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The nurse is developing a weight reduction plan for an obese patient who wants to lose weight. Which of the following questions should the nurse ask first?
- A. Which food types do you like best?
- B. How long have you been overweight?
- C. What kind of physical activities do you enjoy?
- D. What factors do you think led to your obesity?
Correct Answer: D
Rationale: The nurse should obtain information about the patient's 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 patient's beliefs are considered in planning.
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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.
Which of the following assessments would suggest to the clinic nurse that the patient has metabolic syndrome?
- A. Take the patient's apical pulse.
- B. Check the patient's blood pressure.
- C. Ask the patient about dietary intake.
- D. Dipstick the patient's urine for protein.
Correct Answer: B
Rationale: Elevated blood pressure is one of the characteristics of metabolic syndrome. The other information also may be obtained by the nurse, but it will not assist with the diagnosis of metabolic syndrome.
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.
Which of the following surgeries places the patient at greatest risk of dumping syndrome postoperatively?
- A. Vertical banded gastroplasty
- B. Adjustable gastric banding
- C. Vertical sleeve gastrectomy
- D. Lap-Band
Correct Answer: A
Rationale: A possible complication of vertical banded gastroplasty is dumping syndrome. Dumping syndrome is not a possible complication in adjustable gastric banding, vertical sleeve gastrectomy, or Lap-Band.
The nurse is caring for a patient who has undergone bariatric surgery and has just arrived on the unit from the recovery room. Which of the following actions should the nurse implement to promote tidal flow and reduce abdominal pressure?
- A. Perform passive range-of-motion exercises.
- B. Elevate the head of the bed 45 degrees.
- C. Inform the patient that ambulation will occur in one hour.
- D. Administer heparin, as ordered.
Correct Answer: B
Rationale: Maintain the head of the patient at a 35- to 40-degree angle to reduce abdominal pressure and increase tidal flow. Passive range-of-motion exercises may be completed but will not affect abdominal pressure. Ambulation postoperatively is not expected in the first couple of hours. Heparin may be ordered but that will not promote tidal flow or reduce abdominal pressure.