Perry/Hockenberry chapter 9. Maternal and Fetal Nutrition

The nurse is assessing a patient who recently delivered a child. The laboratory reports of both the mother and the child show high amounts of lead in the blood. What clinical condition observed in the mother during pregnancy could be the reason for the abnormal levels of lead?1Pica2Anemia3Malnutrition4Preeclampsia

1

A pregnant woman experiencing nausea and vomiting should:drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.eat small, frequent meals (every 2 to 3 hours).increase her intake of high-fat foods to keep the stomach full and coated.limit fluid intake throughout the day.

.eat small, frequent meals (every 2 to 3 hours)

The nurse is assessing a patient who is 4 months pregnant. On reviewing the patient's previous report the nurse finds that the patient was 51 kg during the second month of pregnancy. If the patient's height is 1.4 m, what is the optimal weight gain per week that the patient would have at this stage of pregnancy?0.1 kg0.3 kg0.5 kg2.0 kg

0.3

During the assessment of a pregnant patient, the nurse instructs the patient to eat eight to ten servings of vegetables and fruits, three servings of milk products, and incorporate low-fat meats daily. What is the most probable reason for giving such instruction? To prevent:1Hypertension2Hypercalcemia3Hypouricemia4Hypothyroidism

1

The nurse instructs a pregnant patient to stay away from Brie, Camembert, and the soft Mexican cheeses. What would be the possible clinical reason for giving such advice to the patient?1Possibility of listeriosis developing2Physiologic anemia3Sigmoid diverticulosis4Phenylketonuria (PKU)

1

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein-containing foods? Select all that apply.1 Dried beans2 Seeds3 Peanut butter4 Bagel5 Eggs

1235

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? Select all that apply.1 Underweight women should gain 12.5 to 18 kg.2 Overweight women should gain at least 7 to 11.5 kg.3 Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale.4 In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.5 Normal weight women should gain 11.5 to 16 kg.

1235

What measures should the nurse instruct a pregnant patient to take to relieve the symptoms of morning sickness during the first trimester? Select all that apply.1 Consume food when it is not hot.2 Eat food in smaller portions.3 Include smaller amounts of fluids.4 Include foods that are high in fats.5 Include food high in starch content.

125

The nurse instructs a Middle Eastern patient who is pregnant regarding the importance of including a good amount of fruits in the diet to improve folate levels in the body. Which fruits should the nurse recommend to the patient? Select all that apply.1 Grapes2 Peaches3 Apricots4 Star fruit5 Pomegranates

13

A pregnant patient does not drink milk because of lactose intolerance. Which foods should the nurse instruct the patient to incorporate in her diet to prevent calcium deficiency? Select all that apply.1 Sardines2 Avocadoes3 Cooked pasta4 Wheat bread5 Refried beans

15

A pregnant woman at 7 weeks of gestation complains to her nurse-midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse-midwife should suggest that the woman:1drink warm fluids with each of her meals.2eat a high-protein snack before going to bed.3keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed.4schedule three meals and one midafternoon snack a day.

2

A pregnant woman experiencing nausea and vomiting should:1drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.2eat small, frequent meals (every 2 to 3 hours).3increase her intake of high-fat foods to keep the stomach full and coated.4limit fluid intake throughout the day.

2

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. The nurse's best response is to tell the woman that her pattern of weight gain should be approximately:1a pound a week throughout pregnancy.22 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy.3a pound a week during the first two trimesters, then 2 lbs per week during the third trimester.4a total of 25 to 35 lbs

2

The nurse is preparing a diet chart for a Hispanic pregnant patient who is a vegetarian. The patient complains of leg cramps. What does the nurse ensure to include in the patient's diet?1Melon fruit2Turnip greens3Whole or 2% milk4Canned sardines

2

The nurse notices that the hemoglobin levels of an infant who is breastfed have reduced drastically since birth. What is the probable reason for the infant to have anemia?1The infant's mother is still taking folic acid and B vitamins.2The infant's mother is consuming large amounts of caffeine.3The infant's mother continues to take oral iron supplements.4The infant's mother drinks large amounts of water and juices.

2

The nurse observes that a patient has a decreased vitamin D level during a prenatal visit. Which associated risk should the nurse suspect to observe in the patient?1Goiter2Tetany3Ketonuria4Macrosomia

2

The nurse reviews the medical history of a patient and instructs the patient to prevent conception. Which finding led the nurse to make such a decision? The patient is using:1Sucralose (Splenda).2Isotretinoin (Accutane).3Saccharin (Sweet'N Low).4Aspartame (NutraSweet).

