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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.
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What information will the nurse include for an overweight 35-year-old woman who is starting a weight-loss plan?
- A. Weigh yourself at the same time every morning and evening.
- B. Stick to a 600- to 800-calorie diet for the most rapid weight loss.
- C. Low carbohydrate diets lead to rapid weight loss but are difficult to maintain.
- D. Weighing all foods on a scale is necessary to choose appropriate portion sizes.
Correct Answer: C
Rationale: The restrictive nature of fad diets makes the weight loss achieved by the patient more difficult to maintain. Portion size can be estimated in other ways besides weighing. Severely calorie-restricted diets are not necessary for patients in the overweight category of obesity and need to be closely supervised. Patients should weigh weekly rather than daily.
Which statement by the nurse is most likely to help a morbidly obese 22-year-old man in losing weight on a 1000-calorie diet?
- A. It will be necessary to change lifestyle habits permanently to maintain weight loss.
- B. You will decrease your risk for future health problems such as diabetes by losing weight now.
- C. You are likely to notice changes in how you feel with just a few weeks of diet and exercise.
- D. Most of the weight that you lose during the first weeks of dieting is water weight rather than fat.
Correct Answer: C
Rationale: Motivation is a key factor in successful weight loss and a short-term outcome provides a higher motivation. A 22-year-old patient is unlikely to be motivated by future health problems. Telling a patient that the initial weight loss is water will be discouraging, although this may be correct. Changing lifestyle habits is necessary, but this process occurs over time and discussing this is not likely to motivate the patient.
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.
A few months after bariatric surgery, a 56-year-old man tells the nurse, My skin is hanging in folds. I think I need cosmetic surgery. Which response by the nurse is most appropriate?
- A. The important thing is that you are improving your health.
- B. The skinfolds will disappear once most of the weight is lost.
- C. Cosmetic surgery is a possibility once your weight has stabilized.
- D. Perhaps you would like to talk to a counselor about your body image.
Correct Answer: C
Rationale: Reconstructive surgery may be used to eliminate excess skinfolds after at least a year has passed since the surgery. Skinfolds may not disappear over time, especially in older patients. The response, The important thing is that your weight loss is improving your health, ignores the patients concerns about appearance and implies that the nurse knows what is important. Whereas it may be helpful for the patient to talk to a counselor, it is more likely to be helpful to know that cosmetic surgery is available.
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.