OB chapter 15

18. Many clients are concerned about the increased levels of mercury in fish and may be reluctant to include this source of nutrients in their diet. What is the best advice for the nurse to provide? a. Canned white tuna is a preferred choice. b. Shark, swordfish, and mackerel should be avoided. c. Fish caught in local waterways is the safest. d. Salmon and shrimp contain high levels of mercury.

B

7. To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take the recommended iron supplements? a. On a full stomach b. At bedtime c. After eating a meal d. With milk

B

2. Foodborne illnesses can cause adverse effects for both mother and fetus. The nurse is in an ideal position to evaluate the clients knowledge regarding steps to prevent a foodborne illness. The nurse asks the client to teach back the fours simple steps of food preparation. What are they? (Select all that apply.) a. Purchase b. Clean c. Separate d. Cook e. Chill

B, C, D, E

11. With regard to weight gain during pregnancy, the nurse should be aware of which important information? a. In pregnancy, the womans height is not a factor in determining her target weight. b. Obese women may have their health concerns, but their risk of giving birth to a child with major congenital defects is the same as with women of normal weight. c. Women with inadequate weight gain have an increased risk of delivering a preterm infant with intrauterine growth restriction (IUGR). d. Greater than expected weight gain during pregnancy is almost always attributable to old-fashioned overeating.

C

13. Which minerals and vitamins are usually recommended as a supplement in a pregnant clients diet? a. Fat-soluble vitamins A and D b. Water-soluble vitamins C and B6 c. Iron and folate d. Calcium and zinc

C

21. A woman in the 34th week of pregnancy reports that she is very uncomfortable because of heartburn. Which recommendation would be appropriate for this client? 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

12. Which nutritional recommendation regarding fluids is accurate? a. A womans daily intake should be six to eight glasses of water, milk, and/or juice. b. Coffee should be limited to no more than 2 cups, but tea and cocoa can be consumed without worry. c. Of the artificial sweeteners, only aspartame has not been associated with any maternity health concerns. d. Water with fluoride is especially encouraged because it reduces the childs risk of tooth decay.

A

17. Which guidance might the nurse provide for a client with severe morning sickness? a. Trying lemonade and potato chips b. Drinking plenty of fluids early in the day c. Immediately brushing her teeth after eating d. Never snacking before bedtime

A

20. A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. Which recommendation would the nurse make for this particular client after a tennis match? a. Drink several glasses of fluid. b. Eat extra protein sources such as peanut butter. c. Enjoy salty foods to replace lost sodium. d. Consume easily digested sources of carbohydrate.

A

22. Which information regarding protein in the diet of a pregnant woman is most helpful to the client? 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. However, the nurse or midwife may need to refer a client to a registered dietitian for in-depth nutritional counseling. Which conditions would require such a consultation? (Select all that apply.) a. Preexisting or gestational illness such as diabetes b. Ethnic or cultural food patterns c. Obesity d. Vegetarian diets e. Multifetal pregnancy

A, B, C, D

14. Which vitamins or minerals may lead to congenital malformations of the fetus if taken in excess by the mother? a. Zinc b. Vitamin D c. Folic acid d. Vitamin A

D

1. Which nutrients recommended dietary allowance (RDA) is higher during lactation than during pregnancy? a. Energy (kcal) b. Iron c. Vitamin A d. Folic acid

A

30. The nurse has formulated a diagnosis of Imbalanced nutrition: Less than body requirements for the client. Which goal is most appropriate for this client to obtain? a. Gain a total of 30 pounds. b. Consistently take daily supplements. c. Decrease her intake of snack foods. d. Increase her intake of complex carbohydrates.

A

8. After the nurse completes nutritional counseling for a pregnant woman, she asks the client to repeat the instructions to assess the clients understanding. Which statement indicates that the client 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 is born. d. Eating protein will prevent me from being diabetic.

