Nokea
A 40-year-old obese woman reports that she wants to lose weight. Which question should the nurse ask first?
- A. What factors led to your obesity?
- B. Which types of food do you like best?
- C. How long have you been overweight?
- D. What kind of activities do you enjoy?
Correct Answer: A
Rationale: The nurse should obtain information about the patients perceptions of the reasons for the obesity to develop a plan individualized to the patient. The other information also will be obtained from the patient, but the patient is more likely to make changes when the patients beliefs are considered in planning.
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After bariatric surgery, a patient who is being discharged tells the nurse, I prefer to be independent. I am not interested in any support groups. Which response by the nurse is best?
- A. I hope you change your mind so that I can suggest a group for you.
- B. Tell me what types of resources you think you might use after this surgery.
- C. Support groups have been found to lead to more successful weight loss after surgery.
- D. Because there are many lifestyle changes after surgery, we recommend support groups.
Correct Answer: B
Rationale: This statement allows the nurse to assess the individual patients potential needs and preferences. The other statements offer the patient more information about the benefits of support groups, but fail to acknowledge the patients preferences.
Which information will the nurse prioritize in planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass?
- A. Educating the patient about the nasogastric (NG) tube
- B. Instructing the patient on coughing and breathing techniques
- C. Discussing necessary postoperative modifications in lifestyle
- D. Demonstrating passive range-of-motion exercises for the legs
Correct Answer: B
Rationale: Coughing and deep breathing can prevent major postoperative complications such as carbon monoxide retention and hypoxemia. Information about passive range of motion, the NG tube, and postoperative modifications in lifestyle will also be discussed, but avoidance of respiratory complications is the priority goal after surgery.
After successfully losing 1 lb weekly for several months, a patient at the clinic has not lost any weight for the last month. The nurse should first
- A. review the diet and exercise guidelines with the patient.
- B. instruct the patient to weigh and record weights weekly.
- C. ask the patient whether there have been any changes in exercise or diet patterns.
- D. discuss the possibility that the patient has reached a temporary weight loss plateau.
Correct Answer: C
Rationale: The initial nursing action should be assessment of any reason for the change in weight loss. The other actions may be needed, but further assessment is required before any interventions are planned or implemented.
A client is in the bariatric clinic 1 month after having gastric bypass surgery. The client is crying and says I didnt know it would be this hard to live like this. What response by the nurse is best?
- A. Assess the clients coping and support systems.
- B. Inform the client that things will get easier.
- C. Re-educate the client on needed dietary changes.
- D. Tell the client lifestyle changes are always hard.
Correct Answer: A
Rationale: The nurse should assess this clients coping styles and support systems in order to provide holistic care. The other options do not address the clients distress.
After the nurse teaches a patient about the recommended amounts of foods from animal and plant sources, which menu selections indicate that the initial instructions about diet have been understood?
- A. 3 oz of lean beef, 2 oz of low-fat cheese, and a tomato slice
- B. 3 oz of roasted pork, a cup of corn, and a cup of carrot sticks
- C. Cup of tossed salad and nonfat dressing topped with a chicken breast
- D. Half cup of tuna mixed with nonfat mayonnaise and a half cup of celery
Correct Answer: B
Rationale: This selection is most consistent with the recommendation of the American Institute for Cancer Research that one third of the diet should be from animal sources and two thirds from plant source foods. The other choices all have higher ratios of animal origin foods to plant source foods than would be recommended.