Deck 22: Nursing Care of Patients With Nutritional Disorders

Question 1

The nurse is preparing information for a community seminar on the hazards of obesity. Which disorders should the nurse include as being complications of obesity?

A) cardiovascular diseases
B) obstructive sleep apnea
C) diabetes mellitus type 2
D) hypotension
E) renal insufficiency

Answer 1

cardiovascular diseases
obstructive sleep apnea
diabetes mellitus type 2

Question 2

The nurse teaches a patient about the medication orlistat (Xenical). Which patient statement indicates the need for additional teaching?

A) "I should take this medication 30 minutes before eating."
B) "This medication will reduce the amount of fat my body absorbs."
C) "I will need to take supplements of vitamins A, D, E, and K daily."
D) "A low-calorie diet will need to be followed."

Answer 2

"I should take this medication 30 minutes before eating."

Question 3

While completing the health history, the nurse learns that a patient often eats excessive amounts of food when alone and when not hungry, and has intense feelings of self-disgust afterwards. The patient denies purging after these episodes. The nurse realizes that the patient is at risk of developing which health problem?

A) type 2 diabetes mellitus
B) type 1 diabetes mellitus
C) dehydration
D) electrolyte imbalances

Answer 3

type 2 diabetes mellitus

Question 4

The nurse is reviewing data collected from an adolescent patient suspected of having anorexia nervosa. Which findings should the nurse identify as contributing to this diagnosis?

A) distorted body image
B) loss of control over food intake
C) purging
D) binge eating
E) normal or above average body weight

Question 5

A patient diagnosed with obesity asks about the appetite suppressant phentermine to assist with a weight loss program. Which information in the patient's health history might restrict the patient's ability to take this medication?

A) frequent use of alcohol
B) history of narcolepsy
C) a family history of thrombophlebitis
D) a body mass index of 31 kg/m²

Question 6

The mother of a teen is concerned that her daughter's nutritional status is compromised since the daughter has an increased interest in losing weight, weighs herself several times each day, and at times ingests large amounts of food. The daughter has not lost or gained much weight, but the mother wonders if her daughter has anorexia nervosa. How should the nurse respond to this mother?

A) These are behaviors consistent with bulimia nervosa.
B) These are behaviors consistent with early-onset anorexia nervosa.
C) These are behaviors consistent with binge-eating disorder.
D) These are behaviors consistent with a metabolic disorder.

Question 7

The nurse is planning care for a patient with anorexia nervosa. Which problem should the nurse identify as a priority for this patient?

A) inadequate oral intake
B) feelings of adequacy
C) loss of control
D) skewed opinion of appearance

Question 8

A patient who is 5 feet 5 inches tall and weighs 144 lbs asks the nurse if she would be considered obese. How should the nurse respond to this patient?

A) "You are a normal weight for your height."
B) "Yes, you are slightly obese for your height."
C) "You are slightly overweight."
D) "You are moderately obese."

Question 9

The nurse is assisting with the placement of a central subclavian access device in a patient with malnutrition. Using the diagram, indicate where the nurse would expect the catheter to be placed in this patient.

Question 10

A patient has been researching medications to help achieve a weight loss goal. What is the medication classification that the nurse should review with the patient that could help meet the patient's goal?

A) lipase inhibitor
B) antiepileptic
C) anticholinergics
D) adrenergics

Question 11

The nurse suspects that a patient has a vitamin C deficiency. What did the nurse assess to come to this conclusion?

A) delayed wound healing
B) swollen bleeding gums
C) depression
D) night blindness
E) muscle wasting

Question 12

A 57-year-old female patient who weighs 130 lbs. (59.09 kg) and is 5 feet 2 inches tall (1.57 meters) wants assistance to develop a weight reduction plan. What is this patient's body mass index (BMI), which will help the nurse with nutritional planning? _______

Question 13

The nurse is caring for an adolescent with anorexia nervosa. What should the nurse include in this patient's plan of care?

A) Provide a variety of cold or room-temperature foods.
B) Serve the patient three balanced meals per day.
C) Discuss weight-gain needs with the patient.
D) Observe the patient's activities for 15 minutes after eating.

Question 14

After following a structured diet, a patient diagnosed with diabetes mellitus is surprised to learn that his blood glucose levels have decreased and oral medications are no longer required. What explanation regarding the impact of diet on diabetes management should the nurse give the patient?

A) Less body mass means less insulin is needed to maintain constant glucose levels.
B) Body mass reduces cellular resistance to insulin.
C) Reduced dietary intake of carbohydrates is responsible for the weight loss.
D) Reduced dietary intake results in a reduced need for insulin.

