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Roth 10e NCLEX Chapter 16

MULTIPLE CHOICE 1. An overweight client who is obese and recently began taking a prescription weight loss medication presents with nervousness and insomnia. The client does not remember the name or type of medication. Based on the symptoms, what type of drug will the nurse suspect the client is taking? a. a diuretic c. sibutramine b. an amphetamine d. orlistat ANS: B Amphetamines are sometimes prescribed for the treatment of obesity because they depress the appetite. Amphetamines cause nervousness and insomnia and can be habit forming. PTS: 1 MULTIPLE RESPONSE 1. The nurse was teaching a client at the local recreation center about how body fatness relates to risk for health problems. Which of the following statements made by the client indicates more teaching is needed? Select all that apply. a. A BMI above 30 means I will get type 2 d. In men, a waist circumference of greater diabetes eventually. than 40 inches confers a greater risk for heart disease. b. A waist to hip ratio less than 0.80 in e. Normal weight is that which is appropriate females increases the risk for coronary for maintenance of good health for a large heart disease group of people. c. Fat distributed around the abdomen poses f. more health risk than fat in the thighs and buttocks. ANS: A, B, E, F Normal weight is that which is appropriate for the maintenance of good health for a particular individual at a particular time. A person with BMI above 30 is considered obese and at increased risk for certain chronic diseases, such as type 2 diabetes and coronary heart disease. Being obese does not mean that these chronic diseases will absolutely develop in the obese person. A waist to hip ratio greater than 0.80 in females increases the risk for coronary heart disease. In men, a waist circumference of greater than 40 inches confers a greater risk for heart disease. A moderate amount of fat is a necessary component of the body. It protects organs from injury and acts as insulation. PTS: 1 REF: Introduction We should strive to have as little fat on our bodies as possible, since fat does nothing good for us. REF: Pharmaceutical Treatment of Obesity

2. A client comments to the nurse that obesity afflicts only those who are weak-willed and cannot control themselves. What could the nurse tell this client are the factors that contribute to obesity? Select all that apply. a. genetic factors d. physiological factors b. inactivity e. poor diet c. metabolic factors f. psychological factors ANS: A, B, C, D, E, F

There is no one cause for excess weight, but poor diet and inactivity appear to be leading factors. Genetic, physiological, metabolic, biochemical, and psychological factors can also contribute to obesity. PTS: 1 REF: Causes

3. The nurse is teaching an overweight client about weight reduction. What message(s) would be appropriate for the nurse to convey to the client? a. A reduction of 3,000 calories a week will d. Dont worry about losing weight unless result in a 1 pound weight loss per week. you become obese. b. Base your eating plan on MyPyramid, but e. Use a meal replacement drink 3 times a control the calorie content. day until you reach your weight goal. c. Count fat grams and limit fat to 20% of f. Use exchange lists to plan your diet. total calories. ANS: B, C, F There is no magic way of losing weight. Nor is there one best way to lose weight. Several reasonable strategies for weight reduction exist. The simplest is to eat a normal diet based on MyPyramid but with the calorie content control. Exchange list also provide another method to healthfully control the calorie content of the meal. Limiting fat in the diet by counting fat grams is another way to control excess calorie intake. Whatever method is chosen, a reduction of 3,500 calories will result in a weight loss of 1 pound per week. Avoid fad diets, such as liquid meal replacements) as they rarely provide a healthful diet. PTS: 1 REF: Dietary Treatment of Overweight and Obesity

4. The usual diet should consist of 10% to 20% protein, 45% to 65% carbohydrate, 20%-35% or less of fat. What should the diet composition be for someone on a weight reduction plan? a. 10% to 20% protein, 45% to 65% c. 20-35% protein, 40-50% protein, no more carbohydrate, 20%-35% or less of fat. than 15% fat b. 20-35% protein, 35% carbohydrate, 30% d. 50% protein, 25-35% carbohydrate, no fat more than 15% fat ANS: A The usual diet should consist of 10% to 20% protein, 45% to 65% carbohydrate, 20%-35% or less of fat. For weight reduction, the normal proportions of nutrients are consumed, but the total number of calories is reduced. PTS: 1 REF: Dietary Treatment of Overweight and Obesity

