PrepU: Chapter 42
A nurse cares for an obese client taking phentermine for weight loss. What client teaching will the nurse include when discussing precautions about the medication? A) "Do not drink alcohol while taking this medication." B) "Do not drive while taking this medication." C) "Take the medication at night before bedtime." D) "Take the medication with a full glass of water."
A) "Do not drink alcohol while taking this medication."
A nurse cares for a client who is obese. The health care provider prescribes orlistat in an effort to help client lose weight, along with diet and exercise. When teaching the client about this medication, what will the nurse include? A) "It binds with enzymes to help prevent digestion of fat." B) "It decreases your appetite." C) "It works to make you feel full." D) "It binds with enzymes to decrease carbohydrate absorption."
A) "It binds with enzymes to help prevent digestion of fat."
A client with obesity is prescribed orlistat for weight loss. The client asks the nurse, "I understand the medication prevents digestion of fat, but what happens if I eat fat?" What is the nurse's best response? A) "The fat is passed in your stools." B) "The fat is excreted in your urine." C) "The fat is absorbed in your intestines." D) "The fat remains undigested in your stomach."
A) "The fat is passed in your stools."
A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use? A) "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." B) "A prosthetic device binds the stomach and creates a very small pouch and restricts oral intake." C) "85% of the stomach is removed surgically, leaving a much smaller tube-like structure." D) "The stomach is stapled to a very small pouch and the entire small intestine is rerouted.
A) "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted."
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. A) "This diet decreases the diversity of gut microbes." B) "This diet decreases the gut microbes that lead to a leaner body." C) "This diet mutates the shape of the gut microbes." D) "This diet alters the mechanism of the gut microbes." E) "This diet increases the number of gut microbes."
A) "This diet decreases the diversity of gut microbes." B) "This diet decreases the gut microbes that lead to a leaner body."
A client with obesity is prescribed lorcaserin for weight loss. The client reports dry mouth. What is the nurse's best response? A) "This is an expected finding with this medication." B) "How much water are drinking?" C) "Taking this medication with meals decreases this symptom." D) "Your dose may need to be adjusted."
A) "This is an expected finding with this medication."
A nurse cares for a client with a BMI of 36 kg/m2 and nonalcoholic fatty liver disease. The client asks the nurse if he is a candidate for bariatric surgery. How should the nurse respond to the client? A) "Yes, your BMI and chronic condition meets the criteria for bariatric surgery." B) "Yes, your chronic condition meets the criteria for bariatric surgery but not your BMI." C) "No, you do not have any qualifying criteria for bariatric surgery." D) "No, you have one qualifying condition but not the other; this excludes you from bariatric surgery."
A) "Yes, your BMI and chronic condition meets the criteria for bariatric surgery."
A client with newly diagnosed hypertension asks what to do to decrease the risk for related cardiovascular problems. Which risk factor is not modifiable by the client? A) Age B) Obesity C) Inactivity D) Dyslipidemia
A) Age
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? A) All options are correct. B) increased age C) obesity D) not giving birth
A) All options are correct.
A nurse researcher is reviewing data obtained from a developing nation on nutrition and metabolism issues facing that country. What is the nurse's understanding of the "double-burden" many developing nations now face? A) Both undernutrition and obesity B) Both low metabolism and high metabolism C) Both obesity and scare food sources D) Both undernutrition and sedentary lifestyles
A) Both undernutrition and obesity
A nurse cares for a client with obesity who is also diagnosed with depression. Which medication does the nurse expect the health care provider will prescribe, which also aids in weight loss? A) Bupropion B) Amitriptyline C) Nortriptyline D) Doxepin
A) Bupropion
The nurse plans care for a client with obesity. What does the nurse recognize is the primary pathophysiological reason clients with obesity are at greater risk for developing thromboembolism? A) Compromised peripheral blood flow B) Increased blood viscosity C) Impaired clotting D) Increased fat accumulation in the blood
A) Compromised peripheral blood flow
A nurse working with clients with obesity understands that the hypothalamus plays an important role in hunger and satiety. Which statement best describes the role of the hypothalamus in hunger and satiety? A) It signals higher neural pathways that lead to eating behaviors. B) It signals the release of ghrelin, which increases feelings of hunger. C) It signals the release of neuropeptide y, which leads to feelings of satiety. D) It signals the GI system to slow gastric motility.
A) It signals higher neural pathways that lead to eating behaviors.
A nurse is planning care for a client who will be arriving to the unit postoperatively from bariatric surgery. In an effort to decrease the risk of venous thromboembolism (VTE), which health care provider orders does the nurse anticipate? A) Mechanical compression and prophylactic anticoagulation B) Mechanical compression only C) Prophylactic anticoagulation only D) Early ambulation only
A) Mechanical compression and prophylactic anticoagulation
A client with obesity is diagnosed with type 2 diabetes. In order to promote weight loss in the client and aid in glucose management, which medication will the nurse anticipate the health care provider ordering? A) Metformin B) Glipizide C) Glyburide D) Pioglitazone
A) Metformin
A client with obesity reports pain in the joints. Which musculoskeletal condition related to obesity does the nurse suspect the client has? A) Osteoarthritis B) Rheumatoid arthritis C) Inflammatory arthritis D) Necrotizing arthritis
A) Osteoarthritis
A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrifty gene" theory of obesity? A) Over time, we have become efficient in food storage and deposition of fat stores. B) A single gene mutation is responsible for the epidemic. C) Over time, we have become less efficient in hunting and gathering of food. D) Multiple mutations of genes over time have lead to the epidemic.
A) Over time, we have become efficient in food storage and deposition of fat stores.
