Obesity Prepu
Capillary blood glucose
A client who is recovering from bariatric surgery reports a rapid onset of nausea, bloating, and cramping after eating a meal. The nurse's assessment reveals diaphoresis and a heart rate of 98 beats per minute. What assessment should the nurse prioritize once the client's immediate symptoms resolve? · Bowel auscultation · Respiratory rate and oxygen saturation · Capillary blood glucose · Electrolytes
Biliopancreatic diversion with duodenal switch
A client with a body mass index of 44.5 kg/m2 has been referred to the bariatric clinic. Initial assessment reveals that the client is a suitable candidate for bariatric surgery. What type of surgery is most likely to meet this client's needs?
Nausea
A client with obesity is prescribed liraglutide for weight loss. Which common side effect will the nurse include in the client teaching? · Flatus · Bradycardia · Oily stools · Nausea
These are less likely to cause dumping syndrome.
A nurse cares for a client who is post op bariatric surgery and the nurse offers the client a sugar-free beverage. What is the primary purpose of offering a sugar-free beverage? · These are less likely to cause dumping syndrome. · These ease nausea. · These are less likely to raise the blood sugar. · These ease gastric distention.
Acute pain related to surgical procedure
A nurse plans care for a client who is post op bariatric surgery. Which nursing diagnosis will be the priority?
· Effects of analgesics and anesthesia
Which of the following factors may contribute to rapid and shallow respirations in a postoperative client? Select all that apply. · Effects of analgesics and anesthesia · Obesity · Constricting dressings · Pain · Abdominal distention
· Epilepsy · History of bulimia · History of alcohol abuse · Uncontrolled hypertension
A nurse cares for an obese client who wants more information about naltrexone/bupropion to help with weight loss. Which medical conditions does the nurse recognize as contraindications to this medication? Select all that apply. · Epilepsy · History of bulimia · History of alcohol abuse · Uncontrolled hypertension · Asthma
Rapid gastric dumping
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 · Decreased motility · Excessive fat intake · Decreased gastric size
Notify the health care provider.
A client with obesity taking lorcaserin reports feeling agitated lately and has had diarrhea for several days. What is the nurse's priority response? · Obtain a stool sample. · Assess the frequency of bowel movements. · Notify the health care provider. · Prepare for intravenous fluid replacement.
Class I obesity
A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI? · Overweight · Normal weight · Class II obesity · Class I obesity
35 kg/m2
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? · 40 kg/m2 · 34 kg/m2 · 35 kg/m2 · 29 kg/m2
Wound dehiscence
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for? · Hypotension · Contractures · Phlebitis · Wound dehiscence
All options are correct.
An older client underwent a lumpectomy for a breast lesion that was determined to be malignant. Which factors in the client's history may have increased the risk of breast cancer? · increased age · All options are correct. · obesity · not giving birth
Impaired skin integrity Impaired gas exchange
The nurse is admitting a client with traumatic injuries who also has class III obesity. When planning this client's care, the nurse should address the client's heightened risk of what nursing diagnoses related to obesity? Select all that apply. Unilateral neglect Impaired skin integrity Bowel incontinence Deficient fluid volume Impaired gas exchange
"You will be injecting the medication on a daily basis."
The nurse is providing medication administration teaching for a client with obesity who is prescribed liraglutide for weight loss. What will the nurse include in the teaching? · "You will be taking the medication for a short-term only." · "You will be taking the medication with meals." · "You will be injecting the medication on a daily basis." · "You will be taking the medication with another medication."
A BMI >40 kg/m2
What statement best describes a client with severe or extreme obesity? · A BMI >40 kg/m2 · Waist-to-hip ratio <33 inches in males · A BMI >35 kg/m2 · Waist-to-hip ratio <30 inches in females
· Lean skeletal mass decreases as an individual ages. · Adipose tissue increases as an individual ages. · Metabolism decreases as an individual ages.
A nurse cares for older adult clients with obesity and understands that older adults have greater risk for developing obesity than the general population. What pathophysiological concepts contribute to this? Select all that apply. · Lean skeletal mass decreases as an individual ages. · Adipose tissue increases as an individual ages. · Glucose metabolism is impaired as an individual ages. · Metabolism decreases as an individual ages. · Carbohydrate metabolism is impaired as an individual ages.
