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Quiz Session - Attempts With Random Questions

AANPCB FNP Exam Questions

Page 10 of 50

181.

When formulating a treatment plan for a patient with a diagnosis of hypothyroidism, which of the following statements will guide your plan related to thyroid replacement therapy with levothyroxine (Synthroid, Levothroid, Levoxyl)?

  • For the overweight or obese patient, the ideal body weight is used in dose calculation.

  • For the elderly, the anticipated dosage is approximately 25% of the usual adult dosage.

  • Once an adequate thyroid replacement dose is determined and TSH is normalized, a follow-up TSH level should be completed in 6 weeks.

  • For an underweight patient, ideal body weight should be used to calculate the dosage.

Correct answer: For the overweight or obese patient, the ideal body weight is used in dose calculation.

The anticipated dosage of thyroid replacement for an adult is 75 to 125 mcg of levothyroxine (Synthroid, Levothroid, Levoxyl), or about 1.6 mcg/kg daily. Ideal body weight should be used for this calculation, as the lean body mass, even in the presence of obesity, best reflects levothyroxine needs. However, if the patient is underweight, the actual body weight should be used.

For an elderly person, the anticipated dosage is 75% or less of the adult dosage. Once an adequate thyroid replacement dose is determined (as evidenced by a normalized TSH level), periodic TSH levels should be done after 6 months, then at 12-month intervals (only more frequently if the clinical situation dictates otherwise). 

182.

A 28-year-old patient is seen in the medical clinic due to symptoms that include nausea, anorexia, fever, malaise, and abdominal pain. Your examination reveals yellowing of the skin and sclera. 

Which of the following factors would be consistent with a tentative diagnosis of hepatitis A infection?

  • A history of recent travel to Southeast Asia

  • A history of multiple sex partners

  • A history of a recent blood transfusion 

  • A history of intravenous drug use

Correct answer: A history of recent travel to Southeast Asia

Hepatitis A is primarily transmitted through the oral-fecal route, typically related to contaminated water and food supplies often found in developing regions, such as in parts of Southeast Asia, South America, and the Middle East, but not Western Europe.

Transmission via sexual contact, needle sharing, or via a blood transfusion is very rare for hepatitis A infection. These are common routes of transmission for hepatitis B, C, and D.

183.

A 67-year-old male patient comes to the medical clinic due to constant cramping pain in the lower left quadrant of the abdomen that has persisted over several days, as well as fever, nausea and vomiting, diarrhea, flatulence, and bloating. A complete blood count (CBC) reveals leukocytosis and a left shift.

Which of the following would be the MOST likely tentative diagnosis?

  • Acute colonic diverticulosis

  • Peptic ulcer disease (PUD)

  • Acute cholecystitis

  • Gastroesophageal reflux disease (GERD)

Correct answer: Acute colonic diverticulosis

The symptoms and complete blood count (CBC) results described are characteristic of colonic diverticulosis, a condition in which bulging pockets are present in the intestinal wall. It most often affects the sigmoid colon. In acute diverticulosis, inflammation of the diverticula causes fever, leukocytosis, diarrhea, and left lower quadrant pain. Intestinal perforation is the likely origin of acute diverticulosis with the perforation ranging from pinpoint lesions in the majority to major tears.

PUD is associated with a gnawing or burning pain in the middle or upper stomach between meals or at night, as well as bloating, heartburn, and nausea or vomiting. Signs of acute cholecystitis include severe pain in the upper right abdomen often radiating to the right shoulder or back, tenderness on palpation, and nausea, vomiting, and fever. The primary symptoms of GERD are heartburn, usually described as a burning pain in the middle of the chest, regurgitation, and an acid taste in the mouth.

184.

Which of the following conditions is most likely to raise the suspicion of child abuse in an uninformed provider because of its resemblance to bruising?

  • Mongolian spots

  • Capillary hemangiomas

  • Port-wine stain

  • Erythema toxicum neonatorum

Correct answer: Mongolian spots

Mongolian spots are the most common type of pigmented skin lesion in newborns, occuring in about 90% of children of African and Asian ancestries and in less than 10% of children of European ancestry. The distribution is usually over the lower back and buttocks (lumbosacral area) but can occur over a wider area anywhere on the body. Caused by an accumulation of melanocytes, these are benign lesions that typically fade by the age of seven years without special therapy. Uninformed providers can misinterpret this normal finding as an ecchymotic area, raising the suspicion of child abuse. In contrast to an area of bruising or ecchymosis, when a Mongolian spot is pressed or palpated, there is no discomfort.  

