7/30/2019 Roth 10e Nclex Chapter 16

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 REF: Pharmaceutical Treatment of Obesity

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. We should strive to have as little fat on
more health risk than fat in the thighs and our bodies as possible, since fat does
 buttocks. nothing good for us.
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

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

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There is no one cause for excess weight, but poor diet and inactivity appear to be leading factors.
Genetic, physiological, metabolic, biochemical, and psychological factors can also contribute to
obesity.

PTS: 1 REF: Causes

3. The nurse is teaching an overweight client about weight reduction. What message(s) would be
appropriate for the nurse to convey to the client?
a. A reduction of 3,000 calories a week will d. Don’t worry about losing weight unless
result in a 1 pound weight loss per week. you become obese.
 b. Base your eating plan on MyPyramid, but e. Use a meal replacement drink 3 times a
control the calorie content. day until you reach your weight goal.
c. Count fat grams and limit fat to 20% of  f. Use exchange lists to plan your diet.
total calories.

ANS: B, C, F
There is no magic way of losing weight. Nor is there one “best” way to lose weight. Several
reasonable strategies for weight reduction exist. The simplest is to eat a normal diet based on
MyPyramid but with the calorie content control. Exchange list also provide another method to
healthfully control the calorie content of the meal. Limiting fat in the diet by counting fat grams is
another way to control excess calorie intake. Whatever method is chosen, a reduction of 3,500 calories
will result in a weight loss of 1 pound per week. Avoid fad diets, such as liquid meal replacements) as
they rarely provide a healthful diet.

PTS: 1 REF: Dietary Treatment of Overweight and Obesity

4. The usual diet should consist of 10% to 20% protein, 45% to 65% carbohydrate, 20%-35% or less of 
fat. What should the diet composition be for someone on a weight reduction plan?
a. 10% to 20% protein, 45% to 65% c. 20-35% protein, 40-50% protein, no more
carbohydrate, 20%-35% or less of fat. than 15% fat
 b. 20-35% protein, 35% carbohydrate, 30% d. 50% protein, 25-35% carbohydrate, no
fat more than 15% fat

ANS: A

The usual diet should consist of 10% to 20% protein, 45% to 65% carbohydrate, 20%-35% or less of 
fat. For weight reduction, the normal proportions of nutrients are consumed, but the total number of 
calories is reduced.

PTS: 1 REF: Dietary Treatment of Overweight and Obesity

5. 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. The client does not want to reduce food intake, preferring to create a
caloric deficit with exercise. Which of the following responses are appropriate? Select all that apply.
a. Exercise is an adjunct to a weight loss d. Exercising 90+ minutes a day will result
 program and is rarely sufficient to reduce in weight loss.
weight significantly without dietary
modifications.
 b. Exercising 30 minutes a day may not e. It takes 60-90 minutes of exercise a day to
result in weight loss, but it will reduce the  prevent weight gain.
risk for developing chronic diseases.
c. Exercising 60-90 minutes a day will result f. It takes 90+ minutes of exercise a day to
in weight loss. maintain weight loss.

ANS: A, B, E, F

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Exercise, particularly aerobic exercise, is an excellent adjunct to any weight loss program. Exercise
alone rarely results in weight loss. General daily guidelines for exercise are 30 minute to prevent
chronic diseases, 60-90 minutes to prevent weight gain, and over 90 minutes to maintain weight loss.

PTS: 1 REF: Exercise

6. A client who has Class II obesity as well as severe type 2 diabetes is considering gastric bypass
surgery. The nurse is reviewing possible complications with the client. Which of the following
nutrition related complications should the nurse discuss with the client? Select all that apply.
a. calcium deficiency d. nausea and vomiting
 b. dumping syndrome e. vitamin B12 deficiency
c. iron deficiency f. vitamin C deficiency

ANS: A, B, C, D, E
The nutrition related complications of gastric bypass surgery are iron, vitamin B12 and calcium
deficiencies as well as dumping syndrome which can cause nausea and vomiting, diarrhea, bloating
and dizziness.

PTS: 1 REF: Surgical Treatment of Obesity

7. An underweight client tells the public health nurse she wants to bring her weight up to a healthier 
weight before becoming pregnant. Which of the following questions/statements would be appropriate
for the nurse to make? Select all that apply.
a. Are your parents also small? d. Have you ever been diagnosed with
depression?
 b. Being underweight at conception will e. Luckily, it is much easier to gain weight
have no effect on your pregnancy. than it is to lose it.
c. Do you have sufficient money to buy f. You should see a physician to rule out
food?  possible medical reasons for being
underweight.

ANS: A, C, D, F

Underweight can be caused by inadequate consumption of nutritious food, because of depression,

disease, anorexia nervosa, bulimia, or poverty, or it can be genetically determined. It can be as difficult
for an underweight person to gain weight as it is for an overweight person to lose weight.

PTS: 1 REF: Underweight

NUMERIC RESPONSE

1. The nurse is completing the nutrition assessment of a client. The client is a female who is 5’5.25” tall,
weighs190 pounds, and has an average frame. When the nurse uses the “rule of thumb” method, this
client’s ideal body weight (IBW) is found to be how many pounds?

ANS:
126.5

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 client is 65.25 inches tall, so her ideal body weight is 126.5. Since the client is not described as
either large- or small-boned, no further adjustments are needed.

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PTS: 1 REF: Introduction

2. The nurse has determined the client’s daily caloric intake to maintain current weight to be 2,000
calories. The client wants to lose 2 pounds a week. How many calories will the nurse say the client
should consume each day?

ANS:
1,200

A reduction of 3,500 calories will result in a weight loss of 1 pound. So, a reduction of 1,000 calories
 per day would result in a 2 pound weight loss in one week. However, caloric intake should not be
reduced below 1,200 calories or the client would not receive the necessary nutrients.

PTS: 1

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