H&C Prep U Chapter 48: Assessment and Management of Patients with 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."

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching

"I need to drink 8 oz of water before eating."

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 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 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 with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response

"This is an expected finding with this medication."

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

$147 billion

Calculate the BMI of a client who is 6 feet 1 inch tall and weighs 200 pounds. Round to one decimal

26.4

What statement best describes a client with severe or extreme obesity

A BMI >40 kg/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 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

Breast Colorectal Cervical

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 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

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 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

Hypertension Coronary artery disease Heart failure Myocardial infarction

Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply

Hypertension Obesity Family history Age greater of 45 years or older History of gestational diabetes

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 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 client who is post op bariatric surgery reports diarrhea. What is the most likely cause of the client's symptoms

Poor dietary choices

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 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 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

They are at greater risk for falls. They are admitted to nursing homes more than other older adults. They have lower SpO2 levels.

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.

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."

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

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 Fowler's

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 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 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 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 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 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

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

At its most fundamental level, what does obesity result from

A metabolic imbalance

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

Behavior Environment Physiology Genetics

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

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.

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

Discuss Obesity

A nurse teaches a client who will undergo bariatric surgery the importance of avoiding problematic foods post surgery. Which foods will the nurse suggest the client avoid? Select all that apply

Doughy breads Overcooked meats Pasta Rice

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

Gastritis Esophagitis

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

The nurse working with clients who have obesity understand that gut microbes perform numerous digestive, metabolic, and immunologic functions. What is the nurse's understanding of how these microbes contribute to obesity? Select all that apply

Individuals with obesity have less diverse gut microbes than those of normal weight. Specific gut microbes have been linked to a leaner body shape.

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 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 "thrify gene" theory of obesity

Over time, we have become efficient in food storage and deposition of fat stores.

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 an older adult client with obesity who also has glaucoma. Which obesity medication is contraindicated in this client

Phentermine

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

Potassium 3.3 mEq/L Bicarbonate 19 mEq/L

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 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

• Hyperlipidemia • Tobacco use • Obesity

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

Cushing's disease

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.

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 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 teaches a client with obesity about the various medication options for the treatment of obesity. Which medication will the nurse include when teaching the client about the class of medications that stimulate noradrenergic receptors

Phentermine