Question 15

The nurse is caring for a 28-year-old female patient who weighs 200 pounds (90.91 kg) and is 5 feet 6 inches tall (1.68 meters). What should the nurse calculate this patient's body mass index to be? ________

Question 16

A patient desiring to begin a very-low-calorie diet (VLCD) for rapid weight reduction is concerned about the safety of the diet. What information should the nurse provide to the patient?

A) VLCDs are not recommended for people over age 50.
B) VLCDs result in significant losses of muscle mass in response to the protein restriction.
C) VLCDs are safe for patients who have a lower body mass index and need to lose a small amount of weight rapidly.
D) VLCDs are safest for middle-aged and senior patients.

Question 17

The goal of reducing or eliminating binge eating and purging behavior has been established for a patient with bulimia nervosa. What interventions should the nurse expect to be prescribed to help the patient achieve this goal?

A) nutritional counseling
B) cognitive‒behavioral therapy
C) antidepressants
D) vitamin therapy
E) hospitalization

Question 18

A patient planning to begin a weight loss diet asks the nurse for suggestions as to how to balance her eating. What information should the nurse provide to the patient?

A) The diet should reduce calories to 1,000‒1,600 per day, with less than 10% of the total calories coming from fat.
B) The diet should be between 750 and 1,000 calories per day, with less than 15% of the total calories coming from fat.
C) The diet should simply cut 500 calories per day from the normal intake.
D) The best diet will be between 1,250 and 1,500 calories per day, with 15% of the calories being sources of protein.

Question 19

The nurse is helping a patient identify ways to adhere to a weight reduction plan. What should the nurse suggest to help this patient?

A) Set aside small nonfood rewards when you meet a goal.
B) Eat alone to reduce outside distractions.
C) Drink water or a diet beverage after eating to promote feelings of fullness.
D) Allow at least 45 minutes to 1 hour to promote full enjoyment of a meal.

Question 20

A patient is suspected of having protein calorie malnutrition (PCM) with a body mass index of less than 18. Which laboratory tests should the nurse expect to be prescribed for this patient?

A) serum albumin
B) lymphocyte count
C) serum electrolytes
D) complete blood count (CBC)
E) Urinalysis

Question 21

An elderly patient who uses a walker tells the nurse, "I'm so alone now that my family is gone." The nurse realizes that this patient might be at risk for developing what health problem?

A) malnutrition
B) obesity
C) psychosis
D) immobility

Question 22

An overweight patient states, "I'm trying to stick to my diet and exercise plan, but my spouse tells me that I'm fine the way I am." What type of problem is this patient experiencing?

A) lack of family and social support to adhere to the plan
B) eating more than is required for bodily functions
C) difficulty with exercise and activity
D) generalized feelings of self-reproach

Question 23

During a physical assessment, the nurse suspects that the patient might be experiencing metabolic syndrome. Which assessment finding provides evidence for this nurse's assumption?

A) blood pressure 150/96
B) difficulty ambulating
C) low waist-to-hip ratio
D) heart rate 72 and regular

Question 24

A patient with malnutrition is experiencing ongoing diarrhea after every meal. The nurse realizes that this patient could have what health problem?

A) malabsorption
B) a food allergy
C) carbohydrate intolerance
D) pending cardiovascular overload

Question 25

The parent of a 19-year-old patient being evaluated for bulimia asks what diagnostic tests can be done. What is the nurse's best response?

A) "There is no specific test that can determine bulimia."
B) "You should ask the doctor about this."
C) "Your child will need a psychiatric evaluation to determine the diagnosis."
D) "Bulimia is rarely diagnosed correctly."

Question 26

The nurse hears a parent say to a child, "If you behave, we'll stop and get you an ice cream cone when we're done here." What should the nurse realize is occurring with the parent?

A) rewarding behavior with food
B) frustration with the child's behavior
C) anxiety due to parenting
D) hunger as a motivating factor

Question 27

The nurse is preparing to administer total parenteral nutrition intravenously to a patient with malnutrition. What fat soluble vitamin should the nurse note is absent from the nutritional mixture?

A) vitamin K
B) vitamin A
C) vitamin D
D) vitamin E

Question 28

A patient is prescribed a hypertonic solution with vitamins and minerals to be administered through a peripheral intravenous access line. The nurse recognizes this as being what treatment?

A) intravenous fluid support
B) total parenteral nutrition
C) enteral nutrition
D) short-term total parenteral nutrition

Question 29

The parent of a 12-year-old states, "My child saw an older adolescent who was extremely overweight. Ever since then, my child won't eat." The nurse realizes that the child might be demonstrating what behavior?

