Nokea
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.
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The nurse is caring for a patient who returns to the surgical nursing unit following a vertical banded gastroplasty with a nasogastric tube to low, intermittent suction and a patient-controlled analgesia (PCA) machine for pain control. Which of the following nursing actions should be included in the postoperative plan of care?
- A. Irrigate the nasogastric (NG) tube frequently with normal saline.
- B. Offer sips of sweetened liquids at frequent intervals.
- C. Remind the patient that PCA use may slow the return of bowel function.
- D. Support the surgical incision during patient coughing and turning in bed.
Correct Answer: D
Rationale: The incision should be protected from strain to decrease the risk for wound dehiscence. The patient should be encouraged to use the PCA since pain control will improve cough effort and patient mobility. NG irrigation may damage the suture line or overfill the stomach pouch. Sugar-free clear liquids are offered during the immediate postoperative time to decrease the risk for dumping syndrome.
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 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.
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.