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Which of the following topics is of most importance for the nurse to include when teaching a patient about testing for possible metabolic syndrome?
- A. Blood glucose test
- B. Cardiac enzyme tests
- C. Postural blood pressures
- D. Resting electrocardiogram
Correct Answer: A
Rationale: A fasting blood glucose test from 4-6 mmol/L 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.
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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.
The nurse is collaborating with an obese patient who is enrolled in a behaviour modification program. Which of the following nursing actions is best?
- A. Having the patient write down the caloric intake of each meal
- B. Asking the patient about situations that tend to increase appetite
- C. Encouraging the patient to eat small amounts throughout the day rather than having scheduled meals
- D. Suggesting that the patient have a reward, such as a piece of sugarless candy, after achieving a weight-loss goal
Correct Answer: B
Rationale: Behaviour modification programs focus on how and when the person eats and de-emphasize aspects such as calorie counting. Nonfood rewards are recommended for achievement of weight-loss goals. Patients are often taught to restrict eating to designated meals when using behaviour modification.
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.
The nurse is planning preoperative teaching for a patient undergoing a Roux-en-Y gastric bypass as treatment for morbid obesity. Which of the following interventions is priority?
- A. Demonstrating passive range-of-motion exercises to the legs.
- B. Discussing the necessary postoperative modifications in lifestyle
- C. Teaching the patient proper coughing and deep-breathing techniques
- D. Educating the patient about the postoperative presence of a nasogastric (NG) tube
Correct Answer: C
Rationale: Coughing and deep breathing can prevent major postoperative complications such as carbon monoxide retention and hypoxemia. Information about passive range of motion, the NG tube, and postoperative modifications in lifestyle also will be discussed, but avoidance of respiratory complications is the priority goal after surgery.
Which of the following patient behaviours indicate that an overweight patient has understood the nurse's teaching about the best exercise plan for weight loss?
- A. Walking for 40 minutes 6 or 7 days/week
- B. Lifting weights with friends three times/week
- C. Playing soccer for an hour on the weekend
- D. Running for 10-15 minutes three times/week
Correct Answer: A
Rationale: Exercise should be done daily for at least 15-30 minutes. Exercising in highly aerobic activities for short bursts or only once a week is not helpful and may be dangerous in an individual who has not been exercising. Running may be appropriate, but a patient should start with an exercise that is less stressful and can be done for a longer period. Weightlifting is not as helpful as aerobic exercise in weight loss.