Risk for impaired gas exchange
A nurse is caring for a client who is post operative bariatric surgery. The client's pain has not been well controlled. Which nursing diagnosis is the nurse's priority? · Impaired tissue integrity · Impaired mobility · Risk for impaired gas exchange · Activity intolerance
Biliopancreatic diversion with duodenal switch
A client with a body mass index of 44.5 kg/m2 has been referred to the bariatric clinic. Initial assessment reveals that the client is a suitable candidate for bariatric surgery. What type of surgery is most likely to meet this client's needs? · Roux-en-Y gastric bypass (RYGB) · Gastric banding · Sleeve gastrectomy · Biliopancreatic diversion with duodenal switch
Biliopancreatic diversion with duodenal switch
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? · Gastric banding · Biliopancreatic diversion with duodenal switch · Roux-en-Y · Sleeve gastrectomy
· Prioritize foods that are dense in nutrients .Eat several small meals daily rather than three large meals · Use contraceptives for at least the next year and a half
The nurse is providing discharge education to a 30-year-old woman who has undergone a biliopancreatic diversion with duodenal switch. What guidelines should the nurse provide to the client? Select all that apply. · Sit fully upright during meals and for at least 30 minutes thereafter · Prioritize foods that are dense in nutrients · Drink at least 250 mL (8 oz) of unsweetened beverages during meals · Eat several small meals daily rather than three large meals · Use contraceptives for at least the next year and a half
Compromised peripheral blood flow
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 · Impaired clotting · Increased blood viscosity · Increased fat accumulation in the blood
Addressing obesity
The nurse provides care to a menopausal client, who states, "I read a news article that says I am at risk for coronary vascular disease due to inflammation." Which method should the nurse suggest to the client to aid in the prevention of inflammation that can lead to atherosclerosis? · Addressing obesity · Taking a daily multivitamin · Avoiding use of caffeine · Drinking at least 2 liters of water a day
Poor dietary choices
A client who is post op bariatric surgery reports diarrhea. What is the most likely cause of the client's symptoms? · Decreased intrinsic factor · Medication side effects · Poor dietary choices · Immobility
"Individuals with obesity are twice as likely to develop Alzheimer disease than those who do not have obesity."
A nurse is teaching a group of adults on the risks of obesity on neurological health. What statement will the nurse include in the teaching regarding obesity and the risk for developing Alzheimer disease? · "Individuals with obesity are four times more likely to develop Alzheimer disease than those who do not have obesity." · "Individuals with obesity have the same risk for developing Alzheimer disease than those who do not have obesity." · "Individuals with obesity are twice as likely to develop Alzheimer disease than those who do not have obesity." · "Individuals with obesity have a decreased risk of developing Alzheimer disease than those who do not have obesity."
Both undernutrition and obesity
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 low metabolism and high metabolism · Both undernutrition and obesity · Both obesity and scare food sources · Both undernutrition and sedentary lifestyles
includes an incremental goal of 1-2 pound weight loss this week
The nurse establishes a learning contract with an overweight client. The contract is best if it · is an oral contract between the nurse and the client · has an overall goal of 30-pound weight loss in six months · contains an agreement to ingest a well-balanced diet · includes an incremental goal of 1-2 pound weight loss this week
Disruption at the site of anastomosis.
A nurse cares for a client with sepsis who had bariatric surgery two weeks ago. What is the most likely source of the sepsis?
"Avoid taking non-steroidal anti-inflammatory drugs."
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 antacid drugs." · "Sit in a semi-recumbent position while eating." · "Avoid taking non-steroidal anti-inflammatory drugs." · "Keep the head of your bed propped on blocks at night."
"I need to drink 8 oz of water before eating."
After teaching a client who has had a Roux-en-Y gastric bypass, which client statement indicates the need for additional teaching? · "I should pick cereals with less than 2 g of fiber per serving." · "I need to chew my food slowly and thoroughly." · "A total serving should amount to be less than 1 cup." · "I need to drink 8 oz of water before eating."
· Family history · Obesity · Hypertension · Age greater of 45 years or older · History of gestational diabetes
Which of the following is a risk factor for the development of diabetes mellitus? Select all that apply. · Family history · Obesity · Hypertension · Age greater of 45 years or older · History of gestational diabetes
Osteoarthritis
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has? · Necrotizing arthritis · Osteoarthritis · Inflammatory arthritis · Rheumatoid arthritis
Stimulate GI peristalsis
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose? · Assess for intact swallowing · Assess for gastric perforation · Stimulate digestive hormones · Stimulate GI peristalsis
35 kg/m2
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 · 29 kg/m2 · 34 kg/m2 · 40 kg/m2
Encourage the client to eat slowly and chew food thoroughly
A client has recovered well from bariatric surgery 3 weeks ago, but during the nurse's most recent assessment, the client states, "I'm having some trouble swallowing my food, and that was never an issue before." What is the nurse's best initial action? · Assess the client for signs and symptoms of dumping syndrome · Teach the client about the need to avoid raw fruits and vegetables as well as complex carbohydrates · Arrange for the client to receive a soft or pureed diet · Encourage the client to eat slowly and chew food thoroughly
"You have succeeded in making positive progress."
