Chapter 40: Obesity
The nurse is creating a plan of care for an obese patient who is at risk for cardiovascular disease. How many minutes of daily exercise should the plan include? A. 10 B. 20 C. 30 D. 90
C. 30
The nurse recognizes that a patient with a pear shaped body is at high risk for which health problem? A. Heart disease B. Breast cancer C. Varicose veins D. Diabetes mellitus
C. Varicose veins
Which type of bariatric surgery decreases the amount of small intestine available for nutrient absorption and also removes part of the patient's stomach? A. Biliopancreatic diversion B. Adjustable gastric banding C. Sleeve gastrectomy D. Roux-en-Y gastric bypass surgery
A. Biliopancreatic diversion
The nurse recognizes that which surgical procedure is most effective in enhancing facial appearance after weight loss? A. Lipectomy B. Liposuction C. Restrictive surgery D. Malabsorptive surgery
B. Liposuction
A patient presents with a body mass index (BMI) of 20 kg/m 2. What should the nurse document about the patient's weight classification? A. Obese B. Overweight C. Underweight D. Normal weight
D. Normal weight
While performing a health assessment, the nurse documents a child's weight as 25 kg and height as 1.1 meters. What is the body mass index (BMI) of the child? Record the answer rounded to one decimal place.
A: 20.7 kg/m2
What is the cause of primary obesity? A. The development of metabolic disorders B. The presence of congenital abnormalities C. The presence of lesions in the central nervous system D. The excess caloric intake over the metabolic demand
? D. The excess caloric intake over the metabolic demand
The nurse provides dietary recommendations to an obese patient who is planning to lose weight. What should the nurse include? A. "Bake, broil, or steam your foods." B. "Eliminate carbohydrates from your diet." C. "Two thirds of your diet should be animalsource foods." D. "Eating small pieces of candy between meals is recommended to suppress your appetite."
A. "Bake, broil, or steam your foods."
The nurse provides initial weight-loss instructions to a patient. Which statement made by the patient indicates that additional teaching is needed? A. "I plan to lose 6 pounds a week until I have reached my weight loss goals." B. "I should exercise most days of the week for best results." C. "I will keep a diary of weekly weights to illustrate my weight loss." D. "I will reduce my caloric intake to 1800 calories per day."
A. "I plan to lose 6 pounds a week until I have reached my weight loss goals."
The nurse provides weight-loss education to a patient with a body mass index (BMI) of 30 kg/m 2. Which statement made by the patient indicates the need for further teaching? A. "I will limit intake to 500 calories a day." B. "Engaging in weekend exercise only is not recommended." C. "Two thirds or more of my diet should be plant-source foods." D. "I should track my activity with a goal of 10,000 steps a day."
A. "I will limit intake to 500 calories a day."
What should the nurse include in the discharge education provided to a female patient who underwent bariatric surgery? A. "Postpone pregnancy for 12 to 18 months." B. "Irregular menstruation for 12 months is likely." C. "A result of the surgery is loss of fertility." D. "You will need hormone replacement therapy."
A. "Postpone pregnancy for 12 to 18 months."
What discharge instructions should the nurse provide to a patient who has undergone Roux-en- Y gastric bypass surgery? Select all that apply. A. "You will need to take a calcium supplement." B. "You should take an iron supplement." C. "You will likely experience belching and heartburn." D. "Report vomiting, weakness, or faintness, which may indicate dumping syndrome." E. "You should experience a decrease in total cholesterol."
A. "You will need to take a calcium supplement." B. "You should take an iron supplement." D. "Report vomiting, weakness, or faintness, which may indicate dumping syndrome." E. "You should experience a decrease in total cholesterol."
