Chapter 16 Maternal Nutrition

Women with eating disorders who become pregnant are at risk for a variety of complications including which of the following? 1. Premature birth 2. Too many nutrients available for the fetus 3. Miscarriage 4. High birth weight 5. Perinatal mortality

Answer: 1, 3, 5 Explanation: 1. Risks to the mother and baby include premature birth. 3. Risks to the mother and baby include miscarriage. 5. Risks to the mother and baby include perinatal mortality.

A client tells the nurse that she does not like citrus fruits, and would like suggestions for alternate vitamin C sources. What should the nurse suggest as good sources of vitamin C? 1. Barley and brown rice 2. Strawberries and potatoes 3. Buckwheat and lentils 4. Wheat flour and figs 5. Blueberries and broccoli

Answer: 2, 5 Explanation: 2. Strawberries and potatoes are very good sources of vitamin C. 5. Cantaloupes and broccoli are very good sources of vitamin C.

The nurse is counseling a group of first-trimester clients on diet increases that are necessary during pregnancy. Which information would be necessary to tell the pregnant women? 1. An increase of protein is necessary to provide amino acids necessary for fetal development. 2. Protein contributes to the body's overall energy metabolism. 3. The recommended protein during pregnancy is 70 grams each day. 4. The increased amount of protein that a pregnant woman needs is 15 grams a day. 5. The quality of protein is as important as the amount.

Answer: 1, 2, 3, 5 Explanation: 1. During pregnancy, the woman needs increased amounts of protein to provide amino acids for fetal development, blood volume expansion, and growth of other maternal tissues. 2. Protein contributes to overall energy metabolism. 3. The amount of protein recommended each day during pregnancy is 70 grams. 5. Plant proteins can meet a woman's protein needs; however, more of a given protein may be needed because animal proteins are of higher quality.

The nurse is planning an early-pregnancy class session on nutrition. Which information should the nurse include? 1. Protein is important for fetal development. 2. Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood. 3. Calcium prevents constipation at the end of pregnancy. 4. Zinc facilitates synthesis of RNA and DNA. 5. Vitamin A promotes development of the baby's eyes.

Answer: 1, 2, 4, 5 Explanation: 1. During pregnancy, the woman needs increased amounts of protein to provide amino acids for fetal development. 2. Iron deficiency anemia is associated with an increased incidence of preterm birth, low-birth-weight infants, and maternal and infant mortality. 4. Zinc is involved in RNA and DNA synthesis, and milk production during lactation. 5. Vitamin A promotes healthy formation and development of the fetal eyes.

The pregnant client states she does not want "to take all these supplements." What recommendations could the nurse make for the client? 1. "Folic acid has been found to be essential for minimizing the risk of neural tube defects." 2. "You do not have to take these supplements if you think you are healthy enough." 3. "Most women do not have adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy." 4. "These medications do the same thing. I will call your physician to cancel one of your medications." 5. "You should take the folic acid, but the vitamins are not that important."

Answer: 1, 3 Explanation: 1. An inadequate intake of folic acid has been associated with neural tube defects (NTDs) (e.g., spina bifida, anencephaly). 3. Iron is essential because many pregnant women do not have adequate intake of iron before pregnancy.

The nurse is instructing a pregnant client on her nutritional needs. The nurse tells the client that nutrition is needed for fetal development because fetal growth occurs in overlapping stages from increases of which of the following? 1. Cell numbers 2. Cell membranes 3. Cell size and number 4. Cell size alone 5. Vitamin and mineral intake

Answer: 1, 3, 4 Explanation: 1. Fetal growth occurs by an increase in cell numbers in one stage. 3. Fetal growth occurs by an increase in cell size and number during one stage. 4. Fetal growth occurs by an increase in cell size alone during one stage.

Postpartum nutritional status is determined primarily by assessing which of the following? 1. Dietary history 2. Menstrual history 3. Mother's weight 4. Hemoglobin levels 5. Mother's height

Answer: 1, 3, 4 Explanation: 1. Postpartum nutritional status is determined by assessing the new mother's dietary history. 3. Postpartum nutritional status is determined by assessing the new mother's weight. 4. Postpartum nutritional status is determined by assessing the new mother's hemoglobin levels.

The pregnant teen who was prescribed prenatal vitamins at her initial prenatal visit states that she does not like to take them. How should the nurse respond? 1. "Folic acid has been found to be essential for minimizing the risk of neural tube defects." 2. "You do not have to take these supplements if you think you are healthy enough." 3. "These medications do the same thing. I will call your doctor to cancel one of your medications." 4. "You can trust your doctor to know what you need." 5. "You need the supplements because your dietary intake may not be adequate for fetal development."

Answer: 1, 5 Explanation: 1. The CDC estimates that most neural tube defects could be prevented if women followed folic acid supplementation recommendations before they know they are pregnant. 5. One role of the nurse is educator, and this client needs additional information on why she needs the supplements. This response answers the client's concerns.

