Deck 64: Weight Reduction Strategies and the Pharmacotherapy of Obesity

Question 1

The client has requested a prescription for sibutramine (Meridia)from the nurse practitioner.Which pre-existing health condition(s), if present, would make this medication contraindicated? Select all that apply.
1)Bulimia and anorexia nervosa
2)Heart disease and dysrhythmias
3)BMI greater than 40
4)Depression treated with MAOIs
5)Hepatic impairment

Answer 1

1, 2, 4, 5

Question 2

Orlistat (Alli)is prescribed for each of the following clients.A nurse should question the order for which client?
1)A 48-year-old woman with hypothyroidism
2)A 22-year-old man with borderline type II diabetes
3)A 58-year-old woman with long-term asthma
4)A 62-year-old man with presbyopia

Answer 2

1

Question 3

Which lifestyle strategy would the nurse teach the client to promote healthy weight reduction?
1)Reduce the intake of calories and increase the amount of physical activity.
2)Consume fruits and vegetables daily and eliminate all intake of meat and fish.
3)Begin a program of weight lifting and high-impact aerobic exercise.
4)Avoid eating between meals by consuming only three meals per day.

Answer 3

1

Question 4

The nurse is assessing the body mass index of a 43-year-old sedentary male using a BMI calculation graph.The client is 5' 7", and weighs 180 pounds.The nurse determine that the client's BMI indicates:
1)Healthy weight.
2)Overweight.
3)Obesity.
4)Morbid obesity.

Question 5

Which of these statements, if made by a client, would indicate that further instruction is needed about orlistat (Alli)?
1)"I can eat as much as I want when taking this medication and still lose weight."
2)"I should report restlessness, shivering, or perfuse sweating to the prescriber."
3)"I should take the drug in the morning, because the drug might interfere with sleep."
4)"I should check blood pressure and pulse regularly, and report any consistently high readings."

Question 6

The school health nurse is discussing weight loss agents with a group of college women at the health promotion session.Which of the following concepts would the nurse include in the teaching? Select all that apply.
1)Several effective weight loss pills are readily available through telemarketers.
2)Stimulants such as Dexedrine are highly addictive, and are no longer prescribed.
3)Fenfluramine, one part of the Fen-Phen combination, causes heart disease.
4)Ephedra is a healthy method for weight reduction, and doesn't require a prescription.
5)Leptin as a weight-loss medication has not shown to be effective.

Question 7

A client has been on weight-reduction diet for two months.The nurse would anticipate that the total weight loss for this time frame should be:
1)16 pounds.
2)8 pounds.
3)30 pounds.
4)60 pounds.

Question 8

The nurse knows that what hormone that increases appetite and food consumption is secreted by the hypothalamus?
1)Antidiuretic hormone (ADH)
2)Follicle-stimulating hormone (FSH)
3)Neuropeptide Y (NPY)
4)Insulin-like growth factors (ILGFs)

Question 9

The client who is taking sibutramine (Meridia)is experiencing side effects related to the medication.The nurse would assess the client for which of the following?
1)Postnasal drainage, pruritus, and drowsiness
2)Headache, constipation, and xerostomia
3)Facial twitching, backache, and anxiety
4)Compulsive gambling and promiscuity

Question 10

The school nurse has prepared a learning activity for a high school health promotion course.To assess the class understanding, the nurse instructs the students to select the correct statements that apply to the brain's role in regulating appetite.Which of the following are correct? Select all that apply.
1)Hunger occurs when the cerebellum recognizes the level of glucose or hormone in the blood.
2)Leptin receptors of obese client are thought to develop a resistance to the satiety effects.
3)The degree of satiety is directly recognized by a region of the brainstem known as the satiety center.
4)Receptors for leptin are located in the thalamus.
5)Neuropeptide Y (NPY)in the hypothalamus is associated with increase in appetite.

Question 11

The client who has self-initiated a low-carbohydrate diet asks the nurse "Why do carbohydrates cause obesity?" Which statement is the nurse's best response? "Carbohydrates in the diet:
1)"Cause a release of insulin from the pancreas, which coverts carbohydrates to fat."
2)"Are necessary in the diet, and no specific nutrient limitation prevents obesity."
3)"Trigger a release of fat and protein from the liver and cause weight gain."
4)"Reduce the number of fat cells in certain body areas, such as hips and abdomen."

