Nutrition
Obesity
Surgical Procedures for Obesity
TPN
Tube Feedings
100

A patient has a calculated BMI of 31 and therefore, is considered...?

Obese. 
100

Obesity is defined as a disease that is characterized by abnormal or excessive accumulation of...?

Body Fat

100

Bariatric surgeries are performed only after ____ methods have failed. 

Non-surgical
100

TPN must be administered ____. 

Centrally
100

A _____ tube feeding occurs 3-4 times a day and is usually provided via plunger or gravity. 

Bolus 

200

What is the ideal body weight of a male who is 6'1? 

184

200

One lifestyle modification in losing weight is to decrease daily caloric intake by...? 

500-1000 calories

200

You are caring for a patient s/p bariatric surgery. In providing education, you inform her that she will eat ____ small meals per day and should stop when she is full. 

6-8

200

You have assisted in the placement of a surgically-placed central catheter. How should you confirm that the catheter has been placed correctly? 

X-ray

200

You are caring for a patient who is receiving continuous tube feedings via pump. While completing her assessment, you check residual and obtain the amount of 200 mL. What is your next action? 

Check your hospital policy. 

Common policies: hold TF for 30 minutes and recheck residual, administer Metoclopramide, or call the physician for further orders. 

300

Biochemical assessment: Low serum albumin and prealbumin are used to measure _____ deficits in adults.

Protein
300

You are providing education to an obese patient. You inform him that physical activity plays a large role in not only losing weight, but maintaining a healthy lifestyle. How many minutes should the patient engage in moderate physical activity per day?

30

300

You are providing discharge instructions to a patient who underwent bariatric surgery. Prior to leaving, the patient asks if she can continue to take Ibuprofen for her arthritis. As an experienced nurse, you know NSAIDS should be avoided in these patients because they can lead to the development of...? 

Stomach Ulcers

300

You have been asked to remove a PICC line. After obtaining the appropriate supplies, you provide patient education regarding their role within the removal. One critical piece of information to provide is that the patient must ____ while the nurse removes the catheter. 

Hold their breath. 

Fun Fact: You can ask them to hum their favorite tune. Some patients start to panic at the thought of breath-holding. 

300
You are caring for a patient who has been receiving continuous tube feedings for 5 days. While receiving bedside report, the nurse informs you that the patient has had increasing loose stools throughout the past 48 hours. What potential complication could be causing this occurrence? 

C-diff 

400

You are caring for an 80-year-old female patient who was recently diagnosed with osteoporosis. While providing patient education, you included the importance of maintaining a diet high in nutrient? 

Calcium

400

A patient has been recently prescribed Orlistat to manage her obesity. You inform her that this medication can cause loose stools. When asked why this occurs, you tell her that the medication impedes the digestion of...? 

Fats, specifically triglycerides 

400

You are a nurse on a medical-surgical unit. You have been assigned Ms. Jones who recently underwent a bariatric surgery. During your initial assessment, she states that she is experiencing increased abdominal pain. Upon further assessment, you note that she has a fever of 38C and HR of 116. When reviewing her labs, you noted that she has moderate leukocytosis. Based on this information and your nursing judgement, what might Ms. Jones be developing? 

Anastomosis

400
You are caring for an 80-year-old female who has been admitted with pancreatitis. She had a dual-lumen PICC line placed 3 days ago with no complications. The patient has been prescribed TPN which has been infusing with no issues noted.  She also has a Morphine PCA for pain. The doctor has just ordered an IV Cefazolin STAT: a medication that is not compatible with Morphine. Can you combine it with the TPN? Why or why not? 

No. The TPN line should be used for TPN only. 

400

You are caring for a patient who is NPO and receiving bolus tube feedings. The physician has prescribed Pantoprazole to treat the patient's GERD. After checking the medication order and record, you note that this medication cannot be crushed. What is your next nursing action? 

Request an order for IV Pantoprazole. 

500

You are a nurse in the Emergency Department. You have been assigned to Mr. T, a 46-year-old male. He presented today due to increasing fatigue, weakness, and irritability. During your assessment, he reveals that he is a vegetarian and abstains from eating meat. Based on this information and your nursing knowledge, the patient is most likely deficient in what nutrient? 

Iron
500

You have been assigned to assess Ms. Pizza who has presented to the clinic today for increased heart rate. When reviewing her current medications, you note that she is taking one for the management of her obesity. Which weight-loss medication possesses this side effect? 

Phentermine-Topiramate

500

What bariatric surgical method is recommended for long-term weight loss because it uses a combined restrictive and malabsorptive procedure. 

Roux-en-Y

500

You have been caring for a patient who is receiving TPN. This morning, she refused her labs to be drawn and told the phlebotomist that she will refuse all further labs. Why is this an issue in preparing her next TPN? 

TPN is individualized to the patient's current nutritional needs. Without daily laboratory values, the next TPN dose cannot be calculated. 

500

You are caring for a patient receiving continuous tube feedings via pump. At approximately 0400, the technician informs you that she reports increasing shortness of breath, has a respiratory rate of 28, and a SpO2 saturation of 91% on 2L NC. Upon assessment, you note coarse lung sounds bilaterally. Based on this information and your nursing knowledge, what may be the cause of the patient's shortness of breath? 

Aspiration Pneumonia