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The nurse is coaching a community group for individuals who are overweight. Which participant behavior is an example of the best exercise plan for weight loss?
- A. Walking for 40 minutes 6 or 7 days/week
- B. Lifting weights with friends 3 times/week
- C. Playing soccer for an hour on the weekend
- D. Running for 10 to 15 minutes 3 times/week
Correct Answer: A
Rationale: Exercise should be done daily for 30 minutes to an hour. Exercising in highly aerobic activities for short bursts or only once a week is not helpful and may be dangerous in an individual who has not been exercising. Running may be appropriate, but a patient should start with an exercise that is less stressful and can be done for a longer period. Weight lifting is not as helpful as aerobic exercise in weight loss.
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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 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.
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.
Which nursing action is appropriate when coaching obese adults enrolled in a behavior modification program?
- A. Having the adults write down the caloric intake of each meal
- B. Asking the adults about situations that tend to increase appetite
- C. Suggesting that the adults plan rewards, such as sugarless candy, for achieving their goals
- D. Encouraging the adults to eat small amounts frequently rather than having scheduled meals
Correct Answer: B
Rationale: Behavior modification programs focus on how and when the person eats and de-emphasize aspects such as caloric counting. Nonfood rewards are recommended for achievement of weight-loss goals. Patients are often taught to restrict eating to designated meals when using behavior modification.
The nurse is caring for a 54-year-old female patient on the first postoperative day after a Roux-en-Y gastric bypass procedure. Which assessment finding should be reported immediately to the surgeon?
- A. Bilateral crackles audible at both lung bases
- B. Redness, irritation, and skin breakdown in skinfolds
- C. Emesis of bile-colored fluid past the nasogastric (NG) tube
- D. Use of patient-controlled analgesia (PCA) several times an hour for pain
Correct Answer: C
Rationale: Vomiting with an NG tube in place indicates that the NG tube needs to be repositioned by the surgeon to avoid putting stress on the gastric sutures. The nurse should implement actions to decrease skin irritation and have the patient cough and deep breathe, but these do not indicate a need for rapid notification of the surgeon. Frequent PCA use after bariatric surgery is expected.