Assessment and Management of Patients with Obesity

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.

How to empty the drain Recording drainage amount When to contact the health care provider How to measure the drainage amount

A male client in a wheelchair comes in for his yearly physical examination. He is unable to stand. The nurse retrives the wheelchair scale to obtain an accurate weight. The nurse understands the importance of this assessment with this client. What is the nurse's reasoning for obtaining an accurate weight?

People with disabilities have an increased incidence of obesity.

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

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 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 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"

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.

Heart failure hypertension Coronary artery disease myocardial infarction

A client with obesity is interested in trying olistat 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 middle-aged obese female presents to the ED with severe radiating right-sided flank pain, nausea, vomiting, and fever. A likely cause of these symptoms is:

acute cholecystitis

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 (NSAIDs)

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 a client who is post op bariatric surgery. Which position will the nurse place the client in order to best promote comfort?

low fowlers

A nurse is educating a community group about coronary artery disease. One member asks about how to avoid coronary artery disease. Which of the following items are considered modifiable risk factors for coronary artery disease? Choose all that apply.

obesity hyperlipidemia tobacco use

A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply.

weight BMI waist circumference

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 is caring for a client who will undergo bariatric surgery. Which nutritional recommendation will the nurse include in the client teaching?

"Increase your intake of plant-based proteins."

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 greater prevalence of obesity in comparison to the general population."

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 nurse researches the cost and financial impact of obesity in America. What is the annual health care cost tied to obesity?

147 billion

A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk?

23

A client weighs 215 lbs and is 5' 8" tall. What would the nurse calculate this client's body mass index (BMI) as being?

32.7

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?

35kg/m2

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 cares for a client with obesity who is also diagnosed with depression. Which medication does the nurse expect the health care provider will prescribe, which also aids in weight loss?

Bupropion

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 1 obesity

A morbidly obese client asks the nurse if medications are available to assist with weight loss. The nurse knows that the client would not be a candidate for phentermine if the following is part of the client's health history:

Coronary artery disease

A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity?

Cushings disease

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 join disorder

The nurse cares for clients with obesity and understands that causes are multifactorial. What factors contribute to the development of obesity? Select all that apply.

Genetics Behavior Physiology Environment

The nurse observes that a client's medical report indicates that the client has Cushing syndrome. During inspection, the nurse notes that the client's BMI is 31, waist circumference is 40 inches, and localized fat pads exist around the neck and upper part of the back. Which of the following must the nurse keep in mind while planning the client's care?

The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.

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 examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply.

Those with less income are impacted at a greater prevalence of disease. Those with less education are impacted at a greater prevalence of disease

A nurse cares for a client who is postoperative bariatric surgery and has experienced frequent episodes of dumping syndrome. The client now reports anorexia. What is the primary reason for the client's report of anorexia?

fear of eating

The client with osteoarthritis is seen in the clinic. Which assessment finding indicates the client is having difficulty implementing self-care?

has weight gain of 5 pounds

A health care provider recommends behavior interventions for a client with obesity. What does the nurse understand is most effective behavioral intervention for clients with obesity?

high intensity

Place the pathophysiology of obesity in the correct order.

increase body fat adiposopathy release of biochemical mediators chronic inflammation disease

A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching?

nausea

A nurse cares for older adults with obesity and understands that this particular population is impacted differently than the general population. What does the nurse understand is true regarding older adults with obesity? Select all that apply.

there are at greater risk for falls they are admitted to nursing homes more than other older adults they have lower SPO2 levels

Which group of clients is at high risk of developing breast cancer?

women who are obese

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 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 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 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."

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."

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 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?

Manual compression and prophylactic anticoagulation

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

The nurse cares for a client with obesity and discusses the increased risk of certain cancers related to obesity. Which cancers will the nurse include in the teaching? Select all that apply.

colorectal cervical breast

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.

increase adipose tissue impairment of peripheral blood flow blood stasis formation of thrombus

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 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 clients ability to eat

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 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 is educating a client who will undergo bariatric surgery on methods to prevent dysphagia. What teaching will the nurse include? Select all that apply.

eat slowly chew your food throughly avoid eating tough foods avoid eating overcooked meats

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 client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has?

osteoarthritis

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 dizziness tachycardia

The charge nurse was discussing with the nursing student that studies have been published that suggest inflammation increases the risk of heart disease. Which modifiable factor would the nursing student target in teaching clients about prevention of inflammation that can lead to atherosclerosis?

addressing obesity

A client who is postoperative bariatric surgery is diagnosed with bile reflux. Which conditions are associated with bile reflux? Select all that apply.

esophagitis gastritis

The nurse cares for a client who is post op bariatric surgery whose bowel sounds have returned and is tolerating oral intake. What teaching will the nurse provide the client about the nutrition required at this time? Select all that apply.

"You need to drink plenty of water in between meals." "Eat slowly." "You will have six small meals per day."

When discussing lifestyle modifications with a client who has obesity, what caloric deficit should the nurse recommend in order for the client to safely lose weight?

500-1000 calories

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

Place the pathophysiological steps in correct order for the development of dumping syndrome

hypertonic food bolus from the stomach to the small intestine release of metabolic peptides tachycardia dizziness diaphoresis nausea vomiting bloating abdominal cramping and diarrhea rapid rise of glucose, release of insulin, reactive hypoglycemia

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 major health concerns

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 more efficient in food and deposition of fat stores

A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for?

wound dehiscence