Pathophysiology Introductory Concepts And Clinical Perspectives By Capriotti DO MSN CRNP – Test Bank

Complete Test Bank With Answers

 

 

Sample Questions Posted Below

 

Chapter 5: Obesity and Nutritional Imbalances

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. A client has a pigmented rash on the sun-exposed areas of the client’s skin. Which nutrient deficiency results in this condition?

1.	Folate
2.	Niacin
3.	Vitamin A
4.	Vitamin K

____ 2. Which nutrient deficiency causes beriberi?

1.	Thiamine
2.	Riboflavin
3.	Vitamin B6
4.	Vitamin B12

____ 3. A client displays behaviors that involve a desire for perfection and success in academics, and psychiatric characteristics, such as being socially isolated and emotional, and having a severely restricted diet. Which disorder could the client possibly have?

1.	Anorexia nervosa
2.	Bulimia nervosa
3.	Binge eating
4.	Purging disorder

____ 4. According to the United States Department of Agriculture (USDA), what is the recommended daily allowance for calcium consumption?

1.	1.7 mg
2.	60 mg
3.	400 mg
4.	1000 mg

____ 5. According to the United States Department of Agriculture (USDA), what is the recommended daily allowance for potassium consumption?

1.	20 mg
2.	300 mg
3.	2,400 mg
4.	3,500 mg

____ 6. A client reports excessive pain in the hips, knees, and joints. Which condition could be the root cause for the development of these symptoms?

1.	Dumping syndrome
2.	Hypogonadism
3.	Insulinoma
4.	Obesity

____ 7. A client is to undergo gastric bypass surgery. Which part of the intestine should be cut to connect to the newly-created pouch in the superior portion of the stomach?

1.	Omentum
2.	Jejunum
3.	Duodenum
4.	Subcutaneous tissue

____ 8. What is the basal metabolic rate (BMR) for a 28-year-old man who weighs 65 kg and is 170 cm tall?

1.	1,616 calories/day
2.	1,166 calories/day
3.	1,161 calories/day
4.	1,661 calories/day

____ 9. What is the basal metabolic rate (BMR) of a 26-year-old woman who weighs 55 kg and is 163 cm tall?

1.	1,345 calories/day
2.	1,543 calories/day
3.	1,453 calories/day
4.	1,354 calories/day

____ 10. What percentage of body fat is considered to be acceptable in women?

1.	35% to 40%
2.	25% to 31%
3.	21% to 24%
4.	14% to 20%

____ 11. What is the percentage of body fat for a man who is considered to be obese?

1.	30% to 40%
2.	20% to 25%
3.	14% to 17%
4.	6% to 13%

____ 12. What is the lean body mass of a man whose weight is 164 lbs and body fat is 22%?

1.	128 lbs
2.	182 lbs
3.	218 lbs
4.	281 lbs

____ 13. A client is diagnosed with a deficiency of ascorbic acid. Which disease could this condition lead to?

1.	Scurvy
2.	Megaloblastic anemia
3.	Rickets
4.	Beriberi

____ 14. An 18-year-old client, who is within a normal weight range, admits to using laxatives and diuretics. The client displays increased symptoms of depression and reports a sore throat and tooth decay. What question should a nurse ask the client to evaluate if the client is suffering from bulimia nervosa?

1.	“Do you engage in self-induced purging?”
2.	“Do you suffer from constipation?”
3.	“Do you have hypertension?”
4.	“Do you have a habit of starving intentionally?”

____ 15. Which vitamin works in close correlation with the parathyroid hormones to regulate the absorption of calcium?

1.	Vitamin A
2.	Vitamin C
3.	Vitamin D
4.	Vitamin K

Multiple Response

Identify one or more choices that best complete the statement or answer the question.

____ 16. Which statements are true with regard to liposuction? Select all that apply.

1.	It does not involve the use of an anesthetic.
2.	It is a cosmetic procedure.
3.	It is associated with high mortality rates.
4.	It promotes weight loss by limiting the amount of food that the client consumes.
5.	It requires clients to wear compression garments preoperatively.

____ 17. A 40-year-old client has a body mass index (BMI) of 45. The client wants to undergo gastric bypass surgery. Which statements of the nurse would justify the advantages of the surgery? Select all that apply.