Capillary hemangioma is a congenital vascular malformation; it does not resemble a bruise. A port-wine stain is a flat hemangioma. Erythema Toxicum Neonatorum (ETN) resembles flea bites, not bruises.

185.

A 16-year-old male patient seen at the urgent care clinic describes sudden pain that began around the navel and has shifted to the lower right abdomen. The pain increases with walking or if he coughs. He has a low-grade fever and nausea with vomiting.

Which of the following assessments is essential to include in the examination of this patient?

  • With the patient lying down, place your hand on his right knee and have the patient raise the same knee against force, or with the patient lying down on the left side, ask him to extend his right leg at the hip.

  • Place the non-dominant hand palm down and flat on the patient's abdomen with fingers parallel to the lower costal margin pointed toward the midline. Percuss with the middle finger of the dominant hand by firmly tapping the middle finger of the non-dominant hand.

  • Have the patient take a deep breath, then begin abdominal palpation over the right lower quadrant near the anterior iliac spine. Palpate with one or two hands, palms down, moving upward 2-3 cm at a time toward the lower costal margin.

  • Place the patient in the supine position and percuss over the abdomen from the umbilicus to the flanks, and then roll the patient to the side, facing away from the examiner, and repeat percussion from the umbilicus to the flank area.

Correct answer: With the patient lying down, place your hand on his right knee and have the patient raise the same knee against force, or with the patient lying down on the left side, ask him to extend his right leg at the hip.

The symptoms described are consistent with acute appendicitis. Psoas sign is an assessment technique used to rule out appendicitis and is elicited by placing the examiner's hand on the right knee and having the patient raise the same knee against force, or with the patient lying down on the left side, having him extend the right leg at the hip. Tenderness resulting from this assessment is a positive sign, which indicates the psoas muscle is inflamed and strongly suggests peritoneal irritation and the diagnosis of appendicitis.

The liver is examined by percussion by placing the non-dominant hand palm down and flat on the patient's abdomen with fingers parallel to the lower costal margin pointed toward the midline. The middle finger of the dominant hand taps firmly on the middle finger of the non-dominant hand. 

Palpation of the abdomen is an important assessment technique but not essential to assess for appendicitis. To palpate the abdomen, have the patient take a deep breath, then begin palpation over the right lower quadrant near the anterior iliac spine. Palpate with one or two hands, palms down, moving upward 2-3 cm at a time toward the lower costal margin. 

To assess for ascites, place the patient in the supine position and percuss over the abdomen from the umbilicus to the flanks, and then roll the patient to the side facing away from the examiner and repeat percussion from the umbilicus to the flank area.

186.

When performing annual well-woman examinations in the women's clinic, which findings would lead you to modify a patient's plan of care to include pharmacological intervention related to osteoporosis?

  • A postmenopausal patient has experienced a fracture of the distal forearm.

  • A patient took prednisone for six weeks related to a flare-up of inflammatory bowel disease.

  • A patient is now over age 65.

  • A patient is 55-years-old and has a Fracture Risk Assessment Tool analysis score of 9.5%.

Correct answer: A postmenopausal patient has experienced a fracture of the distal forearm.

Postmenopausal women with a low-impact (fragility) fracture, such as a fracture of the distal forearm, are potential candidates for pharmacologic intervention.

Osteoporosis prevention, bone mineral density testing, and treatment measures should be considered for anyone who has started on or has been taking or has a history of taking exogenous glucocorticoid therapy at a dose of more than 5 mg prednisone or the equivalent per day for 3 or more months rather than just six weeks. Clinicians should screen for osteoporosis in women aged 65 years of age and older and in younger women whose fracture risk is equal to or greater than 9.3% from Fracture Risk Assessment Tool analysis or are considered to be at fracture risk, but pharmacological intervention is not indicated on that basis alone.

187.