The nurse is caring for a patient with an energy utilization and storage disorder called metabolic syndrome. Which treatment strategies will be helpful for this patient? Select all that apply. A. Administering metformin B. Administering tranexamic acid C. Providing information on nutritious dietary intake D. Advising the patient to consume palm kernel oil E. Providing information on positive lifestyle changes
A. Administering metformin C. Providing information on nutritious dietary intake E. Providing information on positive lifestyle changes
The nurse is caring for a patient who has undergone bariatric surgery. Which nursing interventions will be beneficial to this patient? Select all that apply. A. Assisting the patient to walk in the evening after the surgery B. Administering carbohydrate-rich foods C. Maintaining the patient in the semi- Fowler's position D. Being prepared to perform a head-tilt maneuver E. Maintaining the patient on large quantities of liquid intake
A. Assisting the patient to walk in the evening after the surgery C. Maintaining the patient in the semi- Fowler's position D. Being prepared to perform a head-tilt maneuver
The nurse is caring for an obese patient who is being considered for bariatric surgery. What do the criteria guidelines for bariatric surgery include? A. BMI of 40 kg/m 2 or more B. BMI of 28 kg/m 2 or more C. BMI of 30 kg/m 2 or more D. BMI of 32 kg/m 2 or more with other significant co-morbidities
A. BMI of 40 kg/m 2 or more
A community health nurse is conducting an assessment of a new patient. Which assessments should the nurse include when screening the patient for metabolic syndrome? Select all that apply. A. Blood pressure B. Resting heart rate C. Physical endurance D. Waist circumference E. Fasting blood glucose
A. Blood pressure D. Waist circumference E. Fasting blood glucose
The nurse is caring for a patient who has undergone Roux-en-Y gastric bypass surgery. The nurse should monitor the patient for signs of which deficiencies? Select all that apply. A. Calcium B. Iron C. Cobalamin D. Folic acid E. Protein
A. Calcium B. Iron C. Cobalamin D. Folic acid
A patient receives a prescription for a nonamphetamine drug for weight loss. What information should the nurse include in the patient's medication education? Select all that apply. A. Dose of the drug B. Action of the drug C. Side effects of the drug D. Encouraging the use of additional overthe- counter diet aids E. Informing the patient that the drugs will be enough to cure obesity F. Telling the patient to consult with the health care provider before modification of dosage
A. Dose of the drug B. Action of the drug C. Side effects of the drug F. Telling the patient to consult with the health care provider before modification of dosage
An obese patient tells the nurse, "As part of my weight loss program, I have begun exercising daily for an hour in the morning and an hour in the evening. I also have a goal of 10,000 steps a day, but I started by walking one-third of the recommended steps. I have been swimming and cycling." The patient reports feeling fatigued at the end of the day. What recommendation should the nurse make? A. Exercise for an hour each day. B. Continue swimming but do not cycle. C. Change the goal to 5,000 steps a day. D. Start by walking 2,000 steps, with incremental increases.
A. Exercise for an hour each day.
A patient takes orlistat for weight loss. The nurse anticipates that which supplement will be prescribed? A. Fat-soluble vitamin supplements B. Water-soluble vitamin supplements C. Iron supplement D. Folic acid supplement
A. Fat-soluble vitamin supplements
An obese patient underwent biliopancreatic diversion with a duodenal switch. The nurse should monitor the patient for which complications? Select all that apply. A. Malabsorption of fat-soluble vitamins B. Steatorrhea C. Iron deficiency D. Dumping syndrome E. Calcium deficiency
A. Malabsorption of fat-soluble vitamins B. Steatorrhea C. Iron deficiency D. Dumping syndrome
A patient with a BMI of 26.1 kg/m² is scheduled for a laparoscopic hernia repair at an outpatient surgical facility. Which nursing action is appropriate prior to the surgery? A. Orlistat B. Locaserin C. Liraglutide D. Phentermine/topiramate
A. Orlistat
Which nursing intervention would be beneficial for an obese patient who is at risk for deep venous thrombosis after surgery? Select all that apply. A. Providing compression stockings B. Administering low-dose heparin C. Administering aspirin medication D. Encouraging range-of-motion exercises E. Instructing in cough and deep-breathing techniques
A. Providing compression stockings B. Administering low-dose heparin D. Encouraging range-of-motion exercises
The nurse is teaching a patient about developing strategies for a weight-loss program. What should the nurse include in the education? Select all that apply. A. Providing information about stimulus control and self-monitoring B. Stating that diet therapy alone is often effective C. Advising to stay focused on reasons to lose weight. D. Recommending that weight loss medication is part of the initial plan E. Including a reduced-calorie diet, exercise, and behavior modification in the plan
A. Providing information about stimulus control and self-monitoring C. Advising to stay focused on reasons to lose weight. E. Including a reduced-calorie diet, exercise, and behavior modification in the plan
While performing a physical assessment, the nurse documents a patient's height as 66 inches and the patient's weight as 160 pounds. What body mass index (BMI) value should the nurse enter in the patient's medical record? Record the answer using two decimal places.
A: 25.82 lbs/in 2 Wt. x 703 = x ex. 1lb x 703 = 703 A x A = AA ex. 66 x 66
An obese patient is scheduled for cosmetic surgery for body image enhancement. The nurse provides education about reducing the risk of obesity recurrence. Which statement made by the patient indicates the need for further teaching? A. "I can include baked food in my diet." B. "I can eat candy and honey any time." C. "I need to exercise every day." D. "I need to drink low-fat milk and eat salads."
B. "I can eat candy and honey any time."
The nurse collaborates with an obese patient to create a plan that contains specific daily weight loss goals. Which statement made by the patient indicates an appropriate goal to include in the plan? A. "I plan to eat fewer carbohydrates at every meal." B. "I plan to eat at least 3 cups of vegetables daily." C. "I will participate in a community walk for cancer." D. "I will seek medical advice for a weight loss program."
B. "I plan to eat at least 3 cups of vegetables daily."
The nurse provides education to a patient about reducing the risk of obesity. Which statement made by the patient indicates the need for further teaching? A. "I should eat two ounces of baked chicken for dinner." B. "I should incorporate canned fruits into my everyday diet." C. "I should eat vegetables and salad at lunch and dinner." D. "I should include a cup of low-fat milk at breakfast."
