NURS Chapter 12
The nurse is caring for a new mother immediately after delivery. The mother wants to know factors that negatively affect breastfeeding. Which of the following statements by the nurse are CORRECT? Select all that apply.
"Having twins will significantly make breast feeding more challenging for you." "Due to your use of tobacco in the form of smoking during your pregnancy, your ability to breastfeed may be negatively impacted." "Do not give your infant water in the first 6 months as this is not best practice and can interfere with your duration of breastfeeding."
The nurse reviews the caloric intake requirement for a client with a prepregnancy body mass index (BMI) 21 of in the 20th week of gestation. Which client statement indicates that teaching has been effective?
"I should add 400 calories per day to my diet." A healthy eating pattern for a pregnant client of healthy body weight increases by 400 cal/day beginning in the second trimester and lasting through the course of pregnancy. Oil allowance increases by 4 g/day, and an additional 80 calories are allotted for solid fat. Following the same eating plan as during the 1st trimester does not provide an adequate amount of calories. Gaining 20 lbs. during the 3rd trimester is too much of weight to gain for a client with a prepregnancy BMI of 21.
A mother who just delivered her baby is positive for HIV. The mother asks the nurse if she can breastfeed her infant. Which of the following is the best response by the nurse?
"No, you should not breastfeed because you are positive for HIV."
The nurse is seeing an adolescent client in the office for a prenatal visit. The client is afraid of gaining more than 7 pounds of weight during the pregnancy. Which response by the nurse explains why the suggested amount of weight gain is more than 7 pounds?
"Numerous body changes will affect your weight gain, such as your placenta, amniotic fluid and blood volume."
A client is concerned about the recommendation to eat 8 oz of fish per week because of the mercury content in fish. What statement by the nurse best explains this recommendation?
"The benefit of DHA and omega-3 offset the mercury content in the approved list of fish to consume.
The nurse is creating a chart to provide visualization of weight gain for women from all body mass index (BMI) categories. What rate should the nurse distinguish for second trimester weight gain for a client who had a prepregnancy BMI of 27.5?
0.6 lbs per week
Which of the following statements express the basic principles of healthy eating before, during, and after pregnancy? Select all that apply.
Eat plenty of fruits and vegetables. Eat whole-grain bread and cereals. Eat lean protein foods.
Gestational hypertension is defined as a systolic blood pressure greater than or equal to _____ mmHg or a diastolic reading greater than or equal to 90 mmHg with onset after 20 weeks of gestation and without proteinuria. Enter the correct number ONLY.
140
The nurse knows that what vitamin will be lacking in clients who do not consume animal products?
V12
A client is concerned that she will be unable to consume the recommended amount of calcium during pregnancy as she does not like dairy. Which alternatives will the nurse suggest to the client? Select all that apply.
Collards Okra Turnip greens Natural sources that contain calcium are milk, yogurt, hard natural cheese, pasteurized processed American cheese, bok choy, broccoli, Chinese/Napa cabbage, collards, kale, okra, turnip greens, legumes, and almonds. Fortified foods that contain calcium are fortified breakfast cereals, fortified orange juice, and fortified brands of nondairy milks (almond, soy, rice, coconut).
A client has asked the nurse, "What is the recommended intake for iron during pregnancy?" What is the nurse's correct response?
27mg/day
The nurse is discussing weight gain with a group of pregnant women in a prenatal clinic. One of the women in the group has been measured with a body mass index (BMI) of 17.5. The nurse knows this client should gain how much weight during her pregnancy?
28-40lbs
Women with a BMI equal to or greater than _________ are considered obese. Enter the correct number ONLY.
30
Women who are underweight prepregnancy (BMI < 18.5) are encouraged to gain 28 to ______ pounds in pregnancy. Enter the correct number ONLY.
40
The recommended dosage of folate for nonpregnant women is _____ μg.
400
The World Health Organization (WHO) recommends that infants be exclusively breastfed for the first ______ months of life. Enter the correct number ONLY.
6
A pregnant woman in the second trimester of her fourth pregnancy is wondering what foods she should eat to increase her intake of iron. Which of the following menus should the nurse recommend?
6 oz. chicken, 1/2 cup of lima beans, one baked potato with skin on
When educating high school students about adolescent pregnancy, which teaching will the nurse give?
It increases health risks to both infant and mother.
The nurse is educating a pregnant client and instructs her to avoid deli meats and unpasteurized cheeses. This is because of risk of infection with:
Listeria monocytogenes.
A client in the 8th week of gestation is experiencing nausea and vomiting every morning and throughout the day. What should the nurse suggest to help with this client's nutritional status?
Snack on dry crackers and hard candy throughout the day
Which of the following statements about preeclampsia are CORRECT? Select all that apply.
