Create an NCLEX style question focused on weight reduction strategies and pharmacotherapy of obesity.
NCLEX style question focused on weight reduction strategies and pharmacotherapy of 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
2. 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.
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
3. 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.
Which nursing action is appropriate
when coaching obese adults enrolled in a behavior modification
program?
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
4. 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.
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
5. 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.
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."
d. "Perhaps you would like to talk to a counselor about your body
image."
ANS: C
6. 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 patient's 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.
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
7. 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.
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
8. 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.
Which assessment action will help
the nurse determine if an obese 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.
ANS: B
9. 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.
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
10. 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.
What information will the nurse
include for an overweight 35-year-old woman who is starting a
weight-loss plan?
a. Weigh yourself at the same time every morning and evening.
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
11. 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.
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
12. The waist-to-hip ratio for this patient is 0.95, which exceeds
the recommended level of <0.80. A patient with a BMI of 18 kg/m2
is considered underweight. A BMI of 24 kg/m2 is normal. Health
risks associated with obesity increase in women with a waist
circumference larger than 35 in (89 cm) and men with a waist
circumference larger than 40 in (102 cm).
A 61-year-old man is being admitted
for bariatric surgery. Which nursing action can the nurse delegate
to unlicensed assistive personnel (UAP)?
a. Demonstrate use of the incentive spirometer.
b. Plan methods for bathing and turning the patient.
c. Assist with IV insertion by holding adipose tissue out of the
way.
d. Develop strategies to provide privacy and decrease
embarrassment.
ANS: C
13. UAP can assist with IV placement by assisting with patient
positioning or holding skinfolds aside. Planning for care and
patient teaching require registered nurse (RN)-level education and
scope of practice.
After successfully losing 1 lb
weekly for several months, a patient at the clinic has not lost any
weight for the last month. The nurse should first
a. review the diet and exercise guidelines with the patient.
b. instruct the patient to weigh and record weights weekly.
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.
ANS: C
14. 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.
Which finding for a patient who has
been taking orlistat (Xenical) 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 complains of bloating after meals.
d. The patient is experiencing a weight loss plateau.
ANS: B
15. 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 side effects of orlistat and indicate that
the nurse should remind the patient that fat in the diet may
increase these side effects. Weight loss plateaus are normal during
weight reduction.
A 40-year-old obese woman reports
that she wants to lose weight. Which question should the nurse ask
first?
a. "What factors led to your obesity?"
b. "Which types of food do you like best?"
c. "How long have you been overweight?"
d. "What kind of activities do you enjoy?"
ANS: A
For free online practice given links can helpfull:
https://nurseslabs.com/fundamentals-nursing-nclex-practice-quiz-9-25-questions/
https://www.flashcardmachine.com/nursing.html
https://quizlet.com/subject/fundamentals-nursing-nutrition-questions/
Links for online paid practice:
https://study.com/academy/exam/course/nursing-101-fundamentals-of-nursing.html#3
https://www.khanacademy.org/test-prep/nclex-rn/nclex-practice-questions
Refer to the books like Saunders Comprehensive Review for the NCLEX-RN® Examination, NCLEX-RN Premier 2017 with 2 Practice Tests, HESI Comprehensive Review NCLEX-RN
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Create an NCLEX style question focused on weight reduction strategies and pharmacotherapy of obesity.
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