Question 1

After discussing appropriate exercise activities with a patient who is overweight who is starting to exercise as part of a weight-loss program,the nurse will determine that the instructions have been understood when the patient reports which of the following?

Accepted Answer

Walking for 40 minutes 6 or 7 days a week is the best choice for a patient who is overweight and starting an exercise program for weight loss. It is a low-impact activity that can be easily incorporated into daily routines and can be sustained over time. Running for 10 to 15 minutes three times a week may not be sustainable or safe for someone who is overweight and not accustomed to regular exercise. Lifting weights may be beneficial for building muscle and improving overall fitness, but may not be the most effective exercise for weight loss. Playing soccer for an hour on the weekend may provide some cardiovascular benefits, but may not be enough to impact weight loss goals.

Question 2

In planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass as treatment for morbid obesity,on what does the nurse place the highest priority?

Accepted Answer

Teaching the patient proper coughing and deep breathing techniques, along with methods of turning and positioning, is crucial to prevent postoperative complications such as pneumonia and deep vein thrombosis. These techniques help maintain lung expansion and circulation, which are vital for recovery.

Question 3

In developing a weight-reduction plan for an obese patient who is motivated to lose weight,it is most important for the nurse to assess which of the following data first?

Accepted Answer

Assessing the patient's social, emotional, and behavioral etiologies of obesity is crucial as it provides insight into the root cause of the patient's weight gain and helps to tailor the weight loss plan to address these underlying factors. This information can also help the nurse identify potential barriers to successful weight loss and provide appropriate support to the patient. While the other options are also important, assessing these factors can be done after the nurse has gained an understanding of the patient's emotional and behavioral challenges when it comes to weight loss.

Question 4

When teaching a patient about recording the weight during a weight-loss program,how often would the nurse recommend that the patient get weighed?

Accepted Answer

Weighing oneself once a week is recommended for tracking weight loss because it allows for a clear view of progress while minimizing daily fluctuations due to factors like water retention or food intake. Daily or more frequent weigh-ins can lead to discouragement and obsession over natural weight variations.

Question 5

A patient has been taking orlistat (Xenical)for several months as part of a weight loss program that also includes a low-fat diet.Which of these data obtained by the nurse indicates that a change in therapy may be needed?

Accepted Answer

The presence of paleness and many bruises in a patient taking orlistat may indicate a deficiency in fat-soluble vitamins (such as vitamin K, which is important for blood clotting), suggesting a need for a change in therapy or supplementation.

Question 6

A patient has been on a 1000-calorie diet with a daily exercise routine to promote weight reduction.During the first 2 months of her program,she lost 9 kg of a goal of 23 kg,but she is discouraged that she has not lost any weight for the last 2 weeks.What should the nurse inform the patient about?

Accepted Answer

Plateaus where no weight is lost are a normal occurrence during a weight-loss program. It is important for the nurse to reassure the patient and encourage her to continue with her diet and exercise routine. The nurse should also discuss the possibility of adjusting her calorie intake or exercise regimen to break through the plateau. It is important for the nurse to avoid making assumptions about the patient's adherence to the diet and exercise program or attributing the plateau to water gain without further assessment.

Question 7

A patient returns to the surgical nursing unit following a vertical banded gastroplasty with an NG tube to low,intermittent suction and a patient-controlled analgesia (PCA)machine for pain control.During the postoperative care of the patient,the nurse recognizes the need for which of the following?

Accepted Answer

Supporting the surgical incision during coughing is essential to prevent wound dehiscence, a complication where the wound reopens along the surgical incision. This is a standard postoperative care practice to ensure proper healing and prevent complications.

Question 8

A patient is being evaluated at the clinic for possible metabolic syndrome.The nurse will explain the purpose of which test to the patient?

Accepted Answer

A fasting blood glucose test is used to evaluate for metabolic syndrome, which includes criteria such as elevated glucose levels, high blood pressure, and central obesity. Resting electrocardiogram, postural blood pressures, and cardiac enzyme tests are not typically used to evaluate for metabolic syndrome.

Question 9

The nurse provides discharge instructions to a patient following gastric bypass surgery for treatment of obesity.What does the nurse teach the patient?

Accepted Answer

The nurse should teach the patient to avoid foods high in carbohydrates to prevent weight gain and to not drink fluids with meals to prevent overstretching the stomach pouch. The patient should also be instructed to eat small, frequent meals consisting of nutrient-dense foods such as lean protein, vegetables, and fruits. Additionally, the nurse should encourage the patient to engage in regular physical activity to promote weight loss and prevent weight regain.

Question 10

A few months after bariatric surgery,the patient tells the nurse,"My skin is hanging in folds.I think I need cosmetic surgery." Which following response by the nurse is most appropriate?

