Download NBC-HWC Exam Exam Study Guide Latest Updated 2024/2025 and more Exams Nursing in PDF only on Docsity!
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Coach preparation prior to session - ansCoach is calm, present, and emotionally available. Review available client materials. Logistics. First Session - ans1. Describe the coaching process
- Review information and assessments provided by client.
- Determine if client is appropriate candidate
- Clarify roles and expectations Early (typically 1st or 2nd session) - ans1. Explore the client's values, vision, purpose and priorities.
- Explore understanding of his/her health and wellness.
- Empower the client to select area that feels important Routine Ongoing Sessions - ansPre-determined for a period of weeks/months Coach asks about current state Facilitates review of previous action steps Uses process as appropriate Supports client in defining new action steps Reflects client's understanding, perspectives and learning Articulates new personal discoveries Program Termination - ansRecognition of progress Learning and Closure Establish plan for maintaining progress w/ emphasis on support and resources Mindfulness - ansnon-judgmental awareness of what's happening in the present moment Mindful Listening - ansListen to facts, feelings and needs behind facts, silence own voice Present - ans1. Active Listening
- Building Presence
- Mindfulness Most important moment of coaching session - ansMinute right before it starts: 1.Prepare
- Get Present
- Get Curious Logistics - ansCoaching Agreement Prepare meeting space Confirm time and location Simple content reflection - ansparaphrasing-"what I am hearing is" Double-sided reflection - ansmakes sense of discrepant information Reframe - anspositions clients statement differently Complex reflection - ansOffers the coaches interpretation of emotion or meaning-"So what I am hearing is that you feel frustrated when..." Amplified Reflection - ansA non-judgmental but gentle exaggeration of the reason to sustain behavior in order to evoke the other side of the ambivalence. open-ended questions - ansquestions that allow respondents to answer however they want Evocative Questions - ansstrategic open questions the natural answer to which is change talk
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Brainstorming - anscoming up with as many solutions to a problem as possible in a short period of time with no censoring of ideas closed-ended questions - ansQuestions that can be answered in short or single word responses. Bottom Lining - ans-Helps person get to the heart of the matter (client avoiding difficult convo) -Helps coach not talk too much -Less words -Essence of message
again, focusing and refocusing Scaling Questions - ansA solution-focused therapy intervention used when presenting problems are vague and goals are difficult to specify. The therapist asks clients to rate on a scale of zero to ten, how they are currently feeling compared to an earlier time. If they report feeling better, the therapist asks them how they achieved the improvement. They might also be asked to rate how confident they are that they will be able to maintain their resolve to change a behavior and to identify what they might do to improve their chances of making progress toward their goals. SMART Goals - ans1. Specific
- Measurable
- Attainable/Achieveable
- Realistic/Relavant
- Timely Transtheoretical Model - ansModel of behavior change that identifies six distinct stages people go through in altering behavior patterns; also called the stages of change model Stages of Change - ansprecontemplation, contemplation, preparation, action, maintenance Precontemplation - ansClient does not exercise and is not planning to start exercising within 6 months. Contemplation stage of change - ansThinking about it, ready to change w/in 6 months Preparation stage of change - ansmaking small changes in preparation for a change in the next month action stage - ansThe stage of change in the TTM where individuals have made specific, overt modifications in their lifestyle within the past 6 months. Maintenance stage of change - anssustained change over time; begins 6 months after action has started and continues indefinitely Termination/adoption stage - ansstage of change in which people have eliminated an undesirable behavior or maintained a positive behavior for more than six months Patient Activation Measure (PAM) - ansMeasures client activation level. Pts with higher scores are better able to engage in their health and have better health outcomes and lower HC costs. Lower scores- more likely to feel overwhelmed with managing their health; less likely to understand or have confidence. By understanding a pts level of activation, can create individualized care plans to increase activation and engagement. Visualizing - ansThe act of imagining and seeing pictures in the mind behavioral goals - ansprocess goals, reinforced positive actions, modifying behaviors in areas that refocus development
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High-level wellness chronic disease - ansa disease that develops gradually and continues over a long period of time Hypertension - anshigh blood pressure hypertension risk factors - ans*Non-Modifiable: Family history, age, gender, ethnicity [african american; male] *Modifiable: Obesity, substance abuse, stress, diet, and sedentary lifestyle -Tobacco damages the lining of the artery walls, prone to plaque accumulation. -Nicotine constricts the blood vessels, elevate HR and BP. diabetes - ansA condition in which the body is unable to produce enough insulin, the hormone required for the metabolism of sugar Diabetes risk factors - ansover weight, high blood pressure, family history, race obesity - anshaving an excess amount of body fat obesity risk factors - ansModifiable - Physical inactivity excess calorie intake low socioeconomic status
Non-modifiable - Age, heredity, ethnicity/race, metabolism, culture cardiovascular disease - ansa disease of the heart and blood vessels cardiovascular disease risk factors - ansPhysical inactivity Smoking High blood pressure Diabetes Inflammation Abnormal Blood Lipids High Sugar Intake Sex Age Family History Overweight/Obesity Trans Fat intake high cholesterol - ansHyperlipidemia (HLD) high cholesterol risk factors - ans- DM
- Unhealthy diet
- Physical Inactivity
- Obesity
- Age
- Sex - LDL rise easier for women than men
- Race or ethnicity metabolic syndrome - ansA syndrome marked by the presence of usually three or more of a group of factors (as high blood pressure, abdominal obesity, high triglyceride levels, low HDL levels, and high fasting levels of blood sugar) that are linked to increased risk of cardiovascular disease and Type 2 diabetes.