2

When assessing a pregnant woman in the second trimester, the nurse finds the patient to be healthy, but the patient reports mild edema. What should the nurse infer from this finding?1The patient has a vitamin B deficiency.2This is a normal finding; it results from estrogen.3The patient is consuming too many calories.4The nurse should check the blood glucose

2

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:1spina bifida.2intrauterine growth restriction.3diabetes mellitus.4Down syndrome.

2

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. What is the nurse's best response to explain how to achieve optimal weight gain during pregnancy?a pound a week throughout pregnancy.2 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy.a pound a week during the first two trimesters, then 2 lbs per week during the third trimester.a total of 25 to 35 lbs

2 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy.

throughout my pregnancy, but now that I have delivered my baby, I want to be able to drink alcohol." What should the nurse inform the patient? Select all that apply.1 "You would not be able to produce sufficient milk for the baby."2 "Your child may develop psychomotor retardation if you drink."3 "Your child would not be able to suck milk if you have alcohol."4 "Your child may become anemic if you drink any form of alcohol."5 "Your child would not be able sleep properly if you have alcohol."

23

The nurse teaches a group of students about the use of artificial sweeteners during pregnancy. Arrange the artificial sweeteners in a descending order according to their sweetness as compared to sugar.1.Acesulfame K (Sunett)2.Sucralose (Splenda)3.Aspartame (NutraSweet)4.Saccharin (Sweet'N Low)

2413

The nurse measures the weight and height of a patient who is trying to conceive and documents that the patient is overweight. What would have been a possible body mass index (BMI) of this patient?32.5 kg/m228.5 kg/m218.5 kg/m223.9 kg/m2

28.5 kg/m2

The nurse instructs the patient to eat nuts, legumes, cocoa, and whole grains during the second trimester of pregnancy. What is the rationale for this instruction? The patient has:1A diet that is low in zinc.2A low intake of vitamin A.3A low intake of magnesium.4Decreased vitamin D intake.

3

The nurse is teaching a patient with anemia when and how to take the prescribed iron supplements. The nurse provides a list of beverages for the patient to stay away from while taking the iron supplement. What is the rationale for this?1They can affect the process of hematopoiesis.2They increase red blood cell (RBC) destruction.3They can decrease iron supplement absorption.4They can increase the plasma levels of caffeine.

3

The nurse notices that a pregnant patient is worried about gaining weight and has stayed away from eating foods high in carbohydrates. What should the nurse do to ensure adequate nutrition?1Inform the patient that lack of proper nutrition may delay the newborn's delivery date.2Suggest the patient increase her protein intake to compensate for the carbohydrate levels.3Inform the patient that breastfeeding aids in losing the weight gained during pregnancy.4Inform the patient that a decreased intake of carbohydrates during pregnancy causes fetal obesity.

3

What question does the nurse ask while assessing the socioeconomic status of a pregnant patient?1"What prescription medications do you take?"2"Do you have any factories around your house?"3"Do you have any medical or dental insurance?"4"Are there any diseases that run in your family?"

3

The nurse is providing dietary education to a patient who is 4 months pregnant. Which diet should the nurse suggest to the patient for proper neural development of the fetus?1Nuts, beans and legumes, cocoa, meats, and whole grains2Iodized salt, milk and milk products, yeast breads, and rolls3Citrus fruits, broccoli, melons, strawberries, and tomatoes4Asparagus, eggs, fortified cereals, and green leafy vegetables

4

The nurse observes a patient had preeclampsia during the second trimester of her pregnancy. Which is the most likely reason for preeclampsia in this patient?1Hypervitaminosis2Severe hypotension3Lower extremity edema4Body mass index (BMI) of 34.2 kg/m2

4

17. Which nutritional recommendation about fluids is accurate?a. A woman's daily intake should be 8 to 10 glasses (2.3 L) of water, milk, or juice.b. Coffee should be limited to no more than two cups, but tea and cocoa can be consumed without worry.c. Of the artificial sweeteners, only aspartame has been not associated with any maternity health concerns.d. Water with fluoride is especially encouraged because it reduces the child's risk of tooth decay.

A

23. To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she:a. try a tart food or drink such as lemonade or salty foods such as potato chips.b. drink plenty of fluids early in the day.c. brush her teeth immediately after eating.d. never snack before bedtime.