A 33-year-old female with a diagnosis of Familial Mediterranean Fever (FMF) presented to the clinic with complaints of an increase in the frequency of FMF attacks of peritonitis in the last several months. The patient, who was four months pregnant, stated that she had lost her grandmother to cancer in the last two months and that she and her husband had received notice that he was being laid off from work before the end of the month. She stated that she had recently had symptoms of a cold and that last week she had traveled out of state to be with her mother-in-law after her father-in-law suffered a severe heart attack. Using the information provided in the scenario and your knowledge of FMF, which of the following most likely contributed to the patient's increase in FMF attacks?

  • Stress

  • Illness

  • Pregnancy

  • Travel

Correct answer: Stress

While there are no consistent triggers that have been identified as being responsible for Familial Mediterranean Fever (FMF) attacks, many patients are ultimately able to identify specific causes for their attacks. Emotional stress and menstruation are but two of the known triggers for an FMF attack characterized by the acute onset of high fever and associated severe chest or abdominal pain. Other causes include strenuous exercise, trauma, cold exposure, and infection. Certain medications have also been implicated as triggering an FMF attack. While the majority of individuals affected with FMF experience brief, episodic attacks lasting for one to three days, a small percentage of patients experience chronic, painful inflammation and amyloidosis, which may ultimately cause death due to organ destruction. Up to 90% of patients with FMF are diagnosed by the time they are 20, with the remainder receiving a diagnosis before the age of 30 years. Most patients experience fewer than one FMF attack per year.

188.

A diagnosis of type II diabetes mellitus (T2DM) would be appropriate in your 46-year-old obese patient who presents with polyphagia and polyuria and has a:

  • Plasma glucose of 236 mg/dL two hours after a 75-gram glucose load

  • Hemoglobin A1C of 6.4%

  • Eight-hour fasting glucose of 124 mg/dL

  • Random blood sugar of 188 mg/dL

Correct answer: Plasma glucose of 236 mg/dL two hours after a 75-gram glucose load

Testing for T2DM among people at increased risk is often lacking. In addition, patients with T2DM are often asymptomatic at onset, further leading to a delay in diagnosis.

The criterion for establishing a diagnosis of T2DM includes:

  • an 8-hour fasting glucose ≥ 126 mg/dL
  • a random plasma glucose of ≥ 200 mg/dL coupled with symptoms of polyphagia, polydipsia, polyuria, unexplained weight loss, or hyperglycemic crisis
  • a two-hour plasma glucose ≥ 200 mg/dL after a 75-gram glucose load
  • hemoglobin A1c ≥ 6.5% (A1c of 5.7% to 6.4% places the individual at an increased risk for T2DM)

189.

A 41-year-old female patient who presented to the clinic with symptoms consistent with a Urinary Tract Infection (UTI) provided a urine sample for an in-office urine dipstick. Knowing that the presence of nitrites in a urine sample is highly suspicious for a UTI, the Nurse Practitioner (NP) student was surprised to find that the patient's sample was negative for nitrites. Which of the following microorganisms associated with causing UTI is most likely to not contribute to a finding of positive nitrites on dipstick urinalysis?

  • S. saprophyticus

  • E. coli

  • K. pneumoniae

  • P. mirabilis

Correct answer: S. saprophyticus

Urinalysis using a urine dipstick continues to be one of the most common methods of evaluating for the presence of Urinary Tract Infection (UTI) in patients during office visits. While a finding of positive nitrites on dipstick urinalysis is highly suspicious for UTI, not all organisms that cause UTI can reduce nitrates to nitrites. Gram-negative bacteria such as E. coli, K. pneumoniaecan, and P. mirabilis, which are all common causes of UTIs, are able to reduce nitrates to nitrites. A positive finding of nitrites coupled with a positive leukocyte esterase finding most likely indicates UTI due to a gram-negative microorganism. Gram-positive microorganisms such as enterococci, staphylococci, and adenovirus are also capable of causing UTI, but are not able to convert nitrates to nitrites; this can result in a false-negative interpretation of dipstick urinalysis. 

190.

A family nurse practitioner (FNP) who works in solo practice in a rural farming community evaluated a 23-year-old male patient who presented to the office with a localized painful, erythematous swollen area on his arm. The patient was helping his father separate their pigs for slaughter and was bitten by one of them. The FNP examines the patient and does not find any systemic concerns, and the patient's vital signs are all normal. The patient denies any drug allergies. 

What is the most appropriate treatment option?