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metabolic syndrome risk factors - ans- Waist Circumference: Men >108, Women >
- HDL: Men <40, Women <
- Triglycerides: >
- BP: >140/> -Insulin Resistance: FBS ≥ heart disease - ansany disease of the heart muscle or other working parts of the heart heart disease risk factors - ans- Not controllable: age, sex, family history -controllable: smoking, high lipids, high cholesterol, hypertension, obesity, diabetes, mental stress, lack of exercise stroke - ansA sudden attack of weakness or paralysis that occurs when blood flow to an area of the brain is interrupted Stroke risk factors - ansHTN, HF, hyperlipidemia, diabetes, smoking, chronic AFIB, obesity, physical inactivity inflammation - ansa localized response to an injury or to the destruction of tissues Hypertension signs and symptoms - ans-Frequently asymptomatic in early stages -Initial signs vague and non-specific -Fatigue, malaise, sometimes morning occipital headache Effects of high blood pressure - ansCan harden your arteries which decreases flow of blood and oxygen to your heart (which can cause chest pain aka angina, heart failure, heart attack). Can burst/block arteries that supply blood/oxygen to the brain, causing a stroke. high blood pressure - ans140/ normal blood pressure - ans120/ controlling high blood pressure - ans90% of high blood pressure is treatable Exercise - aerobic Weight reduction Low sodium intake Stress reduction No smoking Decrease in alcohol and caffeine intake Reduce cholesterol intake Pre-diabetes - ansA condition in which a person's blood glucose levels are above normal but not high enough for a diagnosis of type 2 diabetes. A1C levels - ansNormal: below 5.7% Prediabetes: 5.7 to 6.4% Diabetes: 6.5% or above : really effects the periodontium and overall health negatively Diabetes symptoms - ans-increased thirst -frequent urination -excessive eating -weight loss type 2 diabetes - ansDiabetes of a form that develops especially in adults and most often obese individuals and that is characterized by high blood glucose resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production.
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rheumatoid arthritis - ansa chronic autoimmune disorder in which the joints and some organs of other body systems are attacked risk factors for arthritis - ans-age -sex -overweight and obesity -previous joint injury -occupation -smoking Fibromyalgia - anschronic condition with widespread aching and pain in the muscles and fibrous soft tissue chronic inflammation - ansa response of blood vessels to harmful substances, such as germs, damaged cells, or irritants; can lead to heart disease, cancer, allergies, and muscle degeneration chronic inflammation causes - anslow grade, persistent infections or irritant from foreign bodies, viruses, bacteria, fungi, large parasite, injured tissue surrounding healing fx, disease causing excessive and inappropriate activation of immune system, obesity conditions associated with chronic inflammation - ansCoronary artery disease, diabetes, obesity, arthritis cancer, kidney disease, and Alzheimer Disease. Anti-inflammatory diet - ansHelps with osteoarthritis; fresh fruits and veggies; resembles the Mediterranean diet lipid abnormalities - ansclozapine olanzapine risperidone quetiapine can see an increase in total chol LDL and trig, too LDL cholesterol - ansbad. low density lipoprotein. low protein, high fat HDL cholesterol - ansgood. high density lipoprotein. high protein, low fat high cholesterol levels - ans>240 mg/dL High cholesterol risks - ansheart disease and stroke MyPlate - ansA food-group plan that provides practical advice to ensure a balanced intake of the essential nutrients. Healthy eating plate - ans- Harvard's and it provides more detail about which protein (no processed meats) no emphasis on dairy products healthy oils Nutrition and Weight - ansA general understanding of basic and management should exist to educate clients and provide general guidance in this area. However, providing individual nutrition assessment, meal plans, or recommendations for nutritional therapy are best left to an RD or other qualified licensed professionals. DASH diet - ansDietary Approaches to Stop Hypertension Hydration - anstaking in fluids so that the body functions properly physical activity - ansany form of movement that causes your body to use energy