Accepted Answer

It is appropriate for the nurse to acknowledge the patient's concern about excess skin and provide a realistic option for addressing it. Once the patient's weight has stabilized after bariatric surgery, cosmetic surgery may be a viable option to remove the excess skin.

Question 11

The obese patient is at risk for which of the following types of cancer?

Accepted Answer

Obesity is a known risk factor for colorectal cancer. It is not a significant risk factor for lung, pancreas, or liver cancer.

Question 12

Which one of the following represents a "healthy plate"?

Accepted Answer

The healthy plate should consist of one-half fruits and vegetables, one-fourth whole grains, and one-fourth lean protein. Option A and C do not have enough fruits and vegetables, and option B does not have enough whole grains. Option D has a good balance of all three food groups.

Question 13

When working with an obese patient who is enrolled in a behaviour modification program,which nursing action is most appropriate?

Accepted Answer

Asking the patient about situations that tend to increase appetite can provide insight into potential triggers for overeating, and can help the patient develop coping strategies for these situations. Writing down caloric intake and scheduling small meals throughout the day are also important components of weight loss, but addressing emotional and situational triggers is a crucial aspect of behaviour modification. Offering rewards may reinforce the idea that food is a source of pleasure or comfort, which can undermine weight loss efforts in the long run.

Question 14

When developing a weight-reduction plan for a patient with obesity who is starting a weight-loss program,which question is it most important for the nurse to ask?

Accepted Answer

Understanding the patient's motivation for losing weight can help the nurse tailor the weight loss plan to the patient's individual needs and goals. It can also help the nurse identify any potential barriers or challenges the patient may face during the weight loss journey. While physical activities, duration of overweight, and previous diets may also be important factors to consider, understanding the patient's motivation for weight loss should be the primary focus.

Question 15

The nurse is developing a weight loss plan for a 21-year-old patient with obesity.Which statement is most likely to help the patient in losing weight on the planned 800-calorie diet?

Accepted Answer

Providing short-term, tangible benefits like feeling better in a few weeks can motivate the patient to adhere to the diet plan.

Question 16

When taking the health history from a patient with obesity,which information obtained by the nurse is most helpful in determining whether the patient will be successful in losing weight?

Accepted Answer

The patient's readiness to make a change in their lifestyle is the most important factor in determining success in weight loss. If the patient is not motivated or committed to making changes, it will be difficult for them to achieve their weight loss goals. BMI and past weight loss history may provide some insight but do not guarantee success in the present. Riding a stationary bicycle may be a positive lifestyle choice, but it is not directly related to weight loss success.

Question 17

The nurse teaches the patient that medical monitoring will be required for how long after bariatric surgery?

Accepted Answer

Medical monitoring is required for life after bariatric surgery. This is because these patients are at increased risk for complications such as nutritional deficiencies, dumping syndrome, and weight regain. Regular follow-up assessments and blood work are necessary to monitor for these issues and make adjustments to the treatment plan as needed.

Question 18

The nurse is assessing patients at the outpatient clinic.Which of these patients is at risk for health complications related to weight?

Accepted Answer

The patient has a waist measurement of 75 cm and a hip measurement of 85 cm, which indicates a waist-to-hip ratio of 0.88. A waist-to-hip ratio of 0.85 or higher in women is associated with an increased risk of health complications related to weight, such as heart disease, stroke, and type 2 diabetes.

Question 19

A patient with obesity asks the nurse about using orlistat for weight reduction.What does the nurse tell the patient?

Accepted Answer

The nurse should inform the patient that weight-reduction drugs may be helpful in weight loss but that changes in diet and exercise need to be maintained to prevent weight gain from recurring. This advice is supported by research and is considered best practice in weight management. Option A is inaccurate because orlistat is a fat-soluble vitamin inhibitor and may lead to a deficiency in these vitamins if not taken in conjunction with vitamins. Option B is judgmental and shames the patient, which is not an appropriate nursing response. Option D is an extreme statement and not entirely accurate as orlistat has been approved by the FDA for long-term use with monitoring by a healthcare provider.

Question 20

In the clinic,the nurse is assessing a new patient who has abdominal obesity and hypertension.What further assessment should the nurse do to assess for possible metabolic syndrome?

Accepted Answer

Abdominal obesity is a key component of metabolic syndrome. Measuring the patient's waist size can help determine if they meet the criteria for metabolic syndrome (waist circumference greater than 40 inches in men or 35 inches in women). Taking the patient's apical pulse may be important for assessing cardiovascular health, but it is not related to metabolic syndrome. Asking the patient about dietary intake may also be important, but it is not specific to metabolic syndrome. Determining the patient's ethnic origin may provide some information about their risk for certain health conditions, but it is not directly related to assessing for metabolic syndrome.

Quiz 43: Nursing Management: Obesity