CBC Nutritional Counseling Strategies 3

Question 1

Which micronutrient deficiency is most closely associated with rapid weight loss and persistent vomiting after bariatric surgery, requiring urgent counseling and supplementation?

Accepted Answer

Thiamine (vitamin B1)

Answer

Thiamine stores deplete within weeks, and deficiency during vomiting can cause Wernicke encephalopathy, making it a supplementation emergency.

Question 2

A patient 1 year after Roux-en-Y gastric bypass asks why she must take vitamin B12 even though she eats meat. The best explanation is that:

Accepted Answer

Bypassing the stomach reduces intrinsic factor and acid needed for B12 absorption

Answer

Gastric bypass diminishes acid and intrinsic factor production, impairing B12 release and absorption regardless of dietary intake.

Question 3

During a counseling session, a patient reports grazing on crackers and chips throughout the day 18 months post-op with weight regain. The most effective strategy is to:

Accepted Answer

Establish structured meal and snack times with protein-first planning

Answer

Grazing responds best to structured eating schedules that restore planned, protein-forward meals rather than bans or drastic measures.

Question 4

Which counseling recommendation addresses calcium supplementation after malabsorptive bariatric procedures?

Accepted Answer

Use calcium citrate in divided doses of 500-600 mg, separated from iron

Answer

Calcium citrate absorbs without stomach acid and should be split into doses of 500-600 mg taken apart from iron to avoid competition.

Question 5

A patient asks whether she can drink alcohol socially after gastric bypass. The counselor should explain that:

Accepted Answer

Altered anatomy speeds absorption, raising intoxication and addiction transfer risk

Answer

Post-bypass patients absorb alcohol faster and peak higher, increasing both intoxication risk and susceptibility to alcohol use disorder.

(CBC) Certified Bariatric Counselor Practice Test

(CBC) Certified Bariatric Counselor Practice Test

CBC Nutritional Counseling Strategies 3