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Physical Activity Guidelines - ans*150 minutes of moderate-intensity aerobic physical activity per week to reduce risk for chronic disease *Strength training 2 to 3 times per week *Include balance exercises *Include flexibility exercises Physical activity guidelines for older adults - ans-same as adults except: -if they cannot do 150 min because of chronic conditions, should do as much as they can -focus on balance activities if at risk for falls -be aware of how chronic health conditions affect ability to do regular physical activity ACSM recommendations - ansCARDIORESPIRATORY EXERCISE Should get at least 150 min moderate exercise a week RESISTANCE EXERCISE -each muscle group 2-3 days/week -variety exercises and equipment FLEXIBILITY EXERCISE -2or3 times/week to improve range motion -hold 10-30 sec 2-4 times -best w/ warm muscles NEUROMETER EXERCISE -"functional fitness training" involve motor skills (balance, agility, coordination, gait) (tai ji, yoga) -2 or 3 days/week 20-30 min. sedentary lifestyle - ansa way of life that involves little physical activity Sleep guidelines - ans9 to 11 hours for those aged 5-13 years and 8 to 10 hours those aged 14- years Adequate sleep is necessary to: - ansfight off infection, support the metabolism of sugar to prevent DM, perform well in school and work effectively and safely.
if left untreated sleep disorders and chronic short sleep is associated with increased risk of: Heart disease HTN Obesity DM All-cause mortality Lack of sleep can cause - ansDiabetes, cardiovascular disease, heart attacks, stroke, depression, high bp, obesity and infections Sleep and Health - ansSleep is an essential component of chronic disease prevention and health promotion Requirements change with age and life circumstances Regulated by waking time and circadian rhythms Hormones during sleep affect memory, blood pressure, and kidney function. Common sleep disorders - ans-chronic insomnia
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social determinants of health - ansThe conditions in which people are born, grow, live, work, and age, shaped by the distribution of money, power, and resources at global, national, and local levels social isolation - ansa complete/ near complete lack of contact with people and society for members of social spears; not the same thing as loneliness, which is temporary How stress affects the body - ansdecreases immune system's efficiency Coping with stress - ansEnsure adequate rest and a healthy diet. Use creative solutions to minimize stressors and adapt quickly to stressor. Regular moderate exercise Engage in distracting activities. Counseling and support services Relaxation techniques relaxation and meditation - anscan help alleviate hypertension, anxiety, headaches, and insomnia Relaxation Techniques for Stress Management - ansyoga, qigong, tai chi, diaphragmatic breathing, meditation, visualization, progressive muscle relaxation, massage therapy, biofeedback Meditation - ansthe focusing of attention to clear one's mind and produce relaxation tobacco use - ansThe use of any nicotine-containing tobacco product, such as cigarettes and smokeless tobacco Smoking Health Effects - ansImpairs natural development in teenagers. Impairs lung function and diffusion rates. Increases chances of asthma. Damages cilia, alveoli, bronchioles, trachea, larynx. Narrows respiratory airways. Increases chance of emphysema and lung and throat cancers. Causes shortness of breath, coughing, wheezing and mucus in the lungs. quitting smoking - ansBlood pressure and pulse return back to normal after 20 minutes of smoking a cigarette After 8 hours carbon monoxide levels in the blood drop A chance of heart attack decreases after one day Within 2 weeks to 3 months, lung function by 30% substance abuse - ansAny unnecessary or improper use of chemical substances for nonmedical purposes moderate alcohol use - ans2 drinks per day for men, 1 drink per day for women. Is not considered harmful for the average adult. Able to function appropriately in work, family, & social situations. Prescription Opioid Abuse - ansNarcotic analgesics can produce drug dependence when prescribed clinically, but over-used. Oxycodone and hydrocodone are two examples of prescribed drugs that are sought after by those dependent on narcotic analgesics. A favorite prescription drug for abuse is the long acting oxycodone products. These products are designed to release the analgesic over 12 hours, thus they contain more drug per tablet than conventional products. Abusers will grind the tablet, dissolve the material in water, and inject the solution. well-being - ansself-perceived happiness or satisfaction with life. Used along with measures of objective well-being (for example, physical and economic indicators) to evaluate people's quality of life.
