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Which of the following information should the nurse plan to include in discharge teaching for a patient after gastric bypass surgery?
- A. Avoid drinking fluids with meals.
- B. Choose high-fat foods for at least 30% of intake.
- C. Choose foods that are high in fibre to promote bowel function.
- D. Development of flabby skin can be prevented by daily exercise.
Correct Answer: A
Rationale: Intake of fluids with meals tends to cause dumping syndrome and diarrhea. Food choices should be low in fat and fibre. Exercise does not prevent the development of flabby skin.
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A patient who has been successfully losing 0.5 kg weekly for several months is weighed at the clinic and has not lost any weight for the last month. Which of the following actions should the nurse do first?
- A. Review the diet and exercise guidelines with the patient.
- B. Instruct the patient to weigh weekly and record the weights.
- 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.
The nurse is providing nutritional teaching to a patient who is to start on a very-low-calorie diet. Which of the following calorie amounts should the nurse tell the patient that daily calories are not to exceed?
- A. 500
- B. 800
- C. 1100
- D. 1400
Correct Answer: B
Rationale: A very-low-calorie diet does not exceed 800 calories/day. A low-calorie diet is between 800 and 1200 calories/day.
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.
The nurse obtains these assessment data for a patient who has been taking orlistat for several months as part of a weight loss program. Which of the following findings 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 is experiencing a plateau in weight loss.
- D. The patient complains of abdominal bloating after meals.
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 adverse effects of orlistat and indicate that the nurse should remind the patient that fat in the diet may increase these adverse effects. Weight loss plateaus are normal during weight reduction.
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.