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AJN, American Journal of Nursing:
doi: 10.1097/01.NAJ.0000418923.30353.2e
Feature Articles

CE Test 2.5 Hours: Outcomes and Complications After Bariatric Surgery

Contrada, Emily

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Continued Education
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To provide registered professional nurses with information on the potential outcomes of, and complications from, five of the most common bariatric procedures.

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After reading this article and taking this test, you will be able to

* describe five of the most common bariatric procedures and their expected outcomes.

* identify complications of bariatric surgery and nursing implications for patient care.

1. Bariatric surgery may be contraindicated for patients who have

a. obstructive sleep apnea.

b. type 1 diabetes.

c. a history of joint replacement.

d. severe congestive heart failure.

2. The most commonly performed bariatric procedure in the United States is

a. biliopancreatic diversion with duodenal switch (BPD-DS).

b. vertical sleeve gastrectomy (VSG).

c. Roux-en-Y gastric bypass (RYGB).

d. adjustable gastric banding (AGB).

3. The authors note that VSG significantly improves or resolves

a. heart failure.

b. sleep apnea.

c. heart dysrhythmias.

d. hypertension.

4. In patients who have undergone BPD-DS, digestive enzymes cannot mix with food until food reaches the

a. proximal duodenum.

b. distal jejunum.

c. distal ileum.

d. proximal ascending colon.

5. In a study by Iaconelli and colleagues, the remission rate for type 2 diabetes within 1 year of BPD-DS surgery was

a. 70%.

b. 80%.

c. 90%.

d. 100%.

6. Which statement is true regarding AGB?

a. The tightness of the silicone band can be adjusted.

b. It's an irreversible procedure.

c. It's a malabsorptive procedure with a restrictive component.

d. The first AGB device was the REALIZE band.

7. Patients who've undergone vertical banded gastroplasty (VBG) tend to feel early satiety because

a. stomach emptying is delayed.

b. the duodenum is bypassed.

c. most of the stomach has been removed.

d. the pyloric valve has been removed.

8. Remission of type 2 diabetes after bariatric surgery is less likely in patients who

a. use metformin (Glucophage) to manage their diabetes.

b. have a family history of diabetes.

c. have had diabetes for longer periods of time.

d. use both insulin and oral agents to manage their diabetes.

9. Remission rates for type 2 diabetes have been highest for patients who've undergone

a. AGB.

b. BPD-DS.

c. RYGB.

d. VBG.

10. One of the 2 comorbidities most predictive of postoperative complications after bariatric surgery is

a. diabetes.

b. hyperlipidemia.

c. hypertension.

d. sleep apnea.

11. Symptoms of dumping syndrome may include

a. abdominal cramping.

b. syncope.

c. bradycardia.

d. constipation.

12. In patients who have undergone bariatric surgery, cholelithiasis

a. occurs less often in women.

b. is related to postoperative weight loss, rather than to the surgery.

c. is avoided because the gall bladder is removed during surgery.

d. occurs in 55% to 65% of patients within 3 months of surgery.

13. Strategies to prevent postoperative pulmonary embolism and deep vein thrombosis include all of the following except

a. early and frequent postoperative ambulation.

b. administration of low-molecular-weight heparin.

c. administration of oral clopidogrel (Plavix).

d. the use of pneumatic sequential compression devices.

14. A swallowing study on postoperative days 1 or 2 may be done to detect

a. cholelithiasis.

b. dumping syndrome.

c. pancreatitis.

d. an anastomotic leak.

15. One of the top 3 causes of death after bariatric surgery is

a. gastrointestinal bleeding.

b. sepsis.

c. small bowel obstruction.

d. bypass obstruction.

16. A study by Livhits and colleagues found that significant factors in successful weight loss included all of the following except

a. taking a higher dosage of antianxiety medication.

b. being more physically active.

c. attending postoperative support group meetings.

d. following up with a physician.

17. Abdominoplasty for excess skin removal has a complication rate as high as

a. 20%.

b. 30%.

c. 40%.

d. 50%.

18. Which statement is true regarding nutritional issues after bariatric surgery?

a. Caffeinated, carbonated liquids will aid weight loss.

b. Protein deficiency is common and protein shakes may be prescribed.

c. The diet should be low-fat, high-carbohydrate, high-protein.

d. Fluids should be consumed with meals to aid digestion.

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