Adult Health Ch. 48
A nurse cares for a female client of childbearing age who will undergo bariatric surgery. When teaching the client about precautions after surgery, which teaching will the nurse include that is specific to this population?
"You should avoid pregnancy for at least 18 months after surgery."
A nurse examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply.
Those with less education are impacted at a greater prevalence of disease. Those with less income are impacted at a greater prevalence of disease.
The nurse establishes a learning contract with an overweight client. The contract is best if it
includes an incremental goal of 1-2 pound weight loss this week
A nurse caring for a client with obesity recognizes the client is at risk for renal complications related to obesity. Which disease or condition is associated with obesity?
Renal cancer
A nurse cares for an obese client taking phentermine/topiramate-ER. Which laboratory findings will the nurse recognize as most concerning and will report to the health care provider? Select all that apply.
Bicarbonate 19 mEq/L Potassium 3.3 mEq/L
A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI?
Class I obesity
The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first
Collaborates with the client to establish an agreed-upon goal
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use?
"The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
The nurse is teaching a group of clients with obesity about the risks of disease associated with obesity. Which respiratory conditions or diseases will the nurse include in the teaching, which are associated with obesity? Select all that apply.
Asthma Infection Obstructive sleep apnea
The nurse plans care for a client with obesity. What does the nurse recognize is the primary pathophysiological reason clients with obesity are at greater risk for developing thromboembolism?
Compromised peripheral blood flow
The nurse is admitting a client with traumatic injuries who also has class III obesity. When planning this client's care, the nurse should address the client's heightened risk of what nursing diagnoses related to obesity? Select all that apply.
Impaired skin integrity Impaired gas exchange
A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching?
Nausea
Understanding the definition of eating disorders is important in communicating facts while managing these conditions. Which is not an eating disorder?
obesity
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication?
"Do not drink alcohol while taking this medication."
A nurse cares for a client who wants to know more information about bariatric surgery. The client asks the nurse, "What weight loss can I expect?" What is the nurse's best response?
"Expect to lose 10-35% of total body weight 2 to 3 years postoperatively."
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says:
"I should become involved in a weight loss program."
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include?
"It binds with enzymes to help prevent digestion of fat."
A nurse cares for a client with obesity who is scheduled to undergo vagal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply.
"It is a pacemaker-type device that is implanted under your skin." "A pre-programed pulsating signal is delivered." "Recharge the device two times per week."
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response?
"The fat is passed in your stools."
Calculate the BMI of a client who weighs 160 lbs and is 5 feet 6 inches tall. Round to one decimal.
25.8
Calculate the BMI of a client who is 6 feet 1 inch tall and weighs 200 pounds. Round to one decimal.
26.4
Calculate the BMI of a client who is 180 pounds and is 5 feet 2 inches tall. Round to one decimal point.
32.9
A nurse caring for adults with obesity recognizes that obesity is classified based on BMI. Which BMI does the nurse recognize as Class II obesity?
35 kg/m2
A nurse provides medication teaching for a client with obesity who is prescribed Lorcaserin. Which statement will the nurse include in the teaching?
"Avoid driving heavy equipment."
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client?
Age
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face?
Both undernutrition and obesity
A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?
Cushing's disease
Place the pathophysiological steps in order of how a client with obesity is at greater risk for venous thromboembolism in comparison to the general population.
Increased adipose tissue impairment of peripheral blood flow blood stasis formation of a thrombus
A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers?
"Avoid taking non-steroidal anti-inflammatory drugs."
A nurse cares for a client with a BMI of 36 kg/m2 and nonalcoholic fatty liver disease. The client asks the nurse if he is a candidate for bariatric surgery. How should the nurse respond to the client?
"Yes, your BMI and chronic condition meets the criteria for bariatric surgery."
A client who is 6 months postoperative bariatric surgery tells the nurse, "I hate what my body looks like now. All these skin folds really bother me." What is the nurse's best response?
"You are not alone in having these feelings."
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.
BMI Weight Waist circumference
A client comes to the emergency department complaining of pain in the right leg. When obtaining the history, the nurse learns that the client has a history of obesity and hypertension. Based on this information the nurse anticipates the client having which musculoskeletal disorder?
Degenerative joint disease
A nurse cares for a client who is 36 hours postoperative from bariatric surgery and is suspected of having a hemorrhage related to the procedure. What is the nurse's understanding of the most likely cause of the hemorrhage?
Disruption of a staple
The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?
Has a weight gain of 5 pounds
A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate?
Mechanical compression and prophylactic anticoagulation
A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering?
Metformin
A nurse cares for a client with obesity who reports taking "a medication of weight loss" but cannot remember the name of it. The client also reports nervousness and feeling "jittery". Which medication is the client most likely taking?
Phentermine
A nurse prepares community teaching on healthy lifestyle modifications to a group of older adults. When discussing obesity rates of older adults in comparison with the rest of the population, what will the nurse include?
"Older adults have a slightly higher prevalence of obesity in comparison to the general population."
A nurse working in a cardiac health care office notes increased risk of certain cardiac conditions as a result of obesity. Which conditions can be associated with obesity? Select all that apply.
Coronary artery disease Heart failure Hypertension Myocardial infarction
A nurse geneticist is researching the gut microbiome and its relationship to disease. What is true regarding the microbiome?
It has over 100 times more genes than the human genome.
A client with obesity taking lorcaserin reports feeling agitated lately and has had diarrhea for several days. What is the nurse's priority response?
Notify the health care provider.
A nurse is preparing a presentation for a local community group addressing the influences on health care delivery. Which of the following would the nurse include in presentation when describing disease patterns?
Obesity along with conditions associated with it has become a major health concern.
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?
Osteoarthritis
A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity?
Over time, we have become efficient in food storage and deposition of fat stores.
A client who is postoperative from bariatric surgery reports foul-smelling, fatty stools. What is the nurse's understanding of the primary reason for this finding?
Rapid gastric dumping
A client who is postoperative open RYGB bariatric surgery is scheduled for discharge and will have a Jackson-Pratt drain to care for while at home. Which teaching will the nurse include specific to this? Select all that apply.
Recording drainage amount How to measure the drainage amount When to contact the health care provider How to empty the drain
A client with obesity is interested in trying orlistat for weight loss. Which disease or condition in the client's medical history alert the nurse of potential complications if the client uses this medication?
Renal insufficiency
A nurse works in a bariatric clinic and cares for client with obesity who will or have undergone bariatric surgery. What is the nurse's understanding of how the procedure works?
Restricts the client's ability to eat.
A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis? Select all that apply.
Sweating Tachycardia Dizziness
A nurse epidemiologist examines the overall decrease in life expectancy related to obesity. What finding is true?
There is a 6-20 year decrease in overall life expectancy for those with obesity.
A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage?
These are less likely to cause dumping syndrome.
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for?
Wound dehiscence
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose?
Stimulate GI peristalsis
A client who is obese and the nurse have established a goal for the client to achieve a weight loss of 1 pound each week. One month later, the nurse evaluates that the client has lost 2 pounds. The nurse first states
"You have succeeded in making positive progress."
An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true?
Diabetes mellitus is more common in Hispanics and Blacks than in Whites.
A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity?
Gabapentin
A nurse cares for an obese client who wants more information about naltrexone/bupropion to help with weight loss. Which medical conditions does the nurse recognize as contraindications to this medication? Select all that apply.
History of alcohol abuse Uncontrolled hypertension History of bulimia Epilepsy