The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement? 1. "I am drinking a minimum of 8 to 10 glasses of liquid a day." 2. "I have started cutting back on my protein intake." 3. "At least three times a day, I drink a glass of milk." 4. "My calorie intake is higher than during the pregnancy."

Answer: 2 Explanation: 2. An adequate protein intake is essential while breastfeeding because protein is an important component of breast milk.

Which of the following is important for the development of the central nervous system of the fetus? 1. Calcium and phosphorus 2. Essential fatty acids 3. Iron 4. Vitamin D

Answer: 2 Explanation: 2. Essential fatty acids are important for the development of the central nervous system of the fetus. Of particular interest are the omega-3 fatty acids and their derivatives.

A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption? 1. Vitamin A 2. Vitamin C 3. Vitamin D 4. Vitamin E

Answer: 2 Explanation: 2. Vitamin C is known to enhance the absorption of iron from meat and nonmeat sources.

The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs? 1. Wheat bread and pasta 2. Ice cream and peanut butter 3. Eggs and tofu 4. Beans and potatoes

Answer: 3 Explanation: 3. The best food choices that are nondairy and complete proteins alone are eggs and tofu.

The nurse is preparing a prenatal class about infant feeding methods. The maternal nutritional requirements for breastfeeding and formula-feeding will be discussed. What statement should the nurse include? 1. "Breastfeeding requires a continued high intake of protein and calcium." 2. "Formula-feeding mothers should protect their health with a lot of calcium." 3. "Producing breast milk requires calories, but any source of food is fine." 4. "Formula-feeding mothers need a high protein intake to avoid fatigue."

Answer: 1 Explanation: 1. Lactation requires calories, along with increased protein and calcium intake.

A nurse is discussing the serving sizes in the grains food group with a new prenatal patient in the clinic. Which food equals one serving size from the grains food group? 1. One hamburger roll 2. One slice of bread 3. One cup of pasta 4. One tortilla 5. One ounce of dry cereal

Answer: 2, 4, 5 Explanation: 2. One slice of bread is one serving. 4. One tortilla is one serving. 5. One ounce of dry cereal is one serving.

When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority? 1. 40-year-old gravida 2 2. 22-year-old primigravida 3. 35-year-old gravida 4 4. 15-year-old nulligravida

Answer: 4 Explanation: 4. An expectant adolescent must meet the nutritional needs for her own growth in addition to the nutritional needs of pregnancy.

The nurse is presenting a preconception counseling class. The nurse instructs the participants that niacin intake should increase during pregnancy to promote metabolic coenzyme activity. The nurse will know that teaching has been effective if a client suggests which food as a source of niacin? 1. Fish 2. Apples 3. Broccoli 4. Milk

Answer: 1 Explanation: 1. Dietary sources of niacin include meats, fish, and whole grains. Page Ref: 331

The nurse is preparing for a postpartum home visit. The client has been home for a week, is breastfeeding, and experienced a third-degree perineal tear after vaginal delivery. The nurse should assess the client for which of the following? 1. Dietary intake of fiber and fluids 2. Dietary intake of folic acid and prenatal vitamins 3. Return of hemoglobin and hematocrit levels to baseline 4. Return of protein and albumin to predelivery levels

Answer: 1 Explanation: 1. This mother needs to avoid the risk of constipation. She might be hesitant to have a bowel movement due to anticipated pain from the perineal tear, and constipation will decrease the healing of the laceration.

The nurse evaluates the diet of a pregnant client and finds that it is low in zinc. The nurse knows that zinc intake should increase during pregnancy to promote protein metabolism. Which food should the nurse suggest in order to increase intake of zinc? 1. Shellfish 2. Bananas 3. Yogurt 4. Cabbage

Answer: 1 Explanation: 1. Zinc is found in greatest concentration in meats, shellfish, and poultry. Other good sources include whole grains and legumes.

A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give? 1. "Protein is important; therefore, the addition of one serving of meat a day is necessary." 2. "A daily supplement of vitamin B12 is important." 3. "The high fiber in a vegetarian diet is dangerous for pregnant women." 4. "Eggs are important to add to your diet. Eat six eggs per week." 5. "Milk products contain protein, but they are very low in iron."

Answer: 2, 5 Explanation: 2. Supplementation may be recommended for vegans who have difficulty meeting the recommended amounts of vitamin B12 through food sources. 5. Milk products will provide needed protein, but are not significant sources of iron.

In early-pregnancy class, the nurse emphasizes the importance of 8-10 glasses of fluid per day. How many of these should be water? 1. 1 to 2 2. 2 to 4 3. 4 to 6 4. 3 to 5

Answer: 3 Explanation: 3. A pregnant woman should consume at least 8 to 12 (8 oz) glasses of fluid each day, of which 4 to 6 glasses should be water.