CBC Pre-Surgical Patient Assessment 2 — Questions and Answers
Question 1: According to standard NIH criteria, which patient generally qualifies for bariatric surgery consideration?
- BMI of 40 or higher, or BMI of 35+ with obesity-related comorbidities (Correct answer)
- BMI of 30 or higher regardless of comorbidities
- BMI of 25+ with a family history of obesity
- Any patient who has failed one diet attempt
Correct answer: BMI of 40 or higher, or BMI of 35+ with obesity-related comorbidities
Traditional NIH criteria require a BMI ≥40, or ≥35 with significant obesity-related comorbidities such as type 2 diabetes or hypertension.
Question 2: During a pre-surgical psychosocial evaluation, which finding is most likely to delay surgical clearance?
- Active, untreated binge eating disorder (Correct answer)
- A history of mild seasonal allergies
- Previous participation in a commercial weight-loss program
- Stable employment with health insurance
Correct answer: Active, untreated binge eating disorder
Active untreated eating disorders like binge eating disorder typically require treatment and stabilization before surgery is approved.
Question 3: Why is a nicotine cessation requirement common before bariatric surgery?
- Nicotine impairs wound healing and increases risk of anastomotic ulcers (Correct answer)
- Nicotine causes rapid postoperative weight gain
- Smoking interferes with vitamin absorption only
- Insurance companies require it for billing codes
Correct answer: Nicotine impairs wound healing and increases risk of anastomotic ulcers
Nicotine restricts blood flow, impairing healing and significantly raising the risk of marginal ulcers after gastric bypass.
Question 4: A counselor assessing a patient's weight history should primarily document which of the following?
- Past weight-loss attempts, methods used, and outcomes (Correct answer)
- Only the patient's current weight and height
- The weight of immediate family members
- The patient's preferred post-surgery clothing size
Correct answer: Past weight-loss attempts, methods used, and outcomes
A thorough weight history captures prior weight-loss attempts, methods, and results to demonstrate supervised effort and inform treatment planning.
Question 5: Which screening tool is most commonly used to assess depression during a pre-bariatric psychological evaluation?
- PHQ-9 (Correct answer)
- MMSE
- AUDIT
- Snellen chart
Correct answer: PHQ-9
The Patient Health Questionnaire-9 (PHQ-9) is a standard validated screen for depression severity in pre-surgical evaluations.
Question 6: A patient reports drinking six alcoholic beverages daily. Why is this a major pre-surgical concern beyond general health risks?
- Alcohol use disorder risk increases after bariatric surgery due to altered absorption (Correct answer)
- Alcohol prevents anesthesia from working entirely
- Alcohol has no calories so intake is hard to track
- Alcohol use disqualifies patients from all future surgery permanently
Correct answer: Alcohol use disorder risk increases after bariatric surgery due to altered absorption
Bariatric surgery, especially gastric bypass, accelerates alcohol absorption and is associated with increased risk of alcohol use disorder postoperatively.
Question 7: What is the primary purpose of the medically supervised weight-loss period many insurers require before surgery?
- To document adherence capacity and establish lifestyle changes needed postoperatively (Correct answer)
- To guarantee the patient reaches a normal BMI before surgery
- To eliminate the need for postoperative follow-up
- To test whether surgery can be avoided entirely in all cases
Correct answer: To document adherence capacity and establish lifestyle changes needed postoperatively
The supervised period assesses the patient's ability to adhere to dietary and behavioral changes essential for postoperative success.
CBC Pre-Surgical Patient Assessment 2
According to standard NIH criteria, which patient generally qualifies for bariatric surgery consideration?