Question 1

After discussing appropriate exercise activities with a patient who is overweight who is starting to exercise as part of a weight-loss program,the nurse will determine that the instructions have been understood when the patient reports which of the following?

A) Playing soccer for an hour on the weekend
B) Running for 10 to 15 minutes three times a week
C) Walking for 40 minutes 6 or 7 days a week
D) Lifting weights with friends three times a week

Accepted Answer

Walking for 40 minutes 6 or 7 days a week is the best choice for a patient who is overweight and starting an exercise program for weight loss. It is a low-impact activity that can be easily incorporated into daily routines and can be sustained over time. Running for 10 to 15 minutes three times a week may not be sustainable or safe for someone who is overweight and not accustomed to regular exercise. Lifting weights may be beneficial for building muscle and improving overall fitness, but may not be the most effective exercise for weight loss. Playing soccer for an hour on the weekend may provide some cardiovascular benefits, but may not be enough to impact weight loss goals.

Question 2

In planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass as treatment for morbid obesity,on what does the nurse place the highest priority?&#10;A) Demonstrating passive range-of-motion exercises to the legs&#10;B) Teaching the patient about the postoperative presence of a nasogastric (NG)tube connected to suction&#10;C) Teaching the patient proper coughing and deep breathing techniques and methods of turning and positioning&#10;D) Discussing the necessary postoperative modifications in lifestyle

Accepted Answer

Teaching the patient proper coughing and deep breathing techniques, along with methods of turning and positioning, is crucial to prevent postoperative complications such as pneumonia and deep vein thrombosis. These techniques help maintain lung expansion and circulation, which are vital for recovery.

Question 3

In developing a weight-reduction plan for an obese patient who is motivated to lose weight,it is most important for the nurse to assess which of the following data first?&#10;A) The patient's current level of physical activity&#10;B) The length of time that the patient has been obese&#10;C) The patient's social,emotional,and behavioural etiologies of obesity&#10;D) Anthropometric measurements of height,weight,BMI,waist-to-hip ratio,and skinfold thickness

Accepted Answer

Assessing the patient's social, emotional, and behavioral etiologies of obesity is crucial as it provides insight into the root cause of the patient's weight gain and helps to tailor the weight loss plan to address these underlying factors. This information can also help the nurse identify potential barriers to successful weight loss and provide appropriate support to the patient. While the other options are also important, assessing these factors can be done after the nurse has gained an understanding of the patient's emotional and behavioral challenges when it comes to weight loss.

Question 4

When teaching a patient about recording the weight during a weight-loss program,how often would the nurse recommend that the patient get weighed?&#10;A) Daily for the first 2 weeks,and then weekly thereafter&#10;B) Every other day,in the morning&#10;C) Once a week&#10;D) Twice a week

Accepted Answer

Weighing oneself once a week is recommended for tracking weight loss because it allows for a clear view of progress while minimizing daily fluctuations due to factors like water retention or food intake. Daily or more frequent weigh-ins can lead to discouragement and obsession over natural weight variations.

Question 5

A patient has been taking orlistat (Xenical)for several months as part of a weight loss program that also includes a low-fat diet.Which of these data obtained by the nurse indicates that a change in therapy may be needed?

A) The patient complains of abdominal bloating after meals.
B) The patient has lost 14 kg of the original 30-kg goal.
C) The patient frequently has liquid stools.
D) The patient is pale and has many bruises.

Accepted Answer

The presence of paleness and many bruises in a patient taking orlistat may indicate a deficiency in fat-soluble vitamins (such as vitamin K, which is important for blood clotting), suggesting a need for a change in therapy or supplementation.

Question 6

A patient has been on a 1000-calorie diet with a daily exercise routine to promote weight reduction.During the first 2 months of her program,she lost 9 kg of a goal of 23 kg,but she is discouraged that she has not lost any weight for the last 2 weeks.What should the nurse inform the patient about?

A) She has probably been unconsciously returning to her former eating habits.
B) She has reached the weight considered by her body to be most efficient for her.
C) Plateaus where no weight is lost normally occur during a weight-loss program.
D) Her steady weight may be due to water gain from eating foods that are high in sodium content.

Accepted Answer

Plateaus where no weight is lost are a normal occurrence during a weight-loss program. It is important for the nurse to reassure the patient and encourage her to continue with her diet and exercise routine. The nurse should also discuss the possibility of adjusting her calorie intake or exercise regimen to break through the plateau. It is important for the nurse to avoid making assumptions about the patient's adherence to the diet and exercise program or attributing the plateau to water gain without further assessment.