B. "I should incorporate canned fruits into my everyday diet."
The nurse has completed initial instruction with a patient regarding a weight-loss program. The nurse determines that the teaching has been effective when the patient makes which statement? A. "I plan to lose 4 pounds a week until I have met my 60-pound weight loss goal." B. "I will keep a diary of weekly weights to track my weight loss." C. "I will restrict my carbohydrate intake to less than 30 g/day to maximize weight loss." D. "I should not exercise more than my program requires because increased activity increases the appetite."
B. "I will keep a diary of weekly weights to track my weight loss."
After completing an assessment, the nurse classifies a patient as overweight based on which body mass index (BMI) range? A. 18.5 to 24.9 kg/m 2 B. 25 to 29.9 kg/m 2 C. 30 to 40 kg/m 2 D. Greater than 40 kg/m 2
B. 25 to 29.9 kg/m 2
The nurse provides dietary information to an overweight patient related to portion sizes. The nurse should include that the recommended portion size of animal protein is how many ounces? A. 1 ounce B. 3 ounces C. 5 ounces D. 7 ounces
B. 3 ounces
When teaching a patient about reducing weight by using a calorie-restricted diet, what instructions should the nurse include? Select all that apply. A. Skip meals if not hungry. B. Exercise regularly. C. Avoid concentrated sweets. D. Select fried foods. E. Select steamed and baked foods.
B. Exercise regularly. C. Avoid concentrated sweets. E. Select steamed and baked foods.
The nurse performs a physical assessment on a patient with glaucoma and determines that the patient is overweight. The nurse expects that which medication will be prescribed to suppress the patient's appetite? A. Orlistat B. Lorcaserin C. Topiramate D. Phentermine and topiramate
B. Lorcaserin
A patient has a height of 180 cm and weighs 70 kg. In which weight category should the patient be placed? A. Underweight B. Normal weight C. Overweight D. Obese
B. Normal weight
The nurse identifies that orlistat has been prescribed to an obese patient for what reason? A. To reduce swelling B. To block fat breakdown and absorption in the intestine C. To suppress appetite D. To decrease the risk of sleep apnea
B. To block fat breakdown and absorption in the intestine
Which statement made by a patient who underwent a bariatric surgery indicates the need for further teaching about steps to maintain proper weight? A. "I should reduce carbohydrates in my diet." B. "I should limit cheese and butter in my diet." C. "I should drink plenty of fluids with my meals." D. "I should increase the protein content in my diet."
C. "I should drink plenty of fluids with my meals."
The nurse reviews the medical records of four female patients and identifies that which patient is at increased risk for metabolic syndrome? A. A patient with a waist-to-hip ratio of 0.6 B. A patient with a body mass index (BMI) of 24 kg/m 2 C. A patient with a waist circumference of 37 inches D. A patient with a family history of obesity
C. A patient with a waist circumference of 37 inches
An obese patient consults a nurse for weight-loss advice. The patient states, "I never feel full, so I keep eating." Which medications may be helpful to this patient? Select all that apply. A. Orlistat B. Metformin C. Lorcaserin D. Liraglutide E. Phentermine/topiramate
C. Lorcaserin D. Liraglutide E. Phentermine/topiramate
The nurse is caring for a patient with metabolic syndrome. Which nursing intervention will be beneficial for the patient? Select all that apply. A. Recommending a sodium-rich diet B. Monitoring estrogen levels C. Monitoring serum lipid levels D. Monitoring blood glucose level E. Recommending foods low in saturated fats
C. Monitoring serum lipid levels D. Monitoring blood glucose level E. Recommending foods low in saturated fats
The nurse is interacting with a dieting obese patient. Which statement made by the patient indicates that the patient is practicing stimulus control? A. "I maintain a diary about my diet and eating times every day." B. "I decided that I will pamper myself with a massage after I lose 5 lbs." C. "I will treat myself with my favorite food after losing 10 pounds of weight." D. "I avoided going near the food court because the smell is very tempting."
D. "I avoided going near the food court because the smell is very tempting."
A patient has a body mass index (BMI) of 27 kg/m 2. The nurse has discussed weight-loss goals with the patient. Which statement made by the patient indicates understanding of the teaching? A. "I will exercise for 15 minutes every day of the week." B. "I will limit my intake to 500 calories per day." C. "I will increase my intake of sugar-free foods and beverages." D. "I will begin to steam and broil my foods for most meals."
D. "I will begin to steam and broil my foods for most meals."
At the first visit to the clinic, a patient with a body mass index (BMI) of 29 kg/m 2 tells the nurse, "I do not want to become obese." Which question used for assessing weight issues is the most important for the nurse to ask? A. "What is your waist circumference?" B. "How is your overall health affected by your body weight?" C. "What is your history of gaining weight and losing weight?" D. "In what ways are you interested in managing your weight differently?"