A

31. A pregnant patient would like to know a good food source of calcium other than dairy products. Your best answer is:a. legumes.b. yellow vegetables.c. lean meat.d. whole grains.

A

5. A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned that during and after tennis matches this woman consumes:a. several glasses of fluid.b. extra protein sources such as peanut butter.c. salty foods to replace lost sodium.d. easily digested sources of carbohydrate.

A

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned regarding what this woman consumes during and after tennis matches. Which is the MOST important?A. Several glasses of fluidB. Extra protein sources, such as peanut butterC. Salty foods to replace lost sodiumD. Easily digested sources of carbohydrate

A

When planning a diet with a pregnant woman, the nurse's FIRST action would be to:A. Review the woman's current dietary intake.B. Teach the woman about the food pyramid.C. Caution the woman to avoid large doses of vitamins, especially those that are fat-soluble.D. Instruct the woman to limit the intake of fatty foods.

A

With regard to protein in the diet of pregnant women, nurses should be aware that:A. Many protein-rich foods are also good sources of calcium, iron, and b vitamins.B. Many women need to increase their protein intake during pregnancy.C. As with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.D. High-protein supplements can be used without risk by women on macrobiotic diets

A

1. Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a patient to a registered dietitian for in-depth nutritional counseling in the following situations: (Select all that apply.)a. preexisting or gestational illness such as diabetes.b. ethnic or cultural food patterns.c. obesity.d. vegetarian diet.e. allergy to tree nuts.

ABCD

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein containing foods? (Select all that apply.)A. Dried beansB. SeedsC. Peanut butterD. BagelE. Eggs

ABCE

Which suggestions should the nurse include when teaching about appropriate weight gain in pregnancy? (Select all that apply.)A. Underweight women should gain 12.5 to 18 kg.B. Obese women should gain at least 7 to 11.5 kg.C. Adolescents are encouraged to strive for weight gains at the upper end of the recommended scale.D. In twin gestations, the weight gain recommended for a single fetus pregnancy should simply be doubled.E. Normal weight women should gain 11.5 to 16 kg.

ABCE

The nurse informs a patient who is in the second trimester of pregnancy about having an increased risk for miscarriage and intrauterine growth restriction (IUGR). What patient behavior would be the most likely reason for cautioning the patient? The patient consumes:At least 25 g of fiber in 24 hours.At least 250 mg of caffeine daily.A minimum of 30 mg of iron daily.A minimum of 70 g of protein daily

At least 250 mg of caffeine daily.

11. To prevent gastrointestinal upset, patients should be instructed to take iron supplements:a. on a full stomach.b. at bedtime.c. after eating a meal.d. with milk.

B

12. Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:a. spina bifida.b. intrauterine growth restriction.c. diabetes mellitus.d. Down syndrome.

B

14. Maternal nutritional status is an especially significant factor of the many factors that influence the outcome of pregnancy because:a. it is very difficult to adjust because of people's ingrained eating habits.b. it is an important preventive measure for a variety of problems.c. women love obsessing about their weight and diets.d. a woman's preconception weight becomes irrelevant.

B

A pregnant woman at 7 weeks of gestation complains to her nurse midwife about frequent episodes of nausea during the day with occasional vomiting. She asks what she can do to feel better. The nurse midwife could suggest that the woman:A. Drink warm fluids with each of her meals.B. Eat a high-protein snack before going to bed.C. Keep crackers and peanut butter at her bedside to eat in the morning before getting out of bed.D. Schedule three meals and one midafternoon snack a day.

B

A pregnant woman experiencing nausea and vomiting should:A. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.B. Eat small, frequent meals (every 2 to 3 hours).C. Increase her intake of high-fat foods to keep the stomach full and coated.D. Limit fluid intake throughout the day.

B

A pregnant woman with a body mass index (BMI) of 22 asks the nurse how she should be gaining weight during pregnancy. The nurse's BEST response would be to tell the woman that her pattern of weight gain should be approximately:A. A pound a week throughout pregnancy.B. 2 to 5 lbs during the first trimester, then a pound each week until the end of pregnancy.C. A pound a week during the first two trimesters, then 2 lbs per week during the third trimester.D. A total of 25 to 35 lbs.

