Chapter40, Nursing Mngmt: Obesity

An obese patient receives a prescription for orlistat for weight loss. What should the nurse include in the patient's medication teaching? "Take a stool softener." "Consume a high-calorie diet." "Take vitamin supplements." "Take folic acid supplements."

"Take vitamin supplements."

While performing a health assessment, the nurse documents a child's weight as 25 kg and height as 1.1 meters. What is the body mass index (BMI) of the child? Record the answer rounded to one decimal place.

20.7

The nurse reviews the medical record of a patient and notes documentation of class I obesity. This determination was made because the patient has which body mass index (BMI)? 26 kg/m 2 32 kg/m 2 37 kg/m 2 42 kg/m 2

32 kg/m 2 A patient who has a BMI between 30 and 35 kg/m 2 is class I obese. A patient who has a BMI between 25 and 29.9 kg/m 2 is overweight but not obese. A patient with a BMI between 35 and 40 kg/m 2 is class II obese. A patient who has a BMI that is more than 40 kg/m 2 is a severely obese or class III obese patient.

The nurse measures the waist circumferences of four patients and identifies that which patient has a high risk of obesity? A 20-year-old male with a waist circumference of 32 inches A 40-year-old male with a waist circumference of 40 inches A 30-year-old female with a waist circumference of 38 inches A 22-year-old female with a waist circumference of 30 inches

A 30-year-old female with a waist circumference of 38 inches

The nurse is reviewing cultural and ethnic factors related to obesity. Which statement does the nurse identify as being true? Among men, Hispanics have the lowest prevalence of being overweight or obese. Native Americans have a lower prevalence of being overweight than the general population. Among women, African Americans have the highest prevalence of being overweight or obese. Asian Americans have the same prevalence of being overweight and obese compared with the general population.

Among women, African Americans have the highest prevalence of being overweight or obese.

The nurse teaches an elderly patient that aging problems can be exacerbated by obesity and includes what example? Arthritis Sinusitis Vision problems Chewing difficulty

Arthritis

Which type of bariatric surgery decreases the amount of small intestine available for nutrient absorption and also removes part of the patient's stomach? Biliopancreatic diversion Adjustable gastric banding Sleeve gastrectomy Roux-en-Y gastric bypass surgery

Biliopancreatic diversion Biliopancreatic diversion is a malabsorptive surgery that involves removing 70% of the stomach. This surgery decreases the amount of small intestine available for nutrient absorption.

The nurse concludes that a patient has metabolic syndrome based on what abnormal laboratory result? Platelet count Creatinine level Cholesterol level White blood cell count

Cholesterol level

An obese patient tells the nurse, "I feel hungry all the time." The nurse suspects that what hormone abnormality is causing the patient's symptom? Increased levels of insulin hormone Decreased levels of leptin hormone Decreased levels of ghrelin hormone Increased levels of peptide YY hormone

Decreased levels of leptin hormone

The nurse assesses a patient who is obese. What psychosocial health risks are associated with obesity? Select all that apply. Depression Discrimination Impaired flexibility Stress incontinence Exercise intolerance

Depression Discrimination

A severely obese patient has undergone Roux-en-Y gastric bypass (RYGB) surgery. The nurse will monitor for dumping syndrome, which is characterized by which symptoms? Select all that apply. Diarrhea Sweating Faintness Constipation Nausea and vomiting

Diarrhea Sweating Faintness Nausea and vomiting

Two weeks after a subtotal gastrectomy, a patient reports the sudden onset of faintness, weakness, and diaphoresis after eating a meal. The nurse suspects what complication? Acute pancreatitis Dumping syndrome Acute myocardial infarction Mesenteric artery embolism

Dumping syndrome Dumping syndrome is the most likely cause of these symptoms about 2 weeks after surgery. Dumping syndrome is believed to be caused by food directly entering the jejunum without first being processed in the stomach

The nurse is caring for an obese patient who takes orlistat. The nurse should monitor the patient for which adverse effect? Insomnia Dizziness Fecal incontinence Abnormal heart rate

Fecal incontinence

Which patient has the highest morbidity risk? Male: height 73 inches; body mass index (BMI) 29 kg/m 2 Female: height 66 inches; weight 150 lbs. Male: waist circumference 46 in. Female: 70 inches; obesity class III

Female: 70 inches; obesity class III

The nurse reviews the medical record of a patient with obesity and identifies that the patient is at risk for which conditions? Select all that apply. Gallstones Sleep apnea Hypothyroidism Esophageal cancer Systemic lupus erythematosus (SLE)

Gallstones Sleep apnea Esophageal cancer

An obese patient tells the nurse, "I just can't stop eating." The nurse recalls that which hormone that is primarily produced in the stomach plays a role in compulsive eating? Cholecystokinin Ghrelin Leptin Insulin

Ghrelin

The nurse recalls that levels of which hormone increase after starvation and decrease in response to food in the stomach? Ghrelin Peptide YY Neuropeptide Y Cholecystokinin

Ghrelin

The nurse determines that an obese patient has varicose veins and cellulite. Which body condition creates a high risk for this condition? Gynoid body shape Android body shape Primary obesity Secondary obesity

Gynoid body shape A patient with gynoid obesity is at risk for osteoporosis, varicose veins, and cellulite due to fat being mainly located in the upper legs.