D. "In what ways are you interested in managing your weight differently?"
The nurse recalls that which organ secretes the neuropeptide Y hormone to control obesity? A. Colon B. Pancreas C. Stomach D. Hypothalamus
D. Hypothalamus
An obese patient reports consuming a high-fat diet daily. The nurse recognizes that which medication that is used to treat obesity blocks fat breakdown? A. A serotonin agonist B. A sympathomimetic C. Lorcaserin D. Orlistat
D. Orlistat
The nurse is reviewing the surgical notes of a patient who underwent bariatric surgery and notes that a small gastric pouch was created and attached directly to the small intestine. The remaining stomach and first segment of the small intestine are bypassed. Which surgical technique was performed? A. Adjustable gastric banding B. Sleeve gastrectomy C. Vertical banded gastroplasty D. Roux-en-Y gastric bypass surgery
D. Roux-en-Y gastric bypass surgery
A patient who underwent restrictive bariatric surgery has a sleeved-shaped stomach with a 60 to 150 mL capacity and no bypass of the intestine. The nurse recognizes that the patient had what type of surgery? A. Biliopancreatic diversion B. Roux-en-Y gastric bypass C. Adjustable gastric banding D. Sleeve gastrectomy
D. Sleeve gastrectomy
A patient is prescribed phentermine/topiramate for obesity. The nurse should monitor the patient for what serious side effect? A. Hyperthyroidism B. Migraine attacks C. Seizure disorders D. Respiratory distress
A. Hyperthyroidism
The nurse reviews the hormone deficiencies associated with obesity. When at a normal level, which hormone acts in the hypothalamus to suppress appetite and increase fat metabolism? A. Leptin B. Insulin C. Ghrelin D. Peptide YY
A. Leptin
The nurse reviews the medical record of a patient and notes documentation of class I obesity. This determination was made because the patient has which body mass index (BMI)? A. 26 kg/m 2 B. 32 kg/m 2 C. 37 kg/m 2 D. 42 kg/m 2
B. 32 kg/m 2
The nurse is administering postoperative care to a patient that underwent bariatric surgery. What is a priority intervention? A. Ambulating the patient B. Administering analgesics C. Providing solid foods to the patient D. Providing a low-protein diet to the patient
B. Administering analgesics
The nurse develops a weight-reduction plan with a patient. The nurse should encourage the patient to set a weight-loss goal of how many pounds in a 4-week time period? A. A goal of 1 to 2 pounds B. A goal of 3 to 5 pounds C. A goal of 4 to 8 pounds D. A goal of 5 to 10 pounds
C. A goal of 4 to 8 pounds
The nurse determines that an obese patient has varicose veins and cellulite. Which body condition creates a high risk for this condition? A. Gynoid body shape B. Android body shape C. Primary obesity D. Secondary obesity
A. Gynoid body shape
The nurse assists the patient who has undergone bariatric surgery in making dietary selections. Which types of food items should be recommended? A. High-protein B. High-carbohydrate C. High-fat D. High-roughage
A. High-protein
When providing teaching to an obese patient, the nurse should emphasize that a healthy weight loss average is how many pounds per week? A. 2 pounds B. 3 pounds C. 6 pounds D. 8 pounds
A. 2 pounds
The nurse teaches an elderly patient that aging problems can be exacerbated by obesity and includes what example? A. Arthritis B. Sinusitis C. Vision problems D. Chewing difficulty
A. Arthritis
When teaching the patient about the use of weight-reducing drug therapy, what instructions should the nurse include? Select all that apply. A. Become familiar with the side effects of drug therapy. B. Utilize any of the available over-the-counter weight-loss drugs. C. Weight loss caused by weight-reducing drugs is permanent. D. Avoid modification of the drug dosage without medical advice. E. Recognize that a weight-loss program includes other components, rather than relying only on drugs.
A. Become familiar with the side effects of drug therapy. D. Avoid modification of the drug dosage without medical advice. E. Recognize that a weight-loss program includes other components, rather than relying only on drugs.
