Deck 63: Weight Reduction Strategies and the Pharmacotherapy of Obesity

Question 1

Which hormone that increases appetite and food consumption is secreted by the hypothalamus?

A)Follicle-stimulating hormone (FSH)
B)Antidiuretic hormone (ADH)
C)Insulin-like growth factors (ILGFs)
D)Neuropeptide Y (NPY)

Answer 1

Neuropeptide Y (NPY)

Question 2

Which statement made by the client about taking phenylpropanolamine indicates that further teaching is necessary?

A)"This medication was removed from the market due to increased incidence of stroke."
B)"Phenylpropanolamine was sold over the counter until it was discontinued."
C)"It is acceptable to take these pills on occasion when I want to lose a few pounds."
D)"I should dispose of any of these pills I might still have."

Answer 2

"It is acceptable to take these pills on occasion when I want to lose a few pounds."

Question 3

The nurse questions the prescription of orlistat (Alli)for which client?

A)A 58-year-old woman with long-term asthma
B)A 48-year-old woman with hypothyroidism
C)A 22-year-old man with borderline type II diabetes
D)A 62-year-old man with presbyopia

Answer 3

A 48-year-old woman with hypothyroidism

Question 4

The home health nurse is discussing nutrition with a client who asks,"What do you think of the new grapefruit-only diets that have become popular?" Which response by the nurse is the most appropriate?

A)Weight loss through intake of grapefruit is not possible."
B)Grapefruit is one of the healthiest food sources available."
C)Comply with this type of diet for 6 months to avoid citrus overdose."
D)Most fad diets have no scientific basis."

Question 5

The client who has self-initiated a low-carbohydrate diet asks the nurse,Why do carbohydrates cause obesity?" Which statement by the nurse is most appropriate?

A)"Carbohydrates cause a release of insulin from the pancreas,which coverts carbohydrates to fat."
B)"Carbohydrates reduce the number of fat cells in certain body areas,such as hips and abdomen."
C)"Carbohydrates trigger a release of fat and protein from the liver and cause weight gain."
D)"Carbohydrates alone do not cause obesity."

Question 6

The parent of an adolescent female tells the nurse,"I am concerned about my daughter's weight gain,but she doesn't look obese." Which response by the nurse is the most appropriate?

A)"If your daughter is 10% more than the ideal weight,she is morbidly obese."
B)"Teenage girls are often obese and should be monitored for excessive caloric intake."
C)"The ideal body weight fluctuates,depending upon gender,height,and general build."
D)"Your daughter's body mass index (BMI)should be calculated each month to determine obesity."

Question 7

The nurse is assessing the body mass index (BMI)of a 43-year-old sedentary male,using a BMI calculation graph.The client is 5'7" and weighs 204 pounds.The nurse determine that the client's BMI indicates:

A)healthy weight.
B)morbid obesity.
C)obesity.
D)overweight.

Question 8

Which lifestyle strategy would the nurse teach the client to promote healthy weight reduction?

A)Avoid eating between meals by consuming only three meals per day.
B)Reduce the intake of calories and increase the amount of physical activity.
C)Consume fruits and vegetables daily and eliminate all intake of meat and fish.
D)Begin a program of weight lifting and high-impact aerobic exercise.

Question 9

A client has been on a weight-reduction program for 2 months.The nurse anticipates that the total weight loss for this time frame should be:

A)60 pounds.
B)16 pounds.
C)6 pounds.
D)30 pounds.

Question 10

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?

A)"Type of food and beverages consumed."
B)"Chronic conditions such as diabetes."
C)"Physical activity and caloric intake."
D)"Water and fluid retention."

Question 11

The school health nurse is discussing weight loss agents with a group of college women at the health promotion session.Which concepts does the nurse include in the teaching plan?
Select all that apply.

A)Several effective weight loss pills are readily available through telemarketers.
B)Ephedra is a healthy method for weight reduction and does not require a prescription.
C)Fenfluramine,one part of the Fen-Phen combination,causes heart disease.
D)Leptin as a weight-loss medication has not shown to be effective.
E)Stimulants such as Dexedrine are highly addictive and are no longer prescribed.

Question 12

Which of these statements,if made by a client,would indicate that further instruction is needed about orlistat (Alli)?

A)"I should take the drug once a day."
B)"I should report stomach discomfort or oily stools to the prescriber."
C)"I should check blood pressure and report any consistently high readings."
D)"I can eat as much as I want when taking this medication and still lose weight."

Question 13

The nurse determines that the client understands an important principle of weight reduction when the client makes which statement?

A)"Obesity is closely linked with health risks,such as diabetes and hypertension."
B)"The most common cause of obesity is genetically linked hyperthyroidism."
C)"Everyone in my family is overweight; there is nothing I can do about my obesity."
D)"Lifestyle changes are not effective in weight loss if an individual's history includes obesity."