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health - ansa state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity Prevention - anstaking steps to keep something from happening or getting worse Well-being concepts - ansA measurement of people's perspective that their lives are going well, including living conditions, the quality of their relationships, positive emotions and resilience. Maslow's Hierarchy - ansA theory that arranges the five basic needs of people—physiological, security, social, esteem, and self-actualization—into the order in which people strive to satisfy them Deficiency Needs (Maslow) - ansBasic requirements for physical and psychological well-being as identified by Maslow. These needs must be satisfied, but once they are, a person's motivation to satisfy them diminishes. The four lower-level needs are:
- esteem
- belonging
- safety
- survival Ardell's Model of Wellness - ansa model of wellness that believes that self-responsibility is the foundational dimension to the others motivational interviewing - ansa collaborative, person-centered form of guiding to elicit and strengthen motivation for change DARN - ansDesires Abilities Reasons Needs OARS - ansOpen-ended questions Affirmations Reflective listening Summaries DEARS - ansDevelop discrepancy Express empathy Amplify ambivalence Roll with resistance Support self-efficacy Ethics - ansthe principles of right and wrong that guide an individual in making decisions walk the talk - anssupport your words with actions NBHWC Code of Ethics - ansIs designed to provide appropriate guidelines, accountability and enforceable standards of conduct for all NBHWC Credential- holders. In line with the NBHWC definition of coaching, all NBHWC Credential-holders commit to abiding by the following Code of Ethics. NBHWC Scope of practice - ansdescribes the role of the coach and clarifies the handling of dual professional roles
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Confidentiality and Privacy - ansThere is a difference between ( more to do with information) and (more to do with the person) NBHWC Pledge of Ethics: - ansAs a Health and Wellness coach, I acknowledge and agree to honor my ethical and legal obligations to my coaching clients and sponsors, colleagues, and to the public at large. I pledge to comply with the NBHWC Code of Ethics and to practice these standards with those whom I coach, teach, mentor or supervise. scope of practice - ansa set of regulations and ethical considerations that define the scope, or extent and limits Coach's role - ansaccountability partner, not director, in navigating behavioral change and exploring opportunities for growth and development. They do not diagnose, interpret medical data, prescribe or de-prescribe, recommend supplements, provide nutrition consultation or create meal plans, provide exercise prescription or instruction, consult and advise, or provide psychological therapeutic interventions or treatment. The following conversation occurs in the 7th coaching session: Client: I am having a difficult time talking with my spouse this week. He seems to be upset by everything I say and do. I don't get it. Coach: I get it. My husband was so short with me last week and I felt like I was to blame for everything. I have definitely been there. What are we going to do? The coach's response is an example of which of the following? a) Empathy b) Sympathy c) Pity d) Evaluation - ansb) sympathy When is the best time to use a decisional balance tool? a) When client shows discord b) When client needs sympathy c) When client shows change talk d) When client is ambivalent about a change - ansd) when client is ambivalent about a change Frequent interruptions from the client may be a sign of what? a) change talk b) sustain talk c) low self-efficacy d) discord between the coach & client - ansd) discord between the coach and client In the US, there remains a wide variation of opiod Rx rates across varying states. This CANNOT be explained by what: a) size of populations b) quantity of surgeries, per capita c) health status of the varying populations d) access to healthcare - ansc) health status of the varying populations What is the best for assessing visceral fat? a) skin calipers b) BBMI
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c) waist circumference d) waist-to-hip ratio - ansc) waist circumference Normal B/P - anssystolic: less than 120 diastolic: less than 80 Non violent communication (NVC) - ansObserve, Feel, Need, Express/Request VS Evaluations,Thoughts,Strategies,Demands (what we end up with w/o NVC) Elevated BP - ans120-129/< Blue Zones - ansrefers to areas where humans live past the age of 100, longevity hot spots. green space - ansan area of grass, trees, or other vegetation set apart for recreational or aesthetic purposes in an otherwise urban environment. diabetes mellitus - ansa group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both Normal A1C - ansless than 5.7% Diabetes A1C range - ans6.5% and above Prediabetes A1C - ans5.7-6.4% fasting plasma glucose (FPG) - ansalso known as fasting blood sugar test. measures circulating glucose level in a patient who has fasted at least 8 hours FPG normal range - ans<100 mg/dL FPG prediabetes range - ans>100mg/dl-<126mg/dl FPG diabetes range - ans>126mg/dl OGTT normal range - ans<140 mg/dL OGTT prediabetes range - ans>140mg/dl-<200mg/dl OGTT diabetes range - ans>200mg/dl BMI ranges for overweight and obese - ansoverweight: 25-29.99, obese: 30 or more Class 1 obese 30 to < Class 2 obese 35 to < Class 3 obese > BMI fallacies - ans-reflects body fat without regard to distribution -inaccurate for athletes -inaccurate for older sedentary adults -inaccurate for ethnic groups with different body types low risk waist circumference - ans- Women: <31.5"