The nurse is caring for a client who has just received a diagnosis of hypertension. What lifestyle change(s) should the nurse recommend to the client to decrease the consequences of hypertension? Select all that apply. A) Restrict salt/sodium. B) Manage stress effectively. C) Use smokeless tobacco. D) Adhere to an exercise plan. E) Reduce caffeine intake.
A) Restrict salt/sodium. B) Manage stress effectively. D) Adhere to an exercise plan. E) Reduce caffeine intake.
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? A) Serotonin syndrome B) C-difficile infection C) Acute gastritis D) Cushing's syndrome
A) Serotonin syndrome
A nurse cares for a client who is post op from bariatric surgery. Once able, the nurse encourages oral intake for what primary purpose? A) Stimulate GI peristalsis B) Assess for intact swallowing C) Assess for gastric perforation D) Stimulate digestive hormones
A) Stimulate GI peristalsis
A nurse teaches homecare nutrition expectations to a client who will undergo bariatric surgery. Which foods will the nurse suggest the client keep on hand at home after surgery? Select all that apply. A) Sugar-free gelatin B) Sugar-free pudding C) Fat-free milk D) Yogurt E) Ice cream
A) Sugar-free gelatin B) Sugar-free pudding C) Fat-free milk
Understanding the definition of eating disorders is important in communicating facts while managing these conditions. Which is not an eating disorder? A) obesity B) anorexia nervosa C) bulimia nervosa D) binge eating
A) obesity
A nurse is reviewing the medical records of several patients and their risk for health problems. The nurse determines that the patient with which body mass index (BMI) would have the lowest risk? A) 18 B) 23 C) 28 D) 31
B) 23
A nurse cares for a client who is 5 feet 11 inches tall and weighs 225 pounds. What statement describes the client's BMI? A) Overweight B) Class I obesity C) Class II obesity D) Normal weight
B) Class I obesity
The nurse is working with a client who has difficulty controlling blood sugar. The client is classified as overweight. The client does not adhere to a low-calorie diet and forgets to take medications and check blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, what action will the take first? A) Informs the client about what goal the nurse wants the client to achieve B) Collaborates with the client to establish an agreed-upon goal C) Sets the long-term goal as "the client's glycohemoglobin will be 6.9% in 3 months" D) Plans the short-term goal as "the client's blood sugar each AM will be less than 110 mg/dL"
B) Collaborates with the client to establish an agreed-upon goal
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. A) Sit fully upright during meals and for at least 30 minutes thereafter B) Prioritize foods that are dense in nutrients C) Drink at least 250 mL (8 oz) of unsweetened beverages during meals D) Eat several small meals daily rather than three large meals E) Use contraceptives for at least the next year and a half
B) Prioritize foods that are dense in nutrients D) Eat several small meals daily rather than three large meals E) Use contraceptives for at least the next year and a half
A nurse is providing discharge instruction for a client who is postoperative bariatric surgery. What statement will the nurse include when providing teaching aimed at decreasing the risk of gastric ulcers? A) "Sit in a semi-recumbent position while eating." B) "Keep the head of your bed propped on blocks at night." C) "Avoid taking non-steroidal anti-inflammatory drugs." D) "Avoid taking antacid drugs."
C) "Avoid taking non-steroidal anti-inflammatory drugs."
A nurse is caring for a client who has a history of sleep apnea. The client understands the disease process when he says: A) "I need to keep my inhaler at the bedside." B) "I should eat a high-protein diet." C) "I should become involved in a weight loss program." D) "I should sleep on my side all night long."
C) "I should become involved in a weight loss program."
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? A) Avoiding use of caffeine B) Taking a daily multivitamin C) Addressing obesity D) Drinking at least 2 liters of water a day
C) Addressing obesity
A nurse cares for a client with obesity. Which medication that the client takes may be contributing to the client's obesity? A) Topiramate B) Metformin C) Gabapentin D) Bupropion
C) Gabapentin
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? A) Provide soft, calorie-dense foods for the next 24 hours and reassess B) Resume providing three nutritious meals a day and emphasize the need for the client to report GI symptoms C) Give the client six small meals a day and encourage fluid intake, as tolerated D) Provide the client with a small snack and then increase the quantity of food by 10% per meal until normal intake is resumed
C) Give the client six small meals a day and encourage fluid intake, as tolerated
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? A) Orlistat B) Lorcaserin C) Phentermine D) Naltrexone/bupropion
C) Phentermine
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? A) Insert the NG tube cautiously due to the client's recent GI surgery B) Question the order because decreased bowel motility is expected postoperatively C) Question the order due to the client's recent bariatric surgery D) Ensure that the NG tube inserted is at least a size 14 French
C) Question the order due to the client's recent bariatric surgery
A nurse cares for clients with obesity. Which clinical measurements use quantified measurements to diagnose obesity? Select all that apply. A) Blood pressure B) Total cholesterol C) Weight D) BMI E) Waist circumference
C) Weight D) BMI E) Waist circumference
The nurse is preparing to assess a new client who has class III obesity. In order to provide empathic and holistic care for this client, the nurse should first: A) seek advice from a colleague who is known to provide empathic care. B) remind himself or herself that obesity is a treatable health problem. C) examine his or her own preconceptions and beliefs about obesity. D) anticipate having some discomfort or anxiety when assessing the client.
C) examine his or her own preconceptions and beliefs about obesity.
A nurse is caring for a client with obesity and diabetes after abdominal surgery. What is the client at increased risk for? A) Hypotension B) Contractures C) Phlebitis D) Wound dehiscence
D) Wound dehiscence
