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 may be easiest 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 lb in the first 6 months of an effective weight-loss diet.&#34;&#10;D) &#34;You should select a diet that has a higher fat ratio to prevent hunger between meals.&#34;

Accepted Answer

For patients watching calories, a low-fat diet makes sense, because fats have a higher concentration of calories per ounce. Drugs are used as adjuncts to weight-loss diets and are reserved for people at increased health risks who have not been able to lose weight after a 6-month program of diet and exercise. The goal for weight loss in the first 6 months is 10% of total body weight. A diet with a higher fat ratio does not necessarily reduce between-meal hunger.

Question 2

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

Orlistat works by altering the absorption of fats. It does not affect how energy is stored, the metabolic rate, or the appetite.

Question 3

A nurse is working with a group of patients. One patient states, &#34;My goal is to reduce my weight from 280 to 230 lb in 6 months.&#34; What response by the nurse would be most appropriate for this patient?&#10;A) &#34;Most weight loss occurs in the first 6 months, so you should try to reduce your weight to 200 lb.&#34;&#10;B) &#34;Safe and maintainable weight loss should be about 10% of body weight in 6 months.&#34;&#10;C) &#34;That is a realistic goal for your weight-reduction program.&#34;&#10;D) &#34;Weight loss of more than 20 lb in 6 months could be dangerous.&#34;

Accepted Answer

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

Question 4

A nurse is teaching a group of patients about weight management options. Which statement by the patient indicates a need for further teaching?&#10;A) &#34;Although some drugs often show benefits, these benefits do not outweigh the risks.&#34;&#10;B) &#34; Antiobesity drugs should be used only as adjuncts to a comprehensive weight loss program of diet and exercise.&#34;&#10;C) &#34;Most patients regain lost weight when antiobesity drugs are discontinued.&#34;&#10;D) &#34;The side effects of most of these drugs are too uncomfortable to maintain compliance.&#34;

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 5

A patient has been taking phentermine and topiramate [Osymia] for 6 months for weight loss. The nurse weighs the patient and notes a 3% weight loss since beginning the drug. 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

If a patient who is taking phentermine and topiramate has not lost 5% of weight by 6 months, the drug should be discontinued. Patients losing only 3% or less by 3 months of therapy may benefit from an increased or continued dose. Switching to another nonamphetamine produce is not recommended.

Question 6

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 of 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 7

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 8

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 9

A patient will begin taking phentermine and topiramate [Osymia] to help with weight loss and asks the nurse why the second ingredient is necessary. Which is the correct response by the nurse?&#10;A) &#34;Topiramate helps reduce the risk of seizures that can occur with phentermine.&#34;&#10;B) &#34;Topiramate helps produce feelings of satiety to augment the drug effects.&#34;&#10;C) &#34;Topiramate increases the appetite suppression caused by phentermine.&#34;&#10;D) &#34;Topiramate increases the rate of weight loss by acting as a stimulant.&#34;

Accepted Answer

Topiramate is an antiseizure medication that acts to induce a sense of satiety in patients taking the combination product. It is not given for its antiseizure properties. Phentermine causes appetite suppression. Topiramate does not act as a stimulant.

Question 10

A female patient with diabetes who is obese will begin taking lorcaserin [Belviq] to help with weight loss. What will the nurse include when teaching this patient about this drug?&#10;A) &#34;This drug is safe to take if you become pregnant.&#34;&#10;B) &#34;This drug does not have serious adverse effects.&#34;&#10;C) &#34;You may need to check your blood glucose levels more often.&#34;&#10;D) &#34;You will need to increase your insulin dose to prevent hyperglycemia.&#34;

Accepted Answer

About 30% of patients with diabetes will experience an increase in hypoglycemic episodes when taking lorcaserin. It is classified as Pregnancy Risk Category X and should not be taken by women who are pregnant. It has uncommon, but severe adverse effects. Since it can cause hypoglycemia, patients will not likely have to increase insulin doses.

Question 11

What are the benefits of a weight management program that includes regular exercise and good nutrition?&#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 12

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

The answer of Which statement by a patient about to...

Question 13

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

The answer of A nurse performing an admission history on...

Deck 82: Drugs for Weight Loss