5. A client who is trying to lose weight tells the nurse that exercising 30 minutes every day of the week is not helping with the weight loss. The client does not want to reduce food intake, preferring to create a caloric deficit with exercise. Which of the following responses are appropriate? Select all that apply. a. Exercise is an adjunct to a weight loss d. Exercising 90+ minutes a day will result program and is rarely sufficient to reduce in weight loss. weight significantly without dietary modifications. b. Exercising 30 minutes a day may not e. It takes 60-90 minutes of exercise a day to result in weight loss, but it will reduce the prevent weight gain. risk for developing chronic diseases. c. Exercising 60-90 minutes a day will result f. It takes 90+ minutes of exercise a day to in weight loss. maintain weight loss. ANS: A, B, E, F

Exercise, particularly aerobic exercise, is an excellent adjunct to any weight loss program. Exercise alone rarely results in weight loss. General daily guidelines for exercise are 30 minute to prevent chronic diseases, 60-90 minutes to prevent weight gain, and over 90 minutes to maintain weight loss. PTS: 1 REF: Exercise

6. A client who has Class II obesity as well as severe type 2 diabetes is considering gastric bypass surgery. The nurse is reviewing possible complications with the client. Which of the following nutrition related complications should the nurse discuss with the client? Select all that apply. a. calcium deficiency d. nausea and vomiting b. dumping syndrome e. vitamin B12 deficiency c. iron deficiency f. vitamin C deficiency ANS: A, B, C, D, E The nutrition related complications of gastric bypass surgery are iron, vitamin B12 and calcium deficiencies as well as dumping syndrome which can cause nausea and vomiting, diarrhea, bloating and dizziness. PTS: 1 REF: Surgical Treatment of Obesity

7. An underweight client tells the public health nurse she wants to bring her weight up to a healthier weight before becoming pregnant. Which of the following questions/statements would be appropriate for the nurse to make? Select all that apply. a. Are your parents also small? d. Have you ever been diagnosed with depression? b. Being underweight at conception will e. Luckily, it is much easier to gain weight have no effect on your pregnancy. than it is to lose it. c. Do you have sufficient money to buy f. You should see a physician to rule out food? possible medical reasons for being underweight. ANS: A, C, D, F Underweight can be caused by inadequate consumption of nutritious food, because of depression, disease, anorexia nervosa, bulimia, or poverty, or it can be genetically determined. It can be as difficult for an underweight person to gain weight as it is for an overweight person to lose weight. PTS: 1 NUMERIC RESPONSE 1. The nurse is completing the nutrition assessment of a client. The client is a female who is 55.25 tall, weighs190 pounds, and has an average frame. When the nurse uses the rule of thumb method, this clients ideal body weight (IBW) is found to be how many pounds? ANS: 126.5 The clients ideal body weight is calculated using the rule of thumb method as follows: For a female, assume 100 pounds for the first 60 inches and add 5 pounds per inch for each inch over 60. The client is 65.25 inches tall, so her ideal body weight is 126.5. Since the client is not described as either large- or small-boned, no further adjustments are needed. REF: Underweight

PTS: 1

REF: Introduction

2. The nurse has determined the clients daily caloric intake to maintain current weight to be 2,000 calories. The client wants to lose 2 pounds a week. How many calories will the nurse say the client should consume each day? ANS: 1,200 A reduction of 3,500 calories will result in a weight loss of 1 pound. So, a reduction of 1,000 calories per day would result in a 2 pound weight loss in one week. However, caloric intake should not be reduced below 1,200 calories or the client would not receive the necessary nutrients. PTS: 1

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