Copyright © 2019, Elsevier Inc. All Rights Reserved. 1Chapter 23: Obesity and Disorders of NutritionMcCance/Huether: Pathophysiology: The Biologic Basis of Disease in Adults and Children, 8th EditionMULTIPLE CHOICE 1. A researcher is moving to an area with a year-round cold climate. The researcher asks the health care professional how people in these areas are able to adjust to the temperature. What response by the professional is most accurate?a. They have less adipose tissue.b. They have more beige (bAT) adipose tissue.c. Their bone marrow produces more adipose tissue.d. They gain weight which insulates them.ANS: BChronic exposure to cold climates causes the conversion of white adipose tissue (WAT) to beige adipose tissue, which is thermogenic. Changing the amount of adipose tissue overall does not help with acclimation to cold climates.PTS: 1 DIF: Cognitive Level: Understanding 2. A health care professional wishes to provide community screening for obesity. Which population should the professional focus on as the priority?a. Caucasiansb. Non-Hispanic blacksc. Hispanicsd. AsiansANS: BNon-Hispanic blacks have the highest age-adjusted rate of obesity at 48.1% followed by Hispanics (42.5%), non-Hispanic whites (34.5%), and non-Hispanic Asians (11.7%). The professional’s priority should be on the group with the highest prevalence rate, which is non-Hispanic blacks.PTS: 1 DIF: Cognitive Level: Remembering 3. The student asks the professor for a definition of “orexigenic neurons.” What description by the professor is most accurate?a. Promote appetite and stimulate eatingb. Suppress appetite and inhibit eatingc. Increase overall metabolismd. Promote satiety after eatingANS: AOrexigenic neurons promote appetite, stimulate eating, and decrease metabolism. The anorexigenic neurons suppress appetite, inhibit eating, increase metabolism, and promote satiety after eating.PTS: 1 DIF: Cognitive Level: Understanding 4. A student asks the health care professional why obese people are at higher risk for hypertension than non-obese individuals. What response by the professional is best?a. They produce more ghrelin in the stomach.b. Their thyroid gland secretes less hormone.c. They produce more angiotensinogen.d. They secrete fewer endocannabinoids.ANS: CAngiotensinogen is a precursor of angiotensin I, which, converted to angiotensin II, is a potent vasoconstrictor. Angiotensinogen is produced both by the liver and by adipocytes; therefore obese individuals have more, leading to increased vasoconstriction and increased systemic vascular resistance which leads to high blood pressure. Ghrelin, produced in the stomach, increases food intake. The thyroid gland function is not directly linked to obesity. Endocannabinoids are associated with increase in appetite and nutrient absorption.PTS: 1 DIF: Cognitive Level: Understanding 5. Which individual does the health care professional determine is obese?a. Body mass index 23 kg/m2b. Body mass index 25 kg/m2c. Body mass index 29 kg/m2d. Body mass index 32 kg/m2ANS: DOverweight is defined as a body mass index (BMI) of >25 kg/m2, while a BMI of >30 kg/m2 is considered obese. The individual with the BMI of 23 kg/m2 would be considered of normal weight, those with BMIs of 25 and 29 kg/m2 would be considered overweight, and the person with the BMI of 32 kg/m2 is obese.PTS: 1 DIF: Cognitive Level: RememberingCopyright © 2019, Elsevier Inc. All Rights Reserved. 2 6. A health care professional is caring for a patient admitted to the hospital with severe anorexia. What action by the health care professional would be most important?a. Ensuring the patient is on a cardiac monitorb. Facilitating laboratory testing of electrolytesc. Arranging a psychiatry consultationd. Assessing the patient’s favorite foodsANS: APatients with severe anorexia can have cardiac dysrhythmias, so this patient should be placed on a cardiac monitor as the priority. The other actions are appropriate; they just do not take priority.PTS: 1 DIF: Cognitive Level: Applying 7. A person has abnormally severe tooth decay and erosion of the tooth enamel. What problem should the health care professional assess the person for?a. Anorexia nervosab. Binge eatingc. Bulimiad. Refeeding syndromeANS: CChronic vomiting and exposure to gastric acids leads to loss of tooth enamel and decay. These are not signs of anorexia, binge eating, or refeeding syndrome.PTS: 1 DIF: Cognitive Level: Applying 8. A patient weighs 82 pounds and is hospitalized for anorexia. In order to prevent refeeding syndrome, how many calories should the person eat in the first two days?a. 400b. 745c. 936d. 1200ANS: BIn order to prevent refeeding syndrome, feedings should start slowly at about 20 kcal/kg/day. This 82-pound person weighs 37.2727 kg, so that would be 745 calories a day.PTS: 1 DIF: Cognitive Level: Applying 9. A severely malnourished patient is in the hospital to improve nutrition. On the second day, the patient reports palpitations and difficulty breathing. After placing the patient on a cardiac monitor, what action does the health care professional take next?a. Take the patient’s temperature.b. Have lab drawn for electrolyte levels.c. Cancel the patient’s next meal.d. Facilitate a chest x-ray.ANS: BRefeeding syndrome occurs when patients are fed too quickly, causing rapid shifts of fluids and electrolytes, often leading to dysrhythmias. After placing the patient on a cardiac monitor, the professional should next ensure that serum electrolytes are measured. The patient’s temperature is not relevant to this situation. The patient should continue to eat although calories should be decreased. There may or may not be a need for a chest x-ray.PTS: 1 DIF: Cognitive Level: AnalyzingMULTIPLE RESPONSE 1. A student asks the professor about the functions of adipose tissue. What responses by the professor are accurate? (Select all that apply.)a. Provides insulationb. Helps with mechanical supportc. Dysregulates thyroid functiond. Secretes adipokinese. Helps generate heatANS: A, B, D, EAdipose tissue has multiple functions including providing insulation and mechanical support, secreting adipokines, and heat generation. They do not specifically cause thyroid dysregulation.PTS: 1 DIF: Cognitive Level: UnderstandingCopyright © 2019, Elsevier Inc. All Rights Reserved. 3 2. A health care professional is speaking to a weight-loss support group and encourages the participants to have regular
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