NURSE (CBN®) EXAM 2026
The Certified Bariatric Nurse (CBN®) Exam 2026 Ultimate
Success Workbook: 200 High-Yield Practice Questions with
Detailed Rationales, Verified Answers, and Comprehensive
Clinical Review for the Bariatric Nursing Certification
DOMAIN 1: CLINICAL MANAGEMENT — PREOPERATIVE (PRE-HOSPITAL)
QUESTION 1:
A 48-year-old female patient with a BMI of 42 kg/m² and a history of hypertension, type 2 diabetes,
and obstructive sleep apnea is being evaluated for bariatric surgery. According to established
eligibility criteria, which of the following is a primary indication that this patient is a candidate for
metabolic and bariatric surgery?
A. BMI ≥ 40 kg/m² with no comorbid conditions
B. BMI ≥ 35 kg/m² with one or more obesity-related comorbid conditions
C. BMI ≥ 30 kg/m² with type 2 diabetes
D. BMI ≥ 35 kg/m² regardless of comorbid conditions
ANSWER:
B. BMI ≥ 35 kg/m² with one or more obesity-related comorbid conditions
RATIONALE:
National guidelines for bariatric surgery eligibility include patients with a BMI ≥ 40 kg/m² or BMI ≥ 35
kg/m² with at least one obesity-related comorbidity such as type 2 diabetes, hypertension, or sleep
apnea . This patient has a BMI of 42 kg/m² with multiple comorbidities, making her an excellent
candidate. Option A does not require comorbidities at BMI ≥ 40, but option B is more specific to the
criteria. Option C is incorrect because BMI ≥ 30 is generally not sufficient without other qualifying
factors. Option D is incorrect because BMI ≥ 35 alone without comorbidities is not typically sufficient
for surgical candidacy.
QUESTION 2:
A patient with a history of gout is being evaluated for bariatric surgery. The nurse should educate
the patient that following surgery:
A. Gout will be completely cured immediately
B. Gout may temporarily worsen postoperatively due to rapid weight loss and changes in uric acid
metabolism
C. Gout is unaffected by bariatric surgery
D. Gout is a contraindication to bariatric surgery
ANSWER:
B. Gout may temporarily worsen postoperatively due to rapid weight loss and changes in uric acid
metabolism
, NURSE (CBN®) EXAM 2026
RATIONALE:
Gout may temporarily worsen in the early postoperative period due to rapid weight loss, which
increases uric acid levels . Patients with a history of gout should be educated about this and may
require prophylactic colchicine or allopurinol during the rapid weight loss phase. Over time, weight
loss generally improves gout. Gout is not a contraindication to surgery (D), and it is not immediately
cured (A). The condition is definitely affected by surgery (C), particularly in the early postoperative
period .
QUESTION 3:
A patient with a BMI of 51 kg/m² is being evaluated for bariatric surgery. Which of the following
preoperative tests is essential for evaluating cardiac function in this patient who also has a history of
hypertension?
A. Pulmonary function test
B. Echocardiogram
C. Upper endoscopy
D. Sleep study
ANSWER:
B. Echocardiogram
RATIONALE:
An echocardiogram assesses cardiac structure and function, which is essential for identifying
cardiovascular risks before surgery. Patients with hypertension and obesity have increased
cardiovascular risks that may affect surgical outcomes . A pulmonary function test (A) and sleep
study (D) address respiratory issues, while upper endoscopy (C) evaluates the gastrointestinal tract.
Cardiac evaluation is critical in patients with hypertension and obesity due to the increased
prevalence of underlying cardiac conditions .
QUESTION 4:
A patient asks the nurse about the expected amount of weight loss after bariatric surgery. The nurse
calculates the patient's ideal body weight using the Hamwi method. A 5'6" female patient's ideal
body weight range would be:
A. 100 lbs
B. 120-130 lbs
C. 150-160 lbs
D. 180-190 lbs
ANSWER:
B. 120-130 lbs
RATIONALE:
The Hamwi method for females is 100 lbs for the first 5 feet, plus 5 lbs for each additional inch. For
5'6" (66 inches): 100 + (6 × 5) = 130 lbs. The range is typically 120-130 lbs . This calculation helps
determine excess weight and expected weight loss goals. However, ideal body weight formulas are
, NURSE (CBN®) EXAM 2026
less commonly used now; percent excess weight loss (%EWL) and percent total weight loss (%TWL)
are preferred outcome measures in bariatric practice .