1.	Gastric bypass surgery limits the volume of food consumed to one-half to 1 ounce.
2.	Gastric bypass surgery is done by surgically restructuring the upper portion of the stomach.
3.	Gastric bypass surgery usually results in gradual weight loss over a long period of time.
4.	Gastric bypass surgery does not involve any complications or surgical risks.
5.	Gastric bypass surgery alters the ability of the stomach and small bowel to absorb calories and nutrients.

____ 18. A client undergoes gastric bypass surgery and reports symptoms postsurgery. Which symptoms can be interpreted as dumping syndrome?  Select all that apply.

1.	Rapid food digestion
2.	Abdominal cramps
3.	Proximal stomach pouch herniation
4.	Severe hypotension
5.	Diarrhea

____ 19. A nurse is explaining about the advantages and disadvantages of gastric banding surgery to a client who is scheduled for the procedure. Which statements made by the nurse with regard to the advantages and disadvantages of gastric banding surgery are correct? Select all that apply.

1.	Gastric banding surgery promotes weight loss by limiting the amount of food that can be consumed and producing early satiety.
2.	Gastric banding surgery is a laparoscopic procedure and does not carry the typical risks associated with surgery.
3.	Gastric banding surgery carries no risk of a ruptured suture line.
4.	Gastric banding surgery may cause vomiting.
5.	Gastric banding surgery carries the risk of rapid gastric emptying.

____ 20. A nurse is explaining about the risks of dumping syndrome to a client who recently had undergone gastric bypass surgery. Which statements made by the nurse with regard to the risks of dumping syndrome are correct? Select all that apply.

1.	Dumping syndrome may cause excessive sweating.
2.	Dumping syndrome is too severe a complication to be controlled through changes to the diet and eating habits.
3.	Dumping syndrome may place the client at risk for hyperglycemia.
4.	Dumping syndrome causes a malabsorption of nutrients.
5.	Dumping syndrome may cause diarrhea.

____ 21. Which vitamins are fat-soluble? Select all that apply.

1.	Vitamin A
2.	Vitamin B
3.	Vitamin C
4.	Vitamin D
5.	Vitamin E

____ 22. Which statements are true about pharmacological interventions for weight loss? Select all that apply.

1.	Weight loss medications are very effective.
2.	Weight loss is short term.
3.	Weight loss medications, such as over-the-counter appetite suppressants, have sympathomimetic side effects.
4.	Weight loss medications are indicated for people who have a body mass index (BMI) of 27 or greater with concurrent obesity-related medical problems.
5.	Weight loss medications, such as appetite suppressants, are relatively safe and can be bought over the counter without a prescription from a primary health-care provider.

____ 23. A client is diagnosed with obesity as a secondary effect. Which disorder could possibly be caused by obesity? Select all that apply.

1.	Hypothyroidism
2.	Prader-Willi syndrome
3.	Polycystic ovarian syndrome
4.	Cushing’s syndrome
5.	Leptin receptor gene mutation at 7q31

____ 24. Which statements are true with regard to free fatty acids? Select all that apply.

1.	They cause glucose intolerance.
2.	They send satiety signals to the brain.
3.	They cause cirrhosis.
4.	They are created through lipolysis.
5.	They cause hypertension.

Completion

Complete each statement.

25.A client comes in for a consultation with a bariatric surgeon to inquire about surgical options to lose weight. The client’s body mass index (BMI) is checked to see if the client would be a candidate for the bariatric surgery. A nurse records the client’s height as 5 feet, 4 inches and weight as 258 pounds. What is the client’s BMI? Record your answer to one decimal point. ____________________

Chapter 5: Obesity and Nutritional Imbalances

Answer Section

MULTIPLE CHOICE

1.ANS:2

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Moderate

Heading: Nutritional Imbalances 

Integrated Processes: Nursing Process 

Client Need: Health Promotion and Maintenance

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1	This is incorrect. A deficiency in folate causes megaloblastic anemia.
2	This is correct. Vitamin B is a water-soluble vitamin; therefore, it is not stored in the body. Niacin is a component of vitamin B and is also known as vitamin B3. A deficiency in vitamin B causes pellagra, which is characterized by a pigmented rash on sun-exposed areas of the skin.
3	This is incorrect. A deficiency in vitamin A causes nightblindness.
4	This is incorrect. A deficiency in vitamin K causes bleeding and elevated prothrombin time.