- Men: <37" intermediate risk waist circumference - ans-Women: 31.6"-34.9" -Men: 37.1"-39.9" High risk waist circumference - ansWomen :<35" Men: <40" Risk of heart attack/stroke using waist to hip ratio - ansWomen: >. Men: >. Metabolic Syndrome (must have 3 of the 5 metabolic risk factors) - ansLarge waistline (>35" for women, >40" for men) High Triglycerides (>150 mg/dl)
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E=Ethics: regarding distribution lists management, discrimination issues R= Respond to other coach violations Professional conduct with clients - ans(B.E.T.) o B= Boundary: with regard to standard of practice; no intimacy E= Expectations: with regards to agreements/nature of coaching T= Truth: no misleading; protect clients; refer them out; accept terminations; HIPPA Privacy Rules - ans(A.S.)o A= Agreement: information sharing, privacy, business associates S= Strict confidentiality 2003 blood pressure guidelines - ansNormal :systolic: less than 120 mm Hg diastolic: less than 80 mm Hg At risk: (prehypertension) systolic: 120-139 mm Hg diastolic: 80-89 mm Hg High Blood Pressure: (hypertension) systolic: 140 mm Hg or higher diastolic: 90 mm Hg or higher 2017 Blood Pressure Guidelines - ansNormal: systolic: less than 120 mm Hgdiastolic: less than 80 mm Hg Elevated: systolic: (prehypertension) 120-129 mm Hg diastolic: less than 80 mm Hg High Blood Pressure: systolic: (hypertension) 130 mm Hg or higher diastolic: 80 mm Hg or higher MyPlate Reccomendations - ans-grains: 6oz, 6-11 servings -vegetables: 2.5 cups, 3-5 servings -fruits: 2 cups, 2-4 servings -dairy: 3 cups, 2-3 servings -protein: 5.5 oz, 2-3 servings Physical Activity Guidelines - ans*150 minutes of moderate-intensity aerobic physical activity per week to reduce risk for chronic disease *Strength training 2 to 3 times per week *Include balance exercises *Include flexibility exercises regional variation in use of prescription opioids - anscannot be explained by the underlying health status of the population Most common drugs involved in the prescription opioid overdose deaths include: - ansMethadone Oxycodone (such as Oxycontin) Hydrocodone (such as Vicodin) As many as in patients receiving long term opioid therapy in a primary care setting struggles with opioid addiction - ans1 in 4 Benzodiazepines - ansThe most common group of antianxiety drugs, which includes Valium and Xanax. Side effects of opioids - ansTolerance, physical dependence, increased sensitivity to pain, nausea, vomiting, dry mouth, constipation, sedation and respiratory depression, sleepiness,
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dizziness, confusion, low levels of testosterone that can result in lower sex drive, energy and strength, itching and sweating meditation health benefits - anshelps people manage anxiety, stress, depression, pain or symptoms related to withdrawal from nicotine, alcohol or opioids Common Stress Reactions - ans-Disbelief and shock -Feeling sad, frustrated, helpless and numb -Fear and anxiety about the future -Feeling guilty -Anger, tension, and irritability -Difficulty concentrating on making decisions -Crying -Reduced interest in usual activities -Wanting to be alone -No desire for food or loss of appetite -Sleeping too much or too little -Nightmares of bad memories -Re-occuring thoughts of the event -Headaches, back pains and stomach problems -Increased heart rate and difficulty breathing -Increased smoking or use of alcohol or drugs Ways to cope with stress - ans-Follow a normal routine as much as possible -Take care of yourself -Talk about your feelings and accept help -Turn if off and take a break -Get out and help others signs that more help might be needed: - ansfeeling sad or depressed for more than two weeks • Not being able to take care of yourself or family • Not being able to do your job or go to school because of your stress • Alcohol or drug use • Thinking about suicide Physical Activity Guidelines - ans*150 minutes of moderate-intensity aerobic physical activity per week to reduce risk for chronic disease *Strength training 2 to 3 times per week *Include balance exercises *Include flexibility exercises Physical activity guidelines for Older Adults - ans-same as adults except: -if they cannot do 150 min because of chronic conditions, should do as much as they can -focus on balance activities if at risk for falls -be aware of how chronic health conditions affect ability to do regular physical activity Physical Activity Guidelines for Women during pregnancy/postpartum - ansat least 150 minutes of moderate-intensity aerobic activity a week under the care of a physician