B

With regard to nutritional needs during lactation, a maternity nurse should be aware that:A. The mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy.B. Caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.C. Critical iron and folic acid levels must be maintained.D. Lactating women can go back to their prepregnant calorie intake

B

Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:A. Spina bifida.B. Intrauterine growth restriction.C. Diabetes mellitus.D. Down syndrome.

B

29. When providing care to the prenatal patient, the nurse understands that pica is defined as:a. intolerance of milk products.b. iron deficiency anemia.c. ingestion of nonfood substances.d. episodes of anorexia and vomiting.

C

3. A pregnant woman's diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. The nurse would be most concerned about this woman's intake of:a. calcium.b. protein.c. vitamin B12.d. folic acid.

C

8. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 18.0. The nurse knows that this woman's total recommended weight gain during pregnancy should be at least:a. 20 kg (44 lbs).b. 16 kg (35 lbs).c. 12.5 kg (27.5 lbs).d. 10 kg (22 lbs).

C

1. A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this?a. This weight gain indicates possible gestational hypertension.b. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).c. This weight gain cannot be evaluated until the woman has been observed for several more weeks.d. The woman's weight gain is appropriate for this stage of pregnancy.

D

10. A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice:a. "Discontinue all contraception now."b. "Lose weight so that you can gain more during pregnancy."c. "You may take any medications you have been taking regularly."d. "Make sure that you include adequate folic acid in your diet."

D

7. A pregnant woman's diet history indicates that she likes the following list of foods. The nurse would encourage this woman to consume more of which food to increase her calcium intake?a. Fresh apricotsb. Canned clamsc. Spaghetti with meat sauced. Canned sardines

D

9. A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman:a. substitute other calcium sources for milk in her diet.b. lie down after each meal.c. reduce the amount of fiber she consumes.d. eat five small meals daily.

D

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How would the nurse interpret this?A. This weight gain indicates possible gestational hypertension.B. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).C. This weight gain cannot be evaluated until the woman has been observed for several more weeks.D. The woman's weight gain is appropriate for this stage of pregnancy.

D

When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:A. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.B. Iron absorption is inhibited by a diet rich in vitamin C.C. Iron supplements are permissible for children in small doses.D. Constipation is common with iron supplements.

D

During the assessment of a pregnant patient, the nurse instructs the patient to eat eight to ten servings of vegetables and fruits, three servings of milk products, and incorporate low-fat meats daily. What is the most probable reason for giving such instruction? To prevent:HypertensionHypercalcemiaHypouricemiaHypothyroidism

Hypertension

The nurse is assessing a 27-year-old pregnant patient on her first prenatal visit. The patient weighs 80 kg and is 1.6 m tall. What does the nurse infer from this observation? The patient:Has a desirable weight.Is thought to be obese.Is overweight for height.Is underweight for height

Is thought to be obese

The nurse is preparing a diet chart for a pregnant African-American patient who is a strict vegan. What does the nurse include in the diet chart of the patient? Select all that apply.MelonYogurtTurnipsCooked hamCooked peas

Melon, Turnips, Cooked peas

Why does the nurse advise a pregnant patient to eat salty foods, such as crackers, or suck on a lemon slice? To prevent:NauseaScurvyLethargyHypotension

Nausea

The nurse reviews the medical reports of a pregnant patient and suspects the health care provider will instruct the patient not to add the artificial sweetener aspartame (NutraSweet) in her daily diet. What would be the possible reason for this instruction based on the patient's medical history?Phenylketonuria (PKU)Type 2 diabetes mellitusHistory of diverticulosisPhysiologic anemia

PKU

The nurse instructs a pregnant patient to stay away from Brie, Camembert, and the soft Mexican cheeses. What would be the possible clinical reason for giving such advice to the patient?Possibility of listeriosis developingPhysiologic anemiaSigmoid diverticulosisPhenylketonuria (PKU)

Possibility of listeriosis developing

While assessing a pregnant Hispanic patient, the nurse finds that 600 mg of calcium supplements are prescribed for the patient. What observed patient pattern would be the probable reason for including calcium supplements?Consumes dried figs regularlyIs lactose intolerantReports leg cramps frequentlyConsumes cornbread every day

Reports leg cramps frequently

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse should be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?Several glasses of fluidExtra protein sources, such as peanut butterSalty foods to replace lost sodiumEasily digested sources of carbohydrate

Several glasses of fluid

The nurse advises a pregnant patient to take iron supplements. The nurse also instructs the patient to incorporate whole grains, bran, vegetables, and nuts in the diet, as well as drink adequate amounts of fluids. What is the most likely rationale? Iron supplements can cause:Severe constipation.Pyrosis and peptic ulcers.Nausea and vomiting.Black or dark green stools.

