/dL -HDL cholesterol: 47 mg/dL -Fasting glucose: 110 mg/dL -Blood pressure: 132/88 mmHg -Body mass index: 35 kg/m^2 Her insurance plan allows for three visits with a registered dietitian, who is teaching her how to make healthier food choices, but the dietitian suggested she work with a health coach to assist in additional behaviors changes, like adding physical activity and decreasing sedentary time. Which of the following statements is MOST accurate regarding the impact of physical activity on chronic disease? A. Physical activity can decrease the risk for chronic disease and increase all-cause mortality B. Participation in regular physical activity reduces systemic inflammation and increases stress and anxiety C. Physical activity will not decrease chronic disease due to the significant contributions heredity and genetic predisposition have D. Physical activity can decrease risk for chronic disease and all-cause mortality

D. Physical activity can decrease risk for chronic disease and all-cause mortality

Rafael is a long-standing client who reports having a recent cancer diagnosis. He states that he has been making good progress with his exercise and healthy eating while working with the health coach over the past year and is concerned that he will lose all the gains he has made when he goes through cancer treatment. He is interested in learning more about improving his nutrition to help him through his cancer treatments. Which of the following statements about individuals with cancer is MOST accurate? A. Individuals with cancer should engage in high-intensity exercise and physical activity to improve their endurance and strength to sustain their energy during treatment B. Social support is an important aspect of psychosocial care. However, due to a compromised immune system, individuals with cancer should limit socializing during treatment C. Individuals with cancer should avoid exercise and physical activity until their treatment is complete due to the significant side effects experienced D. Social support is an important aspect of psychosocial care and quality of life which has an impact on physical health and overall well-being

D. Social support is an important aspect of psychosocial care and quality of life which has an impact on physical health and overall well-being

A health coach receives a phone call from a self-described "obese woman with diabetes" who recently received a diagnosis of obstructive sleep apnea. The client states that her physician told her she needs to lose weight and exercise in order to avoid continued degradation of her health. She works as a cashier in a local restaurant, which she says makes it difficult to eat healthy. She states that after work she is responsible for caring for two children and making dinner for the family. The client says that she is unable to enjoy life due to all of her physical health ailments and is ready to make a change but does not know where to begin. What is the MOST appropriate next step for the health coach? A. Assure that the client has the necessary medical clearances to participate in health coaching sessions B. Conduct a pre-screening lifestyle and health-history phone interview to determine the appropriateness of health coaching C. Take an optimistic, strengths-based approach and assure the client that you know there are positive things in her life D. Take time to discuss the coaching process, collaborative partnership, and expectations of both parties

D. Take time to discuss the coaching process, collaborative partnership, and expectations of both parties

Rose, a non-smoker, has successfully completed a 12-week cardiac rehabilitation program after having a mild heart attack and coronary balloon angioplasty procedure. She states that she feels relieved that the angioplasty has unclogged her blocked arteries and she's "good as new." She also says that her cardiologist approved her to continue exercising and has indicated that she needs to be eating a heart-healthy diet and managing her stress. She is taking a low-dose aspirin as well as an ACE inhibitor and is ready to make the necessary behavior changes to get healthy and avoid a second event. Which statement is MOST accurate regarding the current treatment approach for heart disease? A. Medications are the first line of treatment and are monitored to determine efficacy and tolerance B. Balloon angioplasty and coronary artery bypass graft (CABG) are the only effective approaches to truly achieve treatment goals C. Comorbidities like diabetes, overweight, and/or obesity are the only effective predictors of coronary events D. The treatment goals are plaque stabilization and normalization of coronary artery function

D. The treatment goals are plaque stabilization and normalization of coronary artery function

Ruby has type 2 diabetes and is taking metformin to control her blood sugar. She has received medical clearance and has started a physical-activity program per her endocrinologist's recommendation. She says she is completely committed to exercising more, but fears developing hypoglycemia and passing out. Which of the following statements about hypoglycemia is MOST accurate? A. With proper hydration, individuals with type 2 diabetes are able to exercise regularly without developing hypoglycemia B. With proper pre-exercise nutrition, individuals with type 2 diabetes are able to exercise regularly without developing hypoglycemia C. With proper intensity monitoring during exercise and by maintaining blood sugar levels below 250 mg/dL with no ketones in the urine, individuals with type 2 diabetes are able to exercise safely and effectively D. With proper blood sugar monitoring before and after exercise and by maintaining levels in the range of 80 to 180 mg/dL, individuals with type 2 diabetes are able to exercise safely and effectively

D. With proper blood sugar monitoring before and after exercise and by maintaining levels in the range of 80 to 180 mg/dL, individuals with type 2 diabetes are able to exercise safely and effectively

Susan has been working with a health coach for the past month to assist with reducing her sedentary activity and increase her physical activity. She reports being a new mom with a 9-month-old child and lacking the time and energy to participate in a formal exercise program 3 to 5 times per week, which was her physician's recommendation. She states that she is interested in getting her pre-pregnancy muscles back by doing resistance training for muscular endurance exercise and losing 20 pounds over the next 6 months by attending kickboxing aerobic exercise classes, but she states that she does not want to waste her time and wants to know what the best exercise program is for her. What is the best resistance-training recommendation for this client? A. Work each major muscle group using a variety of exercises, doing 10-15 repetitions for 2-4 sets with a >48-hour rest between sessions for any single muscle group B. Work each major muscle group using a variety of multijoint exercises, doing 8-12 repetitions for <2 sets with a >48-hour rest between sessions for any single muscle group C. Work each major muscle group using a variety of multijoint exercises, doing 15-25 repetitions for 2-4 sets with a <48-hour rest between sessions for any single muscle group D. Work each major muscle group using a variety of exercises, doing 15-25 repetitions for <=2 sets with a >48-hour rest between sessions for any single muscle group

D. Work each major muscle group using a variety of exercises, doing 15-25 repetitions for <=2 sets with a >48-hour rest between sessions for any single muscle group


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