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 need to work harder to achieve your goal." · "You have succeeded in making positive progress." · "You are not achieving satisfactory weight loss." · "We will have to re-evaluate your goal."
acute cholecystitis
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: · pancreatitis · hepatitis B · hepatitis A · acute cholecystitis
Renal cancer
A nurse caring for a client with obesity recognizes the client is at risk for renal complications related to obesity. Which disease or condition is associated with obesity? · Rhabdomyolysis · Glomerulonephritis · Renal cancer · Nephrolithiasis
· It impairs normal body function · It has characteristic signs and symptoms · It causes morbidity
A nurse works in a community clinic that treats clients with obesity. The nurse understands that obesity is considered a disease based on what characteristics? Select all that apply. · It impacts both genders equally · It impairs normal body function · It has characteristic signs and symptoms · It causes morbidity · It is common among a population
transesophageal echocardiography
An obese client describes symptoms of palpitations, chronic fatigue, and dyspnea on exertion to the cardiologist. Upon completing the examination, the cardiologist schedules a procedure to confirm the suspected diagnosis. What diagnostic procedure would the nurse expect to be prescribed? · electrocardiography · transesophageal echocardiography · radionuclide angiography · chest radiograph
· "Nausea and vomiting are the most commonly reported side effects." · "The balloon will remain in place for 3 to 6 months."
A client with obesity will undergo intragastric balloon therapy for weight loss. What teaching will the nurse include when educating the client about this procedure? Select all that apply. · "The balloon via a minimally-invasive surgery." · "This procedure has shown greater weight loss results when compared to bariatric surgery." · "Nausea and vomiting are the most commonly reported side effects." · "The balloon will remain in place for 3 to 6 months." · "This procedure works by causing malabsorption of fat."
· Modified RYGB · Gastric band · RYGB
The nurse cares for a client who is post op bariatric surgery and reports dysphagia. Which procedures are most likely to cause these symptoms? Select all that apply. · Modified RYGB · Gastric band · Sleeve gastrectomy · Biliopancreatic diversion · RYGB
· "You need to drink plenty of water in between meals." · "Eat slowly." · "You will have six small meals per day."
The nurse cares for a client who is post op bariatric surgery whose bowel sounds have returned and is tolerating oral intake. What teaching will the nurse provide the client about the nutrition required at this time? Select all that apply. · "You need to drink plenty of water in between meals." · "You will have three meals per day consisting of 500 calories each." · "Eat slowly." · "You will have six small meals per day." · "Stop eating prior to feeling full."
· Breast · Cervical · Colorectal
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 · Brain · Cervical · Colorectal · Skin
Assist the client with ambulating as early and often as possible
The nurse is providing care for a client who had a biliopancreatic diversion with duodenal switch 2 days ago. How should the nurse best address the client's risk for postoperative venous thromboembolism? · Assist the client with performing deep breathing and coughing exercises · Assist the client with ambulating as early and often as possible · Administer coumadin PO as prescribed · Reposition the client at least every 2 hours while in bed
Administer proton pump inhibitors as prescribed
The postoperative nurse is attending beginning-of-shift report and learns that a client who is recovering from bariatric surgery has been experiencing bile reflux. What is the nurse's most appropriate action? · Prepare the client for an emergency cholecystectomy · Administer calcium chloride and pancreatic enzymes as prescribed · Administer proton pump inhibitors as prescribed · Encourage the client to eat smaller amounts and to eat more slowly
Increased adipose stores
What pathophysiological concept is related to the increase in the hormone leptin, as it relates to satiety and hunger? · Alterations in metabolism · Decreased carbohydrate intake · Increased caloric intake Increased adipose stores
Renal insufficiency
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? Diabetes mellitus Renal insufficiency Chronic obstructive pulmonary disease Anemia
Coronary artery disease
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:
Bupropion
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? · Doxepin · Amitriptyline · Nortriptyline · Bupropion
It has over 100 times more genes than the human genome.
