Nokea
The nurse is developing a weight loss plan for a young adult patient who is morbidly obese. Which of the following statements by the nurse is most likely to help the patient in losing weight on the planned calorie-reduced 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. Most of the weight that you lose during the first weeks of dieting is water weight rather than fat.
- D. You are likely to start to notice changes in how you feel with just a few weeks of diet and exercise.
Correct Answer: D
Rationale: Motivation is a key factor in successful weight loss and a short-term outcome provides a higher motivation. A young adult 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.
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A few months after bariatric surgery, an older-adult patient tells the nurse, 'My skin is hanging in folds. I think I need cosmetic surgery.' Which of the following responses by the nurse is best?
- A. Perhaps you would like to talk to a counsellor about your body image.
- B. The important thing is that your weight loss is improving your health.
- C. The skin folds will gradually disappear once most of the weight is lost.
- D. Cosmetic surgery is certainly a possibility once your weight has stabilized.
Correct Answer: D
Rationale: Reconstructive surgery may be used to eliminate excess skin folds after at least a year has passed since the surgery. Skin folds 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 patient's concerns about appearance and implies that the nurse knows what is important. Whereas it may be helpful for the patient to talk to a counsellor, it is more likely to be helpful to know that cosmetic surgery is available.
Which of the following patient behaviours indicate that an overweight patient has understood the nurse's teaching about the best exercise plan for weight loss?
- A. Walking for 40 minutes 6 or 7 days/week
- B. Lifting weights with friends three times/week
- C. Playing soccer for an hour on the weekend
- D. Running for 10-15 minutes three times/week
Correct Answer: A
Rationale: Exercise should be done daily for at least 15-30 minutes. 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. Weightlifting is not as helpful as aerobic exercise in weight loss.
What specific information should the nurse include in patient teaching for an overweight patient starting a weight loss plan?
- A. Weigh yourself at the same time every morning.
- B. Start dieting with a 600- to 800-calorie diet for 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, requiring close supervision. Patients should weigh weekly rather than daily.
Which of the following patients seen in the clinic should the nurse teach about risks associated with obesity?
- A. Patient who has a BMI of 18 kg/m?²
- B. Patient with a waist circumference 86 cm
- C. Patient who has a body mass index (BMI) of 24 kg/m?²
- D. Patient whose waist measures 75 cm and hips measure 85 cm
Correct Answer: D
Rationale: The waist-to-hip ratio for this patient is 0.88, which exceeds the recommended level of <0.80. A BMI of 24 kg/m?² is normal. Health risks associated with obesity increase in women with a waist circumference larger than 89 cm and men with a waist circumference larger than 102 cm. A patient with a BMI of 18 kg/m?² is considered underweight.
The nurse has completed teaching a patient about the recommended amounts of foods from different food groups. Which of the following menu selections indicates that the initial instructions about healthy eating have been understood?
- A. 90 mL of pork roast, a cup of corn, tomatoes, and 125 mL rice
- B. A chicken breast and a cup of tossed salad with nonfat dressing
- C. A 180 mL can of tuna mixed with nonfat mayonnaise and chopped celery
- D. 90 mL of roast beef, 60 mL of low-fat cheese, and a half-cup of carrot sticks
Correct Answer: A
Rationale: This selection is most consistent with What is a Healthy Plate? The other choices are all missing at least one food group.