# Situation: A 78-year-old woman who lives alone is admitted with community-acquired pneumonia. Her daughter reports that she has eaten very little for the past 10 days. Her recorded weights are: 6 months ago, 53.0 kg; 3 months ago, 52.0 kg; 1 month ago, 48.9 kg; today, 46.5 kg. She is 1.55 m tall and has no edema. The nurse compares her weight loss with the 3-month criterion for severe weight loss. What percentage of weight loss should the nurse use? Round off to one decimal place.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=630476  
> language: ko  
> subject: Nursing Practice IV — Care of Clients with Problems in Nutrition and Gastrointestinal, Metabolism and Endocrine, Perception and Coordination

## 문제

Situation: A 78-year-old woman who lives alone is admitted with community-acquired pneumonia. Her daughter reports that she has eaten very little for the past 10 days. Her recorded weights are: 6 months ago, 53.0 kg; 3 months ago, 52.0 kg; 1 month ago, 48.9 kg; today, 46.5 kg. She is 1.55 m tall and has no edema.

The nurse compares her weight loss with the 3-month criterion for severe weight loss. What percentage of weight loss should the nurse use? Round off to one decimal place.

## 보기

1. 10.6% **✔ 정답**
2. 11.8%
3. 4.9%
4. 12.3%

**정답: 1**

## 해설

Percentage weight change = (usual weight − current weight) ÷ usual weight × 100. For 3 months the baseline is the weight 3 months ago: (52.0 − 46.5) ÷ 52.0 × 100 = 5.5 ÷ 52.0 × 100 = 10.6%. A loss of more than 7.5% in 3 months is clinically significant (severe) weight loss.

## 심화 해설

Choosing the right baseline weight
Percentage weight change is calculated as (usual weight − current weight) ÷ usual weight × 100. The key step is choosing the correct usual weight. The question asks about the 3-month criterion, so the baseline is the weight recorded 3 months ago, which is 52.0 kg. Her current weight is 46.5 kg. The loss is 52.0 − 46.5 = 5.5 kg, and 5.5 ÷ 52.0 × 100 = 10.6%. The denominator is always the earlier (usual) weight for the time frame being judged, never today's weight.

Interpreting the result
In nutrition assessment, a loss of more than 7.5% in 3 months is considered clinically significant, or severe, weight loss. Her 10.6% loss clearly exceeds that threshold. Together with very poor intake for the past 10 days and an acute illness, this places her in a high nutritional risk group that needs prompt nutrition support and close monitoring. The absence of edema matters too: it means her weight is not being falsely raised by retained fluid, so the measured loss reflects true tissue loss.

| Calculation | Working | Result |
| --- | --- | --- |
| 3-month loss (correct) | (52.0 − 46.5) ÷ 52.0 × 100 | 10.6% |
| Wrong denominator | 5.5 ÷ 46.5 × 100 | 11.8% |
| 1-month loss | (48.9 − 46.5) ÷ 48.9 × 100 | 4.9% |
| 6-month loss | (53.0 − 46.5) ÷ 53.0 × 100 | 12.3% |

How the distractors are built
Each wrong option reflects a real calculation error. Dividing by the current weight gives 11.8%, which inflates the loss because the denominator is smaller. Using the weight from 1 month ago answers a different question (the 1-month loss of 4.9%), and using the weight from 6 months ago gives the 6-month loss of 12.3%. All three use real numbers from the stem, so they look plausible. Watch out! In calculation items, first match the time frame in the question to the baseline weight, then check that you divided by that baseline.

Exam takeaway
When a stem lists several weights over time, write the formula, pick the weight that matches the time frame asked, and round only at the end, as instructed. Key point! Weight loss of more than 7.5% in 3 months signals severe malnutrition risk and calls for nutrition intervention. Her height of 1.55 m could be used for body mass index, but body mass index alone would miss how quickly she is losing weight.

## 임상 시나리오

Calculating Percentage Weight LossMatching the baseline to the time frame
Formula: (usual weight − current weight) ÷ usual weight × 100. For a 3-month criterion, the usual weight is the weight recorded 3 months ago.

For this client: (52.0 − 46.5) ÷ 52.0 × 100 = 10.6%. A loss of more than 7.5% in 3 months is clinically significant (severe) weight loss.

Her lack of edema means the scale weight reflects true tissue loss rather than fluid shifts.

CautionDo not divide by today's weight or use the 1-month or 6-month weights; each error gives a different percentage that appears among the options.

## 핵심 개념

- **Percentage weight change** — The difference between usual and current weight divided by usual weight, multiplied by 100, to show the proportion lost.
- **Usual weight** — The client's earlier reference weight for the time frame being assessed, used as the denominator in weight-loss calculations.
- **Severe weight loss** — Unintended loss of more than 7.5% of body weight in 3 months, indicating high nutritional risk.
- **Malnutrition** — A state of inadequate intake or uptake of nutrients that changes body composition and impairs function and recovery.

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