A nurse geneticist is researching the gut microbiome and its relationship to disease. What is true regarding the microbiome? · Its function has yet to be discovered. · It has over 10 times more genes than the human genome. · It has over 100 times more genes than the human genome. · It is less diverse than human genome.
Restricts the client's ability to eat.
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? · Impairs gastric motility. · Impairs caloric absorption. · Restricts the client's ability to digest fat. · Restricts the client's ability to eat.
· Obstructive sleep apnea · Infection · Asthma
The nurse is teaching a group of clients with obesity about the risks of disease associated with obesity. Which respiratory conditions or diseases will the nurse include in the teaching, which are associated with obesity? Select all that apply. · Obstructive sleep apnea · Infection · Central sleep apnea · Asthma · Emphysema
500-1,000 calories
When discussing lifestyle modifications with a client who has obesity, what caloric deficit should the nurse recommend in order for the client to safely lose weight? · 250-400 calories · 500-1,000 calories · 300-600 calories · 1,000-1,500 calories
· Leptin signals satiety in the hypothalamus. · Drops in leptin level increases hunger.
A nurse researcher investigates why clients with obesity who have lost weight often regain the weight. The nurse looks at the relationship of leptin and its role in weight gain. What does the nurse determine is true regarding leptin and weight gain? Select all that apply. · Leptin signals satiety in the hypothalamus. · Leptin increases blood glucose in the pancreas. · Drops in leptin level increases hunger. · Leptin signals hyperglycemia in the liver. · Drops in leptin level increases insulin resistance.
Cushing's disease
A nurse cares for a client who has secondary obesity. Which condition is the most likely to result in secondary obesity? · Addison's disease · Grave's disease · Cushing's disease · Crohn's disease
Colorectal cancer
A nurse cares for a client with a BMI of 40 kg/m2. Which gastrointestinal condition or disease does the nurse recognize is associated with the client's BMI? · Ulcerative colitis · Bowel obstruction · Crohn's disease · Colorectal cancer
"Do not drink alcohol while taking this medication."
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 drive while taking this medication." · "Take the medication with a full glass of water." · "Take the medication at night before bedtime." · "Do not drink alcohol while taking this medication."
· Fat-free milk · Gelatin · Pudding
A nurse teaches a client homecare nutrition expectations who will undergo bariatric surgery. Which foods will the nurse suggest the client keep on hand at home after surgery? Select all that apply. · Fat-free milk · Yogurt · Gelatin · Creamy soups · Pudding
· Specific gut microbes have been linked to a leaner body shape. · Individuals with obesity have less diverse gut microbes than those of normal weight.
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 a decreased amount of microbes than those of normal weight. · Individuals with obesity have dysfunctional gut microbes. · Specific gut microbes have been linked to a leaner body shape. · Individuals with obesity have less diverse gut microbes than those of normal weight. · Specific gut microbes have been linked to a larger body shape.
· Client with type 2 diabetes · Client taking medication for migraines · Client taking medication for depression
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 with asthma · Client taking medication for migraines · Client taking medication for depression · Client taking medication for cholesterol
Liraglutide
A nurse cares for a client with obesity who has type 2 diabetes. Which medication does the nurse recognize may assist in weight loss and is also approved to treat type 2 diabetes? · Lorcaserin · Liraglutide · Orlistat · Benzphetamine
· Carbamazepine · Gabapentin
A nurse cares for a client with obesity who takes anticonvulsant medication for the treatment of epilepsy. Which anticonvulsant medications may be contributing to the client's obesity? Select all that apply. · Carbamazepine · Zonisamide · Gabapentin · Lamotrigine · Topiramate
· Adults with greater body mass · Older adults · Males
A nurse cares for clients with obesity who undergo bariatric surgery. Which clients will the nurse identify as having increased risk of infection after surgery? Select all that apply. · Adults with greater body mass · Older adults · Males · Adolescents · Females
· History of a VTE · Age · Higher BMI
A nurse cares for a client who is post op from bariatric surgery. What risk factors does the nurse recognize increases the client's risk for developing venous thromboembolism (VTE)? Select all that apply. · History of a VTE · Gender · Age · Ethnicity · Higher BMI
How to empty the drain Recording drainage amount When to contact the health care provider How to measure the drainage amount
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 change the drain How to empty the drain Recording drainage amount When to contact the health care provider How to measure the drainage amount
"This is an expected finding with this medication.
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response? · "How much water are drinking?" · "Your dose may need to be adjusted." · "Taking this medication with meals decreases this symptom." · "This is an expected finding with this medication."
