Obesity, Exam #2 review questions Questions With Correct Answers.

Obesity, Exam #2 review questions The nurse is teaching about the pathophysiological changes that cause obesity and the minimum amount of kilocalories required to sustain life. Which information should the nurse include? How a decrease in basal metabolic rate contributes to weight gain How increasing resting energy expenditure causes obesity How to calculate body mass index How to determine nutrient density - ANS How a decrease in basal metabolic rate contributes to weight gain The nurse is describing the pathophysiology of obesity, so the answer should explain that the basal metabolic rate is the "cost" of staying alive and is the minimum number of kilocalories needed at rest to maintain life-sustaining activities. The resting metabolic rate per kilogram of body weight is lower in an obese person compared with a normal-weight person. The other answers are incorrect because the resting energy expenditure is also typically lower, not higher, in an obese person; the body mass index is an indirect measure of the amount of body fat, and the nutrient density refers to the ratio of good nutrients to the calories a food contains, but neither choice explains the pathophysiological cause of obesity. A patient diagnosed with hypertension has a calculated body mass index (BMI) of 36 and the following lab results: LDL 190 mg/dL, HDL 40 mg/dL, total cholesterol 240 mg/dL, triglycerides 500 mg/dL. Based on this assessment data, how should the nurse classify the patient's weight? Obesity class II Normal weight Obesity class I Overweight - ANS Obesity class II The most common way to determine if a person is overweight or obese is to calculate body mass index (BMI). The diagnosis of hypertension and the lab results indicate hyperlipidemia, which are two comorbidities of obesity. Based on this information, a BMI greater than 35 with two or more comorbidities is defined as obesity class II. Normal weight is a BMI under 18.5-24.9 with no comorbidities. BMI between 25 and 30 is classified as overweight. A BMI of 30-34.9 with two or more comorbidities is classified as obesity class I. An obese patient has been prescribed a lipase inhibitor, orlistat (Xenical), for weight loss. Which finding is most important to report to the healthcare provider? ANSWER The patient is having recurrent liquid stools. The patient feels bloated after meals. The patient is experiencing a weight-loss plateau. The patient is pale and has extensive bruising. - ANS The patient is pale and has extensive bruising. A 60-year-old female patient is concerned about gaining weight because she is going through menopause. Which factor should the nurse teach the patient to help prevent weight gain as she ages? ANSWER Drinking more water Eliminating the intake of bread, potatoes, and rice Focusing on portion sizes Restricting the intake of carbohydrate-dense foods - ANS Focusing on portion sizes Education is a key to promoting nutritional wellness and preventing nutrition-related alterations, including obesity. Patients may benefit from teaching related to portion sizes. Water is an essential nutrient; however, drinking more water will not prevent weight gain as the patient ages. The patient should not be instructed to avoid particular foods and food groups such as carbohydrates and grains because these foods provide essential nutrients and vitamins to maintain health. The nurse is teaching a patient about the recommended amounts of food from animal and plant sources. Which menu selections made by the patient indicate that the nurse's teaching about diet has been understood? ANSWER 3 oz of lean beef, 2 oz of low-fat cheese, and a sliced tomato 3 oz of roast pork, a cup of corn, and a cup of carrot sticks A cup of tossed salad and nonfat dressing topped with a chicken breast A half cup of tuna mixed with nonfat mayonnaise and a half cup of celery - ANS 3 oz of roast pork, a cup of corn, and a cup of carrot sticks This selection is most consistent with the recommendation of the American Institute for Cancer Research that one third of the diet should be from animal sources and two thirds from plant source foods. The other choices all have higher ratios of animal-origin foods to plant-source foods than would be recommended. The following image is a good representation of the serving size for each food item, except that the patient should only have one pork chop and more green beans. Swapping out sweet potatoes for the regular mashed potatoes would make this meal an even better selection. The nurse is assessing a patient who is obese. Which is the most important observation that the nurse should make? The patient's dislike of vegetables The patient's self-reported shortness of breath after brisk walking The patient's difficulty standing from a seated position The patient's negative self-image caused by obesity - ANS The patient's difficulty standing from a seated position When planning activities for obese patients, it is important to note self-imposed restrictions, such as difficulty moving from a sitting to standing position in order to anticipate for these difficulties while developing a successful workout plan. Knowing that the patient does not like vegetables is good, but there are many other options to help them achieve balanced nutrition without having to directly eat vegetables. Shortness of breath is a commonly reported symptom of obese people who have performed physical activity. Finally, it is important to note negative self-image and issues with self-esteem, but it is easier to focus on the short-term goal of establishing an exercise routine, because this has the potential of leading to higher self-esteem as the patient loses weight. The nurse is presenting information on childhood obesity to a group of parents. Which leading risk factor should the nurse identify as causing obesity in children? Parental obesity Hormonal changes Sedentary lifestyle Slower metabolic rate - ANS Parental obesity Among children, parental obesity and unhealthy food choices in the home environment are leading risk factors for developing obesity. For older adults, the risk factors for obesity include hormonal changes, a sedentary lifestyle, and a slower metabolic rate. The nurse is developing a weight reduction plan for an obese patient with metabolic syndrome and sleep apnea. Which question should the nurse ask first? "What are your favorite types of foods?" What do you think led to your obesity?" "How old were you when your obesity began?" "What physical activities do you like to do?" - ANS What do you think led to your obesity?" The nurse should ascertain the patient's self-perception of how they became obese to make an individualized weight-reduction plan. The other information is important, but it is important to consider the patient's beliefs in planning, because it makes the patient more likely to make the necessary changes. The nurse is coaching obese adults on behavior modification strategies for losing weight. Which nursing action is appropriate?