PTS: 1 CON: Nutrition

2.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Easy

Heading: Nutritional Imbalances 

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is correct. Thiamine is a B-complex vitamin. A deficiency in thiamine causes beriberi, which results in neuropathy and muscle weakness.
2	This is incorrect. Riboflavin is a B-complex vitamin. A deficiency in riboflavin causes cheilosis, which results in fissures and irritation at the edges of the mouth.
3	This is incorrect. A deficiency in vitamin B6 causes neuropathy, depression, and microcytic anemia.
4	This is incorrect. A deficiency in vitamin B12 causes megaloblastic anemia.

PTS: 1 CON: Nutrition

3.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Difficult

Heading: Eating Disorders

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

	Feedback
1	This is correct. Anorexia nervosa is an eating disorder wherein an individual refuses to maintain body weight within the minimal normal standards and displays behaviors such as a desire for perfection and other psychiatric characteristics, including social isolation.
2	This is incorrect. Bulimia nervosa is an eating disorder that is characterized by bouts of extreme overeating, which are followed by fasting or self-induced vomiting.
3	This is incorrect. Binge eating is an eating disorder that is characterized by the consumption of large quantities of food in a short period of time or continuously for the entire day.
4	This is incorrect. Purging disorder is an eating disorder that is characterized by self-induced vomiting, laxative and/or diuretic use, or other extreme methods used to control body weight or shape. Sometimes this condition leads to excessive exercise.

PTS: 1 CON: Nutrition

4.ANS:4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 82

Objective: N/A

Difficulty: Easy

Heading: Treatment

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is incorrect. The USDA recommends a 1.7 mg daily allowance for riboflavin. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
2	This is incorrect. The USDA recommends a 60 mg daily allowance for vitamin C. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
3	This is incorrect. The USDA recommends a 400 mg daily allowance for vitamin D. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
4	This is correct. The USDA recommends a 1,000 mg daily allowance for calcium. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.

PTS: 1 CON: Nutrition

5.ANS:4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 82

Objective: N/A

Difficulty: Easy

Heading: Treatment

Integrated Processes: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is incorrect. The USDA recommends a 20 mg daily allowance for saturated fatty acids. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
2	This is incorrect. The USDA recommends a 300 mg daily allowance for cholesterol. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
3	This is incorrect. The USDA recommends a 2,400 mg daily allowance for sodium. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.
4	This is correct. The USDA recommends a 3,500 mg daily allowance for potassium. This is based on a 2,000-calorie diet for adults and children who are 4 years of age or older.

PTS: 1 CON: Nutrition

6.ANS:4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 88

Objective: N/A

Difficulty: Moderate

Heading: Treatment

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1	This is incorrect. Dumping syndrome causes malabsorption of important nutrients, vitamins, and minerals.
2	This is incorrect. Hypogonadism is characterized by the reduction or absence of hormone secretion. It is a disorder that causes obesity.
3	This is incorrect. An insulinoma is a tumor of the pancreas. It is also a disorder that can cause obesity.
4	This is correct. Disorders that are associated with obesity include cardiovascular disease, diabetes mellitus, osteoarthritis, sleep apnea, and diseases that affect the gallbladder and liver. Osteoarthritis is caused by excessive weight on the knees and hips.

PTS: 1 CON: Nutrition

7.ANS:2

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A

Difficulty: Moderate

Heading: Surgical Options

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1	This is incorrect. The omentum is the membranous covering of the intestine. It is a major area of fat storage in the body.
2	This is correct. Gastric bypass surgery involves the surgical restructure of the upper portion of the stomach. In the procedure, the jejunum is cut and connected to the newly created pouch in the superior portion of the stomach. This creates a smaller pouch in which to intake and digest food.
3	This is incorrect. The duodenum is a part of the intestine that is located in the lower portion of the stomach. It is bypassed in gastric bypass surgery.
4	This is incorrect. Subcutaneous tissue is the membranous covering of the intestine. This is a major area of fat storage in the body.

