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." Explanation: The nurse should tell the client to avoid drinking alcohol while taking this medication. The other answer choices do not pertain to education specific to this medication.

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." Explanation: Older adults have a slightly higher prevalence of obesity when compared to the general population.

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." Explanation: Orlistat (Xenical) prevents the absorption of 30% of fat, decreasing caloric intake. Undigested fat is passed in the stools. The undigested fat is not excreted in the urine, absorbed in the intestines, or left undigested in the stomach.

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." Explanation: Lorcaserin (Belviq), a selective serotonergic 5-HT2C receptor agonist, causes dry mouth. This is an expected and normal finding. Increasing fluid intake does not make this symptom go away. The other answer choices are incorrect.

What statement best describes a client with severe or extreme obesity?

A BMI >40 kg/m2

At its most fundamental level, what does obesity result from?

A metabolic imbalance Explanation: At it's most fundamental level, obesity results from a metabolic imbalance characterized by an excess of caloric consumption relative to caloric expenditures.

A nurse cares for clients who undergo bariatric surgery due to obesity. When teaching the client on the most successful surgery in clients with very high BMI's, which procedure will the nurse mention?

Biliopancreatic diversion with duodenal switch Explanation: The biliopancreatic diversion with duodenal switch is the most successful bariatric surgery for clients with the highest BMI's. The other answer choices represent additional bariatric surgeries; however, these are not the most successful in clients with the highest BMI's.

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 Explanation: To calculate BMI, multiply weight in pounds by 703 and then divide that by height in inches squared. The client's BMI is 31.4 kg/m2. This falls under the Class I obesity category. Normal weight BMI is 18.5-25 kg/m2. Overweight BMI is 25-30 kg/m2. Class II obesity is a BMI 35-40 kg/m2.

Which clients will the nurse recognize as being at high risk for complication if taking Lorcaserin for obesity? Select all that apply.

Client with type 2 diabetes Client taking medication for migraines Client taking medication for depression Explanation: Lorcaserin (Belviq), a selective serotonergic 5-HT2C receptor agonist, can cause hypoglycemia in a client with type 2 diabetes. Additionally, this medication can cause synergistic effects for clients taking medication for migraines or for depression. The client with asthma or the client taking medication for cholesterol are not at increased risk while taking this medication.

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 In obesity, an increase in adipose tissue impairs the peripheral blood flow, leading to blood stasis and the formation of a thrombus.

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 Explanation: Clients with a history of renal sufficiency or liver disease should use caution while taking this medication as it has been linked to increase rates of cholelithiasis and liver failure. The other conditions do not pose an increase risk with this medication.

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. Explanation: Bariatric surgical procedures work by restricting a patient's ability to eat (restrictive procedure), interfering with ingested nutrient absorption (malabsorptive procedures), or both. Bariatric procedures do not impair caloric absorption; rather, nutrients are impaired by malabsorption.

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

Weight BMI Waist circumference

Understanding the definition of eating disorders is important in communicating facts while managing these conditions. Which is not an eating disorder?

obesity Explanation: Anorexia nervosa, bulimia nervosa, binge eating, and compulsive overeating are eating disorders. Obesity is a consequence of overeating.

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?

sponse: Compromised peripheral blood flow Explanation: A client with obesity is at increased risk for developing thromboembolism due to compromised blood flow and resulting venous stasis. Although the client with obesity is at risk for high cholesterol levels, increased fat in the blood does not directly impact the risk for developing thromboembolism. Increased blood viscosity and impaired clotting do not typically occur in obesity and are not the reason a client with obesity would be at greater risk for developing thromboembolism.

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." Explanation: When teaching a female of childbearing age regarding precautions after bariatric surgery, the nurse should instruct the client to avoid pregnancy for at least 18 months after surgery. The ability to conceive after weight loss surgery may improve more often than worsen. Contraceptives are no less effective after surgery than before.

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

26.4 Explanation: To calculate BMI, multiply weight in pounds by 703 and then divide that by height in inches squared

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 Explanation: The WHO mentions that many developing nations now face a double-burden of both undernutrition and obesity. Both of these issues occur simultaneously and create a public health burden to developing nations.

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." Explanation: When discussing weight loss expectations with the client, the nurse should let the client know to expect to lose 10-35% of total body weight 2 to 3 years postoperatively. The client may lose a large amount of weight the first month after surgery; however, this is not generally quantified with exact numbers or ranges.

A nurse evaluates the effectiveness of discharge teaching for a client who is postoperative from bariatric surgery. Which statement made by the client indicates to the nurse that additional teaching is necessary?"

"For minor pain, I should take prescribed ibuprofen." Explanation: The client who is postoperative from bariatric surgery should avoid non-steroidal anti-inflammatory medications due to the risk of gastric ulcers. The other answer choices are all true statements and indicate the client has understood the nurse's teaching.

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." Explanation: The client's BMI of > 35 kg/m2 and a more severe obesity-associated comorbid condition, makes the client a candidate 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 client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what?

32.7 Explanation: Using the formula for BMI, the client's weight in pounds (215) is divided by the height in inches squared (68 inches squared) and then multiplied by 703. The result would be 32.7.

A nurse plans care for a client who is post op bariatric surgery. Which nursing diagnosis will be the priority?

