Ch. 8 - nutrition for childbearing

The nurse is teaching a breastfeeding client about substances to avoid while she is breastfeeding. Which substances should the nurse include in the teaching session. Select all a. Caffeine b. alcohol c. omega-6 fatty acids d. appetite suppressants e. polyunsaturated omega-3 fatty acids

A, B, D

The nurse is teaching a pregnant client about food safety during pregnancy and lactation. Which statements by the client indicate she understood the teaching. select all a. I will limit my intake of shrimp to 12 oz per week b. I will avoid the soft cheese made with unpasteurized milk c. I plan to continue to pack my bologna sandwich for lunch d. I am glad I can still go to the sushi bar during my pregnancy e. I will not eat any swordfish or shark while I am pregnant or nursing.

A, B, E

The nurse is advising a lactose-intolerant pregnant client about calcium intake. Which calcium sources are approximately equivalent to 1 cup of milk. select all a. cup yogurt b. 1 cup of sherbert c. oz of hard cheese d. cups of ice cream e. cup of low-fat cottage cheese.

A, C, D

The nurse is teaching a client taking prenatal vitamins how to avoid constipation. Which should the nurse plan to include in the teaching session. select all a. advise taking a daily laxative for constipation b. recommend a diet high in fruits and vegetables c. encourage an increase in fluid consumption during the day d. increase the intake of whole grains and whole grain products. e. suggest increasing the intake of dairy products, especially cheese.

B, C, D

A client with a BMI of 32 has a positive pregnancy test. What is the maximum number of pounds that the nurse will advise the client to gain during the pregnancy a. 20 b. 25 c. 28 d. 40

a. 20 - the weight gain for obese women is 5 to 9 kg (11 to 20lb)

A pregnant client has lactose intolerance. What recommendation will the nurse provide to best help the client meet dietary needs for calcium a. Add foods such as nuts, dried fruit, and broccoli to the diet. b. consume dairy products but take an over the counter anti gas product c. increase the intake of dark leafy vegetables such as spinach and chard d. use powdered milk instead of liquid forms of milk

a. add foods such as nuts, dried fruit, and broccoli to the diet.

A client post-delivery is concerned about getting back to her pre-pregnancy weight. She had only gained 15 lbs during her pregnancy. Which assessment factor would be of concern at her 6 week postpartum checkup a. client has lost 35 lbs during the 6 week period prior to her scheduled check up b. client states that she is eating healthy and limiting intake of processed foods c. client relates increased consumption of fruits and vegetables in her diet postbirth d. client has resumed her usual exercise pattern of walking around the neighborhood for 10 mins each night

a. client has lost 35 lbs during the 6 week period prior to her scheduled check up

In teaching a pregnant adolescent about nutrition, what should the nurse plan to do a. determine the weight gain needed to meet adolescent growth and add 35 lb b. suggest that she not eat at fast food restaurants to avoid foods of poor nutritional value c. realize that most adolescents are unwilling to make dietary changes during pregnancy d. emphasize the need to eliminate common teen snack foods because they are too high in fat and sodium

a. determine the weight gain needed to meet adolescent growth and add 35 lb rationale: adolescents should gain in the upper range of the recommended weight gain

What will the nurse advise when providing nutrition education to the pregnant client a. every day you need to have at least 6 ounces of protein from sources such as meat, eggs, beans, nuts, soybean products, and tofu b. high dose vitamin A supplements will promote optimal vision while preventing a common cause of blindness in neonates c. meals such as sushi with a cold deli salad made with raw sprouts combine high-fiber foods with protein sources to meet multiple nutritional needs d. vitamin and mineral supplements can meet your nutrient needs if you have inadequate intake because of nausea or a sensation of fullness

a. every day you need to have at least 6 ounces of protein from sources such as meat, eggs, beans, nuts, soybean products, and tofu

What should be the goal of a client with the nursing diagnosis "imbalanced nutrition: Less than body requirements" (related to diet choices inadequate to meet the nutrient requirements of pregnancy). a. gain a total of 30 lb b. decrease intake of snack foods c. take daily supplements consistently d. increase intake of complex carbohydrates

a. gain a total of 30 lbs.

