Deck 41: Nursing Management: Obesity

Question 1

Which topic would be of importance for the nurse to include when teaching a patient about testing for possible metabolic syndrome?

A) Blood glucose test
B) Cardiac enzyme tests
C) Postural blood pressures
D) Resting electrocardiogram

Answer 1

Blood glucose test

Question 2

A patient who has been successfully losing 1 lb weekly for several months is weighed at the clinic and has not lost any weight for the last month. The nurse should first

A) review the diet and exercise guidelines with the patient.
B) instruct the patient to weigh weekly and record the weights.
C) ask the patient whether there have been any changes in exercise or diet patterns.
D) discuss the possibility that the patient has reached a temporary weight loss plateau.

Answer 2

ask the patient whether there have been any changes in exercise or diet patterns.

Question 3

A patient returns to the surgical nursing unit following a vertical banded gastroplasty 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 postoperative plan of care?

A) Irrigate the nasogastric ( NG ) tube frequently with normal saline.
B) Offer sips of sweetened liquids at frequent intervals.
C) Remind the patient that PCA use may slow the return of bowel function.
D) Support the surgical incision during patient coughing and turning in bed.

Answer 3

Support the surgical incision during patient coughing and turning in bed.

Question 4

When developing a weight reduction plan for an obese patient who wants to lose weight, which question should the nurse ask first?

A) "Which food types do you like best?"
B) "How long have you been overweight?"
C) "What kind of physical activities do you enjoy?"
D) "What factors do you think led to your obesity?"

Question 5

After the nurse has completed teaching a patient about the recommended amounts of foods from animal and plant sources, which of these menu selections indicates that the initial instructions about diet have been understood?

A) 3 oz of pork roast, a cup of corn, and a sliced tomato
B) A chicken breast and a cup of tossed salad with nonfat dressing
C) A 6 oz can of tuna mixed with nonfat mayonnaise and chopped celery
D) 3 oz of roast beef, 2 oz of low-fat cheese, and a half-cup of carrot sticks

Question 6

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

A) demonstrating passive range-of-motion exercises to the legs.
B) discussing the necessary postoperative modifications in lifestyle.
C) teaching the patient proper coughing and deep breathing techniques.
D) educating the patient about the postoperative presence of a nasogastric (NG) tube.

Question 7

Which information will the nurse plan to include in discharge teaching for a patient after gastric bypass surgery?

A) Avoid drinking fluids with meals.
B) Choose high-fat foods for at least 30% of intake.
C) Choose foods that are high in fiber to promote bowel function.
D) Development of flabby skin can be prevented by daily exercise.

Question 8

What specific information will the nurse include in patient teaching for an overweight patient who is starting a weight loss plan?

A) Weigh yourself at the same time every morning.
B) Start dieting with a 600- to 800-calorie diet for rapid weight loss.
C) Low carbohydrate diets lead to rapid weight loss but are difficult to maintain.
D) Weighing all foods on a scale is necessary to choose appropriate portion sizes.

Question 9

Which nursing action included in the plan of care for a patient who is being admitted for bariatric surgery can the nurse delegate to nursing assistive personnel (NAP)?

A) Demonstrate use of the incentive spirometer.
B) Plan methods for bathing and turning the patient.
C) Assist with IV insertion by holding adipose tissue out of the way.
D) Develop strategies to provide privacy and decrease embarrassment.

Question 10

A patient has been on a 1000-calorie diet with a daily exercise routine and a prescription for sibutramine ( Meridia ) for 10 weeks. Which information obtained by the nurse is important to report to the health care provider?

A) The patient has not lost any weight for the last 2 weeks.
B) The patient tells the nurse about occasional palpitations.
C) The patient complains about having chronic constipation.
D) The patient reports walking only 3 days during the last week.

Question 11

Which patient behavior indicates that an overweight patient has understood the nurse's teaching about 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) Playing soccer for an hour on the weekend
D) Running for 10 to 15 minutes 3 times/week

Question 12

The nurse is developing a weight loss plan for a 21-year-old patient who is morbidly obese. Which statement by the nurse is most likely to help the patient in losing weight on the planned 1000-calorie diet?

A) "It will be necessary to change lifestyle habits permanently to maintain weight loss."
B) "You will decrease your risk for future health problems such as diabetes by losing weight now."
C) "Most of the weight that you lose during the first weeks of dieting is water weight rather than fat."
D) "You are likely to start to notice changes in how you feel with just a few weeks of diet and exercise."

Question 13

A few months after bariatric surgery, a 62-year-old patient tells the nurse, "My skin is hanging in folds. I think I need cosmetic surgery." Which response by the nurse is most appropriate?

A) "Perhaps you would like to talk to a counselor about your body image."
B) "The important thing is that your weight loss is improving your health."
C) "The skinfolds will gradually disappear once most of the weight is lost."
D) "Cosmetic surgery is certainly a possibility once your weight has stabilized."

Question 14

When the health care provider in the outpatient clinic is considering prescribing sibutramine ( Meridia ) for a patient, which patient information is most important for the nurse to discuss with the provider?

A) The patient has a permanent pacemaker.
B) The patient's goal is to lose 90 lb ( 41 kg ).
C) The patient's blood pressure is usually 135-145/85-95.
D) The patient used fenfluramine ( Pondimin ) in the past for weight loss.

Question 15

Which assessment will the nurse do to help determine if an obese patient seen in the clinic 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 protein.

Question 16

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

A) Having the patient write down the caloric intake of each meal
B) Asking the patient about situations that tend to increase appetite
C) Encouraging the patient to eat small amounts throughout the day rather than having scheduled meals
D) Suggesting that the patient have a reward, such as a piece of sugarless candy, after achieving a weight-loss goal

Question 17

The nurse obtains these assessment data for a patient who has been taking orlistat (Xenical) for several months as part of a weight loss program. Which finding 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 is experiencing a plateau in weight loss.
D) The patient complains of abdominal bloating after meals.

Question 18

Which of these patients in the clinic will the nurse plan to teach about risks associated with obesity?

A) Patient who has a BMI of 18 kg/m²
B) Patient with a waist circumference 34 inches (86 cm)
C) Patient who has a body mass index (BMI) of 24 kg/m²
D) Patient whose waist measures 30 in (75 cm) and hips measure 34 in (85 cm)

Question 19

On the first postoperative day the nurse is caring for a patient who has had a Roux-en-Y gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon?

A) Use of patient-controlled analgesia ( PCA ) several times an hour for pain
B) Irritation and skin breakdown in skinfolds
C) Bilateral crackles audible at both lung bases
D) Emesis of bile-colored fluid past the nasogastric ( NG ) tube