CBC Managing Post-Operative Adjustments 3 — Questions and Answers
Question 1: Which finding in a post-operative client most strongly suggests transfer addiction and warrants further assessment?
- New onset of heavy alcohol use replacing prior compulsive eating (Correct answer)
- Occasional cravings for sweets
- Preference for protein shakes over solid food
- Walking daily instead of watching television
Correct answer: New onset of heavy alcohol use replacing prior compulsive eating
Replacing compulsive eating with escalating alcohol use is the classic pattern of transfer (cross) addiction after bariatric surgery.
Question 2: Why are bariatric patients, particularly after gastric bypass, at elevated risk from alcohol use post-operatively?
- Altered anatomy speeds absorption, producing higher blood alcohol levels from smaller amounts (Correct answer)
- Alcohol has no calories after surgery
- The stomach neutralizes alcohol more effectively
- Alcohol tolerance permanently increases after surgery
Correct answer: Altered anatomy speeds absorption, producing higher blood alcohol levels from smaller amounts
Post-bypass anatomy causes faster alcohol absorption and higher peak blood alcohol concentration, increasing intoxication and addiction risk.
Question 3: A client 4 months post-surgery reports persistent sadness, loss of interest, and hopelessness. What should the counselor do first?
- Screen for depression and refer to a qualified mental health provider as indicated (Correct answer)
- Attribute the mood to normal hormonal shifts and wait
- Recommend increasing exercise as the sole intervention
- Suggest the client focus on how much weight they have lost
Correct answer: Screen for depression and refer to a qualified mental health provider as indicated
Persistent depressive symptoms require screening and appropriate referral, since post-bariatric patients face elevated depression risk.
Question 4: Which client statement indicates a healthy adjustment to the post-operative plateau phase of weight loss?
- "Plateaus are normal, so I'm focusing on my habits rather than the scale." (Correct answer)
- "The surgery failed, so there's no point following the plan."
- "I'll cut my meals to once a day to restart the loss."
- "I'll stop weighing in and stop tracking anything at all."
Correct answer: "Plateaus are normal, so I'm focusing on my habits rather than the scale."
Recognizing plateaus as normal and focusing on behaviors rather than scale numbers reflects realistic, resilient adjustment.
Question 5: A client feels intense guilt after eating a small dessert at a birthday party 5 months post-surgery. The best counseling response addresses which cognitive pattern?
- All-or-nothing thinking that frames one lapse as total failure (Correct answer)
- Accurate self-appraisal that should be reinforced
- Healthy perfectionism that motivates compliance
- Denial of the surgery's dietary requirements
Correct answer: All-or-nothing thinking that frames one lapse as total failure
Framing a single lapse as failure is all-or-nothing thinking, which counselors should restructure to prevent relapse spirals.
Question 6: Which sign suggests a post-operative client may be developing disordered grazing behavior?
- Consuming small amounts of high-calorie foods continuously throughout the day (Correct answer)
- Eating three planned, protein-first meals daily
- Drinking water between meals as instructed
- Keeping a detailed food journal each evening
Correct answer: Consuming small amounts of high-calorie foods continuously throughout the day
Continuous intake of small high-calorie amounts, or grazing, circumvents restriction and is a common maladaptive post-operative pattern.
Question 7: How should a counselor respond when a client reports skipping support group meetings because "things are going fine"?
- Explore the decision and reinforce that ongoing support predicts better long-term outcomes (Correct answer)
- Agree that support groups are only for struggling patients
- Insist the client attend or be discharged from counseling
- Report the client to their surgeon for noncompliance
Correct answer: Explore the decision and reinforce that ongoing support predicts better long-term outcomes
Continued support-group engagement is associated with better long-term weight maintenance, so gentle exploration and psychoeducation are indicated.
CBC Managing Post-Operative Adjustments 3
Which finding in a post-operative client most strongly suggests transfer addiction and warrants further assessment?