Obesity

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? A) Impairs gastric motility. B) Restricts the client's ability to digest fat. C) Impairs caloric absorption. D) Restricts the client's ability to eat.

D) Restricts the client's ability to eat.

A nurse researches the cost and financial impact of obesity in America. What is the annual health care cost tied to obesity? A) $147 billion B) $1 trillion C) $3 trillion D) $118 billion

A) $147 billion

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. A) Myocardial infarction B) Heart murmur C) Coronary artery disease D) Heart failure E) Hypertension

A) Myocardial infarction C) Coronary artery disease D) Heart failure E) Hypertension

A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI? A) Class II obesity B) Class I obesity C) Overweight D) Normal weight

B) Class I obesity

Antiobesity medications work by inhibiting GI absorption of fat and altering central brain receptors to enhance _____ or reduce cravings.

Satiety

A male client in a wheelchair comes in for his yearly physical examination. He is unable to stand. The nurse retrieves 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? A) People with disabilities have an increased incidence of obesity. B) Wheelchairs make clients very self-conscious about their weight. C) A wheelchair-bound client is usually depressed about his or her weight. D) Weight is more difficult to control if a client is wheelchair-bound.

A) People with disabilities have an increased incidence of obesity.

After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? A) "A total serving should amount to be less than 1 cup." B) "I need to drink 8 oz of water before eating." C) "I should pick cereals with less than 2 g of fiber per serving." D) "I need to chew my food slowly and thoroughly."

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

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? A) Diabetes mellitus B) Chronic obstructive pulmonary disease C) Renal insufficiency D) Anemia

C) Renal insufficiency

A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose? A) Stimulate digestive hormones B) Assess for gastric perforation C) Assess for intact swallowing D) Stimulate GI peristalsis

D) Stimulate GI peristalsis

T or F: Patients with dumping syndrome after gastric surgery, should consume at least 16 oz of fluid with each meal.

False

T or F: The average weight loss following bariatric surgery is 35-50% of previous body weight over 2-3 years.

False

T or F: Traditionally, the term morbid obesity applies to adults whose body mass index (BMI) exceeds 30 kg/m2.

False

Lifestyle modification is aimed at weight loss and _____.

Maintenance

T or F: After bowel sounds have returned and oral intake is resumed following bariatric surgery, six small feedings consisting of a total of 600-800 calories per day should be consumed.

True

T or F: Obesity is associated with a 6-20 year decrease in life expectancy.

True

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? A) Both obesity and scare food sources B) Both low metabolism and high metabolism C) Both undernutrition and sedentary lifestyles D) Both undernutrition and obesity

D) Both undernutrition and obesity

A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity? A) Multiple mutations of genes over time have lead to the epidemic. B) A single gene mutation is responsible for the epidemic. C) Over time, we have become less efficient in hunting and gathering of food. D) Over time, we have become efficient in food storage and deposition of fat stores.

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

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: A) Hepatitis A B) Acute cholecystitis C) Pancreatitis D) Hepatitis B

B) Acute cholecystitis

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? A) Lifestyle modification B) Nonsurgical interventions C) Pharmacological management D) Surgical interventions

A) Lifestyle modification

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? A) Metformin B) Glyburide C) Pioglitazone D) Glipizide

A) Metformin

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? A) "You can change how you look." B) "You are not alone in having these feelings." C) "Why would you say that? You look great!" D) "Why are you dissatisfied?"

B) "You are not alone in having these feelings."

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: A) "You need to work harder to achieve your goal." B) "You have succeeded in making positive progress." C) "You are not achieving satisfactory weight loss." D) "We will have to re-evaluate your goal."

B) "You have succeeded in making positive progress."

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. A) Brain B) Breast C) Colorectal D) Cervical E) Skin

B) Breast C) Colorectal D) Cervical

A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply. A) Total cholesterol B) Waist circumference C) Weight D) Blood pressure E) BMI

B) Waist circumference C) Weight E) BMI

A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for? A) Hypotension B) Wound dehiscence C) Contractures D) Phlebitis

B) Wound dehiscence

A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity? A) Metformin B) Topiramate C) Gabapentin D) Bupropion

C) Gabapentin

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? A) Mechanical compression only B) Prophylactic anticoagulation only C) Mechanical compression and prophylactic anticoagulation D) Early ambulation only

C) Mechanical compression and prophylactic anticoagulation

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?" A) "I will avoid drinking fluids during meals." B) "I will chew slowly and thoroughly." C) "For diarrhea, I should take prescribed antimotility medication." D) "For minor pain, I should take prescribed ibuprofen."

D) "For minor pain, I should take prescribed ibuprofen."