During an assessment, a patient reports to the nurse that he or she has a habit of overeating and lives a mostly sedentary lifestyle. Which primary factor that leads to obesity does this example illustrate? A. Caloric intake exceeding energy expended B. Energy expended exceeding caloric intake C. Metabolic problems that relate to insulin resistance D. Corticosteroids causing increased blood sugar levels
A. Caloric intake exceeding energy expended
The nurse assesses a patient who is obese. What psychosocial health risks are associated with obesity? Select all that apply. A. Depression B. Discrimination C. Impaired flexibility D. Stress incontinence E. Exercise intolerance
A. Depression B. Discrimination
A severely obese patient has undergone Rouxen- Y gastric bypass (RYGB) surgery. The nurse will monitor for dumping syndrome, which is characterized by which symptoms? Select all that apply. A. Diarrhea B. Sweating C. Faintness D. Constipation E. Nausea and vomiting
A. Diarrhea B. Sweating C. Faintness E. Nausea and vomiting
The nurse reviews the medical record of a patient with obesity and identifies that the patient is at risk for which conditions? Select all that apply. A. Gallstones B. Sleep apnea C. Hypothyroidism D. Esophageal cancer E. Systemic lupus erythematosus (SLE)
A. Gallstones B. Sleep apnea D. Esophageal cancer
The nurse recalls that levels of which hormone increase after starvation and decrease in response to food in the stomach? A. Ghrelin B. Peptide YY C. Neuropeptide Y D. Cholecystokinin
A. Ghrelin
An obese patient is diagnosed with liver failure. When reviewing the patient's medical records, the nurse finds that the patient is undergoing weight loss therapy. Which medication is likely responsible for the patient's liver failure? A. Orlistat B. Diethylpropion C. Benzphetamine D. Phendimetrazine
A. Orlistat
The nurse is reviewing the assessment findings and body mass index (BMI) of four patients. Which patient is an appropriate candidate for bariatric surgery? A. Patient A B. Patient B C. Patient C D. Patient D
A. Patient A
While providing postoperative care for a patient who underwent bariatric surgery, the nurse finds that the patient is unconscious and has not fully recovered from anesthesia. What action should the nurse take? A. Perform a jaw-thrust maneuver. B. Assist the patient with compression stockings. C. Administer intravenous fluids and electrolytes. D. Open nasal airways by closing the patient's mouth.
A. Perform a jaw-thrust maneuver.
A patient that is participating in a weight-loss program tells the nurse, "When I lose 5 pounds, I plan to have a spa treatment." Which behavioral technique is the patient using? A. Reward B. Motivation C. Self-monitoring D. Stimulus control
A. Reward
The nurse is caring for an obese patient and anticipates that what diagnostic studies will be performed? Select all that apply. A. Serum glucose B. Liver function tests C. Chest x-ray D. Magnetic resonance imaging (MRI) E. Electrocardiogram (ECG)
A. Serum glucose B. Liver function tests C. Chest x-ray E. Electrocardiogram (ECG)
The nurse is teaching a class about weight management and should include what health risks associated with obesity? Select all that apply. A. Sleep apnea B. Breast cancer C. Atrial fibrillation D. Hyperthyroidism E. Gastroesophageal reflux disease (GERD)
A. Sleep apnea B. Breast cancer C. Atrial fibrillation E. Gastroesophageal reflux disease (GERD)
A patient with a body mass index (BMI) of 22 kg/ m 2 asks the nurse for weight-reducing medications. How should the nurse respond? A. Suggest a healthy diet to the patient. B. Suggest a low-dose form of orlistat. C. Report the BMI to the primary health care provider. D. Instruct the patient to avoid carbohydrates in the diet.
A. Suggest a healthy diet to the patient.
While performing the nutritional assessment of a patient, the nurse finds that the patient's height is 1.71 m and weight is 68 kg. What does the nurse interpret based on the patient's body mass index (BMI)? A. The BMI indicates the weight is normal. B. The BMI indicates a higher risk for disease. C. The BMI indicates the weight is above normal. D. The BMI indicates the weight is below normal.
A. The BMI indicates the weight is normal.
During the initial postoperative period following bariatric surgery, the nurse recognizes the importance of monitoring obese patients for respiratory insufficiency based on what knowledge? A. The body stores anesthetics in adipose tissue. B. Postoperative pain may cause a decreased respiratory rate. C. Intubation may be difficult because of extra chin skin folds. D. The patient's head must remain flat for a minimum of 2 hours postprocedure.
A. The body stores anesthetics in adipose tissue.
When developing a weight-reduction plan for an overweight patient, it is important for the nurse to first assess the presence of which factor? A. The patient's readiness to make lifestyle changes B. The patient's current body mass index (BMI) C. The patient's waist-to-hip circumference ratio D. The patient's current employment status
A. The patient's readiness to make lifestyle changes
Why does the nurse, who is preparing a diet regimen for an obese patient, advise the patient to lose approximately 1 to 2 pounds each week? A. To ensure better cosmetic results B. To reduce number of plateau periods C. To reduce risk of venous complications D. To provide a motivation for weight loss
A. To ensure better cosmetic results
When assessing a patient with obesity, what questions are appropriate for the nurse to ask the patient? Select all that apply. A. What kind of food do you prefer? B. Where do you go for a vacation? C. Are other family members obese? D. What is your motivation to lose weight? E. What is your educational background?