  • Prescribe amoxicillin with clavulanate 875 mg/125 mg PO BID

  • Administer a tetanus shot

  • Administer a rabies shot

  • Prescribe clindamycin 300 mg PO QID plus a fluoroquinolone

Correct answer: Prescribe amoxicillin with clavulanate 875 mg/125 mg PO BID

Bite wounds, whether from an animal or a person, affect approximately 50% of individuals living in the US at some point during their lives. Dog and cat bites are the most common, with cat bites being more likely to become infected (80%) due to the penetrating nature (puncture) of the bite. Dog bites are more common in children, who are more likely to be bitten on the face or upper part of the body, but are the least likely type of bite to become infected (5%). Other animals also contribute to bite wounds, including wildlife such as rats, bats, raccoons, and skunks, and farm animals such as pigs. Human bites most often occur in the context of a fight and tend to have the most serious consequences due to the many types of bacteria that may be found in the mouth, potentially causing infection of the bite wound(s). 

Individuals who work on a farm or in another area of agriculture may present with bites from pigs, horses, sheep, or cows, which the primary care provider should be able to manage and treat. After being assessed for the extent of the injury, all bite wounds should be thoroughly irrigated and cleaned using an antimicrobial agent. Bites from certain animals may warrant the administration of a rabies vaccine (bat, raccoon, skunk) and possibly a tetanus vaccine. Almost all bites can be adequately treated with the administration of amoxicillin with clavulanate unless the patient has a contraindication to its use. Pig bites are most likely to become infected with gram-positive cocci, gram-negative bacilli, anaerobic bacteria, and a variety of Pasteurella species. If the patient is unable to take amoxicillin with clavulanate, a third-generation parenteral cephalosporin such as ceftriaxone or cefotaxime should provide adequate bacterial coverage. 

A patient who has been bitten by a dog and is unable to take amoxicillin with clavulanate should be treated using clindamycin 300 mg PO QID plus a fluoroquinolone.

191.

A nurse practitioner (NP) consults with an insulin-dependent diabetic patient who has been experiencing early morning hyperglycemia despite consistent medication usage and dietary control. The NP discusses the Somogyi effect and the dawn phenomenon with the patient, and they discuss methods of altering the patient's insulin administration. 

Which of the following statements describes the similarities and differences between the Somogyi effect and the dawn phenomenon?

  • The dawn phenomenon may be experienced by both diabetics and non-diabetics, but the Somogyi effect is only experienced by diabetics. 

  • The Somogyi effect and dawn phenomenon are both only seen in diabetic patients who use insulin.

  • Both the Somogyi effect and the dawn phenomenon can be effectively managed by altering the bedtime dose of insulin.

  • Patients who use oral hypoglycemic agents to manage their blood glucose are likely to experience the dawn phenomenon but not the Somogyi effect.

Correct answer: The dawn phenomenon may be experienced by both diabetics and non-diabetics, but the Somogyi effect is only experienced by diabetics. 

Diabetic individuals who use insulin to manage their blood glucose are at risk of experiencing early morning hyperglycemia in the form of the Somogyi effect or the dawn phenomenon. These two conditions, while similar, occur due to different etiology. The dawn phenomenon is a normal physiologic event; a transient state of hyperglycemia results from a growth hormone-induced decrease in insulin sensitivity that occurs in all people between 4 and 8 AM. Healthy individuals who do not have diabetes will produce insulin in response to the blood glucose spike, but diabetic individuals are unable to compensate for this spike due to their abnormal insulin responses. The dawn phenomenon can be managed by either splitting the intermediate-acting dose of insulin that is typically administered in the evening and administering a partial dose at dinner and a partial dose at bedtime. An alternative is to switch from intermediate-acting insulin to glargine or detemir or to utilize an insulin pump overnight. 

The Somogyi effect only affects diabetics who use insulin and may be the result of nighttime hypoglycemia from insulin administration triggering an excess release of glucagon and cortisol, swinging the patient into a hyperglycemic state by approximately 7 AM. The Somogyi effect is more common in type 1 diabetics but may also be experienced by type 2 diabetics who are reliant on insulin. The Somogyi effect is best treated by reducing the suppertime dose of intermediate-acting insulin. 

192.

You are working at a human immunodeficiency virus (HIV) clinic when a 40-year-old HIV positive patient informs you that she has had several new partners in the last six months, and she has not informed them of her HIV status. You explain that:

  • There are healthcare agencies available to help notify her partners without disclosing the patient's identity.

