Mixed Deck — All CBC Topics Flashcards

Which counselor action best supports a client experiencing weight-loss plateau frustration six months after surgery?

Answer: Reviewing non-scale victories and reinforcing adherence behaviors

Shifting focus to behavior-based and non-scale successes maintains motivation during expected plateaus.

Which micronutrient deficiency is most commonly associated with Roux-en-Y gastric bypass due to bypassed absorption sites?

Answer: Vitamin B12

B12 absorption requires intrinsic factor and stomach acid, both reduced after bypass, making deficiency common.

A patient celebrates every weight milestone with a large restaurant meal, then feels guilt and restricts for days. The counselor should first help the patient:

Answer: Develop non-food reward alternatives for milestones

Replacing food-based rewards with non-food alternatives breaks the celebration-guilt-restriction cycle.

A post-operative patient begins misusing prescription opioids originally given for surgical pain. This pattern is often described as what phenomenon in bariatric populations?

Answer: Addiction transfer (cross-addiction)

Addiction transfer describes substituting food-related coping with substances or other compulsive behaviors after surgery.

A client repeatedly eats when bored in the evening. Which behavioral technique directly targets the environmental trigger?

Answer: Stimulus control

Stimulus control modifies cues in the environment, such as removing snacks from view, to reduce triggered eating.

What is the role of post-surgical follow-up care in bariatric treatment?

Answer: It ensures long-term success and monitors progress

Post-surgical follow-up care is critical for bariatric patients to monitor their health, manage potential complications, and reinforce lifestyle changes. This ongoing care includes regular medical check-ups, nutritional counseling, and psychological support to ensure patients maintain weight loss, address nutrient deficiencies, and adapt to their new eating habits. It is essential for sustained health improvement and preventing weight regain.

A client rewards herself with a manicure after each week of meeting her exercise goal. This is an example of which behavioral principle?

Answer: Positive reinforcement

Adding a pleasant consequence to increase a desired behavior is positive reinforcement.

A client who is 6 months post-Roux-en-Y gastric bypass reports episodes of fatigue, weakness, and shortness of breath. During a nutritional counseling session, they mention they have not been consistent with their supplement regimen. The counselor should recognize these symptoms as most characteristic of which common nutritional deficiency?

Answer: Iron deficiency anemia

Iron deficiency anemia is one of the most common nutritional deficiencies following Roux-en-Y gastric bypass due to reduced stomach acid and bypassing the duodenum and proximal jejunum, where most iron is absorbed. Symptoms such as fatigue, weakness, and shortness of breath are classic signs of anemia. While other deficiencies are possible, these specific symptoms strongly point towards iron deficiency.

Which bariatric procedure involves removing approximately 80% of the stomach along the greater curvature, leaving a tubular pouch?

Answer: Sleeve gastrectomy

Sleeve gastrectomy removes about 80% of the stomach along the greater curvature, creating a banana-shaped tubular pouch.

A patient six months post-sleeve gastrectomy reports eating small amounts of food continuously throughout the day when stressed. Which maladaptive eating pattern does this describe?

Answer: Grazing

Grazing is the repeated consumption of small amounts of food over extended periods, a common post-surgical maladaptive pattern often triggered by emotion.

Which client is showing the most appropriate use of self-monitoring during post-operative adjustment?

Answer: One who logs food, protein, and fluids daily and reviews patterns weekly with their counselor

Consistent, balanced logging reviewed for patterns supports adjustment, unlike compulsive weighing or selective recording.

Which hormone, produced primarily by adipose tissue, signals satiety to the hypothalamus and often shows resistance in individuals with obesity?

Answer: Leptin

Leptin is secreted by fat cells to suppress appetite, but leptin resistance blunts this signal in obesity.

A counselor is explaining the dietary progression to a patient preparing for a sleeve gastrectomy. Which of the following represents the correct sequence of dietary stages immediately following surgery?

Answer: Clear liquids, full liquids, pureed foods, soft foods

The standard post-bariatric surgery diet progression is designed to allow the stomach to heal. It begins with clear liquids for initial hydration, progresses to full liquids which include protein shakes, then to pureed foods, and finally to soft, solid foods before advancing to a long-term regular diet.

Which of the following is the MOST critical reason for a bariatric counselor to advise extreme caution with alcohol consumption, particularly after Roux-en-Y Gastric Bypass (RYGB)?

Answer: The altered anatomy leads to much faster absorption and significantly higher peak blood alcohol levels.

After RYGB, alcohol passes directly from the small stomach pouch into the jejunum, bypassing the normal 'first-pass metabolism' in the larger part of the stomach. This leads to extremely rapid absorption, a much higher peak blood alcohol concentration (BAC) from a smaller amount of alcohol, and a quicker onset of intoxication. This poses significant safety risks (e.g., unintentional intoxication, DUIs) and increases the risk for developing an alcohol use disorder.

A patient 2 years post-op scores high on depression screening and admits to transferring compulsive eating to online shopping. This pattern is often called:

Answer: Addiction transfer or cross-addiction

Addiction transfer describes replacing compulsive eating with another compulsive behavior such as shopping, gambling, or substance use after surgery.

Which of the following describes the primary mechanism of action for the Laparoscopic Adjustable Gastric Band (LAGB)?

Answer: Purely restrictive by creating a small upper stomach pouch with an inflatable band

The Adjustable Gastric Band works through a purely restrictive mechanism. [1, 3] A silicone band is placed around the upper part of the stomach, creating a small pouch that limits food intake and promotes a feeling of fullness. Unlike other procedures, it does not involve removing any part of the stomach or rerouting the intestines, so it does not cause malabsorption or significant hormonal changes. [9, 24]

In group counseling for bariatric patients, which facilitator behavior best promotes therapeutic group cohesion?

Answer: Encouraging members to share experiences while maintaining confidentiality norms

Cohesion grows from safe, confidential sharing, whereas public comparison and competition undermine trust.

What is a key behavioral strategy for maintaining weight loss?

Answer: Tracking food intake and activity

Tracking food intake and activity is a key behavioral strategy because it increases awareness of eating patterns and energy expenditure, allowing individuals to identify areas for improvement. This self-monitoring provides valuable data to make informed adjustments, reinforce positive habits, and maintain accountability for long-term weight loss success.

A patient who regained 10 pounds says, 'I'm a total failure.' The counselor's best cognitive restructuring response is to:

Answer: Help the patient examine evidence for and against that belief

Cognitive restructuring guides patients to test distorted beliefs against objective evidence.

Why are patients counseled to separate liquids from solid meals by about 30 minutes after bariatric surgery?

Answer: Drinking with meals can flush food through the pouch, reducing satiety and increasing intake

Fluids consumed with meals accelerate pouch emptying, decreasing satiety and potentially allowing greater calorie intake or discomfort.