A pregnant client would like to know a good food source of calcium other than dairy products. Which is the best answer that the nurse should give a. Legumes b. Lean meant c. whole grains d. yellow vegetables

a. legumes rationale: although dairy products contain the greatest amount of calcium, it can also be found in legumes, nuts, dried fruits, and some dark green leafy vegetables.

The traditional diet of Asian women includes little meat and few dairy products and may be low in calcium and iron. The nurse can help a client increase her intake of these foods by which action a. suggest that she eat more tofu, bok choy, and broccoli b. suggest that she eat more hot foods during pregnancy c. emphasize the need for increased milk intake during pregnancy d. tell her husband that she must increase her intake of fruits and vegetables for the babys sake

a. suggest that she eat more tofu, bok choy, and broccoli rationale: the diet should be improved by increasing foods acceptable to the woman.

Which is the common effect of both smoking and cocaine use on the pregnant client. a. vasoconstriction b. increased appetite c. increased metabolism d. changes in insulin metabolism

a. vasoconstriction

The pregnant woman of normal weight enters her 13th week of pregnancy. If the client eats and exercises as directed, what will the nurse anticipate as the ongoing weight gain for the remaining trimesters. a. 0.3 lb per week b. 1 lb every week c. 1.8 lbs every week d. 2 lbs every week

b. 1 lb every week

Which client is most at risk for a low birth weight infant a. 22 yr old, 60 inches tall, normal prepregnant weight b. 18 yr old, 64 inches tall, body mass index is <18.5 c. 30 yr old, 78 inches tall, prepregnant weight is 15 lb above the norm d. 35 yr old, 75 inches tall, total weight gain in previous pregnancies was 33 lb

b. 18 yr old, 64 inches tall, body mass index is <18.5

Identify the appropriate weight gain at 28 weeks gestation for a client with a normal BMI before pregnancy. a. 10 lbs b. 19 lbs c. 25 lbs d. 30 lbs

b. 19 lbs the woman with a normal BMI before pregnancy will gain approximately 4.4 lbs during the first trimester and 1 lb per week during second and third trimesters

The breastfeeding client whose recommended pre-pregnancy caloric intake was 2000 calories per day would need how many calories per day to meet her current needs a. 2300 b. 2500 c. 2750 d. 3000

b. 2500 rationale: the increase for a breastfeeding client is 500 calories above her recommended pre-pregnancy caloric intake.

A client in her fifth month of pregnancy asks the nurse "how many more calories should I be eating daily". What should the nurses response be? a. 180 more calories a day b. 340 more calories a day c. 452 more calories a day d. 500 more calories a day

b. 340 more calories a day

Which pregnant adolescent is most at risk for a nutritional deficit during pregnancy. a. A 16 yr old who is 10lb over weight b. a 17 yr old who is 10 lb under weight c. a 15 yr old of normal height and weight. d. a 16 yr old of normal height and weight.

b. a 17 yr old who is 10lb underweight

The nurse is reviewing the changes in nutrition related to pregnancy with a 17 yr old who is 12 weeks pregnant. They are specifically focusing on the dairy requirements. What is the nurses next action a. Ask, do you like milk, yogurt, and cheese b. Ask, how many servings from the dairy group do you eat each day c. tell her, you need to add no less than 3 cups of dairy based foods each day d. inform her, if you do not like to drink milk, you can eat a spinach salad every day.

b. ask, how many servings from the dairy group do you eat each day. rationale: to individualize the patients teaching plan, the nurse must first assess the patients calcium intake.

Changes in the diet of the pregnant client who has phenylketonuria would include a. adding foods high in vitamin C b. eliminating drinks containing aspartame c. restricting protein intake to <20 g a day d. increasing caloric intake to at least 1800 cal/day

b. eliminating drinks containing aspartame rationale: use of aspartame by women with phenylketonuria can result in fetal brain damage

A pregnant client asks the nurse if she can double her prenatal vitamin dose because she doesnt like to eat vegetables. What is the nurses response about the danger of taking excessive vitamins a. increases caloric intake b. has toxic effects on the fetus c. increases absorption of all vitamins d. promotes development of pregnancy-induced hypertension (PIH)

b. has toxic effects on the fetus. rationale: the use of vitamin supplements in addition to food may increase the intake of some nutrients to doses much higher than the recommended.