QUESTION 5:
A patient is being educated about the importance of preoperative weight loss. Which of the
following statements best explains why even modest preoperative weight loss is beneficial?
A. It has no effect on surgical outcomes
B. It reduces liver size, improves surgical visualization, and may reduce operative time
C. It is required for insurance approval only
D. It increases surgical risk
ANSWER:
B. It reduces liver size, improves surgical visualization, and may reduce operative time
RATIONALE:
Preoperative weight loss (even 5-10% of body weight) reduces liver size and hepatic steatosis,
improves surgical visualization, and may reduce operative time and complications . Many insurance
carriers require documented preoperative weight loss attempts. This also helps patients
demonstrate commitment to lifestyle changes. It does not increase surgical risk (D), and it is not just
for insurance approval (C) .
QUESTION 6:
A patient with a history of non-alcoholic fatty liver disease (NAFLD) is considering bariatric surgery.
The nurse should explain that bariatric surgery:
A. Has no effect on NAFLD
B. Can improve or resolve NAFLD and reduce the risk of progression to cirrhosis
C. Worsens NAFLD
D. Is contraindicated in patients with NAFLD
ANSWER:
B. Can improve or resolve NAFLD and reduce the risk of progression to cirrhosis
RATIONALE:
Bariatric surgery significantly improves or resolves non-alcoholic fatty liver disease in most patients.
Weight loss reduces hepatic steatosis, inflammation, and fibrosis. Patients with NAFLD should be
informed that bariatric surgery may improve liver function and reduce the risk of progression to non-
alcoholic steatohepatitis (NASH) and cirrhosis .
QUESTION 7:
A patient reports taking sertraline (Zoloft) for depression. The nurse's preoperative teaching
regarding this medication should include:
A. Stop taking sertraline 2 weeks before surgery
B. Continue sertraline as prescribed; monitor for absorption changes postoperatively
, NURSE (CBN®) EXAM 2026
C. Double the sertraline dose
D. Switch to a different antidepressant
ANSWER:
B. Continue sertraline as prescribed; monitor for absorption changes postoperatively
RATIONALE:
Patients on psychiatric medications should continue them preoperatively. Postoperatively,
medication absorption may be altered, especially with malabsorptive procedures like RYGB. Some
medications may require dose adjustments or different formulations (e.g., liquid, crushed).
Sertraline should be continued with postoperative monitoring .
QUESTION 8:
A patient with a BMI of 48 kg/m² and severe osteoarthritis asks how bariatric surgery might affect
their joint symptoms. Which response is most accurate?
A. Bariatric surgery will have no effect on joint symptoms
B. Weight loss from surgery typically improves joint pain and function
C. Joint symptoms worsen after bariatric surgery
D. Weight loss only affects joint symptoms if physical therapy is also done
ANSWER:
B. Weight loss from surgery typically improves joint pain and function
RATIONALE:
Weight loss from bariatric surgery typically improves joint pain and function in patients with
osteoarthritis due to reduced mechanical stress on weight-bearing joints . This is one of the benefits
of weight loss surgery that patients often experience. While physical therapy (D) may be beneficial,
weight loss itself has independent positive effects on joint symptoms .
QUESTION 9:
Which of the following best describes the role of the multidisciplinary team in bariatric care?
A. Only the surgeon and anesthesiologist are needed
B. Surgeon, nurse, dietitian, psychologist, and other specialists as needed
C. Only the nurse and dietitian
D. Only the surgeon
ANSWER:
B. Surgeon, nurse, dietitian, psychologist, and other specialists as needed
RATIONALE:
Bariatric surgery requires a multidisciplinary team approach including surgeons, nurses, dietitians,
psychologists, and other specialists as needed . This comprehensive approach optimizes patient
outcomes. The team collaborates to address medical, nutritional, behavioral, and psychosocial
aspects of care throughout the patient's journey .