Severe constipation

The nurse assessing a pregnant patient finds that the patient has signs of a high basal metabolic rate. What dietary constituent in the patient's diet would have caused the high metabolic rate?ShellfishTable saltWhole grainLeafy vegetables

Table Salt

The nurse observes that a patient has a decreased vitamin D level during a prenatal visit. Which associated risk should the nurse suspect to observe in the patient?GoiterTetanyKetonuriaMacrosomia

Tetany

The nurse is teaching a patient with anemia when and how to take the prescribed iron supplements. The nurse provides a list of beverages for the patient to stay away from while taking the iron supplement. What is the rationale for this?They can affect the process of hematopoiesis.They increase red blood cell (RBC) destruction.They can decrease iron supplement absorption.They can increase the plasma levels of caffeine

They can decrease iron supplement absorption.

The diet chart of a patient includes 4 mg of folic acid sources daily along with a prescription for folic supplements. What could be the reason for supplementing folic acid in the patient?To treat physiologic anemiaTo prevent fetal neural tube defectTo supplement nutrients in a first-time pregnant patientTo meet nutritional demands during breastfeeding

To prevent fetal neural tube defect

As the nurse reviews the dietary assessment of a pregnant patient, the nurse finds that the patient strictly follows a Mexican eating style. What foods should the nurse include while preparing 'My Plate' for the patient?Tortillas, jicama, avocadoes, custard, and chorizoBrown rice, okra, blackberries, soy milk, and tofuHominy, turnips, peaches, soy cheese, and seedsHush puppies, sweet potatoes, buttermilk, and pork

Tortillas, jicama, avocadoes, custard, and chorizo

The nurse is assessing a pregnant patient with an iron deficiency. On reviewing the patient's prescription, the nurse finds that the patient has been prescribed iron and folate supplements. Which foods should the nurse instruct the patient to include in the diet chart to prevent the adverse effects of iron and folate supplements?CheesesCitrus fruitsWhole grainsEnriched breads

Whole grains

A patient who is 6 months pregnant is diagnosed with diverticulosis. Which diet should the nurse recommend to the patient?Whole grains, bran, vegetables, and fruitsCitrus fruits and dark green leafy vegetablesShellfish, liver, meats, whole grains, and milkIodized salt, seafood, milk products, and rolls

Whole grains, bran, vegetables, and fruit

The primary health care provider (PHP) prescribes high-dose iron supplements to a pregnant patient with severe anemia during the first trimester. Which other supplements should the nurse expect the PHP to prescribe with iron supplements?ZincCalciumVitamin AMagnesium

ZINC

With regard to nutritional needs during lactation, a maternity nurse should be aware that:the mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy.caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.critical iron and folic acid levels must be maintained.lactating women can go back to their prepregnant calorie intake.

caffeine consumed by the mother accumulates in the infant, who therefore may be unusually active and wakeful.

When counseling a woman about getting enough iron in her diet, the maternity nurse should tell her that:milk, coffee, and tea aid iron absorption if consumed at the same time as iron.iron absorption is inhibited by a diet rich in vitamin C.iron supplements are permissible for children in small doses.constipation is common with iron supplements

constipation is common with iron supplements

The ultrasound scan of a pregnant woman in the second trimester shows an impairment in the development of the fetus's central nervous system. High intake of which food in the patient's diet might have caused this complication?FishPorkSoft cheeseFrozen dessert

fish

With regard to protein in the diet of pregnant women, nurses should be aware that:many protein-rich foods are also good sources of calcium, iron, and B vitamins.many women need to increase their protein intake during pregnancy.as with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.high-protein supplements can be used without risk by women on macrobiotic diets.

many protein-rich foods are also good sources of calcium, iron, and B vitamins

The nurse is assessing a patient who recently delivered a child. The laboratory reports of both the mother and the child show high amounts of lead in the blood. What clinical condition observed in the mother during pregnancy could be the reason for the abnormal levels of lead?PicaAnemiaMalnutritionPreeclampsia

pica

What question does the nurse ask while assessing the socioeconomic status of a pregnant patient?"What prescription medications do you take?""Do you have any factories around your house?"cAre there any diseases that run in your family?""Do you have any medical or dental insurance?"