· Overcooked meats · Doughy breads · Rice · Pasta
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. · Overcooked meats · Doughy breads · Rice · Pasta · Mashed potatoes
Administer proton pump inhibitors as prescribed
The postoperative nurse is attending beginning-of-shift report and learns that a client who is recovering from bariatric surgery has been experiencing bile reflux. What is the nurse's most appropriate action? · Encourage the client to eat smaller amounts and to eat more slowly · Administer calcium chloride and pancreatic enzymes as prescribed · Administer proton pump inhibitors as prescribed · Prepare the client for an emergency cholecystectomy
· Abdomen · Upper thigh Lower thigh · Upper arm
The nurse is teaching injection techniques for a client prescribed liraglutide for the treatment of obesity. Which areas of the body will the nurse suggest for injection sites? Select all that apply. · Abdomen · Upper thigh · Buttocks · Lower thigh · Upper arm
Phentermine
A nurse cares for an older adult client with obesity who also has glaucoma. Which obesity medication is contraindicated in this client?
"Avoid driving heavy equipment."
A nurse provides medication teaching for a client with obesity who is prescribed Lorcaserin. Which statement will the nurse include in the teaching? · "Do not take with calcium products like milk." · "Avoid driving heavy equipment." · "Wash your hands after touching the medication." · "Wear sunblock if you are outside for any length of time."
· Myocardial infarction · Coronary artery disease · Heart failure · Hypertension
A nurse working in a cardiac health care office notes increased risk of certain cardiac conditions as a result of obesity. Which conditions can be associated with obesity? Select all that apply. · Heart murmur · Myocardial infarction · Coronary artery disease · Heart failure · Hypertension
A metabolic imbalance
At its most fundamental level, what does obesity result from? · A genetic alteration · A metabolic imbalance · A hormone imbalance · A lifestyle imbalance
· "This diet decreases the diversity of gut microbes." · "This diet decreases the gut microbes that lead to a leaner body."
A community health nurse prepares teaching regarding gut health and the impact on obesity. What will the nurse include on how the "Western diet" impacts gut health? Select all that apply. · "This diet decreases the diversity of gut microbes." · "This diet mutates the shape of the gut microbes." · "This diet decreases the gut microbes that lead to a leaner body." · "This diet increases the number of gut microbes." · "This diet alters the mechanism of the gut microbes."
· Anxiety · Stroke · Depression · Alzheimer disease
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. · Anxiety · Stroke · Schizophrenia · Depression · Alzheimer disease
· "It is a pacemaker-type device that is implanted under your skin." · "Recharge the device two times per week." · "A pre-programed pulsating signal is delivered."
A nurse cares for a client with obesity who is scheduled to undergo vagal blocking therapy. When teaching the client about the procedure or device, which statements will the nurse include? Select all that apply. · "It is a stent-like device that is inserted into your vein." · "It is a pacemaker-type device that is implanted under your skin." · "Recharge the device two times per week." · "A pre-programed pulsating signal is delivered." · "A liquid medication is slowly delivered."
Educate the client about the need to temporarily limit dietary fiber intake
A client underwent bariatric surgery 2 weeks ago and has been meeting goals for recovery. However, during the nurse's most recent assessment the client reports bowel movements every 2 to 3 days and a sensation of constipation. What is the nurse's best action? · Assess the client's adherence to the prescribed nutrition plan · Encourage the client to eat four to five small meals daily rather than three large meals · Report the assessment findings to the primary provider promptly · Educate the client about the need to temporarily limit dietary fiber intake
People with disabilities have an increased incidence of obesity.
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? People with disabilities have an increased incidence of obesity. Weight is more difficult to control if a client is wheelchair-bound. Wheelchairs make clients very self-conscious about their weight. A wheelchair-bound client is usually depressed about his or her weight.
"It causes delayed gastric emptying."
A nurse reviews with the client the various types of medications used to treat diabetes. Which statement will the nurse use when teaching the client about liraglutide's mechanism of action? · "It diminishes intestinal absorption and metabolism of fats." · "It stimulates central noradrenergic receptors." · "It stimulates central 5-HT2C receptors." · "It causes delayed gastric emptying."
· Sleeve gastrectomy · Gastric banding
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. · RYGB · Total gastrectomy · Biliopancreatic diversion with duodenal switch · Sleeve gastrectomy · Gastric banding
· 48-year-old female with BMI 36 k/m2 and uncontrolled type 2 diabetes. · 34-year-old male with BMI 30 k/m2 and metabolic syndrome with hypertension.
