Obesity practice

Question 1

a) Obesityis an excessively high amount of ? or ?
b)Obesity must viewed as chronic or acute illness?
c)Higest among with race?

Answer 1

a) body fat, adipose tissue
b) Chronic
c)Black,hispanic,lower income

Question 2

Clasification
BMI
a)Normal range
b)Overweight
c) obesity class 1
d)obesity class 2
e)severe oesity 3
f) BMI calcualation
Hight 175cm, 75kg

Answer 2

a) 18.5-24.9
b)25-29.9
c)30-35
d)35-40
e)>40
f) 75/1.75*1.75

Question 3

Classification
a) waist circumferenec
Men? Women?
b) Waist to hio ratio
Men? Women?

Answer 3

a) Men>40
Women>35
b)>0.8

Question 4

Clasification
a) apple shaped
waht is call?
higher rate of?
b) Pear shaped
waht is call?
higher rate of?

Answer 4

a)android obeisty
endometrial cancer, DM,heart diesease, insulin resistance
b) gynoid obisety
osteoporosis,varicose veins,cellulite

Question 5

a) Ghrelin?
b) Peptide(neuropeptide) YY
c) Leptin
d) Insulin
e)Cholecystolinin

Answer 5

a) increase appitie
b) increase appitie
c) supress hunger, most obese pt have leptin resistance
d) decrease appitie
e) delay gastric emptying/makes pt feel full

Question 6

a) Criteria for surgery?
b) What are restricitive procedures?
v) what is combination procedure?

Answer 6

a) BMI> 40
BMI>35 w/ +1 obesity related complications with tretment failure
b)reduce stomach size
adjustable gastric band
sleeve gastrectomy (75% remove)
gastric plication(stomach fold/reversible)
intragastric balloon(newer/Gastric ulcers )
c)malabsorptive=less food is absorbed
Roux-en-Y gastric bypass(RYGB gastric bypass)
BPD/DS

Question 7

Bariatric surgery
a) pre-op care?
b) what is the 5 right for bariatric equipment?

Answer 7

a) appropriate assist device available
(bariatric bed, lift device, air assist)
b) Right assessment(right pt+ environment)
Right equipment
Right number of people
Right body mechanics
Right communication

Question 8

Bariatric surgery
Post-op care?

Answer 8

Air way management
-adipose tissue holds onto anesthesia
ELavate HOB 30-45
Reduce abdominal pressure
(put a pillow on the abdomen)
Diligent turning and walk
Incentive spirometer

Question 9

Dumping syndrome
a) What is it?
b) S/S?
c) how to prevent?
d) what might need?

Answer 9

a) Gastric contents empty too rapidly into small intestine(15-30 min after eating)
b) n/v, weakness, sweating, faintness, tachycardia,diarrhea
c) avoid sugarly food after surgery
don’t take fluid with meal, dec carbonhydrate
d) need iron and calcium supplements(because poor absorption of iron)

Question 10

The best nutritional therapy plan for a person who is obese?
a) is high in animal protein
b) in fat-free and low in carbohydrates
c) restricts intake to under 800 calories per day
d) lower calories with foods from all the basic group

Answer 10

d

Question 11

The bariatric surgical procedure involves creating a gastric pouch that is reversible and no malabsorption occurs.which one?
a) Vetrical gastric banding
b) Biliopancreatic diversion
c) Roux-en-Y gastric bypass
d) Adjustable gastric banding

Answer 11

d

Question 12

Which statemtn best discribe the ethiology of obesity?
a) Obesity primary reesults from a genetic predisposition.
b) Psychosocial factors can override the effects of geneteics in causing obesity.
c) Obesity is the result of complex interactions between genetic and enviromental factor.
d) Genetic factors are more important than enviromentl factors in the ethiology of obesity.

Answer 12

c
b:Psychosocial factors/emotional support,self-esteem

Question 13

Health risks associated with obeisty include? SATA
a) Colorectal cancer
b) Rheumataido arthritis
c) Polycystic over syndrome
d) Nonalcoholic steatohepatitis
e) Systemic lupus erythematosus

Answer 13

a,c,d

Question 14

The obesity classification that in most often associated with cardiovascular health problem is?
a) primary obesity
b) secondary obesity
c) gynoid fat distribution
d) android fat distribution

Answer 14

d

Question 15

A pt with extreme obesity has undergone Roux-en-Y gastric bypass surgery. In plannig postperative care, the nurse anticipates that the pt
a) may have sever diarrhea early in the postoperative period
b) will not be allowed to amblate for 1 to 2 days postperatively
c) wil require nasogastric suction untill the drainage is pale yellow
d) may have limited amounts of oral liquid during the early postoperative period

Answer 15

d

Question 16

Which criteria must be met for a diagnosisi of metabolic syndrome? SATA
a) HTN
b) High triglycerides
c) Elevated plasma glucose
d) Increased waist circumference
e) Decrease low-density lipoproteins

Answer 16

a,b,c,d

Question 17

Before selecting a weight reduction plan with an obese pt, what is most important for the nurse to first asses?
a) motivation to lose weight
b) The length of time that the pt has been obese
c) The pt’s height,weight,BMI,waist-to-hip ration

Answer 17

a
rest of the option will assist in planning if pt is motivated.

