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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.
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Which adult will the nurse plan to teach about risks associated with obesity?
- A. Man who has a BMI of 18 kg/m^2
- B. Man with a 42 in waist and 44 in hips
- C. Woman who has a body mass index (BMI) of 24 kg/m^2
- D. Woman with a waist circumference of 34 inches (86 cm)
Correct Answer: B
Rationale: The waist-to-hip ratio for this patient is 0.95, which exceeds the recommended level of <0.80. A patient with a BMI of 18 kg/m^2 is considered underweight. A BMI of 24 kg/m^2 is normal. Health risks associated with obesity increase in women with a waist circumference larger than 35 in (89 cm) and men with a waist circumference larger than 40 in (102 cm).
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 assessment action will help the nurse determine if an obese patient has metabolic syndrome?
- A. Take the patients apical pulse.
- B. Check the patients blood pressure.
- C. Ask the patient about dietary intake.
- D. Dipstick the patients 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.
A 61-year-old man is being admitted for bariatric surgery. Which nursing action can the nurse delegate to unlicensed assistive personnel (UAP)?
- A. Demonstrate use of the incentive spirometer.
- B. Plan methods for bathing and turning the patient.
- C. Assist with IV insertion by holding adipose tissue out of the way.
- D. Develop strategies to to provide privacy and decrease embarrassment.
Correct Answer: C
Rationale: UAP can assist with IV placement by assisting with patient positioning or holding skinfolds aside. Planning for care and patient teaching require registered nurse (RN) level education and scope of practice.
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.