  • She has a legal responsibility to contact these recent partners and make them aware of her HIV status.

  • You will notify the office staff who can contact her partners for her without disclosing her identity.

  • She is responsible for helping her previous partners obtain HIV screening since she did not disclose her HIV status to them.

Correct answer: There are healthcare agencies available to help notify her partners without disclosing the patient's identity.

Patients who have received a positive HIV test result should be strongly encouraged to disclose their HIV status to their spouse or current and future sex partners and any previous sex partners and recommend they get tested for HIV infection. Healthcare agencies are in place to assist in notifying HIV positive patient's partners without disclosing the patient's identity.

193.

You are examining a 60-year-old female patient with type II diabetes mellitus who has come to the medical clinic with symptoms, including rectal bleeding, persistent abdominal cramping, and unexplained weight loss. She reports that she has experienced alternating constipation and diarrhea for the past month, and when formed, her stool is thinner than usual.

All the following additional factors are significant in relation to the risk for colorectal cancer except:

  • A personal history of internal hemorrhoids

  • A personal history of Crohn's disease 

  • Diet high in fat and red meat consumption

  • Familial polyposis syndrome

Correct answer: A personal history of internal hemorrhoids

A personal history of internal hemorrhoids is not a risk factor for colorectal cancer.

Risk factors for colorectal cancer include the following:

  • A personal history of inflammatory bowel disease (ulcerative colitis and Crohn's disease)
  • A personal history of neoplasia
  • Age older than 50 years
  • A family history of colorectal cancer
  • Familial polyposis syndrome
  • Hereditary non-polyposis colorectal cancer (HNPCC)
  • Diet high in fat and red meat consumption
  • Low calcium intake

194.

You are providing care for a woman with a diagnosed chlamydial infection and have ordered testing to screen for other sexually transmitted infections (STIs). All the following infections are included in a comprehensive STI panel except:

  • Hepatitis A

  • Hepatitis B

  • Syphilis

  • Human immunodeficiency virus (HIV)

Correct answer: Hepatitis A

Hepatitis A is not an STI.

In all STIs, a critical part of care is a discussion of preventative strategies, and practitioners should offer and encourage testing for infection. A comprehensive STI panel includes the following tests: Human Immunodeficiency Virus (HIV), hepatitis (B & C), syphilis, gonorrhea, herpes simplex virus (I and II), and chlamydia.

195.

A 30-year-old male patient presents in the medical clinic due to frequency, urgency, and a burning sensation during urination. Other symptoms include milky, blood-tinged discharge from the penis and redness at the opening of the urethra.

Which of the following is the MOST likely diagnosis?

  • Gonococcal infection

  • Balanitis

  • Genital herpes outbreak

  • Chancroid ulcer

Correct answer: Gonococcal infection

The signs and symptoms of frequency, urgency, and a burning sensation during urination, with milky, blood-tinged discharge from the penis, and redness at the opening of the urethra, are characteristic of gonococcal urethritis and infection with Neisseria gonorrhoeae.

Symptoms of balanitis include pain, redness, itching, swelling, and a foul-smelling discharge from the penis or under the foreskin. 

The initial outbreak of genital herpes presents with fever and flu-like symptoms, nausea, muscle aches, painful urination, and a tingling, burning, or itching sensation in the area where blisters will appear. Blisters may develop on the penis or testicles or on and around the anus, buttocks, or thighs. 

Chancroid is characterized by painful open sores on the genitals, and in some cases, swollen and tender lymph nodes in the groin.

196.

The 16-year-old female you are examining after surgery to repair a torn anterior cruciate ligament (ACL) is concerned she will re-injure her knee when she is able to begin playing basketball again. You know she is at risk for a meniscal tear, as the surgery to repair her ACL was significantly delayed.

Which of the following should you recommend to help reduce the risk of a meniscal tear?

  • Quadriceps-strengthening exercises

  • Using a knee brace when playing basketball

  • Daily use of glucosamine supplement

  • A regular exercise program limiting weight-bearing activities

Correct answer: Quadriceps-strengthening exercises

A meniscal tear is often seen in athletes who take part in contact sports that involve sudden stop-and-go motions. The injury results from twist-type motion, and athletes may report experiencing a popping sound, locking of the knee, or feeling as if their knee "gave out" at the time the injury occurred. Individuals who have suffered a torn Anterior Cruciate Ligament (ACL) previously with a delay in surgical repair are at increased risk of experiencing a meniscal tear. Older adults are also at risk of meniscal tears due to degenerative changes in the knee.

