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A client is awaiting bariatric surgery in the morning. What action by the nurse is most important?
- A. Answering questions the client has about surgery
- B. Beginning venous thromboembolism prophylaxis
- C. Informing the client that he or she will be out of bed tomorrow
- D. Teaching the client about needed dietary changes
Correct Answer: B
Rationale: Morbidly obese clients are at high risk of venous thromboembolism and should be started on a regimen to prevent this from occurring as a priority. Answering questions about the surgery is done by the surgeon. Teaching is important, but safety comes first.
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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.
Which finding for a patient who has been taking orlistat (Xenical) is most important to report to the health care provider?
- A. The patient frequently has liquid stools.
- B. The patient is pale and has many bruises.
- C. The patient complains of bloating after meals.
- D. The patient is experiencing a weight loss plateau.
Correct Answer: B
Rationale: Because orlistat blocks the absorption of fat-soluble vitamins, the patient may not be receiving an adequate amount of vitamin K, resulting in a decrease in clotting factors. Abdominal bloating and liquid stools are common side effects of orlistat and indicate that the nurse should remind the patient that fat in the diet may increase these side effects. Weight loss plateaus are normal during weight reduction.
A 61-year-old man is being admitted for bariatric surgery. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP)?
- A. Demonstrate use of the incentive spirometer.
- B. Plan methods for bathing and turning the patient.
- C. Assist with IV insertion by holding adipose tissue out of the way.
- D. Develop strategies to to provide privacy and decrease embarrassment.
Correct Answer: C
Rationale: UAP can assist with IV placement by assisting with patient positioning or holding skinfolds aside. Planning for care and patient teaching require registered nurse (RN) level education and scope of practice.
When teaching a patient about testing to diagnose metabolic syndrome, which topic would the nurse include?
- A. Blood glucose test
- B. Cardiac enzyme tests
- C. Postural blood pressures
- D. Resting electrocardiogram
Correct Answer: A
Rationale: A fasting blood glucose test >100 mg/dL is one of the diagnostic criteria for metabolic syndrome. The other tests are not used to diagnose metabolic syndrome although they may be used to check for cardiovascular complications of the disorder.
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.