Deck 40: Obesity

Question 1

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."
B)"Tell me what types of resources you think you might use after this surgery."
C)"Support groups have been found to lead to more successful weight loss after surgery."
D)"Because there are many lifestyle changes after surgery, we recommend support groups."

Answer 1

"Tell me what types of resources you think you might use after this surgery."

Question 2

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 do you enjoy?"

Answer 2

"What factors led to your obesity?"

Question 3

Which information in this male patient's electronic health record as shown in the accompanying figure will the nurse use to confirm that the patient has metabolic syndrome ?

A)Weight
B)Waist size
C)Blood glucose
D)Blood pressure
E)Triglyceride level
F) Total cholesterol level

Answer 3

Waist size
Blood glucose

Question 4

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 after meals.
D)The patient is experiencing a weight loss plateau.

Question 5

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)Playing soccer for an hour on the weekend
D)Running for 10 to 15 minutes 3 times/week

Question 6

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 flabby skin can be prevented by exercise.
D)Choose foods high in fiber to promote bowel function.

Question 7

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 protein.

Question 8

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.

Question 9

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 that the adults plan rewards, such as sugarless candy, for achieving their goals
D)Encouraging the adults to eat small amounts frequently rather than having scheduled meals

Question 10

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 IV insertion by holding adipose tissue out of the way.
D)Develop strategies to provide privacy and decrease embarrassment.

Question 11

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 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 12

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 sliced tomato
B)3 oz of roasted pork, a cup of corn, and a cup of carrot sticks
C)Cup of tossed salad and nonfat dressing topped with a chicken breast
D)Half cup of tuna mixed with nonfat mayonnaise and a half cup of celery

Question 13

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 are improving your health."
B)"The skinfolds show everyone how much weight you have lost."
C)"Perhaps you should talk to a counselor about your body image."
D)"Cosmetic surgery may be possible once your weight has stabilized."

Question 14

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 changes in how you feel after a few weeks of diet and exercise."
C)"You will decrease your risk for future health problems such as diabetes by losing weight now."
D)"Most of the weight that you lose during the first weeks of dieting is water weight rather than fat."

Question 15

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 postoperative plan of care?

A)Offer sips of fruit juices at frequent intervals.
B)Irrigate the nasogastric (NG) tube frequently.
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.

Question 16

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

Question 17

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

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

Question 18

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 weights weekly.
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.

Question 19

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 (86 cm)

Question 20

Which information will the nurse prioritize in planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass?

A)Educating the patient about the nasogastric (NG) tube
B)Instructing the patient on coughing and breathing techniques
C)Discussing necessary postoperative modifications in lifestyle
D)Demonstrating passive range-of-motion exercises for the legs