Author Question: A patient who weighs 170 lb wishes to lose weight, with a target weight goal of 125 lb. To initiate ... (Read 81 times)

MirandaLo · **on:** Jul 24, 2018

A patient who weighs 170 lb wishes to lose weight, with a target weight goal of 125 lb. To initiate a program that will result in a loss of 1 lb per week, the primary care NP should recommend a dietary intake of _____ kcal.

a. 1000
b. 1200
c. 1700
d. 2000

Question 2

A man with a BMI of 38 and a waist size of 48 inches is seen in the clinic for an annual well check-up.

The primary care NP orders laboratory tests and notes a fasting plasma glucose of 110 mg/dL, triglyceride level of 220 mg/dL, and high-density lipoprotein level of 40 mg/dL. The man's blood pressure is 160/110 mm Hg. The man has a history of cardiovascular disease and tells the NP he has tried to lose weight numerous times. The NP should consider: a. orlistat (Xenical).
b. phentermine (Adipex-P).
c. an oral antidiabetic agent.
d. a strict low-fat, low-sodium diet.

chereeb · **Reply #1 on:** Jul 24, 2018

Answer to Question 1

B
To lose weight, a patient must decrease intake to below the level needed to maintain weight. The patient must decrease daily calorie consumption by 500 kcal for each pound he or she wishes to lose weekly. Because it takes approximately 10 kcal per pound to maintain weight, the NP can assume that the patient currently takes in 1700 kcal/day and should recommend a diet of 1200 kcal/day for weight loss.

Answer to Question 2

A
This man's BMI and waist circumference indicate that he is obese, and he has more than three indicators of metabolic syndrome. Because of his history of cardiovascular disease, his past failed attempts to lose weight, and his elevated blood pressure, treatment is indicated. Phentermine would be a good initial choice but carries significant risks in patients with cardiovascular disease and high blood pressure. Orlistat is a safer choice for pharmacologic therapy. An oral antidiabetic agent would be used if insulin resistance were present, but his fasting plasma glucose is normal. A strict change in diet is warranted but in this case should be combined with pharmacologic treatment.