The causes of preeclampsia are unknown, but it is believed to be related to an inadequate placental blood supply, possibly from maternal hypertension and involving an inflammatory response (ADA, 2009a). Preeclampsia is twice as prevalent in overweight women and approximately three times as high in obese women (Catalano, 2007). Proper nutrition and calcium supplements may reduce the risk of preeclampsia, but there is no known cure other than delivery of the infant.
The nurse is seeing a client with gestational diabetes mellitus. Which of the following information should the nurse consider when planning long term care for this client?
The client is at high risk for developing type 2 diabetes later in life.
A pregnant woman is in the first trimester of her first pregnancy. The nurse knows that this woman needs more teaching when she states the following?
With careful food selections during pregnancy, I will be able to consume enough iron in my diet to avoid the possibility of having iron-deficiency anemia."
When counseling pregnant clients about weight status, which teaching will the nurse give?
Women who are overweight or obese frequently exceed gestational weight gain (GWG) recommendations during pregnancy.
A healthy 22-year-old pregnant woman who is having a low-risk pregnancy is currently in her first trimester should be encouraged to do which of the following?
engage in safe exercise, paying attention to fall risk.
The nurse is teaching a class for prenatal nutrition, focusing on teratogens. What food source should the nurse include as a teratogen?
alcohol
The nurse is providing a list to include which of the following types of fish that should not be eaten by women who are pregnant or breastfeeding? Select all that apply.
anchovy, Atlantic herring, Atlantic mackerel, mussels, oysters, farmed and wild salmon, sardines, canned light tuna, snapper, and trout.
According to Dietary Reference Intakes (DRIs), pregnant women need to begin adding at least 250 calories during the first trimester. This statement is:
false
Current weight gain recommendations for pregnancy are based on prepregnancy weight. This statement is:
false, Current weight gain recommendations for pregnancy are based on prepregnancy BMI, not weight.
Mercury poisoning related to consuming fish during pregnancy can lead to which for the newborn? Select all that apply.
developmental delay in walking and talking cerebral palsy seizures intellectual disability
A breastfeeding mother who lives in Florida and runs two miles every morning asks how much fluid is needed while she is breastfeeding. Which of the following is the nurse's best response?
drink a glass of fluid every time the baby nurses and a glass of fluid with each meal.
Nutritional requirements for which of the following increase from 18 mg for nonpregnant women to 27 mg during pregnancy?
iron
A client who is pregnant is concerned about eating fish due to the risk of consuming methylmercury. The nurse should recommend she avoid what type of fish to decrease the exposure to mercury?
king mackeral
Food-borne risks are more dangerous during pregnancy. Which of the following statements about listeriosis and pregnancy is CORRECT?
listeriosis during pregnancy can lead to miscarriage, stillbirth, premature delivery or neonatal infection
A pregnant woman has come to the clinic for her first prenatal visit. The nurse is assessing her for a high-risk pregnancy. Which disorder is most likely to result from a high-risk pregnancy due to inadequate nutrition?
low birth weight infant
The nurse is seeing a pregnant client who states she drinks approx. 24 ounces of coffee per day. The nurse should explain to the client that a high intake of caffeine during pregnancy is associated with which of the following?
low birth weight newborns.A high caffeine intake is associated with low birth weight but not with birth defects (ADA, 2008) or preterm birth (Maslova, Bhattacharya, Lin, and Michels, 2010). The half-life of caffeine increases during pregnancy from 3 hours in the first trimester to 80 to 100 hours in late pregnancy
An expectant mother, pregnant with her third baby, is due in 6 weeks. She does not like milk or ready-to-eat cereals. She often leaves for her office job before the sun comes up and does not get home until after dark. The nurse knows that this pregnant woman needs vitamin D supplements for which of the following reasons?
reduce the risk of abnormal neonatal bone metabolism. Women who do not consume adequate vitamin D or have insufficient sunlight exposure should consume supplemental vitamin D to reduce the risk of low serum calcium in the infant and abnormal neonatal bone metabolism.
The nurse is providing a list to include which of the following types of fish that should not be eaten by women who are pregnant or breastfeeding? Select all that apply.
salmon, albacore/white tuna
The nurse knows that obesity during pregnancy is associated with all of the following EXCEPT:
small for gestational age infant.
Herbal supplements are technically unapproved drugs and should not be consumed during pregnancy and lactation. This statement is:
true
Nonnutritive sweeteners, consumed at levels within the U.S. Food and Drug Administration guidelines, are believed to be safe for all pregnant women unless the woman has phenylketonuria. This statement is:
true
A woman who smokes is ____ as likely to deliver a low-birth-weight baby.
twice
