CBC Post-Surgical Patient Care 3 — Questions and Answers
Question 1: A patient 8 months after gastric bypass reports fatigue, and lab work shows microcytic anemia. Which nutrient deficiency is the most likely cause?
- Iron (Correct answer)
- Vitamin C
- Vitamin K
- Zinc
Correct answer: Iron
Iron deficiency is common after bypass because the duodenum, the primary site of iron absorption, is bypassed, producing microcytic anemia.
Question 2: Which symptom pattern distinguishes late dumping syndrome from early dumping syndrome?
- Hypoglycemia symptoms such as shakiness and confusion occurring 1-3 hours after eating (Correct answer)
- Cramping and diarrhea within 15 minutes of eating
- Vomiting immediately after meals
- Heartburn during meals
Correct answer: Hypoglycemia symptoms such as shakiness and confusion occurring 1-3 hours after eating
Late dumping occurs 1-3 hours after eating due to reactive hypoglycemia from an exaggerated insulin response.
Question 3: A counselor is educating a post-surgical patient about alcohol. Which statement is most accurate for patients after gastric bypass?
- Alcohol is absorbed faster and produces higher blood levels, increasing intoxication and addiction risk (Correct answer)
- Alcohol is safe in moderation immediately after surgery
- Alcohol absorption is slower, so effects are milder
- Only carbonated alcoholic drinks pose risks
Correct answer: Alcohol is absorbed faster and produces higher blood levels, increasing intoxication and addiction risk
Altered anatomy accelerates alcohol absorption and raises peak blood alcohol levels, increasing risks of intoxication and alcohol use disorder.
Question 4: Which finding in a sleeve gastrectomy patient 6 weeks post-op most warrants referral back to the surgical team for possible stricture?
- Progressive inability to tolerate liquids with frequent regurgitation (Correct answer)
- Occasional constipation
- A weight-loss plateau lasting one week
- Mild fatigue during exercise
Correct answer: Progressive inability to tolerate liquids with frequent regurgitation
Worsening intolerance of even liquids with regurgitation suggests a stricture or stenosis that requires surgical evaluation.
Question 5: Why is thiamine (vitamin B1) deficiency a medical emergency in a bariatric patient with persistent vomiting?
- It can rapidly cause Wernicke encephalopathy with permanent neurological damage (Correct answer)
- It causes bone fractures
- It leads to gradual hair loss
- It slows wound healing only
Correct answer: It can rapidly cause Wernicke encephalopathy with permanent neurological damage
Thiamine stores deplete within weeks, and prolonged vomiting can precipitate Wernicke encephalopathy, an acute neurological emergency.
Question 6: A patient 4 months post-op has stopped attending support groups and reports eating in response to stress. The counselor's most appropriate first step is to:
- Explore the emotional triggers and re-engage the patient with behavioral support (Correct answer)
- Recommend a stricter diet plan
- Advise the patient that stress eating is normal and requires no action
- Refer immediately for revision surgery
Correct answer: Explore the emotional triggers and re-engage the patient with behavioral support
Addressing emotional eating triggers and reconnecting the patient with support structures is the first-line counseling response.
Question 7: How soon after bariatric surgery are patients typically encouraged to begin walking?
- Within the first 24 hours, as tolerated (Correct answer)
- After 2 weeks of bed rest
- Not until the 6-week follow-up
- Only after full weight-loss goals are met
Correct answer: Within the first 24 hours, as tolerated
Early ambulation, usually the day of or day after surgery, reduces the risk of blood clots and speeds recovery.
CBC Post-Surgical Patient Care 3
A patient 8 months after gastric bypass reports fatigue, and lab work shows microcytic anemia.
Which nutrient deficiency is the most likely cause?