Question 7

A patient returns to the surgical nursing unit following a vertical banded gastroplasty with an NG tube to low,intermittent suction and a patient-controlled analgesia (PCA)machine for pain control.During the postoperative care of the patient,the nurse recognizes the need for which of the following?

A) Promoting return of bowel sounds by discouraging excessive PCA use
B) Maintaining patency of the NG tube with frequent normal saline irrigations
C) Supporting the surgical incision during coughing to prevent dehiscence of the wound
D) Positioning the patient flat in bed on the right side to promote normal stomach emptying

Accepted Answer

Supporting the surgical incision during coughing is essential to prevent wound dehiscence, a complication where the wound reopens along the surgical incision. This is a standard postoperative care practice to ensure proper healing and prevent complications.

Question 8

A patient is being evaluated at the clinic for possible metabolic syndrome.The nurse will explain the purpose of which test to the patient?&#10;A) Resting electrocardiogram&#10;B) Fasting blood glucose test&#10;C) Postural blood pressures&#10;D) Cardiac enzyme tests

Accepted Answer

A fasting blood glucose test is used to evaluate for metabolic syndrome, which includes criteria such as elevated glucose levels, high blood pressure, and central obesity. Resting electrocardiogram, postural blood pressures, and cardiac enzyme tests are not typically used to evaluate for metabolic syndrome.

Question 9

The nurse provides discharge instructions to a patient following gastric bypass surgery for treatment of obesity.What does the nurse teach the patient?&#10;A) Avoid foods high in carbohydrates,and do not drink fluids with meals.&#10;B) Maintain a liquid diet for about 6 weeks until gastric healing is complete.&#10;C) Eat a high-carbohydrate,high-roughage diet to promote bowel function when solid foods are allowed.&#10;D) Use exercise and massage to prevent the development of flabby skin resulting from massive weight loss.

Accepted Answer

The nurse should teach the patient to avoid foods high in carbohydrates to prevent weight gain and to not drink fluids with meals to prevent overstretching the stomach pouch. The patient should also be instructed to eat small, frequent meals consisting of nutrient-dense foods such as lean protein, vegetables, and fruits. Additionally, the nurse should encourage the patient to engage in regular physical activity to promote weight loss and prevent weight regain.

Question 10

A few months after bariatric surgery,the patient tells the nurse,&#34;My skin is hanging in folds.I think I need cosmetic surgery.&#34; Which following response by the nurse is most appropriate?&#10;A) &#34;The skinfolds will gradually disappear once most of the weight is lost.&#34;&#10;B) &#34;The important thing is that your weight loss is improving your health.&#34;&#10;C) &#34;Perhaps you would like to talk to a counsellor about your body image.&#34;&#10;D) &#34;Cosmetic surgery is certainly a possibility once your weight has stabilized.&#34;

Accepted Answer

It is appropriate for the nurse to acknowledge the patient's concern about excess skin and provide a realistic option for addressing it. Once the patient's weight has stabilized after bariatric surgery, cosmetic surgery may be a viable option to remove the excess skin.

Question 11

The obese patient is at risk for which of the following types of cancer?&#10;A) Lung&#10;B) Pancreas&#10;C) Colorectal&#10;D) Liver

Accepted Answer

The answer of The obese patient is at risk for...

Question 12

Which one of the following represents a &#34;healthy plate&#34;?&#10;A) One-fourth meat,one-fourth grain,one-fourth vegetables,one-fourth carbohydrates&#10;B) One-half vegetables,one-half meat and meat alternatives&#10;C) One-fourth carbohydrates,one-half meat,one-fourth fruits and vegetables&#10;D) One-fourth meat,one-fourth grain,one-half vegetables and fruits

Accepted Answer

The answer of Which one of the following represents a...

Question 13

When working with an obese patient who is enrolled in a behaviour modification program,which nursing action is most appropriate?&#10;A) Having the patient write down the caloric intake of each meal&#10;B) Asking the patient about situations that tend to increase appetite&#10;C) Suggesting that the patient have a reward,such as a piece of sugarless candy,after achieving a weight-loss goal&#10;D) Encouraging the patient to eat small amounts throughout the day rather than having scheduled meals

Accepted Answer

The answer of When working with an obese patient who...