PTS: 1 CON: Nutrition

8.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 83

Objective: N/A

Difficulty: Difficult

Heading: Diet 

Integrated Processes: Nursing Process 

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

Feedback: To calculate BMR, use the following formula: 

Men: BMR = 66 + (13.7 x weight in kg) + (5 x height in cm) – (6.8 x age in years)

= 66 + 890.5 + 850 – 190.4

= 1,616 calories/day

PTS: 1 CON: Nutrition

9.ANS:4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 83

Objective: N/A

Difficulty: Difficult 

Heading: Diet 

Integrated Processes: Nursing Process 

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

Feedback: To calculate BMR, use the following formula:

Women: BMR = 655 + (9.6 x weight in kg) + (1.8 x height in cm) – (4.7 x age in years)

= 655 + 528 + 293.4 – 122.2

= 1,354 calories/day

PTS: 1 CON: Medication

10.ANS:2

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 81

Objective: N/A

Difficulty: Easy

Heading: Diagnosis

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is incorrect. In women, a body fat percentage that is above 32% indicates obesity, according to the American Council on Exercise.
2	This is correct. In women, a body fat percentage that is above 25% and below 31% is considered acceptable according to the American Council on Exercise.
3	This is incorrect. In women, a body fat percentage that is above 21% and below 24% is considered normal according to the American Council on Exercise.
4	This is incorrect. In female athletes, a body fat percentage that is above 14% and below 20% is considered normal according to the American Council on Exercise.

PTS: 1 CON: Nutrition

11.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 81

Objective: N/A

Difficulty: Easy

Heading: Diagnosis

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is correct. In men, a body fat percentage that is above 26% indicates obesity according to the American Council on Exercise.
2	This is incorrect. In men, a body fat percentage that is above 18% and below 25% is considered acceptable according to the American Council on Exercise.
3	This is incorrect. In men, a body fat percentage that is above 14% and below 17% is considered normal according to the American Council on Exercise.
4	This is incorrect. In male athletes, a body fat percentage that is above 6% and below 13% considered normal according to the American Council on Exercise.

PTS: 1 CON: Nutrition

12.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 81

Objective: N/A

Difficulty: Difficult

Heading: Diagnosis

Integrated Processes: Nursing Process 

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

Feedback: To calculate BMR, use the following formula: 

Men: Lean Body Mass = Weight × (100 – Body Fat)

= 164 x 0.78

=128 lbs

PTS: 1 CON: Nutrition

13.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Moderate

Heading: Nutritional Imbalances 

Integrated Process: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1	This is correct. Scurvy is a disease that occurs from a severe lack of vitamin C or ascorbic acid in the diet.
2	This is incorrect. Megaloblastic anemia is caused by a folate (folic acid) deficiency.
3	This is incorrect. Rickets is caused by a deficiency in vitamin D.
4	This is incorrect. Beriberi is caused by a deficiency in vitamin B1 (thiamine). It causes neuropathy, muscle weakness, and wasting.

PTS: 1 CON: Nutrition

14.ANS:1

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 87

Objective: N/A

Difficulty: Difficult

Heading: Eating Disorders

Integrated Process: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level:  Evaluate [Evaluating]

Concept: Nutrition

	Feedback
1	This is correct. The nurse should ask the client if the client engages in self-induced purging because purging is a symptom of bulimia nervosa.
2	This is incorrect. The nurse should not ask the client if the client suffers from constipation because constipation is a symptom of anorexia nervosa, not bulimia nervosa.
3	This is incorrect. The nurse should not ask the client if the client has hypertension because hypertension is a symptom of binge eating.
4	This is incorrect. The nurse should not ask the client if the client has a habit of starving intentionally because intentional starving is a symptom of anorexia nervosa.

PTS: 1 CON: Nutrition

15.ANS:3

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Moderate

Heading: Vitamin and Mineral Deficiencies

Integrated Process: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1	This is incorrect. Vitamin A is a fat-soluble vitamin that can be stored in the liver and fat tissue.
2	This is incorrect. Vitamin C is a water-soluble vitamin that is not stored in the body.
3	This is correct. Vitamin D is a fat-soluble vitamin that works in close correlation with the parathyroid hormones to regulate the absorption of calcium.
4	This is incorrect. Vitamin K is a fat-soluble vitamin that plays a key role in helping the blood to clot, thus preventing excessive bleeding.

PTS: 1 CON: Nutrition

MULTIPLE RESPONSE

16.ANS:2, 3, 4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A

Difficulty: Difficult

Heading: Surgical Options

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level:  Analysis [Analyzing]

Concept: Nutrition

	Feedback
1.	This is incorrect. Liposuction involves the use of an anesthetic.
2.	This is correct. Liposuction is a cosmetic procedure.
3.	This is correct. Liposuction is a procedure that is associated with high mortality rates, especially among clients who are morbidly obese. This results from fluid shifts that occur during the procedure.
4.	This is correct. Liposuction promotes weight loss by limiting the amount of food that the client consumes.
5.	This is incorrect. Liposuction is a procedure where compression garments are to be worn postoperatively.