Acute pain related to surgical procedure Explanation: When determining the priority of nursing diagnoses, the nurse must recognize that airway, breathing, and circulation come first always. The client who is in acute pain will be unable to take deep breaths and is at increased risk for pulmonary complications. Acute pain is the priority nursing diagnosis. The other nursing diagnoses are appropriate for this client; however, they are not the priority.

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." Explanation: The only statement that aids in avoiding gastric ulcers is the statement instructing the client to avoid taking non-steroidal anti-inflammatory (NSAID) drugs. Sitting in a semi-recumbent of low Fowler's position aids in digestion but does not aid in the prevention of gastric ulcers. Propping the head of the bed would be beneficial for a client report GERD or acid reflux. antacid drugs do not increase the risk of gastric ulcers.

A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity?

Gabapentin Explanation: Gabapentin (Neurontin) is an anticonvulsant medication which promotes weight gain. The other answer choices are medications which promote weight loss, not gain.

A nurse teaches a client with obesity on the various types of bariatric surgical procedures. Which procedures will the nurse include when discussing restrictive procedures only? Select all that apply.

Gastric banding Sleeve gastrectomy Explanation: Gastric banding and sleeve gastrectomy are both bariatric surgical procedures that are considered restrictive procedures. RYGB and biliopancreatic diversion with duodenal switch are combined restrictive and malabsorptive procedures. Total gastrectomy is not a procedure used for bariatric surgery.

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

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." Explanation: Orlistat (Xenical) works to bind to gastric and pancreatic lipase to prevent the digestion of 30% of ingested fat, thereby decreasing caloric intake.

A nurse is caring for a client with a BMI of 35 kg/m2 who is wanting to lose weight. What is the initial recommendation the nurse will expect from the client's health care provider?

Lifestyle modification Explanation: All answer choices represents the various treatment for obesity; however, lifestyle modification is the initial recommendation for weight loss.

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 Explanation: Positioning the client in low Fowler's position best promotes comfort in the client who is post op bariatric surgery. In addition to decreasing incisional pain, this position also promotes gastric emptying.

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 Explanation: Both mechanical compression (intermittent pneumatic compression devices) and prophylactic anticoagulation with low molecular weight heparin agents are prescribed in the client who is postoperative bariatric surgery. Early ambulation is encouraged; however, it is not the only intervention.

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 Explanation: Metformin (Glucophage) is a diabetes medication that also promotes weight loss. The other medications are diabetes medications; however, these promote weight gain, not weight loss.

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

Osteoarthritis Explanation: Osteoarthritis is an obesity-related musculoskeletal condition. Rheumatoid arthritis, inflammatory arthritis, and necrotizing arthritis are not obesity-related conditions.

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 Explanation: Rapid gastric dumping may lead to steatorrhea, excessive fat in the feces. The primary cause of this finding is rapid gastric dumping. Excessive fat intake can make the problem worse; however, this is not the primary cause of the symptoms. Steatorrhea results from increased motility, not decreased and the size of the stomach does not contribute to this finding.

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." Explanation: In Roux-en-Y bariatric surgery, a horizontal row of staples across the fundus of the stomach creates a pouch with a capacity of 20 to 30 mL. The jejunum is divided distal to the ligament of Treitz, and the distal end is anastomosed to the new pouch. The proximal segment is anastomosed to the jejunum.

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. Explanation: Overall, there is a 6-20 year decrease in overall life expectancy for those with obesity.

A client who is postoperative from bariatric surgery is diagnosed with bile reflux after reports of severe epigastric pain and vomiting of bilious material. What statements are true regarding this condition? Select all that apply

Usually occurs after disruption of the pylorus. Symptoms are usually relieved after pharmacological treatment.

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. Explanation: The socioeconomic disparities of obesity among Americans is great. In general, those who are less educated and earn less income are more likely to have obesity. Home ownership does not decrease the prevalence of obesity.

A public health nurse plans teaching on the neurological morbid diseases and conditions associated with obesity. Which diseases or conditions will the nurse identify in the teaching? Select all that apply.

Alzheimer disease Anxiety Depression Stroke

A client who is post op from bariatric surgery tells the nurse, "I love cereal for breakfast. Do you have recommendations for which kind I should eat?" How should the nurse respond?

Choose a cereal with less than 2 grams of fiber per serving." Explanation: Cereal is acceptable post-bariatric surgery if it does not contain excess sugar and it has less than 2 grams of fiber per serving. A multigrain cereal may contain nuts or seeds, which are not recommended after bariatric surgery.

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. Explanation: According to the "thrifty gene" theory, hunting for scarce food sources during prehistoric times consumed a lot of energy, and food sources were not abundant. Storing fat to provide energy sources during times of food scarcity was a physiologic adaptive response to these environmental challenges and over time, we became more efficient in food storage and fat deposition.

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." Explanation: A client who is postoperative from bariatric surgery may share that they are dissatisfied with their appearance, often due to loose skin folds from excessive weight loss. It is the nurse's role to validate the client's feelings and to make sure the client understands that these feelings are normal. Asking the client why he or she is dissatisfied put the client in a defensive space and is not therapeutic. The client needs validation for his or her feelings; not being told that he or she can change. This may worsen the client's body image.

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

Cushing's disease Explanation: Cushing's disease, results from excess cortisol in the blood. This increases the risk of obesity. The other diseases or conditions listed most likely causes weight loss, not weight gain.