"Do you have any medical or dental insurance?"

A patient who is 6 months pregnant is diagnosed with diverticulosis. Which diet should the nurse recommend to the patient?1Whole grains, bran, vegetables, and fruits2Citrus fruits and dark green leafy vegetables3Shellfish, liver, meats, whole grains, and milk4Iodized salt, seafood, milk products, and rolls

1

A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse should be most concerned regarding what this woman consumes during and after tennis matches. Which is the most important?1Several glasses of fluid2Extra protein sources, such as peanut butter3Salty foods to replace lost sodium4Easily digested sources of carbohydrate

1

13. After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so you can assess her understanding of the instructions given. Which statement indicates that she understands the role of protein in her pregnancy?a. "Protein will help my baby grow."b. "Eating protein will prevent me from becoming anemic."c. "Eating protein will make my baby have strong teeth after he/she is born."d. "Eating protein will prevent me from being diabetic."

A

15. Which statement regarding acronyms in nutrition is accurate?a. Dietary reference intakes (DRIs) consist of recommended dietary allowances (RDAs), adequate intakes (AIs), and upper limits (ULs).b. RDAs are the same as ULs except with better data.c. AIs offer guidelines for avoiding excessive amounts of nutrients.d. They all refer to green leafy vegetables, whole grains, and fruit.

A

16. With regard to protein in the diet of pregnant women, nurses should be aware that:a. many protein-rich foods are also good sources of calcium, iron, and B vitamins.b. many women need to increase their protein intake during pregnancy.c. as with carbohydrates and fat, no specific recommendations exist for the amount of protein in the diet.d. high-protein supplements can be used without risk by women on macrobiotic diets.

A

33. Identify the goal of a patient with the following nursing diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to diet choices inadequate to meet nutrient requirements of pregnancy.a. Gain a total of 30 lbs.b. Take daily supplements consistently.c. Decrease intake of snack foods.d. Increase intake of complex carbohydrates.

A

The nurse is providing dietary education to a patient who is 4 months pregnant. Which diet should the nurse suggest to the patient for proper neural development of the fetus?Nuts, beans and legumes, cocoa, meats, and whole grainsIodized salt, milk and milk products, yeast breads, and rollsCitrus fruits, broccoli, melons, strawberries, and tomatoesAsparagus, eggs, fortified cereals, and green leafy vegetables

Asparagus, eggs, fortified cereals, and green leafy vegetables

20. With regard to nutritional needs during lactation, a maternity nurse should be aware that:a. the mother's intake of vitamin C, zinc, and protein now can be lower than during pregnancy.b. caffeine consumed by the mother accumulates in the infant, who may be unusually active and wakeful.c. critical iron and folic acid levels must be maintained.d. lactating women can go back to their prepregnant calorie intake.

B

24. Three servings of milk, yogurt, or cheese plus two servings of meat, poultry, or fish adequately supply the recommended amount of protein for a pregnant woman. Many patients are concerned about the increased levels of mercury in fish and may be afraid to include this source of nutrients in their diet. Sound advice by the nurse to assist the patient in determining which fish is safe to consume would include:a. canned white tuna is a preferred choice.b. avoid shark, swordfish, and mackerel.c. fish caught in local waterways are the safest.d. salmon and shrimp contain high levels of mercury.

B

30. The most important reason for evaluating the pattern of weight gain in pregnancy is to:a. prevent excessive adipose tissue deposits.b. identify potential nutritional problems or complications of pregnancy.c. assess the need to limit caloric intake in obese women.d. determine cultural influences on the woman's diet.

B

4. A pregnant woman experiencing nausea and vomiting should:a. drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.b. eat small, frequent meals (every 2 to 3 hours).c. increase her intake of high-fat foods to keep the stomach full and coated.d. limit fluid intake throughout the day.

B

6. Which statement made by a lactating woman would lead the nurse to believe that the woman might have lactose intolerance?a. "I always have heartburn after I drink milk."b. "If I drink more than a cup of milk, I usually have abdominal cramps and bloating."c. "Drinking milk usually makes me break out in hives."d. "Sometimes I notice that I have bad breath after I drink a cup of milk."

