Which statement by the nurse is most likely to help a 22-yr-old patient with extreme obesity in losing weight on a 1000-calorie diet?
a. "It will be necessary to change lifestyle habits permanently to maintain weight loss."
b. "You are likely to notice ch
ANS: B
Motivation is a key factor in successful weight loss and a short-term outcome provides a higher motivation. A 22-yr-old patient is unlikely to be motivated by future health problems.
Telling a patient that the initial weight loss is water will be d
After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the initial instructions about diet have been understood?
a. 3 oz of lean beef, 2 oz of low-fat cheese, and a slice
ANS: B
This selection is most consistent with the recommendation of the American Institute for
Cancer Research that one third of the diet should be from animal sources and two thirds from plant source foods. The other choices all have higher ratios of ani
Which nursing action is appropriate when coaching obese adults enrolled in a behavior modification program?
a. Having the adults write down the caloric intake of each meal
b. Asking the adults about situations that tend to increase appetite
c. Suggesting
ANS: B
Behavior modification programs focus on how and when the person eats and de-emphasize aspects such as calorie counting. Nonfood rewards are recommended for achievement of
weight-loss goals. Patients are often taught to restrict eating to designated
The nurse is coaching a community group for individuals who are overweight. Which participant behavior is an example of the best exercise plan for weight loss?
a. Walking for 40 minutes 6 or 7 days/week
b. Lifting weights with friends 3 times/week
c. Play
ANS: A
Exercise should be done daily for 30 minutes to an hour. Exercising in highly aerobic activities for short bursts or only once a week is not helpful and may be dangerous in an individual who has not been exercising. Running may be appropriate, but
A few months after bariatric surgery, a 56-yr-old male patient tells the nurse, "My skin is hanging off of me. I think I might want to surgery to remove the skinfolds." Which response by the nurse is most appropriate?
a. "The important thing is that you a
ANS: D
Reconstructive surgery may be used to eliminate excess skinfolds after at least a year has passed since the surgery. The responses, "The important thing is that your weight loss is improving your health," and "The skinfolds show everyone how much w
After sleeve gastrectomy, a 42-yr-old male patient returns to the surgical nursing unit with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which nursing action should be included in the
ANS: D
The incision should be protected from strain to decrease the risk for wound dehiscence. The
patient should be encouraged to use the PCA because pain control will improve the cough effort and patient mobility. NG irrigation may damage the suture lin
The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?
a. Drink fluids between meals but not with meals.
b. Choose high-fat foods for at least 30% of intake.
c. Developing fla
ANS: A
Intake of fluids with meals tends to cause dumping syndrome and diarrhea. Food choices should be low in fat and fiber. Exercise does not prevent the development of flabby skin.
Which assessment action will help the nurse determine if an obese patient has metabolic syndrome?
a. Take the patient's apical pulse.
b. Check the patient's blood pressure.
c. Ask the patient about dietary intake.
d. Dipstick the patient's urine for prote
ANS: B
Elevated blood pressure is one of the characteristics of metabolic syndrome. The other information will not assist with the diagnosis of metabolic syndrome.
When teaching a patient about testing to diagnose metabolic syndrome, which topic would the
nurse include?
a. Blood glucose test
b. Cardiac enzyme tests
c. Postural blood pressures
d. Resting electrocardiogram
ANS: A
A fasting blood glucose test greater than 100 mg/dL is one of the diagnostic criteria for metabolic syndrome. The other tests are not used to diagnose metabolic syndrome, but they may be used to check for cardiovascular complications of the disorde
What information will the nurse include for an overweight 35-yr-old woman who is starting a weight-loss plan?
a. Weigh yourself at the same time every morning and evening.
b. Stick to a 600- to 800-calorie diet for the most rapid weight loss.
c. Low carbo
ANS: C
The restrictive nature of fad diets makes the weight loss achieved by the patient more difficult to maintain. Portion size can be estimated in other ways besides weighing. Severely calorie-restricted diets are not necessary for patients in the over
Which adult will the nurse plan to teach about risks associated with obesity?
a. Man who has a BMI of 18 kg/m2
b. Man with a 42 in waist and 44 in hips
c. Woman who has a body mass index (BMI) of 24 kg/m2
d. Woman with a waist circumference of 34 inches (
ANS: B
The waist-to-hip ratio for this patient is 0.95, which exceeds the recommended level of less than 0.80. A patient with a BMI of 18 kg/m2
is considered underweight. A BMI of 24 kg/m2 is normal. Health risks associated with obesity increase in women
A patient is being admitted for bariatric surgery. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP)?
a. Demonstrate use of the incentive spirometer.
b. Plan methods for turning the patient after surgery.
c. Assist with I
ANS: C
UAP can assist with IV placement by assisting with patient positioning or holding skinfolds aside. Planning for care and patient teaching require registered nurse (RN)-level education and scope of practice.
After successfully losing 1 lb weekly for several months, a patient at the clinic has not lost any weight for the past month. The nurse should first
a. review the diet and exercise guidelines with the patient.
b. instruct the patient to weigh and record w
ANS: C
The initial nursing action should be assessment of any reason for the change in weight loss. The other actions may be needed, but further assessment is required before any interventions are planned or implemented.
Which finding for a patient who has been taking orlistat (Xenical) is most important to report to the health care provider?
a. The patient frequently has liquid stools.
b. The patient is pale and has many bruises.
c. The patient complains of bloating afte
ANS: B
Because orlistat blocks the absorption of fat-soluble vitamins, the patient may not be receiving an adequate amount of vitamin K, resulting in a decrease in clotting factors. Abdominal bloating and liquid stools are common side effects of orlistat
A 40-yr-old obese woman reports that she wants to lose weight. Which question should the nurse ask first?
a. "What factors led to your obesity?"
b. "Which types of food do you like best?"
c. "How long have you been overweight?"
d. "What kind of activities
ANS: A
The nurse should obtain information about the patient's perceptions of the reasons for the obesity to develop a plan individualized to the patient. The other information also will be obtained from the patient, but the patient is more likely to make
The nurse is caring for a patient on the first postoperative day after a Roux-en- gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon?
a. Bilateral crackles audible at both lung bases
b. Redness, irritation, an
ANS: C
Vomiting with an NG tube in place indicates that the NG tube needs to be repositioned by the surgeon to avoid putting stress on the gastric sutures. The nurse should implement actions to
decrease skin irritation and have the patient cough and deep
Which information will the nurse prioritize in planning preoperative teaching for a patient undergoing a Roux-en- gastric bypass?
a. Educating the patient about the nasogastric (NG) tube
b. Instructing the patient on coughing and breathing techniques
c. D
ANS: B
Coughing and deep breathing can prevent major postoperative complications such as carbon monoxide retention and hypoxemia. Information about passive range of motion, the NG tube, and postoperative modifications in lifestyle will also be discussed,
After bariatric surgery, a patient who is being discharged tells the nurse, "I prefer to be independent. I am not interested in any support groups." Which response by the nurse is best?
a. "I hope you change your mind so that I can suggest a group for you
ANS: B
This statement allows the nurse to assess the individual patient's potential needs and preferences. The other statements offer the patient more information about the benefits of support groups but fail to acknowledge the patient's preferences.
To evaluate an obese patient for adverse effects of lorcaserin (Belviq), which action will the nurse take?
a. Take the apical pulse rate.
b. Check sclera for jaundice.
c. Ask about bowel movements.
d. Assess for agitation or restlessness.
ANS: C
Constipation is a common side effect of lorcaserin. The other assessments would be appropriate for other weight-loss medications.