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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.
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The nurse will be teaching self-management to patients after gastric bypass surgery. Which information will the nurse plan to include?
- A. Drink fluids between meals but not with meals.
- B. Choose high-fat foods for at least 30% of intake.
- C. Developing flabby skin can be prevented by exercise.
- D. Choose foods high in fiber to promote bowel function.
Correct Answer: A
Rationale: Intake of fluids with meals tends to cause dumping syndrome and diarrhea. Food choices should be low in fat and fiber. Exercise does not prevent the development of flabby skin.
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.
A few months after bariatric surgery, a 56-year-old man tells the nurse, My skin is hanging in folds. I think I need cosmetic surgery. Which response by the nurse is most appropriate?
- A. The important thing is that you are improving your health.
- B. The skinfolds will disappear once most of the weight is lost.
- C. Cosmetic surgery is a possibility once your weight has stabilized.
- D. Perhaps you would like to talk to a counselor about your body image.
Correct Answer: C
Rationale: Reconstructive surgery may be used to eliminate excess skinfolds after at least a year has passed since the surgery. Skinfolds 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 patients concerns about appearance and implies that the nurse knows what is important. Whereas it may be helpful for the patient to talk to a counselor, it is more likely to be helpful to know that cosmetic surgery is available.
When teaching a patient about testing to diagnose metabolic syndrome, which topic would the nurse include?
- A. Blood glucose test
- B. Cardiac enzyme tests
- C. Postural blood pressures
- D. Resting electrocardiogram
Correct Answer: A
Rationale: A fasting blood glucose test >100 mg/dL is one of the diagnostic criteria for metabolic syndrome. The other tests are not used to diagnose metabolic syndrome although they may be used to check for cardiovascular complications of the disorder.
Which statement by the nurse is most likely to help a morbidly obese 22-year-old man in losing weight on a 1000-calorie 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. You are likely to notice changes in how you feel with just a few weeks of diet and exercise.
- D. Most of the weight that you lose during the first weeks of dieting is water weight rather than fat.
Correct Answer: C
Rationale: Motivation is a key factor in successful weight loss and a short-term outcome provides a higher motivation. A 22-year-old 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.