Question 18

The nurse is teaching a moderatly abese woman interventions for the management of obesity. Initially, which strategies will support restricting dietary intake to below energy requirement? SATA
a) Limit alcohol
b) Rest when fatigued
c) Determine portion size
d) 1800-2200 calorie diet
e) Attend overeaters anonymous
f) Park farther away from destination

Answer 18

a,c

Question 19

Which explanation about weight reduction should be included when teaching the obese pt and her obese husband?
a) weight gain is caused by psychologic factor
b) daily weigting is recommended to monitor weight loss.
c) progressively increasing physical activity helps decrease weight, cholesterol, adnn BP level
d) men lose weight less quickly than women because they have a higher percentage of metabolically less active fat.

Answer 19

c
b: weekly is recommended
d:men is quicker because women has more higher % of unactive fat

Question 20

Which statement about obesity is explained by genetics?
a) older obese pt have exacerbated change of aging
b) android body shape and weight gain are influenced by genetic
c) white american have higher incidence of obesity than blacks
d) men have a harder time losing weight as they have moe muscle mass

Answer 20

b
a: yes but this is physical function,not genetic
c:blacks and hispanics are higher
d:women has harder time to losing weight

Question 21

A pt has been on a 1000 calories diet with a daily exercise routine.in 2 month, the pt has lost 9kg toward a goal of 23kg, but is now discouraged taht no weight hasbeen lost in the last 2 weeks. intervention?
a) A steady weight may be caused by water gain from eating foods high in sodium
b) Plateaus where no weight is lost normally occur during a weight loss program
c) A weight considered by the body to be most efficient for functioning has been reached
d) A return to firmer eating habits is the most common cayse of not continuing to lose weight

Answer 21

b

Question 22

When medications are used in the treatment of obesity,what is the most important for the nurse to teach the pt?
a) OTC diet aids are safer than other atents and can be useful in cotrolling
b) Drugs should be used only as adjuncts to a diet and exercise program as treatment for a chronic condition
c) All drugs used for weight control can affect central nervous system function and should be used with cautin
d) The primary effect of medication is psychologic, controlling the urge to eat in response to feelings of rejection

Answer 22

b
drugs do not cure obesity: without changes in food intakeand physical activity

Question 23

The nurse has completed initial instruction with a pt about a weight loss program. Which pt comment indicates to the nurse that the teaching has been effective?
a) I will keep a diary of daily weight to illustrate my weight loss
b) I plan to lose 4lb/week until I have lost 60 lb I wan to lose
c) I should not exercise more than what is required so I don’t increase my appetite
d) I plan to join a behavior modification group to help establish long term behavior changes

Answer 23

d
b:1-3lb (0.5-1kg) is ideal
c:exercising more often depress appitie

Question 24

A 40 years old pt has extreme obesity and type 2 DM. She wants to lose weight and she thinks a comination of restrictive and malabsorptive surgery would be best. Which procedure should the nurse teach her about?
a) Lipectomy
b) Sleeve gastrectomy
c) Roux-en-Y gastric bypass
d) Adjustable gastric banding

Answer 24

c
this is a common combination of restricitive (limiting the size of the stomach) and malabsorptive (less food is absorbed)

Question 25

What characteristics describe adjustable gastric banding?SATA
a) 75% of the stomach is remove
b) Stomach restriction can be reversed
c) Eliminates hormones that stimulate hunger
d) Malabsorption of fat soluble vitamins occures
e) Infaltble band allows for modification of gastric stoma size
f) Stomach with a gastric pouch surgically anastomosed to the jejunm

Answer 25

b,e
a and c-gastrectomy
d-biliopancreatic division
f-Roux-en-Y gastric is combination

Question 26

A nurse is providing teaching for a client who has binge-eating disorder and is morbidly obese. The client has been prescribed orlistat. Which of the following statements indicates to the nurse that the client understands the teaching?
1)”I will take my dose of orlistat every morning an hour before breakfast.”
2)”I will eat a no-fat diet to prevent side effects from the medication.”
3)”I will stop taking orlistat and call my doctor if my urine gets darker in color.”
4)”I will feel less hungry during meals while I am taking orlistat.”

Answer 26

3
Orlistat can cause severe liver damage; therefore, the client should be taught manifestations of liver damage, including dark-colored urine, light-colored stools, jaundice, anorexia, vomiting, and fatigue.

Question 27

A nurse is assessing four female clients for obesity. Which of the following clients have manifestations of obesity?
1)A client who has a waist WHR 1.2
2)A client who has a BMI of 28
3)A client who has a waist circumference of 32 inches
4)A client who has a WHR 0.79

Answer 27

A
A WHR >0.8 is considered obese.
BMI of 28 is overweight.