Question 1

A patient asks a nurse which weight-loss diet is most effective. Which response by the nurse is appropriate?&#10;A) &#34;Low-fat diets are best for weight loss, because fat has a higher concentration of calories than proteins and carbohydrates.&#34;&#10;B) &#34;Most diets don't work very well for long-term maintenance, so you should ask your provider about medications to lose weight.&#34;&#10;C) &#34;You should be able to lose 30 to 40 pounds in the first 6 months of an effective weight-loss diet.&#34;&#10;D) &#34;You should select a diet that you are more likely to adhere to for a prolonged period.&#34;

Accepted Answer

In general, the best diet for losing weight is the one the patient is more likely to follow, because a direct correlation exists between the amount of weight lost and adherence to the plan, regardless of which plan is followed. For patients watching calories, a low-fat diet makes sense, because fats have a higher concentration of calories per ounce. However, if a low-fat diet is not palatable and the patient does not stick with it, it is of little use. Drugs are used as adjuncts to weight-loss diets and are reserved for people at increased health risks who have not been able to follow a 6-month program of diet and exercise. The goal for weight loss in the first 6 months is 10% of total body weight.

Question 2

A nurse performing an admission history on a patient learns that the patient is taking orlistat (Xenical), warfarin (Coumadin), and levothyroxine (Synthroid). What will the nurse do?&#10;A) Contact the provider to discuss increasing the warfarin dose.&#10;B) Give the levothyroxine at least 4 hours before giving the orlistat.&#10;C) Suggest that the patient avoid fatty foods while taking these medications.&#10;D) Tell the patient to take the orlistat on an empty stomach.

Accepted Answer

Orlistat may cause hypothyroidism in patients taking levothyroxine; these two drugs should be administered at least 4 hours apart. The vitamin K deficiency that can occur with orlistat may compound the effects of warfarin, so coagulation should be monitored; it is more likely that the warfarin dose would need to be reduced. The patient may still consume foods containing fat, as long as fat accounts for about 30% of the total intake. Orlistat should be taken with food.

Question 3

A 50-year-old patient with a body mass index (BMI) of 26 and a waist circumference (WC) of 37 who smokes asks a nurse about drugs for weight loss. She tells the nurse, "I keep trying to eat less, but it doesn't work." What will the nurse do?

A) Ask her to begin keeping a log of her food intake and activities.
B) Counsel her to quit smoking to reduce her health risk.
C) Suggest she begin walking every day to increase the number of calories burned.
D) Tell her she is a candidate for drug therapy and suggest she contact her provider.

Accepted Answer

Drug therapy can be used for people at increased health risk, such as this woman, but only as an adjunct to diet and exercise and only after a 6-month diet and exercise regimen has failed. The first step should be to ask the patient to keep a log of intake and activity so that she is aware of how many calories she consumes and how many she burns. Counseling her to quit smoking is appropriate in terms of overall health but does not address her current concern. Exercise without diet is not effective, although exercise is a useful adjunct to diet modification. The patient is not a candidate for drug therapy until she has tried a diet and exercise program for 6 months.

Question 4

A nurse is teaching a nursing student about the use of leptin for treating obesity. Which statement by the student indicates understanding of the teaching?&#10;A) &#34;Daily injections of leptin appear to stimulate weight loss in the majority of people who use it.&#34;&#10;B) &#34;Leptin acts to reduce appetite in patients who are known to be leptin deficient.&#34;&#10;C) &#34;Obese patients are almost always leptin deficient and would benefit from this therapy.&#34;&#10;D) &#34;Young patients receiving leptin to treat obesity will experience delayed puberty.&#34;

Accepted Answer

Leptin is useful in patients who are leptin deficient but is not useful in patients who are not. Most obese people are not leptin deficient; they generally have high leptin levels and may be leptin resistant. Leptin has no effect in these patients. Leptin stimulates sexual development.

Question 5

A nurse is counseling a group of patients who are beginning a weight-loss diet. The nurse discusses the role of exercise in weight management. Which statement by a patient indicates a need for further teaching?

A) "Exercise has a greater role in weight-loss maintenance than in weight loss itself."
B) "Exercise helps by reducing abdominal fat and improving cardiovascular fitness."
C) "Once I lose weight, I can reduce the amount of time per week I exercise."
D) "I should begin with at least 30 minutes of exercise per day, 5 days per week."

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Accepted Answer

Exercise is most useful for weight maintenance after weight loss has occurred; the amount of exercise recommended after weight loss has occurred is greater than for weight loss itself, so this statement indicates a need for further teaching. The other statements are all correct.

Question 6

A nurse is teaching a group of patients about weight management options. One patient asks why many potential new drugs for long-term use in weight loss are not available. Which response by the nurse is correct?

A) "Although some drugs have shown benefits, these benefits do not outweigh the risks."
B) "None of these drugs have shown significant weight loss when compared with placebo."
C) "The abuse potential of most of these drugs is generally too high to warrant their use."
D) "The side effects of most of these drugs are too uncomfortable to maintain compliance."