A nurse working in a bariatric clinic assesses various clients with obesity. Which clients will the nurse recognize as meeting the selection criteria for bariatric surgery? Select all that apply. · 55-year-old female with BMI 29 k/m2 and medicated type 2 diabetes. · 52-year-old male with BMI of 40 kg/m2 and unmedicated schizophrenia. · 45-year-old female with BMI of 41 kg/m2 and Cushing's disease due to a pituitary tumor. · 48-year-old female with BMI 36 k/m2 and uncontrolled type 2 diabetes. · 34-year-old male with BMI 30 k/m2 and metabolic syndrome with hypertension.
It signals higher neural pathways that lead to eating behaviors.
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? · It signals higher neural pathways that lead to eating behaviors. · It signals the release of neuropeptide y, which leads to feelings of satiety. · It signals the release of ghrelin, which increases feelings of hunger. · It signals the GI system to slow gastric motility.
"Yes, your BMI and chronic condition meets the criteria for bariatric surgery."
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." · "Yes, your chronic condition meets the criteria for bariatric surgery but not your BMI." · "No, you do not have any qualifying criteria for bariatric surgery." · "No, you have one qualifying condition but not the other; this excludes you from bariatric surgery."
· Individuals with larger waist-to-hip ratios have android obesity. · Individuals with larger waist-to-hip ratios are also referred to as apple-shaped. · Individuals with larger waist-to-hip ratios have larger visceral fat stores.
A nurse cares for clients with obesity and recognizes that clients with larger waist-to-hip ratios are at greater risk for obesity-related morbidity in comparison to others with smaller waist-to-hip ratios. What findings related to this does the nurse recognize as true? Select all that apply. · Individuals with larger waist-to-hip ratios have android obesity. · Individuals with larger waist-to-hip ratios are also referred to as apple-shaped. · Individuals with larger waist-to-hip ratios have larger visceral fat stores. · Individuals with larger waist-to-hip ratios are also referred to as pear-shaped. · Individuals with larger waist-to-hip ratios have gynoid obesity.
· Cholecystokinin · Insulin · Somatostatin
Which hormones released throughout the gastrointestinal tract promote satiety? Select all that apply. · Cholecystokinin · Insulin · Somatostatin · Ghrelin · Neuropeptide y
Phentermine
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? · Lorcaserin · Liraglutide · Phentermine · Orlistat
Gastric banding Sleeve gastrectomy
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 RYGB Biliopancreatic diversion with duodenal switch Total gastrectomy
Give the client six small meals a day and encourage fluid intake, as tolerated
A client is postoperative day 2 after bariatric surgery. The nurse's most recent gastrointestinal assessment indicates the return of bowel sounds. How should the nurse best promote the client's nutritional status? · Provide the client with a small snack and then increase the quantity of food by 10% per meal until normal intake is resumed · Provide soft, calorie-dense foods for the next 24 hours and reassess · Give the client six small meals a day and encourage fluid intake, as tolerated · Resume providing three nutritious meals a day and emphasize the need for the client to report
"Increase your intake of plant-based proteins."
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 monounsaturated fats." · "Increase your intake of plant-based proteins." · "Increase your intake of fluids at meals." · "Increase your intake of complex carbohydrates."
· "Avoid eating tough foods." · "Avoid eating overcooked meats." · "Eat slowly." · "Chew your food thoroughly."
A nurse is educating a client who will undergo bariatric surgery on methods to prevent dysphagia. What teaching will the nurse include? Select all that apply. · "Eat bland foods such as doughy bread." · "Avoid eating tough foods." · "Avoid eating overcooked meats." · "Eat slowly." · "Chew your food thoroughly."
· Both restrictive and malabsorptive · Malabsorptive · Restrictive
A nurse working with clients undergoing bariatric surgery understands that there are various types of bariatric procedures. Which statements represent the types of bariatric procedures? Select all that apply. · Both restrictive and malabsorptive · Malabsorptive · Unobstructive · Restrictive · Obstructive
Disruption at the site of anastomosis.
A nurse cares for a client with sepsis who had bariatric surgery two weeks ago. What is the most likely source of the sepsis? · Bacterial infiltration at the surgical site of the skin. · Colonization of bacteria in the bladder. · Disruption at the site of anastomosis. · Perforation of the gastric contents.
· Client will have decreased anxiety about the procedure. · Client will understand preoperative and postoperative dietary restrictions. · Client will become knowledgeable about the procedure.
