chpt. 16,17

Postpartum nutritional status is determined primarily by assessing which of the following? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Dietary history 3. Mothers weight 4. Hemoglobin levels

The pregnant client states she does not want to take all these supplements. What recommendations could the nurse make for the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Folic acid has been found to be essential for minimizing the risk of neural tube defects. 3. Most women do not have adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy.

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? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Folic acid has been found to be essential for minimizing the risk of neural tube defects. 5. You need the supplements because your dietary intake may not be adequate for fetal development.

Which of the following symptoms, if progressive, are indicative of CHF, the hearts signal of its decreased ability to meet the demands of pregnancy? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. Palpitations 2. Heart murmurs 3. Dyspnea 5. Rales

Women with eating disorders who become pregnant are at risk for a variety of complications including which of the following?

1. Premature birth 3. Miscarriage 5. Perinatal mortality

A pregnant asthmatic client is being seen for her initial prenatal visit. The nurse knows that the fetal implications of maternal asthma include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. Prematurity 2. Low birth weight 3. Hypoxia with maternal exacerbation

The nurse is planning an early-pregnancy class session on nutrition. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. Protein is important for fetal development. 2. Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood. 4. Zinc facilitates synthesis of RNA and DNA. 5. Vitamin A promotes development of the babys eyes.

When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority?

15-year-old nulligravida

The nurse is evaluating the goal Client will remain free of opportunistic infections for an HIV-positive pregnant client. The nurse determines the goal was met when the client has which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

2. No complaint of chills or fever during the pregnancy 3. Weight gain of 30 lbs during the pregnancy 5. Normal erythrocyte sedimentation rate maintained during the pregnancy

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? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

2. One slice of bread 4. One tortilla 5. One ounce of dry cereal

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? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

2. Strawberries and potatoes 5. Blueberries and broccoli

In early-pregnancy class, the nurse emphasizes the importance of 8-10 glasses of fluid per day. How many of these should be water?

4 to 6

The nurse is working with a pregnant 14-year-old. Which statement indicates that additional education is required?

Because I dont eat breakfast, Ill have to eat more at supper.

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?

Breastfeeding requires a continued high intake of protein and calcium.

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?

Dietary intake of fiber and fluids

The nurse is planning an educational session for pregnant vegans. What information should the nurse include?

Eating beans and rice provides complete protein needs.

The prenatal clinic nurse is caring for a 15-year-old client who is at 8 weeks gestation. The client asks the nurse why she is supposed to gain so much weight. What is the best response by the nurse?

Gaining 25-35 pounds is recommended for healthy fetal growth.

A client presents to the antepartum clinic with a history of a 20-pound weight loss. Her pregnancy test is positive. She is concerned about gaining the weight back, and asks the nurse if she can remain on her diet. What is the nurses best response?

I understand that gaining weight after such an accomplishment might not look attractive, but weight gain during pregnancy is important for proper fetal growth.

The nurse is assessing a woman at 10 weeks gestation who is addicted to alcohol. The woman asks the nurse, What is the point of stopping drinking now if my baby probably has been hurt by it already? What is the best response by the nurse?

If you stop now, you and your baby have less chance of serious complications.

A pregnant woman is married to an intravenous drug user. She had a negative HIV screening test just after missing her first menstrual period. What would indicate that the client needs to be retested for HIV?

Persistent candidiasis

The kosher diet followed by many Jewish people forbids the eating of what foods?

Pig products and shellfish

A 20-year-old woman is at 28 weeks gestation. Her prenatal history reveals past drug abuse, and urine screening indicates that she has recently used heroin. The nurse should recognize that the woman is at increased risk for which condition?

Pregnancy-induced hypertension

A woman is 32 weeks pregnant. She is HIV-positive but asymptomatic. The nurse knows what would be important in managing her pregnancy and delivery?

Weekly non-stress testing beginning at 32 weeks gestation

A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

2. A daily supplement of vitamin B12 is important. 5. Milk products contain protein, but they are very low in iron.

The clinic nurse is teaching a pregnant client about her iron supplement. Which information is included in the teaching? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

2. A stool softener might be needed. 3. Start a low dose, and increase it gradually. 5. Iron absorption is poor if taken with meals.