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? A) 23 B) 31 C) 28 D) 18

A) 23

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? A) Compromised peripheral blood flow B) Increased fat accumulation in the blood C) Impaired clotting D) Increased blood viscosity

A) Compromised peripheral blood flow

A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has? A) Necrotizing arthritis B) Osteoarthritis C) Inflammatory arthritis D) Rheumatoid arthritis

B) Osteoarthritis

A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says: A) "I should eat a high-protein diet." B) "I should sleep on my side all night long." C) "I should become involved in a weight loss programs." D) "I need top keep my inhaler at the bedside."

C) "I should become involved in a weight loss programs."

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? A) "The fat is absorbed in your intestines." B) "The fat is excreted in your urine." C) "The fat is passed in your stools." D) "The fat remains undigested in your stomach."

C) "The fat is passed in your stools."

An obese Hispanic client, age 65, is diagnosed with type 2 diabetes. Which statement about diabetes mellitus is true? A) Approximately one-half of the clients diagnosed with type 2 diabetes are obese. B) Nearly two-thirds of clients with diabetes mellitus are older than age 60. C) Diabetes mellitus is more common in Hispanics and Blacks than in Whites. D) Type 2 diabetes mellitus is less common than type 1 diabetes mellitus.

C) Diabetes mellitus is more common in Hispanics and Blacks than in Whites.

A nurse is caring for a client who will undergo bariatric surgery. Which nutritional recommendation will the nurse include in the client teaching? A) "Increase your intake of plant-based proteins." B) "Increase your intake of complex carbohydrates." C) "Increase your intake of monounsaturated fats." D) "Increase your intake of fluids at meals."

A) "Increase your intake of plant-based proteins."

A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity? A) Cushing's disease B) Crohn's disease C) Grave's disease D) Addison's disease

A) Cushing's disease

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? A) Amitriptyline B) Doxepin C) Nortriptyline D) Bupropion

D) Bupropion

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. A) How to empty the drain B) Recording drainage amount C) How to measure the drainage amount D) When to contact the health care provider E) How to change the drain

A) How to empty the drain B) Recording drainage amount C) How to measure the drainage amount D) When to contact the health care provider

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? A) Low Fowler's B) Upright C) High Fowler's D) Lateral

A) Low Fowler's

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? A) "Older adults have a slightly higher prevalence of obesity in comparison to the general population." B) "Older adults have a slightly reduced prevalence of obesity in comparison to the general population." C) "Older adults have the same prevalence of obesity in comparison to the general population." D) "Older adults have a greatly reduced prevalence of obesity in comparison to the general population."

A) "Older adults have a slightly higher prevalence of obesity in comparison to the general population."

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? A) The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment. B) A BMI of 31 indicates obesity, and the nurse instructs the patient to keep a record of food actually consumed over the next 3-7 days. C) Knowing that the client is obese, the nurse plans to provide dietary education to reduce the daily caloric intake using the US Department of Agriculture's MyPlate pyramid. D) The nurse knows that a waist circumference of 40 places the client at risk. The nurse instructs the client to remember all food consumed over the next 24-hour period.

A) 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 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? A) The prevalence of chronic illness is decreasing due to the emphasis on healthy living. B) Most infectious diseases have been controlled or eradicated. C) Obesity along with conditions associated with it has become a major health concern. D) People with acute illnesses are considered the largest group of health care consumers.

C) Obesity along with conditions associated with it has become a major health concern.

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? A) "It works to make you feel full." B) "It binds with enzymes to decrease carbohydrate absorption." C) "It decreases your appetite." D) "It binds with enzymes to help prevent digestion of fat."

D) "It binds with enzymes to help prevent digestion of fat."

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? A) Diabetes mellitus B) Renal insufficiency C) Anemia D) Chronic obstructive pulmonary disease

B) Renal insufficiency

A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis? Select all that apply. A) Dizziness B) Hypertension C) Sweating D) Tachycardia E) Fever

A) Dizziness C) Sweating D) Tachycardia

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? A) "Yes, your chronic condition meets the criteria for bariatric surgery but not your BMI." B) "No, you have one qualifying condition but not the other; this excludes you from bariatric surgery." C) "No, you do not have any qualifying criteria for bariatric surgery." D) "Yes, your BMI and chronic condition meets the criteria for bariatric surgery."

D) "Yes, your BMI and chronic condition meets the criteria for bariatric surgery."

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? A) "Avoid taking non-steroidal anti-inflammatory drugs." B) "Sit in a semi-recumbent position while eating." C) "Avoid taking antacid drugs." D) "Keep the head of your bed propped on blocks at night."

A) "Avoid taking non-steroidal anti-inflammatory drugs."

Causes of obesity are complex and multifactorial and include _____, environmental, physiologic, and genetic factors.