A pregnant client asks the nurse if she should take herbal supplements during pregnancy. What is the best response to her query a. AS long as you have had no reaction to them in the past, they would be safe to use during pregnancy b. prenatal vitamins are the only things should be taken during pregnancy c. nutritional supplements will be prescribed by the HCP based on individual needs d. during pregnancy, no supplementation is required because this is considered to be a healthy state

b. prenatal vitamins are the only things should be taken during pregnancy.

When planning a diet for a pregnant client, which nutritional interventions should be implemented a. fluids should be restricted to 6 glasses a day to minimize fluid retention and occurrence of edema b. protein in the diet should be increased to meet growth and development needs c. nutrient density should be used only if there are problems with weight gain during the course of the pregnancy. d. advise the client that the pattern of weight gain is not as important as the overall weight gained during the pregnancy

b. protein in the diet should be increased to meet growth and development needs.

When planning a diet with a pregnant client, what should the nurses first action be? a. teach the patient about MyPlate b. review the clients current dietary intake c. instruct the client to limit the intake of fatty foods d. caution the client to avoid large doses of vitamins, especially those that are fat-soluble

b. review the clients current dietary intake

A pregnant client arrives for her first prenatal visit at the clinic. She tells you that she has been taking an additional 400 mcg of folic acid prior to her pregnancy. Based on information obtained, she is at 8 weeks gestation. What recommendation would you give regarding folic acid supplementation a. Have the client continue to take 400 mcg folicc acid throughout her pregnancy b. tell the client that she no longer has to take additional folic acid because it will be included in her prenatal vitamins c. have the client increase her folic acid intake to 1000 mcg throughout the rest of her pregnancy d. schedule the client to go for an AFP test

b. tell the client that she no longer has to take additional folic acid because it will be included in her prenatal vitamins

The HCP has recommended an iron supplement for the patient who is 20 weeks pregnant. The nurse is reviewing the recommendation with the patient. What fluid is best for the nurse to recommend when taking an iron supplement. a. 8 oz of milk b. 8 oz of water c. 4 oz of orange juice d. 4 oz of apple juice

c. 4 oz of orange juice

A nurse is developing information to give to a group of pregnant women who are interested in nutritional management of their pregnancy with regard to expected weight gain. The nurse bases the amount of weight gain for pregnant women on calculation of their a. EDC - expected date of confinement b. pre-pregnancy weight c. BMI d. basal energy expenditure (BEE)

c. BMI

A pregnant client comes to the OB clinic and informs you that she is very concerned about the amount of weight gain associated with pregnancy. She then tells you that she wants to switch to a low fat diet during pregnancy. BMI measurements indicate a BMI of 22.7. What would be the best nursing response to this clients stated plan a. tell the client that as long as she maintains a varied diet with regard to the other nutrients, there should be no problems. b. refer the client to a dietician for assistance in planning the low fat diet c. advise the client that it is important to maintain the intake of essential fatty acids during pregnancy. d. Schedule the client for more frequent visits during the next few months to evaluate her weight pattern

c. advise the client that it is important to maintain the intake of essential fatty acids during pregnancy

Which food selections would lead to enhanced iron absorption during pregnancy a. eating additional fiber and grains in the diet b. drinking coffee with meals c. drinking orange juice d. including spinach in the diet two to three times a week

c. drinking orange juice

Which client has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months. a. from 1800 to 2200 calories per day b. from 2000 to 2500 calories per day c. from 2200 to 2530 calories per day d. from 2500 to 2730 calories per day

c. from 2200 to 2530 calories per day

For the pregnant client who is a vegan, what combination of foods will the nurse advise to meet the nutritional needs for all essential amino acids. a. eggs and beans b. fruits and vegetables c. grains and legumes d. vitamin and mineral supplements

c. grains and legumes

A nurse is conducting a prenatal nutritional education class for a group of nursing students. Which should the nurse include as the definition of pica. a. iron deficiency anemia b. intolerance to milk products c. ingestion of nonfood substances d. episodes of anorexia and vomiting

c. ingestion of nonfood substances rationale: the practice of eating substances not normally thought of as food is called pica.

