Counseling

Self-check Questions

Section 3 – “Counseling”
You’ve just completed the “Counseling” section of this module. Before continuing, test your knowledge about psychosocial barriers to appropriate folic acid intake, the “Stages of Change” theory and effective strategies for counseling for folic acid by answering the self-check questions below.  (These questions are for your benefit only—they will not be graded.  Correct answers are given just after the questions. 

1) Which of the following are psychosocial barriers that may prevent an individual from getting the appropriate amount of folic acid?

A. Financial issues affecting purchase of folic acid supplements and enriched foods
B. Lack of awareness of the importance of folic acid
C. Familial or individual behaviors and attitudes
D. All of the above
E. Only A and B

2)  DiClemente and Prochaska's "Stages of Change" theory takes into account the idea that change is not an event, but a process. According to this theory, which of the following describes the five stages of change individuals will go through in deciding to take folic acid?

A. Pre-Action, Contemplation, Preparation, Action, Maintenance
B. Action, Contemplation, Preparation, Pre-Maintenance, Maintenance
C. Pre-contemplation, Contemplation, Preparation, Action, Maintenance
D. Pre-Decision, Decision, Action, Pre-Maintenance, Maintenance

3)  Which of the following does NOT describe an appropriate time or manner in which to approach an individual about the topic of folic acid?

A.  While reviewing the patient’s history or measuring height, weight or blood pressure
B.  When the patient asks a question about nutrition, multivitamins, supplements, or general preventive health measures
C.  If the patient expresses the desire to become pregnant
D.  Telling the patient initially that they probably haven’t been taking enough folic acid        
E.  Starting a conversation about folic acid by asking “What do you know about folic acid?” or  “Do you currently take any vitamin or mineral supplements? Which ones? How often?”

4)   In assessing the need for folic acid, it is important to take into account whether the individual…

A. Is planning to become pregnant
B. Has had a prior NTD-affected pregnancy, a miscarriage, or a family history of pregnancy resulting in NTDs or other birth defects
C. Is of Hispanic origin, or has diabetes or epilepsy
D. Has any barriers preventing him/her from taking folic acid and/or eating a healthy diet
E. All of the above
F. A, B and D only

5)  When counseling for folic acid you may need to refer patients to other medical and social services as well as provide some dietary counseling.  Which of the following is NOT appropriate when you are providing these services?

A. Referring all pregnant women to obtain prenatal care and making sure the patient knows how and where to get prescriptions filled if they require prenatal vitamins or a high-dose folic acid supplement
B. Determining if the individual may be eligible for the Women, Infants and Children (WIC) program or Food Stamps
C. Giving your clients culturally appropriate recipes
D. Telling individuals to just “eat more responsibly” and they will be much better off
E. Helping your clients identify which foods are in their regular diet that contain folic acid or folate, and build on those "building blocks,” and remind them to check the nutrition labels on packaged food