Question 14

When developing a weight-reduction plan for a patient with obesity who is starting a weight-loss program,which question is it most important for the nurse to ask?&#10;A) &#34;What kind of physical activities do you enjoy?&#34;&#10;B) &#34;How long have you been overweight?&#34;&#10;C) &#34;Why do you want to lose weight?&#34;&#10;D) &#34;Have you been on any previous diets?&#34;

Accepted Answer

The answer of When developing a weight-reduction plan for a...

Question 15

The nurse is developing a weight loss plan for a 21-year-old patient with obesity.Which statement is most likely to help the patient in losing weight on the planned 800-calorie diet?&#10;A) &#34;You will decrease your risk for future health problems such as diabetes by losing weight now.&#34;&#10;B) &#34;You are likely to start to notice changes in how you feel with just a few weeks of diet and exercise.&#34;&#10;C) &#34;Most of the weight that you lose during the first weeks of dieting is water weight rather than fat.&#34;&#10;D) &#34;It will be necessary to change lifestyle habits permanently to maintain weight loss.&#34;

Accepted Answer

The answer of The nurse is developing a weight loss...

Question 16

When taking the health history from a patient with obesity,which information obtained by the nurse is most helpful in determining whether the patient will be successful in losing weight? A) The patient's BMI is 39 kg/m². B) The patient has a history of losing weight successfully in the past. C) The patient says,"I am ready to make some changes in my lifestyle." D) The patient rides a stationary bicycle.

Accepted Answer

The answer of When taking the health history from a...

Question 17

The nurse teaches the patient that medical monitoring will be required for how long after bariatric surgery?&#10;A) 6 months&#10;B) 1 year&#10;C) 5 years&#10;D) Lifelong

Accepted Answer

The answer of The nurse teaches the patient that medical...

Question 18

The nurse is assessing patients at the outpatient clinic.Which of these patients is at risk for health complications related to weight? A) A 24-year-old patient with a waist measurement of 75 cm and a hip measurement of 85 cm B) A 33-year-old patient who has a body mass index (BMI)of 24 kg/m² C) A 56-year-old patient who is 180 cm tall and weighs 68 kg D) A 71-year-old patient who is 160 cm,weighs 55 kg,and carries most of the weight in the thighs

Accepted Answer

The answer of The nurse is assessing patients at the...

Question 19

A patient with obesity asks the nurse about using orlistat for weight reduction.What does the nurse tell the patient?&#10;A) This drug can cause serious depletion of fat-soluble vitamins and should be used only for a few weeks.&#10;B) Weight-reduction drugs of any type are used only for those who do not have the will power to reduce their intake of food.&#10;C) Drugs may be helpful in weight loss,but weight gain is likely to recur unless changes in diet and exercise are maintained.&#10;D) The long-term effect of orlistat is not known,and the drug may cause serious side effects,such as heart valve problems.

Accepted Answer

The answer of A patient with obesity asks the nurse...

Question 20

In the clinic,the nurse is assessing a new patient who has abdominal obesity and hypertension.What further assessment should the nurse do to assess for possible metabolic syndrome?&#10;A) Take the patient's apical pulse.&#10;B) Ask the patient about dietary intake.&#10;C) Measure the patient's waist size.&#10;D) Determine the patient's ethnic origin.

Accepted Answer

The answer of In the clinic,the nurse is assessing a...

Question 21

A 47-year-old woman has experienced continual weight gain since her early twenties and is seeking assistance for weight reduction.She is 155 cm tall and weighs 85 kg.The nurse calculates her BMI at 35.3 and classifies her weight condition as which of the following?

A) Obesity
B) Overweight
C) Severe obesity
D) Morbid obesity

Accepted Answer

The answer of A 47-year-old woman has experienced continual weight...

Question 22

Which of the following is a hormone in the body that stimulates appetite?&#10;A) Leptin&#10;B) Insulin&#10;C) Ghrelin&#10;D) Cholecystokinin

Accepted Answer

The answer of Which of the following is a hormone...

Question 23

The nurse has completed initial instruction with a patient regarding a weight-loss program.The nurse determines that the teaching has been effective when the patient makes which following statement?&#10;A) &#34;I will keep a diary of daily weights to illustrate my weight loss.&#34;&#10;B) &#34;I plan to lose 1.8 kg a week until I have lost the 27-kg goal.&#34;&#10;C) &#34;I should not exercise more than what is required because increased activity increases the appetite.&#34;&#10;D) &#34;I plan to join a behaviour modification group to help establish long-term behaviour changes necessary for weight control.&#34;

Accepted Answer

The answer of The nurse has completed initial instruction with...

Deck 43: Nursing Management: Obesity