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WorksheetsExam 1 (MedSurg): Obesity
Total questions: 100
Worksheet time: 53mins
Primary Obesity is the result of energy imbalance where one takes in more calories than they need for the body’s physical and metabolic functions.
True
False
Which of the following is NOT listed as a factor in the etiology and pathophysiology of obesity?
Abnormal increase and accumulation of fat cells
Genetic and environmental influences
Poor work ethic
Personal decisions about food choices, portion sizes, and exercise
Fill in the blank: The greatest increase in number of fat cells occurs from _______ to adolescence.
infancy
adulthood
old age
puberty
Which of the following is a congenital condition associated with secondary obesity?
Prader-Willi Syndrome
Down Syndrome
Fragile X Syndrome
Bowel Obstruction
Over how many genes have been linked to obesity according to the study guide?
10
100
400
1000
A family history of obesity increases a person's chance of developing obesity.
True
False
What is the major site for regulating appetite?
Hypothalamus
Adipocytes
Liver
Pancreas
Neuropeptide Y is a powerful appetite _________?
stimulant
suppressant
inhibitor
regulator
Leptin is made in which type of cells?
Neurons
Adipocytes
Hepatocytes
Myocytes
Leptin ________ appetite.
Stimulates
Suppresses
Ghrelin regulates appetite by ________ leptin.
Stimulating
Inhibiting
Which hormone is thought to play a role in compulsive eating and stimulates hunger?
Leptin
Ghrelin
Insulin
Glucagon
Adipocytes create adipokines, which play a role in all of the following EXCEPT:
Glucose and lipid metabolism
Insulin sensitivity
Energy homeostasis
Muscle atrophy
What is the main difference between atherosclerosis and arteriosclerosis?
Atherosclerosis is the hardening of outside membranes of vasculature, while arteriosclerosis is the buildup of fat cells within vasculature.
Atherosclerosis is the buildup of fat cells within vasculature, while arteriosclerosis is the hardening of outside membranes of vasculature.
Both are the same condition.
Neither involves the vasculature.
SATA: Excess visceral fat associated with adipokine dysfunction leads to which of the following?
Insulin resistance
High LDLs
Hypertension
High HDLs
High triglyceride count
Eating outside of the home frequently can contribute to obesity.
True
False
Which of the following is NOT an environmental factor contributing to obesity?
Greater access to high calorie, energy dense food
Portion size of meals has increased dramatically
Lack of physical exercise
Consumption of fruits and vegetables
Fill in the blank: Eating while watching TV, working, studying, etc. is an example of a ________ factor influencing food use.
psychosocial
nutritional
environmental
biological
SATA: Which of the following are psychosocial health risks of obesity?
T2DM
Metabolic syndrome
Depression
Decreased muscle mass
Social isolation
Which of the following is an endocrine/metabolic health risk of obesity?
Depression
T2DM
Social isolation
Anxiety
Which syndrome is a respiratory complication related to obesity?
Hypoventilation syndrome
Pickwickian syndrome
RSV
Bronchial asthma
Which obesity-related musculoskeletal condition is characterized by joint pain and degeneration?
Osteoarthritis
Rheumatoid fever
Fibromyalgia
Tendinitis
Which obesity-related reproductive condition in men involves decreased testosterone production?
Hypogonadism
Epididymitis
Varicocele
Prostatitis
Fill in the blank: Nonalcoholic steatohepatitis (NASH), gallstones, and gastroesophageal reflux disease (GERD) are GI problems linked to _______.
obesity
hypertension
diabetes insipidus
celiac disease
Fill in the blank: Kidney cancer, chronic kidney disease, and stress incontinence are GU problems associated with _______.
obesity
hypertension
diabetes
smoking
Which type of obesity puts patients at greater risk for cardiovascular problems?
A) Android (Apple)
B) Gynoid (Pear)
C) Generalized
D) None of the above
Obesity is the greatest risk factor for developing which type of diabetes?
Type 1 Diabetes Mellitus
Type 2 Diabetes Mellitus
Gestational Diabetes
MODY
Nonalcoholic steatohepatitis (NASH) can eventually lead to ________.
cirrhosis
pancreatitis
nephritis
gastritis
Weight loss can improve which liver condition?
Acute liver failure
Nonalcoholic steatohepatitis
Gallstones
Hepatitis A
Hepatitis B
Obesity can cause sleep apnea, which is characterized by ________ and hypoventilation.
snoring
coughing
wheezing
sneezing
Obesity hypoventilation syndrome includes all of the following EXCEPT:
Reduced chest wall compliance
Increased work of breathing
Decreased total lung capacity
Increased gas exchange
Obesity triggers inflammatory mediators, cartilage deterioration, and a higher incidence of ________ and gout.
hyperuricemia
hypoglycemia
hypotension
hypokalemia
Obesity is one of the MOST IMPORTANT PREVENTABLE causes of ________.
cancer
flu
fractures
color blindness
What is the FIRST step in the nursing assessment of obesity?
Assess willingness to change
Address patient concerns
Determine if other conditions may be causing or contributing to obesity
Clarify reason for questions about weight
Fill in the blank: In the nursing assessment of obesity, it is important to be ______ and non-judgemental.
sensitive
aggressive
indifferent
critical
Which of the following is NOT a part of health history assessment for obesity?
