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TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

912

Chapter48:AssessmentandManagementofPatientswithObesity  1.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.

Ans:

C Feedback: 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.

2.Afterthenurseteachesapatientabouttherecommendedamountsoffoodsfromanimalandplantsources, whichmenuselectionsindicatethattheinitialinstructionsaboutdiethavebeenunderstood? A)

3ozofleanbeef,2ozoflow-fatcheese,andatomatoslice

B)

3ozofroastedpork,acupofcorn,andacupofcarrotsticks

C)

Cupoftossedsaladandnonfatdressingtoppedwithachickenbreast

D)

Halfcupoftunamixedwithnonfatmayonnaiseandahalfcupofcelery

Ans:

B Feedback: ThisselectionismostconsistentwiththerecommendationoftheAmericanInstituteforCancer Researchthatonethirdofthedietshouldbefromanimalsourcesandtwothirdsfromplantsource foods.Theotherchoicesallhavehigherratiosofanimaloriginfoodstoplantsourcefoodsthanwould berecommended.

3.Whichnursingactionisappropriatewhencoachingobeseadultsenrolledinabehaviormodification program?

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

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

Ans:

B

913

Feedback: Behavior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behaviormodification. 4.Thenurseiscoachingacommunitygroupforindividualswhoareoverweight.Whichparticipantbehavioris anexampleofthebestexerciseplanforweightloss? A)

Walkingfor40minutes6or7days/week

B)

Liftingweightswithfriends3times/week

C)

Playingsoccerforanhourontheweekend

D)

Runningfor10to15minutes3times/week

Ans:

A Feedback: Exerciseshouldbedonedailyfor30minutestoanhour.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.Weightliftingisnotashelpfulasaerobicexerciseinweightloss.

5.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.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

D)

Perhapsyouwouldliketotalktoacounseloraboutyourbodyimage.

Ans:

C

914

Feedback: 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. 6.Afterverticalbandedgastroplasty,a42-year-oldmalepatientreturnstothesurgicalnursingunitwitha nasogastrictubetolow,intermittentsuctionandapatient-controlledanalgesia(PCA)machineforpaincontrol Whichnursingactionshouldbeincludedinthepostoperativeplanofcare? A)

Offersipsoffruitjuicesatfrequentintervals.

B)

Irrigatethenasogastric(NG)tubefrequently.

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.

Ans:

D Feedback: Theincisionshouldbeprotectedfromstraintodecreasetheriskforwounddehiscence.Thepatient shouldbeencouragedtousethePCAbecausepaincontrolwillimprovethe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.

7.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.

Ans:

A

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

915

Feedback: 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. 8.Whichassessmentactionwillhelpthenursedetermineifanobesepatienthasmetabolicsyndrome? A)

Takethepatientsapicalpulse.

B)

Checkthepatientsbloodpressure.

C)

Askthepatientaboutdietaryintake.

D)

Dipstickthepatientsurineforprotein.

Ans:

B Feedback: 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.

9.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

Ans:

A Feedback: 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.

10.Whatinformationwillthenurseincludeforanoverweight35-year-oldwomanwhoisstartingaweightlossplan? A)

Weighyourselfatthesametimeeverymorningandevening.

TestBank-Brunner&Suddarth'sTextbookofMedical-SurgicalNursing14e(Hinkle2017)

B)

Sticktoa600-to800-caloriedietforthemostrapidweightloss.

C)

Lowcarbohydratedietsleadtorapidweightlossbutaredifficulttomaintain.

D)

Weighingallfoodsonascaleisnecessarytochooseappropriateportionsizes.

Ans:

C

916

Feedback: Therestrictivenatureoffaddietsmakestheweightlossachievedbythepatientmoredifficultto maintain.Portionsizecanbeestimatedinotherwaysbesidesweighing.Severelycalorie-restricteddiets arenotnecessaryforpatientsintheoverweightcategoryofobesityandneedtobecloselysupervised. Patientsshouldweighweeklyratherthandaily. 11.Whichadultwillthenurseplantoteachaboutrisksassociatedwithobesity? A)

ManwhohasaBMIof18kg/m2

B)

Manwitha42inwaistand44inhips

C)

Womanwhohasabodymassindex(BMI)of24kg/m2

D)

Womanwithawaistcircumferenceof34inches(86cm)

Ans:

B Feedback: Thewaist-to-hipratioforthispatientis0.95,whichexceedstherecommendedlevelof...