Free CBC Psychosocial Patient Assessment Questions and Answers

Question 1

During a pre-surgical psychosocial assessment for bariatric surgery, a candidate reveals a history of bulimia nervosa, but states they have not engaged in purging behaviors for the past 6 months. What is the most appropriate next step for the bariatric counselor?

Accepted Answer

Refer the patient for specialized cognitive-behavioral therapy to address the eating disorder before surgery can be considered.

Answer

Active or recent bulimia nervosa is considered a significant contraindication for bariatric surgery due to the high risk of post-operative complications and the potential for the purging behaviors to damage the surgical site. Standard practice requires addressing the eating disorder with targeted therapy, like cognitive-behavioral therapy, to ensure the patient is psychologically stable and has developed healthy coping mechanisms before proceeding with a life-altering surgery.

Question 2

A psychosocial evaluation for a bariatric surgery candidate should comprehensively assess all of the following domains EXCEPT:

Accepted Answer

The patient's detailed dietary preferences and favorite foods.

Answer

While eating habits are discussed, a detailed list of favorite foods is not a primary domain of the psychosocial assessment. The core domains include assessing the patient's motivation and realistic expectations for outcomes, psychiatric history and current stability, and the strength of their social support network, which is crucial for post-operative success.

Question 3

A 45-year-old male candidate for bariatric surgery scores high on the minimization/denial scale of a psychological assessment tool like the PsyBari. During the clinical interview, he repeatedly states, "I just need the surgery, and everything will be fine. I don't have any emotional issues with food." How should the counselor interpret this?

Accepted Answer

The patient may be underreporting psychological distress and has unrealistic expectations about the surgery's impact.

Answer

High scores on minimization or denial scales, combined with verbal statements that downplay the psychological aspects of obesity and surgery, suggest the patient may have unrealistic expectations and a lack of insight into the significant lifestyle and emotional adjustments required post-surgery. This is a red flag that requires further exploration to ensure the patient is adequately prepared for the challenges ahead.

Question 4

Which of the following is considered an absolute psychiatric contraindication for bariatric surgery?

Accepted Answer

Active substance abuse.

Answer

While many psychiatric conditions need to be managed and stable, active substance abuse is widely considered an absolute contraindication for bariatric surgery. The risks associated with substance abuse post-operatively, including poor adherence to diet, medical complications, and transfer addiction, are too high. Other conditions like depression or binge eating disorder require assessment and management but are not absolute bars to surgery if well-controlled.

Question 5

A patient, 18 months post-gastric bypass, reports significant weight loss but also feelings of social isolation, irritability, and a new habit of excessive online shopping. This presentation is most indicative of:

Accepted Answer

A potential transfer addiction and unresolved psychological issues.

Answer

After bariatric surgery, some individuals may replace compulsive eating with other compulsive behaviors, a phenomenon known as transfer addiction. The patient's excessive shopping, coupled with negative emotional states like isolation and irritability, suggests that underlying psychological issues that were previously coped with through food are now manifesting in a different, maladaptive way.

(CBC) Certified Bariatric Counselor Practice Test

(CBC) Certified Bariatric Counselor Practice Test

Free CBC Psychosocial Patient Assessment Questions and Answers