B

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?A. Fat-soluble vitamins A and DB. Water-soluble vitamins C and B6C. Iron and folateD. Calcium and zinc

C

18. Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?a. Fat-soluble vitamins A and Db. Water-soluble vitamins C and B6c. Iron and folated. Calcium and zinc

C

2. Which meal would provide the most absorbable iron?a. Toasted cheese sandwich, celery sticks, tomato slices, and a grape drinkb. Oatmeal, whole wheat toast, jelly, and low-fat milkc. Black bean soup, wheat crackers, orange sections, and prunesd. Red beans and rice, cornbread, mixed greens, and decaffeinated tea

C

21. While taking a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as:a. preeclampsia.b. pyrosis.c. pica.d. purging.

C

19. Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?a. Zincb. Vitamin Dc. Folic acidd. Vitamin A

D

22. When counseling a patient about getting enough iron in her diet, the maternity nurse should tell her that:a. milk, coffee, and tea aid iron absorption if consumed at the same time as iron.b. iron absorption is inhibited by a diet rich in vitamin C.c. iron supplements are permissible for children in small doses.d. constipation is common with iron supplements.

D

25. Nutrition is one of the most significant factors influencing the outcome of a pregnancy. It is an alterable and important preventive measure for various potential problems, such as low birth weight and prematurity. While completing the physical assessment of the pregnant patient, the nurse can evaluate the patient's nutritional status by observing a number of physical signs. Which sign would indicate that the patient has unmet nutritional needs?a. Normal heart rate, rhythm, and blood pressureb. Bright, clear, shiny eyesc. Alert, responsive, and good enduranced. Edema, tender calves, and tingling

D

26. Which pregnant woman should restrict her weight gain during pregnancy?a. Woman pregnant with twinsb. Woman in early adolescencec. Woman shorter than 62 inches or 157 cmd. Woman who was 20 lbs overweight before pregnancy

D

27. The major source of nutrients in the diet of a pregnant woman should be composed of:a. simple sugars.b. fats.c. fiber.d. complex carbohydrates.

D

28. A pregnant woman's diet may not meet her need for folates. A good source of this nutrient is:a. chicken.b. cheese.c. potatoes.d. green leafy vegetables.

D

32. To determine the cultural influence on a patient's diet, the nurse should first:a. evaluate the patient's weight gain during pregnancy.b. assess the socioeconomic status of the patient.c. discuss the four food groups with the patient.d. identify the food preferences and methods of food preparation common to that culture.

D

The nurse is developing a dietary teaching plan for a patient on a vegetarian diet. The nurse should provide the patient with which examples of protein-containing foods? Select all that apply.Dried beansSeedsPeanut butterBagelEggs

Dried beans, Seeds, Peanut butter and eggs

The nurse tells a pregnant patient, "Avoid brushing your teeth immediately after eating." What clinical condition could be the possible reason for such instruction?Mild constipationPyrosisExcessive vomitingBleeding gums

Excessive vomiting

The nurse notices that the hemoglobin levels of an infant who is breastfed have reduced drastically since birth. What is the probable reason for the infant to have anemia?The infant's mother is still taking folic acid and B vitamins.The infant's mother is consuming large amounts of caffeine.The infant's mother continues to take oral iron supplements.The infant's mother drinks large amounts of water and juices.

The infant's mother is consuming large amounts of caffeine.

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lbs) since conception. How should the nurse interpret this?This weight gain indicates possible gestational hypertension.This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).This weight gain cannot be evaluated until the woman has been observed for several more weeks.The woman's weight gain is appropriate for this stage of pregnancy

The woman's weight gain is appropriate for this stage of pregnancy.

The nurse is preparing a diet chart for a Hispanic pregnant patient who is a vegetarian. The patient complains of leg cramps. What does the nurse ensure to include in the patient's diet?Melon fruitTurnip greensWhole or 2% milkCanned sardines

Turnip greens

The nurse is assessing the diet chart of a pregnant patient. The nurse notices that the patient prefers risotto or pasta as her grain source; spinach, eggplant, and berries as her vegetable and fruit supplements; and soy milk, almonds, and pistachios as dairy and protein sources. What patient dietary pattern should the nurse interpret upon reviewing the diet chart of this patient?Lacto vegetarianStrict vegetarianLactose intolerantLacto ovo vegetaria

strict vegetarian

The nurse has advised a pregnant patient to eat a diet rich in vitamin C and zinc. What would be the reason for the nurse to advise the patient to follow this diet? The patient:Is a long-time smokerHas nausea and vomitingIs taking iron supplementsHas a reduced metabolic rate

taking iron supplements