CBC Nutritional Counseling 3 — Questions and Answers
Question 1: Which eating behavior is most important to address preoperatively because it predicts poor postoperative weight outcomes?
- Eating breakfast daily
- Grazing on small amounts of food continuously throughout the day (Correct answer)
- Eating vegetables first
- Meal prepping on weekends
Correct answer: Grazing on small amounts of food continuously throughout the day
Grazing circumvents the restrictive effect of surgery and is linked to weight regain.
Question 2: A patient reports vomiting after eating bread and dry chicken. What counseling point addresses this most directly?
- Eat faster to finish before fullness
- Chew thoroughly, eat slowly, and moisten dense foods (Correct answer)
- Switch entirely to liquid meals permanently
- Take antacids before every meal
Correct answer: Chew thoroughly, eat slowly, and moisten dense foods
Dense, dry foods commonly cause obstruction symptoms unless chewed thoroughly and eaten slowly.
Question 3: What is the primary reason bariatric patients are advised to take calcium citrate rather than calcium carbonate?
- Calcium citrate is cheaper
- Calcium citrate does not require stomach acid for absorption (Correct answer)
- Calcium carbonate contains gluten
- Calcium citrate tastes better
Correct answer: Calcium citrate does not require stomach acid for absorption
Reduced gastric acid after surgery impairs carbonate absorption, while citrate absorbs well without acid.
Question 4: A patient 2 years post-op has regained 15 pounds and reports drinking sweetened coffee drinks daily. Which concept best explains the regain?
- Liquid calories bypass restriction and add energy without satiety (Correct answer)
- Coffee slows metabolism
- Caffeine blocks vitamin absorption
- Dairy causes pouch stretching
Correct answer: Liquid calories bypass restriction and add energy without satiety
Caloric liquids pass easily through the pouch, contributing significant calories without triggering fullness.
Question 5: Which laboratory finding would most strongly suggest thiamine deficiency in a post-op patient with persistent vomiting?
- Elevated hemoglobin
- Neurological symptoms such as confusion and gait disturbance (Correct answer)
- High blood glucose
- Low cholesterol
Correct answer: Neurological symptoms such as confusion and gait disturbance
Thiamine deficiency from prolonged vomiting can cause Wernicke encephalopathy with confusion, ataxia, and eye movement problems.
Question 6: When counseling a patient on alcohol after gastric bypass, which point is most accurate?
- Alcohol absorption is unchanged after surgery
- Alcohol reaches higher blood levels faster and increases addiction transfer risk (Correct answer)
- Alcohol is safe if consumed with meals
- Only beer must be avoided
Correct answer: Alcohol reaches higher blood levels faster and increases addiction transfer risk
Altered anatomy accelerates alcohol absorption, producing higher peak levels and elevating risk of alcohol use disorder.
Question 7: A vegetarian patient asks how to meet protein needs post-surgery. Which option is the best recommendation?
- Rely on white rice and fruit
- Incorporate Greek yogurt, eggs, legumes, and soy-based protein sources (Correct answer)
- Eat only leafy greens
- Use sugar-sweetened smoothies
Correct answer: Incorporate Greek yogurt, eggs, legumes, and soy-based protein sources
Dairy, eggs, legumes, and soy provide concentrated, high-quality protein compatible with a vegetarian bariatric diet.
CBC Nutritional Counseling 3
Which eating behavior is most important to address preoperatively because it predicts poor postoperative weight outcomes?