CSOWM MISCELLANEOUS EXAM (ACTUAL
2025/2026) QUESTIONS AND VERIFIED CORRECT
ANSWERS
The PCP prescribes short-term weight-loss management for an obese pt w/ migraine headaches. The nurse recognizes that which med will be most effective for the patient?
- Orlistat
- Topiramate
- Phendimetrazine
Answer: B
Rationale: Topiramate is an anticonvulsant that is taken in
combination with a nonamphetamine like phentermine. It is effective in reducing migraines & treating obesity.
The Obesity Surgery Mortality Risk Score (OS-MRS) identified what 5 preoperative risk factors that predicted increased risk of 30-day morbidity & mortality after RYGB
1. Advanced age: > 45 y/o
2. "Super-obesity": BMI > 50
3. HTN
- Male gender
- Pulmonary Embolism (PE) or surrogate (i.e. DVT, OSA)
- / 4
Insufficient evidence supports the routine screening & supplementation of what mineral?selenium
Routine screening for what mineral deficiency should occur after malabsorptive procedures? Who should receive routine supplementation?
- zinc
- BPD/DS require supplementation
What mineral deficiency presents as hair loss, pica, significant dysgeusia, or in male pts w/ hypogonadism or erectile disfunction?zinc deficiency
Routine screening of copper is NOT indicated but should be evaluated in pts w/ anemia, neutropenia, myeloneuropathy, & poor wound healing. What dose should be included as part of daily MVI? Treatment includes?
- 2 mg/d of copper supplementation 2 / 4
- Severe deficiency treatment includes IV copper 2-4 mg/d for
- days, subsequent treatment of mild-mod oral copper sulfate
or gluconate 3-8 mg/d until levels normalize & symptoms resolve
When being treated for zinc deficiency or using supplemental zinc for hair loss, what other supplement should be taken?
- mg copper for every 8-15 mg zinc (zinc replacement can
cause copper deficiency)
Thiamine supplementation should be included as part of daily MVI. Routine screening is not recommended unless post-op
patient is experiencing:
rapid weight loss, protracted vomiting, PN, excessive ETOH use, neuropathy or encephalopathy, or heart failure
How should thiamine deficiency be treated?severe- IV thiamine 500mg for 3-5 days, followed by 250mg for 3-5 days or until resolution of Sx, then consider 100mg/d thiamine orally indefinitely or until risk factors resolved mild- IV thiamine 100mg for 7-14 days recalcitrant or recurrent deficiency w/o 1 of the above risks= antibiotics for SIBO 3 / 4
Lipid levels & need for lipid-lowering meds should be periodically evaluated as the effect of weight loss on dyslipidemia is ________. Meds should not be stopped unless what?
- variable
- clearly indicated
The effect of weight loss on BP is ________. When should antihypertensive meds be evaluated & stopped?
- variable
- evaluated routinely, stopped only when clearly indicated
Persistent & severe GI sx warrant evaluation. What is the gold standard eval for celiac disease or bacterial overgrowth?When should a stool sample be obtained?
- upper endoscopy w/ small bowel biopsies & aspirates
- screen stool if presence of Clostridium difficile colitis is
suspected
Which of the following components of her presentation contributes most strongly to her personal risk of diabetes?
- / 4