A. What kind of food do you prefer? C. Are other family members obese? D. What is your motivation to lose weight?
While caring for a patient after bariatric surgery, the nurse identifies that the patient is at risk for deep vein thrombosis (DVT). Which treatment strategy should be included in the patient's care plan to prevent this complication? Select all that apply. A. Antifibrinolytic drugs B. Compression stockings C. Vitamin K supplements D. Low-dose heparin E. Active and passive range-of-motion exercises
B. Compression stockings D. Low-dose heparin E. Active and passive range-of-motion exercises
An obese patient tells the nurse, "I feel hungry all the time." The nurse suspects that what hormone abnormality is causing the patient's symptom? A. Increased levels of insulin hormone B. Decreased levels of leptin hormone C. Decreased levels of ghrelin hormone D. Increased levels of peptide YY hormone
B. Decreased levels of leptin hormone
A patient is taking lorcaserin. The nurse should monitor for what adverse effects associated with the medication? Select all that apply. A. Diarrhea B. Dizziness C. Dry mouth D. Constipation E. Abdominal bloating
B. Dizziness C. Dry mouth D. Constipation
Two weeks after a subtotal gastrectomy, a patient reports the sudden onset of faintness, weakness, and diaphoresis after eating a meal. The nurse suspects what complication? A. Acute pancreatitis B. Dumping syndrome C. Acute myocardial infarction D. Mesenteric artery embolism
B. Dumping syndrome
An obese patient tells the nurse, "I just can't stop eating." The nurse recalls that which hormone that is primarily produced in the stomach plays a role in compulsive eating? A. Cholecystokinin B. Ghrelin C. Leptin D. Insulin
B. Ghrelin
What should the nurse include in a postoperative plan of care for a patient who has undergone bariatric surgery? A. Avoid ambulating the patient. B. Give 30 mL of water every 2 hours. C. Give solid foods along with liquids. D. Avoid sugar-free liquids in the patient's diet.
B. Give 30 mL of water every 2 hours.
The nurse reviews the medical record of a female patient who may have metabolic syndrome. Which of the patient's assessment findings are criteria for metabolic syndrome? Select all that apply. A. Body mass index (BMI) B. High-density lipoprotein (HDL) cholesterol results C. Blood pressure (BP) D. Waist circumference E. Triglyceride level results
B. High-density lipoprotein (HDL) cholesterol results D. Waist circumference E. Triglyceride level results
While performing a physical assessment, the nurse observes that the patient has fat primarily in the abdominal area. The fat is also distributed over the arms, neck, and shoulders. The nurse determines that the patient has which health risks? Select all that apply. A. Osteoporosis B. Hypertension C. Varicose veins D. Diabetes mellitus E. Endometrial cancer
B. Hypertension D. Diabetes mellitus E. Endometrial cancer
The nurse is caring for a patient with a herniated lumbar disc whose body mass index (BMI) is 28 kg/m 2. The nurse identifies that the BMI places the patient in which weight category? A. Normal weight B. Overweight C. Obese D. Severely obese
B. Overweight
The nurse reviews the height and weight measurements of a group of patients. Which patient will the nurse document as having a normal body weight? A. Patient A B. Patient B C. Patient C D. Patient D
B. Patient B
The nurse includes lean meat, fish, and eggs in the diet of a patient with obesity. Which component of nutrition is most adequately provided through this diet? A. Fiber B. Protein C. Vitamin C D. Carbohydrates
B. Protein
The nurse recalls that which type of bariatric surgery may result in calcium and folic acid deficiency? A. Biliopancreatic diversion B. Roux-en-Y gastric bypass C. Sleeve gastrectomy D. Vertical banded gastroplasty
B. Roux-en-Y gastric bypass
A patient underwent an irreversible bariatric surgical procedure that involved creating a small gastric pouch and attaching it directly to the small intestine using a piece of the small bowel. The nurse recognizes that the patient had what surgical procedure? A. Biliopancreatic diversion B. Roux-en-Y gastric bypass (RYGB) C. Adjustable gastric banding D. Sleeve gastrectomy
B. Roux-en-Y gastric bypass (RYGB)
A male patient's waist circumference is 36 inches and body mass index (BMI) is 38.0 kg/m 2. What does the nurse interpret from these findings? A. The patient is at high risk for disease. B. The patient is at very high risk for disease. C. The patient is at increased risk for disease. D. The patient is at extremely high risk for disease.
B. The patient is at very high risk for disease.
The nurse calculates that a patient's body mass index is 28 kg/m 2. What does the nurse interpret from the finding? A. The patient is obese. B. The patient is overweight. C. The patient has severe obesity. D. The patient has a normal body weight.
B. The patient is overweight.
The nurse recalls that which anatomical change is observed after biliopancreatic diversion surgery? A. The stomach is sleeve shaped with a 60- to 150-mL capacity. B. There is an anastomosis between the stomach and the intestine. C. A band encircles the stomach, creating a stoma and a gastric pouch. D. A gastric pouch is connected to the jejunum, and the remaining stomach is bypassed.
B. There is an anastomosis between the stomach and the intestine.
A patient who is scheduled for gastric bypass surgery asks for information about dumping syndrome. How should the nurse explain dumping syndrome? A. The inability to digest high-fat foods B. When the passage of food into the small intestine occurs too rapidly C. A decrease in the secretion of insulin caused by carbohydrates D. An increase in the secretion of both bile and pancreatic enzymes
B. When the passage of food into the small intestine occurs too rapidly
An obese patient receives a prescription for orlistat for weight loss. What should the nurse include in the patient's medication teaching? A. "Take a stool softener." B. "Consume a high-calorie diet." C. "Take vitamin supplements." D. "Take folic acid supplements."