A pregnant client who was of normal prepregnancy weight is now 30 weeks pregnant. She asks the nurse what appropriate weight gain for her should be. What is the nurses best response?

25-35 pounds

A diabetic client goes into labor at 36 weeks gestation. Provided that tests for fetal lung maturity are successful, the nurse will anticipate which of the following interventions? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

3. Allowance of labor to progress 4. Hourly blood glucose monitoring

A 26-year-old client is 26 weeks pregnant. Her previous births include two large-for-gestational-age babies and one unexplained stillbirth. Which tests would the nurse anticipate as being most definitive in diagnosing gestational diabetes?

A 100g, 3-hour glucose tolerance test

What would the nurse do to accurately assess a pregnant clients food intake?

Ask her to complete a nutritional questionnaire.

A womans history and appearance suggest drug abuse. What is the nurses best approach?

Ask the woman directly, Do you use any street drugs?

A 26-year-old client is 28 weeks pregnant. She has developed gestational diabetes. She is following a program of regular exercise, which includes walking, bicycling, and swimming. What instructions should be included in a teaching plan for this client?

Carry hard candy (or other simple sugar) when exercising.

The nurse is caring for a pregnant woman who admits to using cocaine and ecstasy on a regular basis. The client states, Everybody knows that alcohol is bad during pregnancy, but whats the big deal about ecstasy? What is the nurses best response?

Ecstasy can cause a high fever in you and therefore cause the baby harm.

Which of the following may be the main presenting symptom of iron deficiency anemia?

Fatigue

A client is at 12 weeks gestation with her first baby. She has cardiac disease, class III. She states that she had been taking sodium warfarin (Coumadin), but her physician changed her to heparin. She asks the nurse why this was done. What should the nurses response be?

Heparin is safer because it does not cross the placenta.

While doing a prenatal assessment on a woman who has hepatitis B and intends to become pregnant, the nurse explains the impact of the hepatitis B on pregnancy and birth. Which statement does the nurse include in the teaching?

Hepatitis B does not usually affect the course of pregnancy.

The client with insulin-dependent type 2 diabetes and an HbA1c of 5.0% is planning to become pregnant soon. What anticipatory guidance should the nurse provide this client?

Insulin needs decrease in the first trimester and usually begin to rise late in the first trimester as glucose use and glycogen storage by the woman and fetus increase.

Which statement is best to include when teaching a pregnant adolescent about nutritional needs of pregnancy?

It is important to eat iron-rich foods like meat every day.

The client at 9 weeks gestation has been told that her HIV test was positive. The client is very upset, and tells the nurse, I didnt know I had HIV! What will this do to my baby? The nurse knows teaching has been effective when the client makes which statement?

My baby can get HIV during the pregnancy and through my breast milk.

A woman confides to the nurse that she has pica. What alternative could the nurse suggest to the client?

Replace ice with frozen fruit pops.

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?

Shellfish

A client with diabetes is receiving preconception counseling. The nurse will emphasize that during the first trimester, the woman should be prepared for which of the following?

The need for less insulin than she normally uses

The client at 20 weeks gestation has had an ultrasound that revealed a neural tube defect in her fetus. The clients hemoglobin level is 8.5. The nurse should include which statement when discussing these findings with the client?

You havent had enough folic acid in your diet. You should take a supplement.

The client with thalassemia intermedia has a hemoglobin level of 9.0. The nurse is preparing an education session for the client. Which statement should the nurse include?

You should not take iron supplements.

Women with HIV should be evaluated and treated for other sexually transmitted infections and for what condition occurring more commonly in women with HIV?

toxoplasmosis

The nurse is working with a pregnant woman who has systemic lupus erythematosus (SLE). What does the nurse anticipate the infant might be born with? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. A tendency to bleed excessively 2. An increased chance of developing infections 3. A hemoglobin less than optimal for good health

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? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. An increase of protein is necessary to provide amino acids necessary for fetal development. 2. Protein contributes to the bodys overall energy metabolism. 3. The recommended protein during pregnancy is 70 grams each day. 5. The quality of protein is as important as the amount.