A) an irrational fear of gaining weight
B) defiance directed at the parent
C) normal preadolescent behavior
D) an internal power struggle

Question 30

A patient who lives alone has a BMI of 3

A) Prepare a meal and eat it in the dining room.
B) Eat out more often to control portion size.
C) Read a book while eating as a distraction from the food.
D) Cook once a week and store the leftovers to reduce the need to cook again.
E) What strategy should the nurse suggest to help this patient reduce overeating?

Question 31

The nurse is reviewing the lipid panel of a patient with a body mass index (BMI) of 3

A) What should the nurse expect this patient's values to be?
B) low high-density lipoprotein (HDL)
C) elevated HDL
D) normal thyroid hormone (TH) level
E) low-density lipoprotein (LDL)

Question 32

A patient has a waist-to-hip ratio of 0.

A) gastrointestinal dysfunction
B) hyperinsulinemia
C) heart disease
D) obesity
E) The nurse realizes that this patient is at risk for developing what disorder?

Question 33

A 33-year-old patient states, "I eat anything I want and just have a laxative for dessert!" The nurse realizes that this patient is exhibiting which behavior?

A) bulimia
B) anorexia
C) effective weight control
D) distorted body image

Question 34

A patient has a body mass index (BMI) of 27. How should the nurse explain this finding to the patient?

A) normal weight
B) overweight
C) obese
D) metabolic syndrome

Question 35

A 45-year-old patient says, "I'm gaining weight but I'm not eating any differently than I did years ago." What should the nurse realize is occurring with this patient?

A) gaining weight associated with aging
B) denying the truth about overeating
C) justifying the weight gain
D) seeking approval to gain weight

Question 36

A patient regained 15 pounds that had been lost the previous year. What should the nurse suggest to this patient?

A) Return to the diet, exercise, and behavior change techniques that worked before.
B) Switch to a new diet in which the weight could be lost again in two weeks.
C) Consider the possibility that the patient's body needs to have the extra 15 lbs.
D) Understand that the increased weight does not make the patient obese.

Question 37

A patient with a BMI of 29 says, "I cut out all my sweet snacks last week, and I still can't lose any weight." How should the nurse respond to this patient?

A) "Let's calculate how many calories you are not eating each day."
B) "I recommend that you go see a dietician."
C) "I'll make a note in your file that you no longer eating sweet snacks."
D) "You didn't gain the weight overnight."

Question 38

The nurse is helping a 57-year-old patient design an exercise plan to achieve weight loss goals. What does the nurse calculate this patient's target heart rate to be?

Question 39

A patient is being evaluated for malnutrition. Which laboratory test results should the nurse recognize will support that finding?

A) low serum potassium
B) low white blood cell count
C) elevated serum albumin
D) elevated red blood cell count
E) low serum sodium

Question 40

An overweight patient tells the nurse, "Every Monday at work we have bagels. I can't stop myself! Sometimes I eat two!" What should the nurse realize this patient is describing?

A) appetite stimulation by external cues
B) extreme hunger from calorie restriction
C) carbohydrate addiction in its early stage
D) metabolic syndrome development

Question 41

At the conclusion of a physical assessment the nurse determines that a patient is experiencing health-related problems of obesity. What information from the patient's health history does the nurse use to make this decision?

A) osteoarthritis
B) varicose veins
C) low back pain
D) allergy to sulfa
E) lactose intolerance

Question 42

The nurse is providing discharge teaching to a patient recovering from bariatric surgery. Which patient statements indicate that teaching about dumping syndrome has been effective?

A) "I should eat three large meals each day."
B) "I should have tea and toast for breakfast."
C) "I should drink fluids frequently while eating a meal."
D) "I should lie down for 30 minutes after eating a meal."
E) "I should avoid eating foods high in simple carbohydrates."

Question 43

A patient is prescribed a 1750 kilocalorie eating plan where 15% of the daily intake is to be protein. How many kilocalories of protein should the nurse instruct the patient to ingest each day? ______ kcal

Question 44

The nurse is reviewing prescribed medications for a patient with obesity. Which medications would the nurse recognize as contraindicated for patients taking lorcaserin (Belviq)?

A) aspirin (ASA)
B) St. John's wort
C) ibuprofen (Motrin)
D) furosemide (Lasix)
E) bupropion (Wellbutrin)

Question 45

A patient with protein-calorie malnutrition has been ingesting a hyperosmolar nutritional supplement three times a day for a week. Which assessment findings indicate that this patient is experiencing dehydration?

A) weight loss
B) dry mucous membranes
C) high urine specific gravity
D) new skin blister on sacrum
E) change in level of consciousness

Question 46

A patient is admitted for treatment of malnutrition. What assessment finding does the nurse identify that indicates the patient is experiencing a vitamin C deficiency?

A) bleeding gums
B) smooth tongue
C) muscle cramps
D) ataxia