Question 12

The parent of an adolescent female tells the nurse, "I am concerned about my daughter's weight gain but she doesn't look obese." Select the best response to this statement provided by the nurse.
1)"If your daughter is 10% more than the ideal weight, she is morbidly obese."
2)"The ideal body weight fluctuates depending upon gender, height, and general build."
3)"Teenage girls are often obese, and should be monitored for excessive caloric intake."
4)"Your daughter's BMI should be calculated each month to determine obesity."

Question 13

The nurse is teaching at a health promotion fair held in one of the local community centers when one of the participants asks, "What are the most important factors leading to obesity" Which statement is the nurse's best response?
1)"Physical activity and caloric intake."
2)"Type of food and beverages consumed."
3)"Chronic conditions such as diabetes."
4)"Water and fluid retention."

Question 14

The client with morbid obesity asks the nurse why leptin is not used for weight reduction.Which response would be most appropriate for the nurse?
1)"Obese individuals develop a resistance to the effects of leptin."
2)"Leptin supplement is only effective in individuals with normal body weight."
3)"The amount of leptin required would potentiate nephrotoxicity."
4)"Oral leptin would cause an increase in body mass index."

Question 15

The nurse knows that due to its secretion by adipocytes, binding of leptin signals the hypothalamus to ________________ appetite.
1)Increase
2)Decrease
3)Maintain
4)Intensify

Question 16

Which statement made by the client about taking phenylpropanolamine indicates that further teaching is necessary?
1)"This medication was removed from the market due to increased incidence of stroke."
2)"I should render the drugs unusable by adding water to pills and then discard in the trash."
3)"Phenylpropanolamine was sold over the counter until it was discontinued."
4)"It is alright to take these pills on occasion when I want to lose a few pounds."

Question 17

The home health nurse is discussing nutrition with a client when asked "What do you think of the new grapefruit-only diets that have become popular?" The nurse should:
1)Tell the client that weight loss through intake of grapefruit is not possible.
2)Advise the client that grapefruit is one of the healthiest food sources available.
3)Guide the client away from fad diets and encourage intake of a balanced diet.
4)Instruct the client to comply with the diet only for six months to avoid citrus overdose.

Question 18

The nurse determines that the client understands an important principle of weight reduction when the client makes which of the following statements?
1)"Everyone in my family is overweight, there is nothing I can do about my obesity
2)"Obesity is closely linked with health risks such as diabetes and hypertension."
3)"The most common cause of obesity is genetically linked hyperthyroidism."
4)"Lifestyle changes are not effective in weight loss if an individual's history includes obesity."

Question 19

The client who has a body mass index of 48 is diagnosed with diabetes.Which statement indicates that the client understands the relationship between diabetes and obesity?
1)"All I need to do is take my medication … no need to worry about my weight."
2)"Being a little overweight is normal, and even healthy, for most diabetics"
3)"I need to eat much more than the normal person due to my diabetes."
4)"My diabetes might improve dramatically if I reduce my body weight."

Question 20

The nurse is discussing orlistat (Alli)with a group of women at a community center when one of the participants asks, "What side effects are associated with this drug?" The nurse discusses:
1)Urinary frequency with urgency.
2)Flatus with oily stool discharge.
3)Headache with photophobia.
4)Tinnitus and hearing loss.

Question 21

The nurse who will be administering orlistat (Alli)to a client knows that prior to the initiation of this drug, ______________ function should be assessed.
1)Neurological
2)Cardiovascular
3)Sensory
4)Biliary

Question 22

The nurse is developing a health teaching document for a client prescribed orlistat (Alli).Which of the following concepts should be included?
1)Increase high-fat meals to minimize GI adverse effects.
2)Decrease physical activity for the first six months on medication.
3)Take a daily multivitamin containing fat-soluble vitamins.
4)Limit food and beverage intake to one daily, or less, if possible.

Question 23

Sibutramine (Meridia)is initiated for a client with obesity.Which of the following health teaching would be most appropriate for this drug?
1)Avoid over-the-counter cold, allergy, and cough medications unless approved by health care provider.
2)If you overeat, you may take more medication to counteract your indulges.
3)Take the medication after your evening meal.
4)You may resume your normal dietary habits while taking this drug.