A nurse is planning care for a client who will undergo bariatric surgery in a week. What goals are acceptable during this point in the client's care? Select all that apply. · Client will have decreased anxiety about the procedure. · Client will understand how to maintain normal bowel function. · Client will understand preoperative and postoperative dietary restrictions. · Client will become knowledgeable about vitamin requirements. · Client will become knowledgeable about the procedure.
· Symptoms are usually relieved after pharmacological treatment. · Usually occurs after disruption of the pylorus.
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. · Symptoms are usually relieved after pharmacological treatment. · Symptoms are usually relieved after vomiting. · Usually occurs after disruption of the pylorus. · Usually occurs after alteration of pancreatic enzymes. · Symptoms are usually relieved after eating.
"The stomach is stapled to a very small pouch and the entire small intestine is rerouted.
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." · "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." · "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." · "The stomach is stapled to a very small pouch and the entire small intestine is rerouted.
· 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 examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply. · Income is not related to the prevalence of disease. · Those with less education are impacted at a greater prevalence of disease. · Education is not related to the prevalence of disease. · Those who own their own homes have a decreased prevalence of disease. · Those with less income are impacted at a greater prevalence of disease.
· Increased adipose tissue causes thinning of the skin and risk for decreased integrity. · Skin folds are associated with more moisture and friction.
A nurse caring for clients with obesity understands these clients are at increased risk for developing pressure ulcers. What does the nurse recognize increases the client's risk for developing pressure ulcers? Select all that apply. · Increased adipose tissue causes thinning of the skin and risk for decreased integrity. · Skin folds are associated with more moisture and friction. · Inflammation is worse and leads to risk of infection. · Normal healing mechanisms are impaired. · Increased adipose tissue decreases the supply of blood, oxygen, and nutrients to peripheral tissue.
Mechanical compression and prophylactic anticoagulation
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? · Prophylactic anticoagulation only · Mechanical compression only · Early ambulation only · Mechanical compression and prophylactic anticoagulation
Hypertonic food releases metabolic peptides.
A client who is post op from bariatric surgery experiences dumping syndrome. What is the nurse's understanding of the cause of this condition?
Insufficient water intake
A client who is post op from bariatric surgery reports constipation. What is the most likely cause of the client's symptoms?
Diuretic medications
A client who is post op from bariatric surgery reports constipation. What is the most likely cause of the client's symptoms? · Diuretic medications · Gastric dysfunction · Insufficient water intake · Impaired gastric motility
"Choose a cereal with less than 2 grams of fiber per serving."
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?
Document the finding.
A nurse cares for a client with obesity who is taking phentermine/topiramate ER and reports tingling around the mouth and fingertips. What is the priority nursing action? · Immediately notify the health care provider. · Obtain the client's vital signs. · Review the client's laboratory results. · Document the finding.
Phentermine
A nurse cares for a client with obesity who reports taking "a medication of weight loss" but cannot remember the name of it. The client also reports nervousness and feeling "jittery". Which medication is the client most likely taking? · Lorcaserin · Naltrexone/bupropion · Orlistat · Phentermine
· Dizziness · Tachycardia · Sweating
A client is diagnosed with dumping syndrome after bariatric surgery. Which findings on the nursing assessment correlate with this diagnosis? Select all that apply. · Fever · Hypertension · Dizziness · Tachycardia · Sweating
Gabapentin
A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity? · Topiramate · Metformin · Gabapentin · Bupropion
High intensity
A health care provider recommends behavior interventions for a client with obesity. What does the nurse understand is most effective behavioral intervention for clients with obesity? · Low effort · High intensity · Motivation-focused · Education-focused
Weight reduction through diet and exercise
A client with newly diagnosed type 2 diabetes is admitted to the metabolic unit. The primary goal for this admission is education. Which goal should the nurse incorporate into her teaching plan? · An eye examination every 2 years until age 50 · Maintenance of blood glucose levels between 180 and 200 mg/dl · Smoking reduction but not complete cessation · Weight reduction through diet and exercise
Serotonin syndrome
A client with obesity has been taking lorcaserin for several months and presents to the health care provider's office reporting fever and diarrhea. Which life-threatening condition does the nurse suspect? · Acute gastritis · Serotonin syndrome · C-difficile infection · Cushing's syndrome
"The fat is passed in your stools."
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 excreted in your urine." · "The fat is absorbed in your intestines." · "The fat remains undigested in your stomach." · "The fat is passed in your stools."
Cyclosporine
A client with obesity reports taking orlistat in order to aid in weight loss. Which medication order for the client will the nurse question? · Lovenox · Cyclosporine · Sertraline · Metformin
"It binds with enzymes to help prevent digestion of fat."
