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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

Which of the following responses are appropriate? Select all that apply. Base your eating plan on MyPyramid. What message(s) would be appropriate for the nurse to convey to the client? a. The simplest is to eat a normal diet based on MyPyramid but with the calorie content control. ANS: B. 20%-35% or less of fat. than 15% fat b. 40-50% protein. Exchange list also provide another method to healthfully control the calorie content of the meal. The nurse is teaching an overweight client about weight reduction. It takes 90+ minutes of exercise a day to in weight loss. 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. no fat more than 15% fat ANS: A The usual diet should consist of 10% to 20% protein. Avoid fad diets. physiological. b. 10% to 20% protein. 25-35% carbohydrate. PTS: 1 REF: Dietary Treatment of Overweight and Obesity 4. 45% to 65% c. Exercising 30 minutes a day may not e. Several reasonable strategies for weight reduction exist. 20-35% protein. The usual diet should consist of 10% to 20% protein. What should the diet composition be for someone on a weight reduction plan? a. It takes 60-90 minutes of exercise a day to result in weight loss. you become obese. 20%-35% or less of fat. Exercise is an adjunct to a weight loss d. but the total number of calories is reduced. no more carbohydrate. but e.There is no one cause for excess weight. total calories. 50% protein. a. Don’t worry about losing weight unless result in a 1 pound weight loss per week. Exercising 60-90 minutes a day will result f. Use a meal replacement drink 3 times a control the calorie content. metabolic. but it will reduce the prevent weight gain. day until you reach your weight goal. E. 20-35% protein. Use exchange lists to plan your diet. ANS: A. a reduction of 3. and psychological factors can also contribute to obesity. maintain weight loss. the normal proportions of nutrients are consumed. 45% to 65% carbohydrate.500 calories will result in a weight loss of 1 pound per week. PTS: 1 REF: Causes 3. such as liquid meal replacements) as they rarely provide a healthful diet. F . Nor is there one “best” way to lose weight. weight significantly without dietary modifications. Exercising 90+ minutes a day will result program and is rarely sufficient to reduce in weight loss. For weight reduction. 30% d. risk for developing chronic diseases. A reduction of 3. Genetic.000 calories a week will d. c. The client does not want to reduce food intake. Limiting fat in the diet by counting fat grams is another way to control excess calorie intake. B. b. Whatever method is chosen. F There is no magic way of losing weight. C. biochemical. preferring to create a caloric deficit with exercise. PTS: 1 REF: Dietary Treatment of Overweight and Obesity 5. c. Count fat grams and limit fat to 20% of f. 20%-35% or less of fat. 35% carbohydrate. but poor diet and inactivity appear to be leading factors. 45% to 65% carbohydrate.

than it is to lose it. A client who has Class II obesity as well as severe type 2 diabetes is considering gastric bypass surgery. General daily guidelines for exercise are 30 minute to prevent chronic diseases. Which of the following nutrition related complications should the nurse discuss with the client? Select all that apply. nausea and vomiting b. F Underweight can be caused by inadequate consumption of nutritious food. anorexia nervosa. a. vitamin C deficiency ANS: A. It can be as difficult for an underweight person to gain weight as it is for an overweight person to lose weight. Exercise alone rarely results in weight loss. dumping syndrome e. The nurse is completing the nutrition assessment of a client. vitamin B12 and calcium deficiencies as well as dumping syndrome which can cause nausea and vomiting. bloating and dizziness.or small-boned. calcium deficiency d.5 The client’s 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 nurse is reviewing possible complications with the client. vitamin B12 deficiency c. is an excellent adjunct to any weight loss program. no further adjustments are needed. it is much easier to gain weight have no effect on your pregnancy. D. An underweight client tells the public health nurse she wants to bring her weight up to a healthier weight before becoming pregnant. B. Which of the following questions/statements would be appropriate for the nurse to make? Select all that apply. 60-90 minutes to prevent weight gain. bulimia. and over 90 minutes to maintain weight loss. The client is 65. The client is a female who is 5’5. REF: Underweight . Being underweight at conception will e. Do you have sufficient money to buy f. D. Are your parents also small? d. diarrhea. E The nutrition related complications of gastric bypass surgery are iron. You should see a physician to rule out food? possible medical reasons for being underweight. disease. a. because of depression. weighs190 pounds.25” tall. particularly aerobic exercise. PTS: 1 REF: Surgical Treatment of Obesity 7. When the nurse uses the “rule of thumb” method. Since the client is not described as either large. so her ideal body weight is 126. c. PTS: 1 REF: Exercise 6.5. iron deficiency f. C. PTS: 1 NUMERIC RESPONSE 1. ANS: A.25 inches tall. and has an average frame. or poverty. Have you ever been diagnosed with depression? b. this client’s ideal body weight (IBW) is found to be how many pounds? ANS: 126. C. Luckily.Exercise. or it can be genetically determined.

The nurse has determined the client’s daily caloric intake to maintain current weight to be 2. However. How many calories will the nurse say the client should consume each day? ANS: 1. caloric intake should not be reduced below 1. PTS: 1 .PTS: 1 REF: Introduction 2.200 calories or the client would not receive the necessary nutrients.500 calories will result in a weight loss of 1 pound. The client wants to lose 2 pounds a week.200 A reduction of 3.000 calories per day would result in a 2 pound weight loss in one week. So. a reduction of 1.000 calories.