The nurse has written the nursing diagnosis Injury, Risk for for a diabetic pregnant client. Interventions for this diagnosis include which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. Assessment of fetal heart tones 2. Perform oxytocin challenge test, if ordered 4. Assist with the biophysical profile assessment

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? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. Cell numbers 3. Cell size and number 4. Cell size alone

During the history, the client admits to being HIV-positive and says she knows that she is about 16 weeks pregnant. Which statements made by the client indicate an understanding of the plan of care both during the pregnancy and postpartally? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

1. During labor and delivery, I can expect the zidovudine (ZDV) to be given in my IV. 3. My baby will be started on zidovudine (ZDV) for six weeks following the birth.

The nurse is evaluating the plan of care for a pregnant client with a heart disorder. The nurse concludes that the plan was successful when data indicate which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. The client gave birth to a healthy baby. 2. The client did not develop congestive heart failure. 4. The client identified manifestations of potential complications. 5. The client can identify her condition and its impact on her pregnancy, labor and birth, and postpartum period.

The nurse is working with a woman who abuses stimulants. The nurse is aware that the fetus is at risk for which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply.

1. Withdrawal symptoms 2. Cardiac anomalies 3. Sudden infant death syndrome 4. Being small for gestational age

A 21-year-old at 12 weeks gestation with her first baby has known cardiac disease, class III, as a result of childhood rheumatic fever. During a prenatal visit, the nurse reviews the signs of cardiac decompensation with her. The nurse will know that the client understands these signs and symptoms if she states that she would notify her doctor if she had which symptom?

A frequent cough

A woman asks her nurse what she can do before she begins trying to get pregnant to help her baby, as she is prone to anemia. What would the nurse correctly advise her to do?

Begin taking folic acid supplements daily.

A nurse is discussing diet with a pregnant woman. Which food should the nurse advise the client to avoid during her pregnancy?

Bologna

The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs?

Eggs and tofu

Which of the following is important for the development of the central nervous system of the fetus?

Essential fatty acids

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?

Fish

A 21-year-old woman is at 12 weeks gestation with her first baby. She has cardiac disease, class III, as a result of having had childhood rheumatic fever. Which planned activity would indicate to the nurse that the client needs further teaching?

I am going to start my classes in water aerobics next week.

The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement?

I have started cutting back on my protein intake.

The client has just been diagnosed as diabetic. The nurse knows teaching was effective when the client makes which statement?

I might be hungry frequently because the sugar isnt getting into the tissues the way it should.

The nurse is doing preconception counseling with a 28-year-old woman with no prior pregnancies. Which statement made by the client indicates to the nurse that the client has understood the teaching?

I need to stop drinking alcohol completely when I start trying to get pregnant.

A pregnant client confides to the nurse that she is eating laundry starch daily. The nurse should assess the client for which of the following?

Iron deficiency anemia

The prenatal clinic nurse has received four phone calls. Which client should the nurse call back first?

Pregnant woman at 28 weeks with history of asthma who is reporting difficulty breathing and shortness of breath

A newly diagnosed insulin-dependent type 1 diabetic with good blood sugar control is at 20 weeks gestation. She asks the nurse how her diabetes will affect her baby. What would the best explanation include?

Your baby will probably be larger than average at birth.

The school nurse is planning a class about nutrition for pregnant teens, several of whom have been diagnosed with iron-deficiency anemia. In order to increase iron absorption, the nurse would encourage the teens to consume more of what beverage?

orange juice

Carbohydrates provide the bodys primary source of energy as well as fiber necessary for proper bowel functioning. If the carbohydrate intake is not adequate, the body will use which of the following for energy?

protein

A pregnant client is lactose intolerant. Which alternative food could this client eat to get sufficient calcium?

turnip greens

A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption?

vitamin c