Question 14

The client has started to take orlistat (Alli)as a part of a weight-loss management program.Which preexisting health condition(s),if present,would make this medication contraindicated?
Select all that apply.

A)Depression treated with monoamine oxidase inhibitors (MAOIs)
B)Cholestasis
C)BMI greater than 40
D)Heart disease and dysrhythmias
E)Bulimia and anorexia nervosa

Question 15

The nurse is providing education to a client who was taking sibutramine (Meridia)as a part of a weight-loss program.The client asks the nurse why the medication was removed from the market.Which statement by the nurse is most appropriate?

A)Sibutramine (Meridia)was removed from the market due to the adverse effects of postnasal drainage,pruritus,and drowsiness."
B)Sibutramine (Meridia)was removed from the market due to the adverse effects of headache,constipation,and xerostomia."
C)Sibutramine (Meridia)was removed from the market to the increased risk of heart attack and stroke."
D)Sibutramine (Meridia)was removed from the market due to the increased risk for facial twitching,backache,and anxiety."

Question 16

The nurse tells a client that,due to leptin secretion by adipocytes,the hypothalamus has what affect on appetite?

A)Intensification of appetite
B)Maintenance of appetite
C)Decrease of appetite
D)Inappropriate appetite

Question 17

The nurse is educating a client about ways to lose weight successfully and safely.Which recommendations does the nurse include in the teaching session?
Select all that apply.

A)Increase the amount carbohydrates in the diet.
B)Reduce calories in the diet.
C)Increase physical activity.
D)Increase the amount of protein in the diet.
E)Increase the amount of fats in the diet.

Question 18

The nurse is reviewing medications that have been proven effective for weight loss.Which medications does the nurse identify as being removed from the market due to safety concerns?
Select all that apply.

A)Amphetamine and dextroamphetamine (Dexedrine)
B)Orlistat (Alli)
C)Fenfluramine and phentermine (Fen-Phen)
D)Ephedra alkaloids
E)Sibutramine (Meridia)

Question 19

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?

A)"Oral leptin would cause an increase in body mass index."
B)"Obese individuals develop a resistance to the effects of leptin."
C)"Leptin supplement is only effective in individuals with normal body weight."
D)"The amount of leptin required would potentiate nephrotoxicity."

Question 20

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 statements should the students choose as correct?
Select all that apply.

A)The degree of satiety is directly recognized by a region of the brainstem known as the satiety center.
B)Hunger occurs when the cerebellum recognizes the level of glucose or hormone in the blood.
C)Receptors for leptin are located in the thalamus.
D)Neuropeptide Y (NPY)in the hypothalamus is associated with increase in appetite.
E)Leptin receptors of clients who are obese are thought to develop a resistance to the satiety effects.

Question 21

The nurse is developing a health teaching document for a client prescribed orlistat (Alli).Which concept does the nurse include?

A)Limit food and beverage intake to once daily,or less,if possible.
B)Increase high-fat meals to minimize GI adverse effects.
C)Decrease physical activity for the first 6 months on medication.
D)Take a daily multivitamin containing fat-soluble vitamins.

Question 22

The nurse who will be administering orlistat (Alli)to a client knows that prior to the initiation of this drug,it is important to assess which body system?

A)Integumentary system
B)Neurological system
C)Biliary system
D)Sensory system

Question 23

A client is receiving orlistat (Alli)to aide in weight reduction.The nurse reviews the all other drugs taken by the client.Which drug should not be taken concurrently with orlistat?

A)Furosemide (a diuretic)
B)Cyclosporine (an antibiotic)
C)Warfarin (an anticoagulant)
D)Ibuprofen (a nonsteroidal anti-inflammatory)

Question 24

Orlistat (Alli)is initiated for a client with obesity who is taking warfarin.What health teaching would be most appropriate for this drug?

A)If you overeat,you may take more medication to counteract your indulgence.
B)You may resume your normal dietary habits while taking this drug.
C)You will need to closely monitor prothrombin time (PT)and international normalized ratio (INR).
D)Take the medication each evening 2 hours before taking warfarin.

Question 25

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 responds by stating:

A)Tinnitus and hearing loss are side effects associated with orlistat (Alli)."
B)Headache with photophobia are side effects associated with orlistat (Alli)."
C)Flatus with oily stool discharge is a side effect often associated with orlistat (Alli)."
D)Urinary frequency with urgency is a side effect associated with orlistat (Alli)."

Question 26

The nurse is assessing a client with a BMI of 28 who is interested in losing weight.Reviewing the client's chart,the nurse notes that the health care provider will consider prescribing an anorexiant because the client has what risk factors?
Select all that apply.

A)Depression
B)Anxiety
C)Hypertension
D)Hyperlipidemia
E)Diabetes