RNSG MISC: PU48 EXAMS 2024 LATEST UPDATED QUESTIONS WITH EXPLAINED CORRECT ANSWERS

Which of the following medications used for obesity improves cardiovascular disease risk factors in obese patients with metabolic syndrome? You Selected: • Rimonabant (Acomplia) Correct response: • Rimonabant (Acomplia) Explanation: Acomplia is the newest medication used to treat obesity. It stimulates weight reduction and improves cardiovascular disease risk factors in obese patients with metabolic syndrome. Meridia was recently pulled from the market because of the increased risk of heart attack and stroke associated with this medication. Orlistat, available by prescription and over the counter as Alli, reduces caloric intake by binding to gastric and pancreatic lipase to prevent digestion of fats. Question 2 A client has gained 55 lb in the last 3 years and is concerned about developing type 2 diabetes mellitus. Additionally, the client's healthcare provider has diagnosed metabolic syndrome. What are the conditions which contribute to developing metabolic syndrome? Select all that apply. You Selected: • elevated blood glucose levels • abdominal obesity Correct response: • abdominal obesity • elevated blood glucose levels Explanation: Metabolic syndrome includes obesity, especially in the abdominal area; high blood pressure (BP); elevated triglyceride, low-density lipoprotein (LDL), and blood glucose levels; and a low high-density lipoprotein (HDL) level. Question 3 A nurse cares for a client with a BMI of 36 kg/m2 and nonalcoholic fatty liver disease. The client asks the nurse if he is a candidate for bariatric surgery. How should the nurse respond to the client? You Selected: • "Yes, your BMI and chronic condition meets the criteria for bariatric surgery." Correct response: • "Yes, your BMI and chronic condition meets the criteria for bariatric surgery." Explanation: The client's BMI of > 35 kg/m2 and a more severe obesity-associated comorbid condition, makes the client a candidate for bariatric surgery. Question 4 A client is scheduled for a Roux-en-Y bariatric surgery. When teaching the client about the surgical procedure, which statement will the nurse use? You Selected: • "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." Correct response: • "The stomach is stapled to create a very small pouch and part of the small intestine is rerouted." Explanation: In Roux-en-Y bariatric surgery, a horizontal row of staples across the fundus of the stomach creates a pouch with a capacity of 20 to 30 mL. The jejunum is divided distal to the ligament of Treitz, and the distal end is anastomosed to the new pouch. The proximal segment is anastomosed to the jejunum. Question 5 A nurse examines the socioeconomic impact of obesity among Americans. Which statements does the nurse understand is true? Select all that apply. You Selected: • Those with less education are impacted at a greater prevalence of disease. • Those with less income are impacted at a greater prevalence of disease. Correct response: • Those with less education are impacted at a greater prevalence of disease. • Those with less income are impacted at a greater prevalence of disease. Explanation: The socioeconomic disparities of obesity among Americans is great. In general, those who are less educated and earn less income are more likely to have obesity. Home ownership does not decrease the prevalence of obesity. Question 6 A nurse researcher studies the pathophysiology and etiology of obesity. What does the nurse discover is true regarding the "thrify gene" theory of obesity? You Selected: • Over time, we have become efficient in food storage and deposition of fat stores. Correct response: • Over time, we have become efficient in food storage and deposition of fat stores. Explanation: According to the "thrifty gene" theory, hunting for scarce food sources during prehistoric times consumed a lot of energy, and food sources were not abundant. Storing fat to provide energy sources during times of food scarcity was a physiologic adaptive response to these environmental challenges and over time, we became more efficient in food storage and fat deposition. Question 7 A nurse cares for a client with obesity who reports taking "a medication of weight loss" but cannot remember the name of it. The client also reports nervousness and feeling "jittery". Which medication is the client most likely taking? You Selected: • Phentermine Correct response: • Phentermine Explanation: Phentermine is a sympathomimetic amine that stimulates central noradrenergic receptors, causing appetite suppression. Feeling jittery and nervousness is associated with this type of medication. The other answer choices represent treatment options for obesity; however, these do not cause the client's symptoms. Question 8 A nurse cares for clients who undergo bariatric surgery due to obesity. When teaching the client on the most successful surgery in clients with very high BMI's, which procedure will the nurse mention? You Selected: • Biliopancreatic diversion with duodenal switch Correct response: • Biliopancreatic diversion with duodenal switch Explanation: The biliopancreatic diversion with duodenal switch is the most successful bariatric surgery for clients with the highest BMI's. The other answer choices represent additional bariatric surgeries; however, these are not the most successful in clients with the highest BMI's. Question 9 A nurse cares for a client who wants to know more information about bariatric surgery. The client asks the nurse, "What weight loss can I expect?" What is the nurse's best response? You Selected: • "Expect to lose 10-35% of total body weight 2 to 3 years postoperatively." Correct response: • "Expect to lose 10-35% of total body weight 2 to 3 years postoperatively." Explanation: When discussing weight loss expectations with the client, the nurse should let the client know to expect to lose 10-35% of total body weight 2 to 3 years postoperatively. The client may lose a large amount of weight the first month after surgery; however, this is not generally quantified with exact numbers or ranges. Question 10 The nurse plans care for a client with obesity. What does the nurse recognize is the primary pathophysiological reason clients with obesity are at greater risk for developing thromboembolism? You Selected: • Compromised peripheral blood flow Correct response: • Compromised peripheral blood flow Explanation: A client with obesity is at increased risk for developing thromboembolism due to compromised blood flow and resulting venous stasis. Although the client with obesity is at risk for high cholesterol levels, increased fat in the blood does not directly impact the risk for developing thromboembolism. Increased blood viscosity and impaired clotting do not typically occur in obesity and are not the reason a client with obesity would be at greater risk for developing thromboembolism. Question 11 Place the pathophysiological steps in order of how a client with obesity is at greater risk for venous thromboembolism in comparison to the general population. You Selected: • Increased adipose tissue • Impairment of peripheral blood flow • Blood stasis • Formation of a thrombus Correct response: • Increased adipose tissue • Impairment of peripheral blood flow • Blood stasis • Formation of a thrombus Explanation: In obesity, an increase in adipose tissue impairs the peripheral blood flow, leading to blood stasis and the formation of a thrombus. Question 12 Calculate the BMI of a client who is 6 feet 1 inch tall and weighs 200 pounds. Round to one decimal. Your Response: • 26.4 Correct response: • 26.4 Explanation: To calculate BMI, multiply weight in pounds by 703 and then divide that by height in inches squared