After having bariatric surgery, a client being discharged tells the nurse, "I prefer to be independent. I'm not interested in joining a support group.”. Which response by the nurse is best?

Choice A rationale

It's widely recommended to attempt lifestyle modifications, such as diet and exercise, before initiating pharmacotherapy for obesity. This approach is due to the potential side effects and costs associated with weight loss medications, making non-pharmacological interventions a safer first option.

Choice B rationale

This statement is incorrect. Drugs used for weight loss can have significant side effects, including gastrointestinal disturbances, increased heart rate, and potential risks of abuse or dependence. It is important for healthcare providers to weigh the benefits and risks before prescribing these medications.

Choice C rationale

Weight loss drugs are typically used in conjunction with lifestyle changes and are not recommended to be used for prolonged periods if ineffective. Continuous monitoring and evaluation of the drug's effectiveness and side effects are crucial in managing obesity with pharmacotherapy.

Choice D rationale

Correct. Current drugs approved for weight loss generally work by either reducing nutrient absorption (e.g., orlistat) or suppressing appetite (e.g., phentermine). These mechanisms help individuals decrease caloric intake and promote weight loss.

Choice E rationale

This statement is inaccurate. The amount of weight loss with medication varies among individuals, and losing at least forty pounds is not a guaranteed outcome. The effectiveness of weight loss drugs depends on several factors, including adherence to the medication and accompanying lifestyle changes.

Choice A rationale

The 19-year-old Native American male hospitalized with a shoulder injury is less likely to develop gallstones. While there is a higher prevalence of gallstones among Native American populations, the risk is not significantly elevated in a young male with no other contributing factors such as obesity, rapid weight loss, or prolonged immobility.

Choice B rationale

The 40-year-old Caucasian pregnant woman who has been on bedrest for the past three months is at a high risk for developing gallstones. Pregnancy increases the risk due to hormonal changes that slow down the emptying of the gallbladder. Prolonged bed rest can lead to bile stasis, and the increased levels of estrogen can raise cholesterol levels in bile, both contributing to gallstone formation.

Choice C rationale

The 64-year-old African-American woman being treated for GERD is at a moderate risk for gallstones. Age and gender are risk factors for gallstones, but without other significant contributing factors such as obesity, rapid weight loss, or specific family history, her risk is not as high as the pregnant woman on bed rest.

Choice D rationale

The 25-year-old Asian woman who has been losing weight steadily for the past year is also at risk for gallstones, but the risk is less compared to the pregnant woman on bed rest. Rapid weight loss can cause gallstones due to the liver secreting extra cholesterol into bile, but steady weight loss over a longer period is less likely to cause such rapid changes in bile composition. .