A patient at 8 weeks gestation complains to the nurse, I feel sick almost every morning. And I throw up at least two or three times a week. What is the nurses best advice to the patient. a a. do you like cheese b. try eating four meals a day instead of three meals a day c. try eating peanut butter on whole wheat bread right before going to bed d. if you can eat enough throughout the day, you dont have to worry about being sick

c. try eating peanut butter on whole wheat bread right before going to bed rationale: eating a bedtime protein snack helps maintain glucose levels throughout the night

When explaining the recommended weight gain to your client, the nurses teaching should include which statement a. all pregnant women need to gain a minimum of 25 to 35 lbs b. the fetus, amniotic fluid, and placenta require 15 lbs of weight gain c. weight gain in pregnancy is based on the clients prepregnant BMI d. more weight should be gained in the first and second trimesters and less in the third

c. weight gain in pregnancy is based on the clients prepregnant BMI

What is the recommended weight gain during pregnancy for a client who begins pregnancy at a normal weight. a. 10 to 15 lb b. 15 to 20 lb c. 20 to 25 lb d. 25 to 35 lb

d. 25 to 35 lb

Which client would require additional calories and nutrients a. A 36 yr old female gravida 2, para 1, in her first trimester b. an 18 yr old female who delivered a 7 lb baby and is bottle feeding c. a 23 yr old female who had a cesarean section birth and is bottle feeding d. a 20 yr old female who had a vaginal birth 5 months ago and is breastfeeding.

d. a 20 yr old female who had a vaginal birth 5 months ago and is breastfeeding

A nurse is teaching a nutrition class to a group of pregnant clients. The nurse should include that the major source of nutrients in the diet of a pregnant woman should be composed of which. a. fats b. fiber c. simple sugars d. complex carbohydrates

d. complex carbohydrates rationale: complex carbohydrates supply the pregnant woman with vitamins, minerals, and fiber.

A pregnant clients diet may not meet her need for folate. What is a good source of this nutrient. a. Chicken b. cheese c. potatoes d. green leafy vegetables.

d. green leafy vegetables. rationale: sources of folate include green leafy vegetables, whole grains, fruits, liver, dried peas, and beans.

Which is the most important reason for evaluating the pattern of weight gain in pregnancy. a. prevents excessive adipose tissue deposits b. determines cultural influences on the woman's diet c. assesses the need to limit caloric intake obese women d. identifies potential nutritional problems or complications of pregnancy

d. identifies potential nutritional problems or complications of pregnancy

To determine cultural influences on a clients diet, what should the nurse do first 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. identify the food preferences and methods of food preparation common to the clients culture

When should iron supplementation during a normal pregnancy begin a. before pregnancy b. in the first trimester c. in the third trimester d. in the second trimester

d. in the second trimester rationale: vitamin supplements should be prescribed in the second trimester, when the need for iron is increased.

Which of the following is associated with inadequate maternal weight gain during pregnancy. a. prolonged labor b. pre-eclampsia c. gestational diabetes d. low birth weight infant

d. low birth weight infant

To increase the absorption of iron in a pregnant client, with what should an iron preparation be given a. tea b. milk c. coffee d. orange juice

d. orange juice rationale: A vitamin C source may increase the absorption of iron.

The nurse is reviewing a list of foods high in folic acid with a patient who is considering becoming pregnant. The nurse determines that the patient understands the teaching when the patient states she will include which list of foods in her diet. a. peaches, yogurt, and tofu b. strawberries, milk, and tuna c. asparagus, lemonade, and chicken breast d. spinach, orange juice, and fortified bran flakes.

d. spinach, orange juice, and fortified bran flakes

the pregnant client with significant iron deficiency anemia is prescribed iron supplements. The client confides to the nurse that she cant take iron because it makes her nauseous. What is the best response by the nurse a. iron will be absorbed more readily if taken with orange juice b. it is important to take this drug regardless of this side effect c. taking the drug with milk may decrease your symptoms d. try taking the iron at bedtime on an empty stomach

d. try taking the iron at bedtime on an empty stomach rationale: iron taken at bedtime may be easier to tolerate

A client who is in week 28 of gestation is concerned about her weight gain of 17 lb. Which is the nurses best response. a. you should not gain anymore weight until you reach the third trimester b. you should try to decrease your amount of weight gain for the next 12 weeks c. you have not gained enough weight for the number of weeks of your pregnancy d. you have gained an appropriate amount for the number of weeks of your pregnancy.

d. you have gained an appropriate amount for the number of weeks of your pregnancy.