PTS: 1 CON: Nutrition

17.ANS:1, 2, 5

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A

Difficulty: Difficult

Heading: Surgical Options

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

	Feedback
1.	This is correct. Gastric bypass surgery promotes weight loss by limiting the volume of food consumed to between one-half and 1 ounce.
2.	This is correct. Gastric bypass surgery is performed by surgically restructuring the upper portion of the stomach to leave an extremely small pouch in place for food digestion.
3.	This is incorrect. Gastric bypass surgery usually results in significant weight loss in a short period of time.
4.	This is incorrect. Gastric bypass surgery is not without possible complications and surgical risks.
5.	This is correct. The connection of the stomach to the small bowel is altered in gastric bypass surgery. The jejunum is cut and connected to the newly created pouch in the superior portion of the stomach. The lower portion of the stomach and the duodenum are bypassed.

PTS: 1 CON: Nutrition

18.ANS:2, 4, 5

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A

Difficulty: Moderate

Heading: Surgical Options

Integrated Processes: Nursing Process

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1.	This is incorrect. Dumping syndrome occurs when the undigested contents of the stomach are transported or “dumped” into the small intestine too rapidly.
2.	This is correct. Abdominal cramps are a symptom that occurs shortly after eating.
3.	This is incorrect. Proximal stomach pouch herniation and suture line rupture are surgical complications related to obesity.
4.	This is correct. Tachycardia and severe hypotension can occur hours after eating.
5.	This is correct. Diarrhea can occur hours after eating.

PTS: 1 CON: Nutrition

19.ANS:1, 4, 5

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A.

Difficulty: Difficult

Heading: Surgical Options

Integrated Processes: Nursing Process 

Client Need: Physiological Integrity: Physiological Adaptation

Cognitive Level: Analysis [Analyzing] 

Concept: Nutrition, Perioperative

	Feedback
1.	This is correct. Gastric banding surgery involves placing a band around the upper portion of the stomach to create a small pouch to hold food. The band limits the amount of food a client can eat by making the client feel full after eating small amounts of food.
2.	This is incorrect. Gastric banding surgery is a laparoscopic procedure, but carries all of the typical risks associated with any major surgery. The risks include rupture of the suture line, infection, and bleeding at the surgical site.
3.	This is incorrect. One of the postoperative risks of gastric banding surgery is the rupture of the suture line.
4.	This is correct. Vomiting may be a side effect of gastric banding surgery when the banding is too tight for the client to tolerate.
5.	This is correct. One of the risks of gastric banding surgery is a malabsorption disorder called rapid gastric emptying or dumping syndrome, where the undigested contents of the stomach are transported or “dumped” into the small intestine too rapidly.

PTS: 1 CON: Nutrition, Perioperative

20.ANS:1, 3, 4, 5

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 84

Objective: N/A.

Difficulty: Moderate

Heading: Surgical Options

Integrated Processes: Nursing Process 

Client Need: Safe and Effective Care Environment – Management of Care

Cognitive Level: Application [Applying]

Concept: Nutrition: Perioperative

	Feedback
1.	This is correct. Dumping syndrome may cause excessive sweating hours after eating.
2.	This is incorrect. Changing diet and eating habits may help control dumping syndrome. High-sugar foods may exacerbate symptoms.
3.	This is correct. Dumping syndrome may place the client at risk for hypoglycemia or low blood sugar.
4.	This is correct. Dumping syndrome causes a malabsorption of nutrients, vitamins, and minerals.
5.	This is correct. Dumping syndrome causes diarrhea.

PTS: 1 CON: Nutrition: Perioperative

21.ANS:1, 4, 5

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 85

Objective: N/A

Difficulty: Easy

Heading: Vitamin and Mineral Imbalances

Integrated Process: Nursing Process

Client Need: Safe and Effective Care Environment – Management of Care

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1.	This is correct. Vitamin A is a fat-soluble vitamin. Fat-soluble vitamins are absorbed through the intestinal tract and are stored in the liver and in fatty tissue.
2.	This is incorrect. B vitamins are water-soluble vitamins. Water-soluble vitamins are not stored in the body, but are readily excreted from the body.
3.	This is incorrect. Vitamin C is a water-soluble vitamin. Water-soluble vitamins are not stored in the body, but are readily excreted from the body.
4.	This is correct. Vitamin D is a fat-soluble vitamin that dissolves in fat and is accumulated in the tissues of the body. It is necessary to prevent and treat rickets, weak bones, and bone loss. Maximum vitamin D intake is obtained through exposure to sunlight.
5.	This is correct. Vitamin E is a fat-soluble vitamin that dissolves in fat and is accumulated in the tissues of the body.