The Certified Bariatric Nurse (CBN®) Exam 2026 Ultimate
Success Workbook: 200 High-Yield Practice Questions with
Detailed Rationales, Verified Answers, and Comprehensive
Clinical Review for the Bariatric Nursing Certification
DOMAIN 1: CLINICAL MANAGEMENT — PREOPERATIVE (PRE-HOSPITAL)
QUESTION 1:
A 48-year-old female patient with a BMI of 42 kg/m² and a history of hypertension, type 2 diabetes,
and obstructive sleep apnea is being evaluated for bariatric surgery. According to established
eligibility criteria, which of the following is a primary indication that this patient is a candidate for
metabolic and bariatric surgery?
A. BMI ≥ 40 kg/m² with no comorbid conditions
B. BMI ≥ 35 kg/m² with one or more obesity-related comorbid conditions
C. BMI ≥ 30 kg/m² with type 2 diabetes
D. BMI ≥ 35 kg/m² regardless of comorbid conditions
ANSWER:
B. BMI ≥ 35 kg/m² with one or more obesity-related comorbid conditions
RATIONALE:
National guidelines for bariatric surgery eligibility include patients with a BMI ≥ 40 kg/m² or BMI ≥ 35
kg/m² with at least one obesity-related comorbidity such as type 2 diabetes, hypertension, or sleep
apnea . This patient has a BMI of 42 kg/m² with multiple comorbidities, making her an excellent
candidate. Option A does not require comorbidities at BMI ≥ 40, but option B is more specific to the
criteria. Option C is incorrect because BMI ≥ 30 is generally not sufficient without other qualifying
factors. Option D is incorrect because BMI ≥ 35 alone without comorbidities is not typically sufficient
for surgical candidacy.
QUESTION 2:
A patient with a history of gout is being evaluated for bariatric surgery. The nurse should educate
the patient that following surgery:
A. Gout will be completely cured immediately
B. Gout may temporarily worsen postoperatively due to rapid weight loss and changes in uric acid
metabolism
C. Gout is unaffected by bariatric surgery
D. Gout is a contraindication to bariatric surgery
ANSWER:
B. Gout may temporarily worsen postoperatively due to rapid weight loss and changes in uric acid
metabolism
, NURSE (CBN®) EXAM 2026
RATIONALE:
Gout may temporarily worsen in the early postoperative period due to rapid weight loss, which
increases uric acid levels . Patients with a history of gout should be educated about this and may
require prophylactic colchicine or allopurinol during the rapid weight loss phase. Over time, weight
loss generally improves gout. Gout is not a contraindication to surgery (D), and it is not immediately
cured (A). The condition is definitely affected by surgery (C), particularly in the early postoperative
period .
QUESTION 3:
A patient with a BMI of 51 kg/m² is being evaluated for bariatric surgery. Which of the following
preoperative tests is essential for evaluating cardiac function in this patient who also has a history of
hypertension?
A. Pulmonary function test
B. Echocardiogram
C. Upper endoscopy
D. Sleep study
ANSWER:
B. Echocardiogram
RATIONALE:
An echocardiogram assesses cardiac structure and function, which is essential for identifying
cardiovascular risks before surgery. Patients with hypertension and obesity have increased
cardiovascular risks that may affect surgical outcomes . A pulmonary function test (A) and sleep
study (D) address respiratory issues, while upper endoscopy (C) evaluates the gastrointestinal tract.
Cardiac evaluation is critical in patients with hypertension and obesity due to the increased
prevalence of underlying cardiac conditions .
QUESTION 4:
A patient asks the nurse about the expected amount of weight loss after bariatric surgery. The nurse
calculates the patient's ideal body weight using the Hamwi method. A 5'6" female patient's ideal
body weight range would be:
A. 100 lbs
B. 120-130 lbs
C. 150-160 lbs
D. 180-190 lbs
ANSWER:
B. 120-130 lbs
RATIONALE:
The Hamwi method for females is 100 lbs for the first 5 feet, plus 5 lbs for each additional inch. For
5'6" (66 inches): 100 + (6 × 5) = 130 lbs. The range is typically 120-130 lbs . This calculation helps
determine excess weight and expected weight loss goals. However, ideal body weight formulas are
, NURSE (CBN®) EXAM 2026
less commonly used now; percent excess weight loss (%EWL) and percent total weight loss (%TWL)
are preferred outcome measures in bariatric practice .
