The occupational health nurse is completing an assessment on an employee who has a history of type 2 diabetes, coronary artery disease, unstable angina, and gastroesophageal reflux disease (GERD). Which statement(s) should prompt the nurse to refer the employee for PROMPT evaluation of their cardiac status? (SELECT ALL THAT APPLY)

Choice A rationale

Eating quickly and leaving the table can lead to overeating because it takes about 20 minutes for the brain to recognize satiety signals from the stomach. Eating slowly and mindfully is a better strategy for weight management as it allows time for these signals to take effect, reducing the likelihood of consuming excess calories.

Choice B rationale

Checking weight twice per day is not recommended. Frequent weight checks can lead to obsession and anxiety. Weight can fluctuate naturally due to various factors such as fluid retention, and monitoring it too often does not provide a clear picture of weight loss progress. A more balanced approach is to weigh oneself once a week.

Choice C rationale

Increasing alcohol intake with meals is not a recommended strategy for weight loss. Alcohol adds empty calories and can stimulate appetite, leading to overeating. It also affects metabolism and can contribute to weight gain rather than weight loss.

Choice D rationale

Learning to recognize satiety is a crucial strategy for weight loss. It involves being aware of the body's hunger and fullness cues, which can prevent overeating. Mindful eating practices help individuals eat in response to true hunger rather than emotional or situational cues.

Choice E rationale

Keeping a food diary helps track food intake, identify eating patterns, and make conscious dietary choices. It is an effective tool for weight loss as it increases awareness of what, how much, and when one eats, helping to manage and reduce caloric intake.

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. .