PTS: 1 CON: Nutrition

22.ANS:2, 3, 4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 83

Objective: N/A

Difficulty: Moderate

Heading: Pharmacology

Integrated Process: Nursing Process

Client Need: Safe and Effective Care Environment – Management of Care

Cognitive Level: Application [Applying]

Concept: Nutrition

	Feedback
1.	This is incorrect. Weight loss medications are only modestly effective and work best as an adjunct to lifestyle changes, such as eating a healthy, low-calorie diet and being physically active.
2.	This is correct. Weight loss medications usually have only a short-term effect.  In a large number of clients, weight is often regained as soon as the treatment is stopped.
3.	This is correct. Weight loss medications have sympathomimetic side effects or those that mimic the effects of the sympathetic nervous system, affecting the heart by increasing the heart rate and the circulation by constricting blood vessels.
4.	This is correct. Weight loss medications are indicated for client who have a relatively “safe” BMI of 27 or greater, but who have concurrent obesity-related medical problems.
5.	This is incorrect. Appetite suppressants are available over the counter or with a prescription; however, both have side effects. Appetite suppressants obtained with a prescription should only be used for a short period of time. Over-the-counter appetite suppressants have sympathomimetic side effects.

PTS: 1 CON: Nutrition

23.ANS:1, 3, 4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 78

Objective: N/A

Difficulty: Difficult

Heading: Risk Factors

Integrated Process: Nursing Process

Client Need: Health Promotion and Maintenance

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition

	Feedback
1.	This is correct. Hypothyroidism results in a lack of the thyroid hormone, which can cause obesity. Once hypothyroidism is treated, the weight gain is usually remedied, thus making this a secondary cause of weight gain.
2.	This is incorrect. Prader-Willi syndrome is a genetic disorder that directly leads to weight gain because of hyperphagia or excessive hunger.
3.	This is correct. Polycystic ovarian syndrome results in weight gain. Once this syndrome is controlled, weight gain can be rectified, thus making this a secondary cause of weight gain.
4.	This is correct. Cushing’s syndrome is caused by the overactivity of the adrenal gland. It also causes weight gain. Treatment of Cushing’s syndrome will rectify the weight gain, thus making this a secondary cause of weight gain.
5.	This is incorrect. Leptin receptor gene mutation at 7q31 is a genetic condition that causes obesity.

PTS: 1 CON: Nutrition

24.ANS:1, 3, 4

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 80

Objective: N/A

Difficulty: Easy

Heading: Adipokines

Integrated Process: Nursing Process

Client Need: Safe and Effective Care Environment – Management of Care

Cognitive Level: Knowledge [Remembering]

Concept: Nutrition

	Feedback
1.	This is correct. Excess free fatty acids disturb the pancreas, which leads to a reduced secretion of insulin and, consequently, glucose intolerance.
2.	This is incorrect. Leptin is released into the blood when fat stores rise in adipocytes, sending satiety signals to the brain.
3.	This is correct. Excess free fatty acids are deposited in the liver, causing nonalcoholic steatohepatitis, which leads to cirrhosis.
4.	This is correct. Free fatty acids are created during the process of lipolysis. Lipolysis involves the hydrolysis of triglycerides into glycerol and free fatty acids.
5.	This is incorrect. There is a clear correlation between high levels of angiotensinogen and hypertension.

PTS: 1 CON: Nutrition

COMPLETION

25.ANS:

44.3

Chapter: Chapter 5, Obesity and Nutritional Imbalances

Page: 81-82

Objective: N/A.

Difficulty: Difficult

Heading: Diagnosis

Integrated Processes: Nursing Process 

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Nutrition 

Feedback: Surgical treatments for obesity are offered to clients who have a BMI of 40 or greater, and clients who have a BMI between 35 and 40 and who have medical problems related to obesity. 

Body Mass Index (BMI) = Weight in pounds × 703 / height in inches / height in inches

Height in inches = 5 feet × 12 = 60 inches + 4 inches = 64 inches

Weight in pounds = 258 × 703 = 181,374

BMI = (181,374 / 64) / 64 = 44.3

PTS: 1 CON: Nutrition