Explore genetic and endocrine factors
Lab tests of liver and thyroid function
Assess willingness to change
Height, weight, waist circumference, BMI
People with visceral fat and android obesity are at an increased risk for cardiovascular disease and metabolic syndrome.
True
False
Fill in the blank: Men with a waist circumference greater than ____ inches are considered obese.
40
36
42
38
Fill in the blank: Women with a waist circumference greater than ____ inches are considered obese.
35
30
40
25
What is the method for describing the distribution of subcutaneous and visceral adipose tissue?
BMI calculation
Waist measurement divided by hip measurement
Blood pressure measurement
Fasting glucose test
Men with a waist to hip ratio (WHR) greater than are considered obese.
0.8
1.2
0.9
Women with a waist to hip ratio (WHR) greater than are considered obese.
1.0
0.7
0.9
Which body shape is characterized by fat located primarily in the abdominal area?
Apple shaped body
Pear shaped body
Banana shaped body
Hourglass shaped body
Apple shaped body is also known as ________ Obesity.
Android
Gynoid
Central
Peripheral
Which body shape is characterized by fat located primarily in the upper legs?
Apple shaped body
Pear shaped body
Banana shaped body
Rectangle shaped body
Pear shaped body is also known as ________ Obesity.
Gynoid
Android
Central
Visceral
Patients with obesity may have which of the following clinical problems?
Body weight problems
Altered blood glucose level
Musculoskeletal problems
All of the above
Achieving an 'ideal' BMI (18.5-24.9) is necessary and should always be a realistic goal for patients with obesity.
True
False
What is one of the overall goals in planning for patients with obesity?
Modify eating pattern
Take part in regular exercise
Achieve and maintain weight loss to a specified level
All of the above
Successful weight management can be a hard, lifelong commitment.
True
False
Modest weight loss of as low as __% can have health benefits. Fill in the blank.
5%
1%
15%
25%
An average weight loss program results in a __% reduction of body weight. Fill in the blank.
10%
2%
25%
50%
5%
Barriers to counselling about obesity include all of the following EXCEPT:
Time constraints
Not wanting to cause embarrassment
Lack of reimbursement for weight loss services
Easy access to weight loss services
There are no 'best' diets.
True
False
Any diet can work if it reduces caloric intake compared to expenditure, includes a variety of healthy foods, and the patient will adhere to it.
True
False
Men have more lean body mass and can lose weight faster than women.
True
False
Postmenopausal women are prone to weight gain.
True
False
What is the recommended amount of moderate exercise per week for obesity management?
60 minutes
100 minutes
150 minutes
200 minutes
Drug therapy for obesity should be used alone without any other interventions.
True
False
Fill in the blank: Behavior therapy for obesity assumes that persons who are obese have _______ eating and exercise patterns.
maladaptive
healthy
sporadic
balanced
SATA: What are some reproductive issues in women that correlate with obesity?
menstrual irregularities
gestational diabetes
infertility
hypogonadism
erectile dysfunction
SATA: What are some reproductive issues in men that correlate with obesity?
hypogonadism
gestational diabetes
gynecomastia
sexual dysfunction
Which types of cancer are associated with obesity for BOTH sexes?
esophageal cancer
thyroid cancer
endometrial cancer
colorectal cancer
lung cancer
In obese patients, pancreatic _____ cells may become overworked and decline in function, contributing to the development of T2DM.
alpha
delta
beta
lymphatic
Fill in the blanks: Medications for obesity are reserved for adults with a BMI of ___ or greater (obese) OR adults with a BMI of ___ or greater (overweight) who also have at least ___ weight-related condition(s).
35, 30, 3
30, 27, 1
25, 20, 2
32, 29, 1
Obese patients should use over the counter diet aids.
Yes, all of them are safe.
No, none of them are safe.
Only if recommended by their health care provider.
Exercise can be used in place of medication for all obese patients.
What is the ONLY treatment found to have a successful and lasting impact on sustained weight loss for those suffering from extreme obesity?
Liposuction
Bariatric surgery
Becoming a "Biggest Loser" contestant
Coronary bypass surgery
Drinking Ozepmic
SATA: Select all of the options that would allow a patient meet the criteria for bariatric surgery.
BMI greater than or equal to 40
BMI greater than or equal to 35, along with at least 1 weight related comorbidity
BMI greater than or equal to 35
BMI greater than or equal to 25, along with at least 1 weight related comorbidity
BMI of greater than or equal to 25
Potential bariatric surgery candidates are screened for mood disorders, binge eating disorders, substance abuse, and illnesses known to reduce life expectancy which are not likely to improve with weight loss. Candidates with one or more of these conditions are:
prime candidates for bariatric surgery
do not qualify for bariatric surgery
are not ideal patients, but will still be allowed to have bariatric surgery
as long as their insurance check clears, they can have whatever surgery they want
SATA: What are the three broad categories of bariatric surgeries?
combination of restrictive and absorptive
restrictive
absorptive
malabsorptive
combination of restrictive and malabsorptive
A patient undergoes a procedure in which they received inflatable equipment around the fundus of the stomach, which can be deflated or inflated more to meet the patient's needs post procedure. What bariatric procedure did this patient receive?
sleeve gastrectomy
adjustable gastric banding
roux-en-Y
gastric pacemaker
liposuction
How are AGB (adjustable gastric banding) procedures USUALLY done?
endoscopically
laparoscopically
colonoscopally
echocardiographically
The stomach pouch created above the band in adjustable gastric banding procedures has a capacity of ______.
