CBC Nutritional Counseling 2 — Questions and Answers
Question 1: A patient 3 weeks post sleeve gastrectomy reports difficulty meeting protein goals. What is the most appropriate initial recommendation?
- Prioritize protein-rich foods and supplements first at each meal (Correct answer)
- Increase carbohydrate intake for energy
- Skip meals to reduce stomach discomfort
- Drink fluids with meals to help food go down
Correct answer: Prioritize protein-rich foods and supplements first at each meal
Protein-first eating ensures adequate intake within the limited gastric capacity after surgery.
Question 2: What is the typical daily protein goal for most adult bariatric surgery patients?
- 20-30 grams
- 60-80 grams (Correct answer)
- 150-200 grams
- 10-15 grams
Correct answer: 60-80 grams
Most guidelines recommend 60-80 grams of protein daily to preserve lean body mass after bariatric surgery.
Question 3: Why are patients advised to avoid drinking liquids within 30 minutes of meals after bariatric surgery?
- Liquids dilute stomach acid too much
- Liquids can flush food through the pouch, reducing satiety and increasing intake capacity (Correct answer)
- Liquids cause vitamin malabsorption
- Liquids slow gastric emptying dangerously
Correct answer: Liquids can flush food through the pouch, reducing satiety and increasing intake capacity
Drinking with meals washes food through the small pouch, decreasing fullness and enabling overeating.
Question 4: A patient who had Roux-en-Y gastric bypass experiences sweating, dizziness, and cramping 20 minutes after eating ice cream. What should the counselor suspect?
- Food allergy
- Early dumping syndrome (Correct answer)
- Anastomotic leak
- Gallstone attack
Correct answer: Early dumping syndrome
Early dumping syndrome occurs when high-sugar foods rapidly enter the small intestine, causing vasomotor and GI symptoms.
Question 5: Which micronutrient deficiency is most commonly associated with Roux-en-Y gastric bypass due to bypassed absorption sites?
- Vitamin C
- Vitamin B12 (Correct answer)
- Sodium
- Biotin
Correct answer: Vitamin B12
B12 absorption requires intrinsic factor and stomach acid, both reduced after bypass, making deficiency common.
Question 6: During the pureed diet phase, which food would be most appropriate to recommend?
- Grilled steak cut into small pieces
- Blended low-fat cottage cheese (Correct answer)
- Raw vegetable salad
- Whole grain crackers
Correct answer: Blended low-fat cottage cheese
Blended cottage cheese is smooth, protein-rich, and consistent with pureed-stage texture requirements.
Question 7: A counselor notices a patient is consuming mostly protein shakes 8 months post-op instead of transitioning to whole foods. What is the best counseling approach?
- Praise the high protein intake and make no changes
- Explore barriers to solid food and encourage gradual transition to whole protein sources (Correct answer)
- Recommend stopping all supplements immediately
- Suggest switching to juice-based meal replacements
Correct answer: Explore barriers to solid food and encourage gradual transition to whole protein sources
Long-term reliance on liquids reduces satiety and may signal eating difficulties, so barriers should be explored and whole foods encouraged.
CBC Nutritional Counseling 2
A patient 3 weeks post sleeve gastrectomy reports difficulty meeting protein goals.
What is the most appropriate initial recommendation?