C. "Take vitamin supplements."
The nurse measures the waist circumferences of four patients and identifies that which patient has a high risk of obesity? A. A 20-year-old male with a waist circumference of 32 inches B. A 40-year-old male with a waist circumference of 40 inches C. A 30-year-old female with a waist circumference of 38 inches D. A 22-year-old female with a waist circumference of 30 inches
C. A 30-year-old female with a waist circumference of 38 inches
The nurse reviews a patient's prescription for a weight loss medication and identifies that the medication will only be used short-term because of the potential for abuse. Which type of medication was prescribed to the patient? A. An antidiabetic drug B. A serotonin agonist C. A nonamphetamine D. A nutrient absorption-blocking drug
C. A nonamphetamine
What concern related to bariatric surgery can be addressed through use of cosmetic surgery A. Dehiscence B. Dumping syndrome C. Altered body image D. Deep venous thrombosis
C. Altered body image
The nurse is reviewing cultural and ethnic factors related to obesity. Which statement does the nurse identify as being true? A. Among men, Hispanics have the lowest prevalence of being overweight or obese. B. Native Americans have a lower prevalence of being overweight than the general population. C. Among women, African Americans have the highest prevalence of being overweight or obese. D. Asian Americans have the same prevalence of being overweight and obese compared with the general population.
C. Among women, African Americans have the highest prevalence of being overweight or obese.
Following a Roux-en-Y gastric bypass, the patient experiences vomiting, nausea, sweating, faintness, and occasional episodes of diarrhea. The nurse reviews the patient's oral consumption after the surgery and suspects that what triggered the patient's symptoms? A. Fish B. Meat C. Candy D. Spinach
C. Candy
The nurse concludes that a patient has metabolic syndrome based on what abnormal laboratory result? A. Platelet count B. Creatinine level C. Cholesterol level D. White blood cell count
C. Cholesterol level
After performing a physical assessment, the nurse determines that the patient has a pearshaped body consistent with gynoid obesity. Which assessment finding supports gynoid obesity? A. Fat deposition in the neck B. Fat deposition in the shoulders C. Fat deposition in the upper legs D. Fat deposition in the abdominal area
C. Fat deposition in the upper legs
The nurse is caring for an obese patient who takes orlistat. The nurse should monitor the patient for which adverse effect? A. Insomnia B. Dizziness C. Fecal incontinence D. Abnormal heart rate
C. Fecal incontinence
The nurse identifies that a patient with android obesity is at risk for what disease? A. Reproductive disease B. Genitourinary disease C. Heart disease D. Respiratory disease
C. Heart disease
After reviewing the laboratory reports of an obese patient, the nurse determines that the patient has nonalcoholic steatohepatitis (NASH). Which condition does the nurse associate with this finding? A. Hyperkalemia B. Hyperuricemia C. Hyperglycemia D. Hyperinsulinemia
C. Hyperglycemia
The nurse calculates a patient's body mass index (BMI) to be 27 kg/m 2. This BMI would fall under which classification? A. Underweight B. Normal body weight C. Overweight D. Obese
C. Overweight
The nurse calculates a patient's body mass index (BMI) to be 27 kg/m2. This BMI would fall under which classification? A. Underweight B. Normal body weight C. Overweight D. Obese
C. Overweight
The primary health care provider prescribes short term weight-loss management for an obese patient with a seizure disorder. The nurse recognizes that which medication will be most effective for the patient? A. Orlistat B. Lorcaserin C. Phentermine/topiramate D. Benzphetamine
C. Phentermine/topiramate
Which type of bariatric surgery is shown in the figure? A. Biliopancreatic diversion B. Adjustable gastric banding C. Sleeve gastrectomy D. Vertical banded gastroplasty
C. Sleeve gastrectomy
An overweight patient states a willingness to lose weight. When developing an effective weight reduction plan, what factors should the nurse assess first? A. The length of time the patient has been obese B. The patient's current level of physical activity C. The patient's psychosocial and environmental influences on obesity D. Anthropometric measurements, such as body mass index (BMI) and skinfold thickness
C. The patient's psychosocial and environmental influences on obesity
The nurse provides discharge education to a patient who has undergone bariatric surgery. Why does the nurse instruct the patient to restrict foods that are high in carbohydrates? A. To reduce the risk of hernia B. To reduce the risk of venous stasis C. To reduce the risk of dumping syndrome D. To reduce the risk of small bowel obstruction
C. To reduce the risk of dumping syndrome
The nurse provides teaching to a severely obese patient who is scheduled for a Roux-en-Y gastric bypass (RYGB) procedure. Which statement made by the patient indicates effective learning? A. "This surgery will preserve the function of my stomach." B. "This surgery will remove the fat cells from my abdomen." C. "This surgery can be modified whenever I need it to be changed." D. "This surgery decreases how much I can eat and how many calories I can absorb."
