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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.
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A client just returned to the surgical unit after a gastric bypass. What action by the nurse is the priority?
- A. Assess the clients pain.
- B. Check the surgical incision.
- C. Ensure an adequate airway.
- D. Program the morphine pump.
Correct Answer: C
Rationale: All actions are appropriate care measures for this client; however, airway is always the priority. Bariatric clients tend to have short, thick necks that complicate airway management.
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.
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.
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 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.