While many cases of meniscal tears are not preventable, some steps can be taken to reduce the risk of this condition. Quadriceps-strengthening exercises should be recommended to help stabilize the joint and prevent a meniscal tear. In addition, stretching exercises before and after physical activity and ensuring proper footwear is used for sports activities can help reduce the risk. 

Use of a knee brace while taking part in athletic activities will not reduce the risk of a meniscal tear.

A daily glucosamine supplement may be included in the treatment plan for someone experiencing the pain of osteoarthritis. A regular exercise program that limits weight-bearing activities is also recommended for individuals with osteoarthritis.

197.

When evaluating the status of a patient in withdrawal from heroin use, you would recognize all the following as symptoms of opioid withdrawal except:

  • Hypotension

  • Tachycardia

  • Pupillary dilation

  • Fever

Correct answer: Hypotension

Hypertension, not hypotension, is a symptom of opioid withdrawal.

Symptoms of opioid withdrawal include:

  • An intense craving for opioids
  • Hypertension
  • Tachycardia
  • Diarrhea
  • Nausea
  • Fever
  • Temperature dysregulation
  • Pupillary dilation
  • Restlessness
  • Myalgia
  • Lacrimation and rhinorrhea

198.

A 62-year-old male patient seen in the medical clinic reports fatigue, weakness, and dyspnea with exertion. You observe edema involving the lower legs, ankles, and feet. All of the following findings on a chest X-ray would help to confirm a diagnosis of heart failure except:

  • Thinning of the interlobular septa

  • Pleural effusions

  • Bilateral infiltrates in a butterfly pattern

  • Kerley B lines

Correct answer: Thinning of the interlobular septa

Thickening, rather than thinning of the interlobular septa, is typically seen on the chest X-ray of a patient with heart failure. This is known as Kerley B lines.

Other findings on the chest X-ray in heart failure include cardiomegaly, alveolar edema with pleural effusions, bilateral infiltrates in a butterfly pattern, loss of sharp definition of the pulmonary vasculature, and haziness of hilar shadows.

199.

Your patient has come to the clinic with an extensive itchy rash related to exposure to poison sumac plants. In developing your plan of care, which topical corticosteroid would be most effective to prescribe?

  • Clobetasol propionate (Olux-e, Olux, Clobex) 0.05%

  • Fluocinolone acetonide (Synalar) 0.2%

  • Triamcinolone acetonide (Kenalog) 0.1%

  • Desoximetasone (Topicort) 0.25%

Correct answer: Clobetasol propionate (Olux-e, Olux, Clobex) 0.05%

The relative potency of topical corticosteroid preparations is primarily based upon their vasoconstrictive activity. Clobetasol propionate (class 1) has a significantly greater vasoconstricting action than the least potent agents, such as hydrocortisone (class 7). In addition, the therapeutic effect of corticosteroids is exhibited through mechanisms such as immunosuppressive and anti-inflammatory properties.  

Clobetasol propionate is a super-high potency topical corticosteroid, significantly more potent than fluocinolone acetonide (low potency), triamcinolone acetonide (low potency), and desoximetasone (high potency).

200.

One of your patients had the gastric sleeve procedure performed three years ago. You would expect to observe that the patient has lost how much of their excess body weight?

  • 40% to 60%

  • 70% to 80%

  • 20% to 30%

  • 30% to 40%

Correct answer: 40% to 60%

In the United States, the gastric sleeve has become the most common type of bariatric surgery technique, followed by gastric bypass. In a well-selected patient population, the average weight loss with the gastric sleeve is approximately 40% to 60% of excess body weight.

A person considering bariatric surgery must have a realistic idea regarding the anticipated outcome. In a well-selected patient population, the average weight loss with the gastric sleeve procedure can result in approximately 60% of excess body weight, most typically within the first three years following the procedure. The most dramatic weight losses are seen in the first months postoperatively. With gastric bypass, the expected weight loss is approximately 70% to 80% of excess body weight. Approximately 85% of patients lose a great deal of weight without major complications and maintain this long term. With any weight loss surgical procedure, future weight regain can occur if recommended dietary and physical activity guidelines are not followed. 

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