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." · "It works to make you feel full." · "It binds with enzymes to decrease carbohydrate absorption." · "It decreases your appetite."
Low Fowler's
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? · Upright · High Fowler's · Lateral · Low Fowler's
Fear of eating
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? · Absorption of food · Size of the stomach · Taste of food · Fear of eating
"Expect to lose 10-35% of total body weight 2 to 3 years postoperatively."
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 50 pounds in the first month after surgery." · "Expect to lose 10-35% of total body weight 2 to 3 years postoperatively." · "Expect to lose 10-35 pounds in the first month after surgery." · "Expect to lose 45-50% of total body weight 2 to 3 years postoperatively."
Bupropion
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? · Doxepin · Nortriptyline · Bupropion · Amitriptyline
"You should avoid pregnancy for at least 18 months after surgery."
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? · "After surgery, contraceptives have much less efficacy." · "You should avoid pregnancy for at least 9 months after surgery" · "After surgery, your ability to conceive is decreased considerably." · "You should avoid pregnancy for at least 18 months after surgery."
Biliopancreatic diversion with duodenal switch
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?
· Weight · BMI · Waist circumference
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply. · Total cholesterol · Weight · BMI · Waist circumference · Blood pressure
Endoscopy
A nurse caring for a client who is post op bariatric surgery notes that the client has no bowel sounds and suspects the client may have a bowel obstruction. What treatment or therapy does the nurse expect the client will require? · GI-motility agent · Nasogastric tube · Stool softener · Endoscopy
· "It decreases stomach contractions." · "It decreases stomach emptying." · "It decreases absorption of calories." · "It decreases pancreatic enzyme secretion."
A nurse is caring for a client who is considering vagal blocking therapy for the treatment of obesity. The client asks the nurse, "How does this therapy make me lose weight?" What is the nurse's best response? Select all that apply. · "It decreases gastric enzyme secretion." · "It decreases stomach contractions." · "It decreases stomach emptying." · "It decreases absorption of calories." · "It decreases pancreatic enzyme secretion."
23
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? · 28 · 18 · 31 · 23
Risk for infection related to anastomotic leak
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 · Risk for constipation and/or diarrhea related to gastric irritation and surgical changes in anatomic structures from bariatric surgery · Risk for infection related to anastomotic leak · Imbalanced nutrition: less than body requirements related to dietary restrictions
"Older adults have a slightly higher prevalence of obesity in comparison to the general population."
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 greatly reduced prevalence of obesity in comparison to the general population." · "Older adults have the same prevalence of obesity in comparison to the general population." · "Older adults have a slightly higher prevalence of obesity in comparison to the general population." · "Older adults have a slightly reduced prevalence of obesity in comparison to the general population."
Over time, we have become efficient in food storage and deposition of fat stores.
A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity? · Multiple mutations of genes over time have lead to the epidemic. · Over time, we have become efficient in food storage and deposition of fat stores. · Over time, we have become less efficient in hunting and gathering of food. · A single gene mutation is responsible for the epidemic.
"Make sure and take a daily multivitamin."
A nurse reviews a client's medication list and notes the client takes orlistat for the treatment of obesity and to promote weight loss. Which client teaching will the nurse include that best promotes health in the client taking this medication? · "Make sure and drink 8 to 10 glasses of water a day." · "Make sure and vigorously exercise daily." · "Make sure and take a daily multivitamin." · "Make sure to take a daily calcium supplement."
· Behavior · Genetics · Environment · Physiology
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. · Immunology · Behavior · Genetics · Environment · Physiology
The nurse recognizes that the client's obesity may be specifically related to the endocrine disorder. The nurse performs a thorough nutritional assessment.
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. · 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 BMI of 31 indicates obesity, and the nurse instructs the patient to keep a record of food actually consumed over the next 3 to 7 days. · Knowing that the client is obese, the nurse plans to provide dietary education to reduce the daily caloric intake using the U.S. Department of Agriculture's MyPlate pyramid.
Question the order due to the client's recent bariatric surgery
· A client who is recovering from bariatric surgery has not had a bowel movement for 48 hours and bowel sounds are absent on auscultation. The nurse has informed the on-call health care provider who has prescribed insertion of a nasogastric tube to low suction. What is the nurse's best action? · Question the order because decreased bowel motility is expected postoperatively · Question the order due to the client's recent bariatric surgery · Ensure that the NG tube inserted is at least a size 14 French · Insert the NG tube cautiously due to the client's recent GI surgery