Behavioral

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? A) Decreased motility B) Decreased gastric size C) Excessive fat intake D) Rapid gastric dumping

D) Rapid gastric dumping

Calculate the BMI of a client who weighs 160 lb and is 5 ft 6 in tall. Round to one decimal.

25.8

A client weighs 215 lbs and is 5' 8" tall. The nurse calculate this client's body mass index (BMI) as what? A) 24.8 B) 44.9 C) 19.5 D) 32.7

D) 32.7

A greater risk for obesity is assessed by a waist circumference that is greater than how many inches for women and >40 inches for men?

35

Calculate the BMI of a client who is 6 ft 1 in tall and weighs 200 lb. Round to one decimal.

26.4

Calculate the BMI of a client who is 180 lb and is 5 ft 2 in tall. Round to one decimal point.

32.9

What statement best describes a client with severe or extreme obesity? A) Waist-to-hip ratio <33 inches in males B) A BMI >35 kg/m2 C) Waist-to-hip ratio <30 inches in females D) A BMI >40 kg/m2

D) A BMI >40 kg/m2

Following bariatric surgery, disruption at the surgical site may cause leakage of gastric contents into the peritoneal cavity, causing _____ and possible sepsis.

Infection

A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response? A) "This is an expected finding with this medication." B) "How much water are you drinking?" C) "Your dose may need to be adjusted." D) "Taking this medication with meals decreases this symptom."

A) "This is an expected finding with this medication."

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. A) "You will have six small meals per day." B) "Stop eating prior to feeling full." C) "You need to drink plenty of water in between meals." D) "You will have three meals per day consisting of 500 calories each." E) "Eat slowly."

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

A client who is post op from bariatric surgery experiences dumping syndrome. What is the nurse's understanding of the cause of this condition? A) Hypertonic food releases metabolic peptides. B) Hypotonic food releases toxic substances. C) Hypotonic food pulls fluid from the blood and small intestines. D) Hypertonic food draws extracellular fluid from the blood into the small intestines.

A) Hypertonic food releases metabolic peptides.

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? A) These are less likely to cause dumping syndrome. B) These ease nausea. C) These are less likely to raise the blood sugar. D) These ease gastric distention.

A) These are less likely to cause dumping syndrome.

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? A) Absorption of food B) Fear of eating C) Size of the stomach D) Taste of food

B) Fear of eating

Place the pathophysiological steps in correct order for the development of dumping syndrome. A) Release of metabolic peptides B) Hypertonic food bolus from the stomach to the small intestine C) Tachycardia, dizziness, sweating, nausea, vomiting, bloating, abdominal cramping, and diarrhea D) Rapid rise of glucose, release of insulin, reactive hypoglycemia

B) Hypertonic food bolus from the stomach to the small intestine A) Release of metabolic peptides C) Tachycardia, dizziness, sweating, nausea, vomiting, bloating, abdominal cramping, and diarrhea D) Rapid rise of glucose, release of insulin, reactive hypoglycemia

The nurse establishes a learning contract with an overweight client. The contract is best if it: A) Contains an agreement to ingest a well-balances diet B) Includes an incremental goal of 1-2 pound weight loss this week C) Is an oral contract between the nurse and the client D) Has an overall goal of 30-pound weight loss in six months

B) Includes an incremental goal of 1-2 pound weight loss this week

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. A) Formation of a thrombus B) Increased adipose tissue C) Blood stasis D) Impairment of peripheral blood flow

B) Increased adipose tissue D) Impairment of peripheral blood flow C) Blood stasis A) Formation of a thrombus

A nurse working with clients with obesity understands that the hypothalamus plays an important role in hunger and satiety. Which statement best describes the role of the hypothalamus in hunger and satiety? A) it signals the release of neuropeptide y, which leads to feelings of satiety. B) It signals higher neural pathways that lead to eating behaviors. C) It signals the release of ghrelin, which increases feelings of hunger. D) It signals the GI system to slow gastric motility.

B) It signals higher neural pathways that lead to eating behaviors.

A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose? A) Stimulate digestive hormones B) Stimulate GI peristalsis C) Assess for intact swallowing D) Assess for gastric perforation

B) 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? A) "Do not drive while taking this medication." B) "Take the medication at night before bedtime." C) "Do not drink alcohol while taking this medication." D) "Take the medication with a full glass of water."

C) "Do not drink alcohol while taking this medication."

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? A) "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." B) "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." C) "The stomach is stapled to a very small pouch and the entire small intestine is rerouted." D) "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."

D) "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."

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? A) Drink at least 2L of water a day B) Encourage use of a multivitamin C) Avoid use of caffeine D) Addressing obesity

D) Addressing obesity

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? A) Muscular dystrophy B) Paget's disease C) Scoliosis D) Degenerative joint disease

D) Degenerative joint disease