QUESTION 5:
A patient is being educated about the importance of preoperative weight loss. Which of the
following statements best explains why even modest preoperative weight loss is beneficial?
A. It has no effect on surgical outcomes
B. It reduces liver size, improves surgical visualization, and may reduce operative time
C. It is required for insurance approval only
D. It increases surgical risk
ANSWER:
B. It reduces liver size, improves surgical visualization, and may reduce operative time
RATIONALE:
Preoperative weight loss (even 5-10% of body weight) reduces liver size and hepatic steatosis,
improves surgical visualization, and may reduce operative time and complications . Many insurance
carriers require documented preoperative weight loss attempts. This also helps patients
demonstrate commitment to lifestyle changes. It does not increase surgical risk (D), and it is not just
for insurance approval (C) .
QUESTION 6:
A patient with a history of non-alcoholic fatty liver disease (NAFLD) is considering bariatric surgery.
The nurse should explain that bariatric surgery:
A. Has no effect on NAFLD
B. Can improve or resolve NAFLD and reduce the risk of progression to cirrhosis
C. Worsens NAFLD
D. Is contraindicated in patients with NAFLD
ANSWER:
B. Can improve or resolve NAFLD and reduce the risk of progression to cirrhosis
RATIONALE:
Bariatric surgery significantly improves or resolves non-alcoholic fatty liver disease in most patients.
Weight loss reduces hepatic steatosis, inflammation, and fibrosis. Patients with NAFLD should be
informed that bariatric surgery may improve liver function and reduce the risk of progression to non-
alcoholic steatohepatitis (NASH) and cirrhosis .
QUESTION 7:
A patient reports taking sertraline (Zoloft) for depression. The nurse's preoperative teaching
regarding this medication should include:
A. Stop taking sertraline 2 weeks before surgery
B. Continue sertraline as prescribed; monitor for absorption changes postoperatively
, NURSE (CBN®) EXAM 2026
C. Double the sertraline dose
D. Switch to a different antidepressant
ANSWER:
B. Continue sertraline as prescribed; monitor for absorption changes postoperatively
RATIONALE:
Patients on psychiatric medications should continue them preoperatively. Postoperatively,
medication absorption may be altered, especially with malabsorptive procedures like RYGB. Some
medications may require dose adjustments or different formulations (e.g., liquid, crushed).
Sertraline should be continued with postoperative monitoring .
QUESTION 8:
A patient with a BMI of 48 kg/m² and severe osteoarthritis asks how bariatric surgery might affect
their joint symptoms. Which response is most accurate?
A. Bariatric surgery will have no effect on joint symptoms
B. Weight loss from surgery typically improves joint pain and function
C. Joint symptoms worsen after bariatric surgery
D. Weight loss only affects joint symptoms if physical therapy is also done
ANSWER:
B. Weight loss from surgery typically improves joint pain and function
RATIONALE:
Weight loss from bariatric surgery typically improves joint pain and function in patients with
osteoarthritis due to reduced mechanical stress on weight-bearing joints . This is one of the benefits
of weight loss surgery that patients often experience. While physical therapy (D) may be beneficial,
weight loss itself has independent positive effects on joint symptoms .
QUESTION 9:
Which of the following best describes the role of the multidisciplinary team in bariatric care?
A. Only the surgeon and anesthesiologist are needed
B. Surgeon, nurse, dietitian, psychologist, and other specialists as needed
C. Only the nurse and dietitian
D. Only the surgeon
ANSWER:
B. Surgeon, nurse, dietitian, psychologist, and other specialists as needed
RATIONALE:
Bariatric surgery requires a multidisciplinary team approach including surgeons, nurses, dietitians,
psychologists, and other specialists as needed . This comprehensive approach optimizes patient
outcomes. The team collaborates to address medical, nutritional, behavioral, and psychosocial
aspects of care throughout the patient's journey .