D. "This surgery decreases how much I can eat and how many calories I can absorb."
What diet should the nurse provide to a patient during the immediate postoperative period after bariatric surgery? A. 20 mL of whole milk B. Porridge with water C. Protein-rich milk shake D. 30 mL water and sugar-free liquid
D. 30 mL water and sugar-free liquid
The nurse recognizes that which finding indicates that a patient has gynoid obesity? A. Apple-shaped body B. Waist-to-hip ratio of 0.7 C. Waist circumference of 32 inches D. Deposition of fat in the upper legs
D. Deposition of fat in the upper legs
The nurse is educating a patient about preparing for bariatric surgery. Which adherence goal is important for the patient to meet prior to surgical intervention? A. Walking 1 mile daily B. Weight reduction of 20% C. Consistent intake of carbohydrates D. Eating according to prescribed reducing diet
D. Eating according to prescribed reducing diet
Which patient has the highest morbidity risk? A. Male: height 73 inches; body mass index (BMI) 29 kg/m 2 B. Female: height 66 inches; weight 150 lbs. C. Male: waist circumference 46 in. D. Female: 70 inches; obesity class III
D. Female: 70 inches; obesity class III
The nurse reviews the laboratory reports of an obese patient who is diagnosed with gout. Which finding does the nurse associate with the patient's condition? A. Hypovolemia B. Hyperkalemia C. Hyponatremia D. Hyperuricemia
D. Hyperuricemia
The nurse is prescribing a diet to promote weight loss to an obese patient. Which information should be included? A. Use whole milk, which has more vitamin D. B. Avoid steamed foods, which removes much of the nutrients. C. Reduce fiber intake, which can cause digestion complications. D. Include fruits and vegetables in each meal.
D. Include fruits and vegetables in each meal.
The nurse recalls that lorcaserin reduces the risk of obesity through what mechanism? A. It activates insulin receptors. B. It blocks the breakdown of fat cells. C. It increases the availability of norepinephrine. D. It activates serotonin receptors to suppress the appetite.
D. It activates serotonin receptors to suppress the appetite.
An overweight patient tells the nurse, "I had a friend who lost a lot of weight on a lowcarbohydrate diet. I would like to try that." The nurse should respond to the patient with what factor in mind? A. Low-carbohydrate diets are safe and easy to follow. B. Low-carbohydrate diets produce long-lasting weight loss. C. Low-fat diets provide more chance of success than low-carbohydrate diets. D. Low-carbohydrate diets reduce the opportunity to get adequate amounts of fiber, vitamins, and minerals.
D. Low-carbohydrate diets reduce the opportunity to get adequate amounts of fiber, vitamins, and minerals.
The nurse is providing postoperative care for a bariatric surgery patient who experiences difficulty breathing and abdominal pressure. What action should the nurse take? A. Perform the jaw-thrust maneuver B. Assist the patient to walk a short distance C. Administer a low dose of heparin to the patient D. Place the patient's head at a 35- to 40- degree angle
D. Place the patient's head at a 35- to 40- degree angle
During the physical examination of a patient, the nurse records the patient's height as 1.72 m and weight as 108 kg. What does the patient's body mass index (BMI) indicate? A. The patient is underweight. B. The patient is at a normal weight. C. The patient falls into class I obesity. D. The patient falls into class II obesity.
D. The patient falls into class II obesity.
While performing a nutritional assessment on a 25-year-old patient, the nurse finds that the patient's height is 1.71 m and weight is 68 kg. What should the nurse interpret from these findings based on the patient's body mass to height index? A. The patient is obese. B. The patient is overweight. C. The patient is underweight. D. The patient has a normal weight.
D. The patient has a normal weight.
The nurse reviews the medical records of four patients and identifies that which patient is a good candidate for liposuction? A. The patient is 75 years old and experiences altered body image concerns. B. The patient has excessive fat around the ankles. C. The patient is obese and desires weight reduction. D. The patient has achieved weight reduction but has excessive fat under the chin.
D. The patient has achieved weight reduction but has excessive fat under the chin.
The nurse assesses a patient with Alzheimer's disease and determines that the patient's body mass index (BMI) is 28.8 kg/m 2. The nurse concludes that the patient most likely has what type of obesity? A. The patient has gynoid obesity. B. The patient has primary obesity. C. The patient has android obesity. D. The patient has secondary obesity.
D. The patient has secondary obesity.
A patient tells the nurse, "I often feel fatigued. I think it's related to my obesity." What action should the nurse take? A. Identify a medical professional who specializes in treating fatigue. B. Help the patient obtain reimbursement for a weight management program. C. Explain that a loss of 3-5% of weight will produce multiple health benefits. D. Use motivational interviewing principles to explore the patient's desires.
D. Use motivational interviewing principles to explore the patient's desires.