A

10. Maternal nutritional status is an especially significant factor of the many that influence the outcome of pregnancy. Why is this the case? a. Maternal nutritional status is extremely difficult to adjust because of an individuals ingrained eating habits. b. Adequate nutrition is an important preventive measure for a variety of problems. c. Women love obsessing about their weight and diets. d. A womans preconception weight becomes irrelevant.

B

16. Assessment of a womans nutritional status includes a diet history, medication regimen, physical examination, and relevant laboratory tests. Which finding might require consultation to a higher level of care? a. Oral contraceptive use may interfere with the absorption of iron b. Illnesses that have created nutritional deficits, such as PKU, may require nutritional care before conception. c. The womans socioeconomic status and educational level are not relevant to her examination; they are the province of the social worker. d. Testing for diabetes is the only nutrition-related laboratory test most pregnant women need.

B

23. A client states that she plans to breastfeed her newborn infant. What guidance would be useful for this new mother? a. The mothers intake of vitamin C, zinc, and protein can now 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 caloric intake.

B

3. Which statement made by a lactating woman leads the nurse to believe that the client 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

31. Which action is the highest priority for the nurse when educating a pregnant adolescent? a. Emphasize the need to eliminate common teenage snack foods because they are high in fat and sodium. b. Determine the weight gain needed to meet adolescent growth, and add 35 pounds. c. Suggest that she not eat at fast-food restaurants to avoid foods of poor nutritional value. d. Realize that most adolescents are unwilling to make dietary changes during pregnancy.

B

15. While obtaining a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. Which nutritional problem does this behavior indicate? a. Preeclampsia b. Pyrosis c. Pica d. Purging

C

2. A pregnant womans diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. Which dietary requirement is the nurse most concerned about? a. Calcium b. Protein c. Vitamin B12 d. Folic acid

C

24. The labor and delivery nurse is preparing a client who is severely obese (bariatric) for an elective cesarean birth. Which piece of specialized equipment will not likely be needed when providing care for this pregnant woman? a. Extra-long surgical instruments b. Wide surgical table c. Temporal thermometer d. Increased diameter blood pressure cuff

C

28. If a clients normal prepregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy? a. 5 b. 10 c. 25 d. 30

C

5. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is this clients total recommended weight gain during pregnancy? a. 20 kg (44 lb) b. 16 kg (35 lb) c. 12.5 kg (27.5 lb) d. 10 kg (22 lb)

C

9. Pregnant adolescents are at greater risk for decreased BMI and fad dieting with which condition? a. Obesity b. Gestational diabetes c. Low-birth-weight babies d. High-birth-weight babies

C

19. Nutrition is an alterable and important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse is able to evaluate the clients nutritional status by observing a number of physical signs. Which physical sign indicates to the nurse that the client has unmet nutritional needs? a. Normal heart rate, rhythm, and blood pressure b. Bright, clear, and shiny eyes c. Alert and responsive with good endurance d. Edema, tender calves, and tingling

D

25. Which pregnant woman should strictly follow weight gain recommendations during pregnancy? a. Pregnant with twins b. In early adolescence c. Shorter than 62 inches or 157 cm d. Was 20 pounds overweight before pregnancy

D

26. The major source of nutrients in the diet of a pregnant woman should be composed of what? a. Simple sugars b. Fats c. Fiber d. Complex carbohydrates

D

27. A pregnant womans diet may not meet her increased need for folates. Which food is a rich source of this nutrient? a. Chicken b. Cheese c. Potatoes d. Green leafy vegetables

D

29. Which action is the first priority for the nurse who is assessing the influence of culture on a clients diet? a. Evaluate the clients weight gain during pregnancy. b. Assess the socioeconomic status of the client. c. Discuss the four food groups with the client. d. Identify the food preferences and methods of food preparation common to the clients culture.

D

4. A client states that she does not drink milk. Which foods should the nurse encourage this woman to consume in greater amounts to increase her calcium intake? a. Fresh apricots b. Canned clams c. Spaghetti with meat sauce d. Canned sardines

D

6. A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant. Which guidance should she expect to receive? 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 regularly taking. d. Make sure you include adequate folic acid in your diet.

D