10-15 L
20-30 L
10-15 mL
20-30 mL
10-30 mL
Sleeve gastrectomies and adjustable gastric bandings are types of _____ bariatric procedures.
malabsorptive
cosmetic
restrictive
absorptive
What percentage of the stomach is removed during a sleeve gastrectomy?
50%
10%
75%
99%
25%
Gastric sleeves often result in the elimination of the hormone _____, which is produced in the stomach and stimulates hunger.
Leptin
Ghrelin
Cortisol
Thyroid Stimulating Hormone
A Roux-en-Y procedure is an example of:
restrictive bariatric surgery
malabsorptive bariatric surgery
combination of restrictive and malabsorptive bariatric surgery
cosmetic bariatric surgery
Fill in the blanks: After a Roux-en-Y procedure, food will bypass 90% of the stomach, _____, and a small segment of the _____.
duodenum, colostrum
jejunum, cecum
duodenum, jejunum
small intestine, large intestine
colon, pancreas
SATA: Some of the many complications of a Roux-en-Y procedure are:
gastrointestinal tract leaks
gastric remnant distention
ulcers
gallstones
hernias
What is dumping syndrome?
When gastric contents empty too slowly into the large intestine
When bladder contents empty into the large intestine
When completely undigested food is excreted
When gastric contents empty too rapidly into the small intestine
When bladder contents empty too slowly into the small intestine
Dumping syndrome is most commonly associated with which of the following bariatric procedures?
Adjustable gastric banding
Sleeve gastrectomy
Roux-en-Y
Liposuction
Gastric pacemakers are surgically implanted devices placed with leads and wires around the _____ nerve, and sends electrical impulses to this nerve to decrease hunger.
occipital
vestibulotrochlear
vagus
trigeminal
glossopharyngeal
A patient has just come back to the unit from the OR after receiving bariatric surgery. It is important that the RN keeps the head of the bed _____ while the patient recovers from anesthesia.
lowered
elevated
in super fowlers
completely flat
Airway _____ is extremely important in post-operative patients.
closure
obstruction
stabilization
elimination
SATA: What are some venous thromboembolism precautions the nurse can set up for bariatric post-operative patients?
TED hose
keep patient bedbound at all times
sequential compression devices
encourage ambulation in the days following the procedure
vitamin K administration
If a patient is in considerable abdominal pain post bariatric surgery, what should the nurse assess for?
hypovolemia and shock
anastomosis leaks
puncture of the esophagus
deep vein thrombosis
What type of diet should patients slowly transition too immediately following bariatric procedures?
low-calorie, full liquid diet within 12 hours
low-sodium, carb controlled diet within 24 hours
low-sugar, clear liquid diet within 24 hours
low-potassium, clear liquid diet within 12 hours
low-sugar, regular diet within 12 hours
For a bariatric diet, the goal is for an average intake of ____ mLs every _____ minutes.
15, 30
30, 20
90, 30
200, 15
200, 30
Geriatric patients have ______ prevalence of obesity.
a decreased
an increased
absolutely no
a slight
Ideal candidates for cosmetic surgery should have already achieved some form weight reduction on their own.
True
False
What is the prevalence of metabolic syndrome in adults over age 60?
25%
50%
75%
99%
Which values of HDL cholesterol levels would indicate metabolic syndrome?
less than 50 in men and less than 40 in women
less than 70 in men and less than 60 in women
less than 40 in men and less than 50 in women
less than 60 in men and less than 70 in women
A triglyceride level greater than ___ would indicate metabolic syndrome.
75
150
100
50
Which systolic and diastolic BP values indicate metabolic syndrome?
SBP: greater than or equal to 130
DBP: greater than or equal to 85
SBP: greater than or equal to 120
DBP: greater than or equal to 80
SBP: greater than or equal to 110
DBP: greater than or equal to 75
SBP: greater than or equal to 125
DBP: greater than or equal to 80
A fasting glucose level greater than or equal to ____ is indicative of metabolic syndrome
40
100
70
90
SATA: Patients with metabolic syndrome are at a higher risk for:
cardiovascular disease
stroke
diabetes
obesity
renal disease
SATA: Some common manifestations of metabolic syndrome are:
impaired fasting glucose
hypertension
hypotension
dyslipidemia
starvation
The cornerstone of treatment for metabolic syndrome is:
sedentary lifestyle
healthy lifestyle
bariatric surgery
GLP-1s
Patients who have had a Roux-en-Y procedure should avoid eating ______.
complex carbohydrates
low sodium foods
sugary foods
high sodium foods
Women have higher percent body fat which is metabolically less active than muscle tissue.
True
False