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Accepted Answer

Several new drugs have shown promise in promoting weight loss, but they are not on the market because the benefits are not significant enough to offset possible risks. A few of these drugs have a high abuse potential, but most have a low abuse potential. Side effects of these drugs that affect comfort have been minor for the most part.

Question 7

A nurse is teaching a patient who is about to begin drug therapy with orlistat (Xenical). The patient, whose BMI is 28, has hypertension and type 2 diabetes mellitus. Which statement by the patient indicates understanding of the teaching?

A) "Dark urine and light-colored stools are expected side effects with this drug."
B) "I should stop taking this drug once my blood pressure and serum glucose have stabilized."
C) "I will need to take a multivitamin containing fat-soluble vitamins every day."
D) "If I have fatty or oily stools or fecal incontinence I should stop taking this drug."

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Accepted Answer

Because orlistat works by reducing fat absorption, fat-soluble vitamins are not absorbed as well. Patients should take a multivitamin containing vitamins A, D, E, and K. The increased fat is lost in stools, resulting in fatty, oily stools and fecal incontinence. These are expected side effects but are not dangerous and can be managed with bulk-forming laxatives. Orlistat is used for long-term weight loss and should be given up to 2 years to sustain weight loss. Dark urine and light-colored stools indicate possible liver damage and the need to discontinue the drug until liver damage has been ruled out.

Question 8

A nurse is working with a group of patients. One patient states, "My goal is to reduce my weight from 280 pounds to 230 pounds in 6 months." What response by the nurse would be most appropriate for this patient?

A) "Most weight loss occurs in the first 6 months, so you should try to reduce your weight to 200 pounds."
B) "Safe and maintainable weight loss should be about 10% of body weight in 6 months."
C) "That is a realistic goal for your weight-reduction program."
D) "Weight loss of more than 20 pounds in 6 months could be dangerous."

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Accepted Answer

Safe and maintainable weight loss should be about 10% of body weight in 6 months (i.e., 28 pounds for this patient). A loss of 50 pounds in 6 months is unrealistic for this patient. Advising the patient to aim for a weight loss of 80 pounds in the first 6 months is less realistic than a reduction of 50 pounds and may actually harm the patient. Weight loss of more than 20 pounds in 6 months is not dangerous, because it falls within the guideline of 10% of body fat (i.e., 28 pounds for this patient).

Question 9

Which statement by a patient about to begin taking orlistat (Xenical) for weight loss therapy indicates an understanding of this drug's actions?&#10;A) &#34;I can eat as much as I want and still lose weight.&#34;&#10;B) &#34;I should avoid fat-soluble vitamin supplements while taking this drug.&#34;&#10;C) &#34;If I take a bulk-forming laxative, I can reduce the incidence of fecal incontinence.&#34;&#10;D) &#34;If I take the drug 4 times daily instead of twice daily, I will lose weight faster.&#34;

Accepted Answer

Because orlistat reduces fat absorption, stools often are fatty or oily, and fecal incontinence can occur. Bulk-forming laxatives can help with this side effect. For orlistat to be effective, patients still need to adopt a reduced-calorie diet with a 30% fat content. Patients should take fat-soluble vitamin supplements to replace those lost in stools. Taking the drug more often does not increase weight loss.

Question 10

A patient asks a nurse about using aspartame as a sweetener to aid weight loss. What will the nurse tell this patient?&#10;A) Aspartame can be used in cooking.&#10;B) Aspartame contributes to an increased risk of Alzheimer's disease.&#10;C) Aspartame is not as sweet as sucrose.&#10;D) Aspartame is unsafe for people who have phenylketonuria (PKU).

Accepted Answer

Aspartame contains phenylalanine, so it is unsafe for patients with PKU. It is unstable when heated and thus cannot be used for cooking. There is no evidence to support the theory that it contributes to the risk of Alzheimer's disease. All calorie-free sweeteners are sweeter than sucrose.

Question 11

A patient who has received a prescription for orlistat (Xenical) for weight loss asks the nurse how the drug works. The nurse will tell the patient that orlistat works by:&#10;A) altering how the body stores energy.&#10;B) reducing the body's absorption of fats.&#10;C) increasing the body's metabolic rate.&#10;D) suppressing the appetite.

Accepted Answer

The answer of A patient who has received a prescription...

Question 12

What are the benefits of a weight management program that includes regular exercise and good nutrition? (Select all that apply.)&#10;A) Reduction of blood pressure in hypertensive patients&#10;B) Prevention of type 1 diabetes&#10;C) Increase in high-density lipoprotein (HDL) cholesterol&#10;D) Reduction of the blood glucose level in individuals with type 2 diabetes&#10;E) Increase in low-density lipoprotein (LDL) cholesterol

Accepted Answer

The answer of What are the benefits of a weight...

Question 13

A patient has been taking phentermine (Adipex-P) for 2 months for weight loss. The patient tells the nurse that the medication no longer causes appetite suppression. The nurse will expect the prescriber to:

A) continue the current dosage for 4 more weeks.
B) discontinue the drug.
C) increase the drug dosage.
D) switch to another nonamphetamine agent.

Accepted Answer

The answer of A patient has been taking phentermine (Adipex-P)...

Deck 82: Drugs for Weight Loss