While performing a physical assessment, the nurse observes that the patient has fat primarily in the abdominal area. The fat is also distributed over the arms, neck, and shoulders. The nurse determines that the patient has which health risks? Select all that apply. Osteoporosis Hypertension Varicose veins Diabetes mellitus Endometrial cancer

Hypertension Diabetes mellitus Endometrial cancer

A patient is prescribed phentermine/topiramate for obesity. The nurse should monitor the patient for what serious side effect? Hyperthyroidism Migraine attacks Seizure disorders Respiratory distress

Hyperthyroidism

The nurse recalls that which organ secretes the neuropeptide Y hormone to control obesity? Colon Pancreas Stomach Hypothalamus

Hypothalamus

The nurse recalls that lorcaserin reduces the risk of obesity through what mechanism? It activates insulin receptors. It blocks the breakdown of fat cells. It increases the availability of norepinephrine. It activates serotonin receptors to suppress the appetite.

It activates serotonin receptors to suppress the appetite.

A patient presents with a body mass index (BMI) of 20 kg/m 2. What should the nurse document about the patient's weight classification? Obese Overweight Underweight Normal weight

Normal weight Patients with a BMI between 18.5 and 24.9 kg/m 2 are considered to have a normal body weight. Patients with a BMI less than 18.5 kg/m 2 are considered underweight, those with a BMI of 25 to 29.9 kg/m 2 are overweight, and those with a BMI of 30 kg/m 2 or above are considered obese.

A patient has a height of 180 cm and weighs 70 kg. In which weight category should the patient be placed? Underweight Normal weight Overweight Obese

Normal weight Body mass index (BMI) is a measure of weight for height. It can be calculated with the formula BMI = weight in kilograms / (height in meters) 2. The BMI of the patient is 21.6 kg/m 2, and hence the weight is normal.

An obese patient is diagnosed with liver failure. When reviewing the patient's medical records, the nurse finds that the patient is undergoing weight loss therapy. Which medication is likely responsible for the patient's liver failure? Orlistat Diethylpropion Benzphetamine Phendimetrazine

Orlistat Orlistat is a nutrient absorption-blocking drug that blocks the breakdown of fats. The increased fat content in the liver may result in liver injury.

The primary health care provider prescribes short-term weight-loss management for an obese patient with a seizure disorder. The nurse recognizes that which medication will be most effective for the patient? Orlistat Lorcaserin Phentermine/topiramate Benzphetamine

Phentermine/topiramate

The nurse recalls that which type of bariatric surgery may result in calcium and folic acid deficiency? Biliopancreatic diversion Roux-en-Y gastric bypass Sleeve gastrectomy Vertical banded gastroplasty

Roux-en-Y gastric bypass

The nurse is teaching a class about weight management and should include what health risks associated with obesity? Select all that apply. Sleep apnea Breast cancer Atrial fibrillation Hyperthyroidism Gastroesophageal reflux disease (GERD)

Sleep apnea Breast cancer Atrial fibrillation Gastroesophageal reflux disease (GERD)

A patient who underwent restrictive bariatric surgery has a sleeved-shaped stomach with a 60 to 150 mL capacity and no bypass of the intestine. The nurse recognizes that the patient had what type of surgery? Biliopancreatic diversion Roux-en-Y gastric bypass Adjustable gastric banding Sleeve gastrectomy

Sleeve gastrectomy Sleeve gastrectomy is a restrictive surgery in which about 85 percent of the stomach is removed, leaving a sleeve-shaped stomach with a 60 to 150 mL capacity. The patient undergoing sleeve gastrectomy has no bypass of the intestine and no risk of malabsorption because it avoids all complications of obstruction, anemia, and vitamin deficiencies.

While performing the nutritional assessment of a patient, the nurse finds that the patient's height is 1.71 m and weight is 68 kg. What does the nurse interpret based on the patient's body mass index (BMI)? The BMI indicates the weight is normal. The BMI indicates a higher risk for disease. The BMI indicates the weight is above normal. The BMI indicates the weight is below normal.

The BMI indicates the weight is normal.

During the initial postoperative period following bariatric surgery, the nurse recognizes the importance of monitoring obese patients for respiratory insufficiency based on what knowledge? The body stores anesthetics in adipose tissue. Postoperative pain may cause a decreased respiratory rate. Intubation may be difficult because of extra chin skin folds. The patient's head must remain flat for a minimum of 2 hours postprocedure.

The body stores anesthetics in adipose tissue.

The nurse assesses a patient with Alzheimer's disease and determines that the patient's body mass index (BMI) is 28.8 kg/m 2. The nurse concludes that the patient most likely has what type of obesity? The patient has gynoid obesity. The patient has primary obesity. The patient has android obesity. The patient has secondary obesity.

The patient has secondary obesity.

The nurse recalls that which anatomical change is observed after biliopancreatic diversion surgery? The stomach is sleeve shaped with a 60- to 150-mL capacity. There is an anastomosis between the stomach and the intestine. A band encircles the stomach, creating a stoma and a gastric pouch. A gastric pouch is connected to the jejunum, and the remaining stomach is bypassed.

There is an anastomosis between the stomach and the intestine. Biliopancreatic diversion surgery is a malabsorptive surgery in which the patient will undergo a 70 percent stomach removal with a duodenal switch. The stomach appears like a tube. The surgery creates an anastomosis between the stomach and the intestine.

The nurse identifies that a patient with android obesity is at risk for what disease? Reproductive disease Genitourinary disease Heart disease Respiratory disease

heart disease

The nurse reviews the hormone deficiencies associated with obesity. When at a normal level, which hormone acts in the hypothalamus to suppress appetite and increase fat metabolism? Leptin Insulin Ghrelin Peptide YY

leptin