Nutrition 299

To prevent birth defects, it is very important for the nurse to correctly assess the woman's nutritional status. Studies have shown a correlation with impaired cognitive development and a deficiency of which nutrient during pregnancy?

iodine

Weight gain during pregnancy has been shown to independently predict long-term weight gain and obesity. This statement is:

true

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 seeing a client who has lost 5 lbs in the second trimester of her pregnancy. Which statement by the pregnant woman indicates that she may be experiencing pica?

"I want to eat only ice."

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."

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."

A mother is at her first prenatal visit and is inquiring about folic acid requirements. What would be the nurse's best reponse?

"The most important time to take folic acid is 1 month before conception and 2-3 months after conception."

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."

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

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

The nurse reviews dietary choices made by a client in the 16th week of gestation. Which selection indicates that the client is adhering to the MyPlate dietary recommendations for pregnancy?

1 cup of skim milk for breakfast, lunch and dinner

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

Teens, especially those ______ years or younger, are associated with high-risk pregnancy. Enter the correct number only.

17

The nurse knows that what vitamin will be lacking in clients who do not consume animal products?

Vitamin B12

Which of the following recommendations promote a healthy eating pattern for pregnant women? Select all that apply.

Eat a variety of nutrient-dense foods and beverages among the basic food groups. Include an adequate amount of vegetables, fruits, whole grains, and milk and milk products. Follow food safety guidelines to reduce the risk of food-borne illness. Avoid excessive intake of cholesterol, added sugars, and salt.

Women who are obese (BMI >30) are encouraged to gain 11 to ______ pounds in pregnancy. Enter the correct number ONLY.

20

All women with a BMI of _____ or higher should be counseled about the risks of unhealthy weight to maternal health and future pregnancies.

25

The client should consume _____ cups of dairy throughout the pregnancy.

3

Women with a BMI equal to or greater than _________ are considered obese. Enter the correct number ONLY.

30

An extra _____ calories per day are recommended for the first 6 months of lactation for women who exclusively breastfeed. Enter the correct number ONLY.

330

Women ________ years or older are associated with high-risk pregnancy. Enter the correct number ONLY.

35

Women of normal prepregnancy weight (BMI 18.5 to 24.9) are encouraged to gain 25 to _________pounds in pregnancy. Enter the correct number ONLY.

35

Women who are underweight prepregnancy (BMI < 18.5) are encouraged to gain 28 to ______ pounds in pregnancy. Enter the correct number ONLY.

40

An extra _____ calories per day for the second 6 months are recommended for women who exclusively breastfeed. Enter the correct number ONLY.

400

Using the Dietary Approaches to Stop Hypertension (DASH) eating pattern during pregnancy is associated with up to ________ % lowered risk of gestational diabetes. Enter the correct number ONLY.

48

The nurse knows that nutrient needs do not increase proportionately. What percentage does iron intake need to increase during pregnancy? Enter the correct number ONLY.

50

The recommended dosage of folate for women who are lactating is _____ ug. Enter the correct number ONLY.

500 ug

Proper nutrition is essential in the outcome of maternal phenylketonuria (PKU) pregnancies. The nurse knows that a woman with PKU should be taught which of the following?

A low-phenylalanine diet is necessary during pregnancy.

A postpartum client who is breastfeeding desires to return to the prepregnancy weight as quickly as possible. What should the nurse recommend to this client?

Add 330 calories to daily intake for the first 6 months.

The nurse is teaching a class for prenatal nutrition, focusing on teratogens. What food source should the nurse include as a teratogen?

Alcohol

A mother is inquiring about what consequences the baby may suffer if she does not take a folic acid supplement. The nurse should explain that neural tube defects are a complication of not enough folid acid during the early stages of development. What are some examples of neural tube defects? Select all that apply.

Anencephaly Spina Bifida

The nurse is seeing a client in her first trimester of pregnancy. The client asks at what rate and how much weight she should gain. The nurse should inform the client that the amount of weight she needs to gain is based on which pre-pregnancy factor?

BMI

A pregnant client comes into the clinic and wants to know the benefits of breastfeeding versus bottle-feeding her infant. Which of the following statements about breastfeeding are CORRECT? Select all that apply.

Breastfeeding promotes optimal maternal-infant bonding. Breastfeeding reduces the risk of upper respiratory infections. Breastfeeding reduces the risk of postpartum hemorrhage. Breastfeeding reduces the risk of sudden infant death syndrome.

The nurse is teaching a breastfeeding class. Which of the following recommendations are correct? Select all that apply.

During lactation, women are urged to follow the same guidelines for seafood consumption as pregnant women. Avoiding alcohol is the safest level of intake while breastfeeding

The pregnant client tells the clinic nurse she is worried about neural tube defects in her baby. Which nutritional sources should the nurse recommend to help clients prevent this fetal complication? Select all that apply.

Folate supplement Breakfast cereals Lentils

The nurse is seeing a pregnant woman who has phenylketonuria (PKU). The client should be taught which of the following?

Foods high in phenylalanine are meat, fish, poultry, and dairy products.

During a clinic visit, the mother of a 3-month-old infant tells the nurse the baby is taking phenyl-free formula. For what reason would the infant require this type of formula?

Inborn error of metabolism

The nurse is providing education regarding the advantages of breastfeeding to a pregnant client. What advantages would the nurse mention that benefit both the mother and the infant rather than just one or the other? Select all that apply.

Increases bonding Reduce the risk of type 2 diabetes

Nutritional requirements for which of the following increase from 18 mg for nonpregnant women to 27 mg during pregnancy?

Iron

The nurse is teaching a pregnant client about safety issues during a prenatal visit. The nurse advises the client that infection with which foodborne organism typically results in spontaneous abortion or stillbirth?

Listeria monocytogenes

Which statement about listeriosis and pregrnant women reflects understanding by the nurse?

Listeriosis is rare except in pregnant women, newborns, older adults, and people with weakened immune systems.

A breastfeeding mother wants to know whether she should continue taking her prenatal vitamin. Which of the following does the nurse know? Select all that apply.

Many vitamin and mineral requirements are higher during lactation than pregnancy. There are no consistent recommendations regarding the use of supplements during lactation. The breastfeeding mother is encouraged to obtain nutrients from food, not prenatal vitamins.

When providing prenatal education, which conditions or circumstances will the nurse exclude from a list of pregnancy high risks? Select all that apply.

Micronutrient supplementation

How many extra calories per day should a client in her first trimester of pregnancy expect to eat?

No extra calories

Which of the following statements about preeclampsia are CORRECT? Select all that apply.

Preeclampsia is 2 times more common in overweight women. Preeclampsia is 3 times more common in obese women. Symptomatology of preeclampsia includes gestational hypertension and proteinuria.

A client is asking the nurse about exercise during pregnancy. Which recommendations are true regarding exercise? Select all that apply.

Pregnant women should do at least 150 minutes of moderate-intensity aerobic activity a week during pregnancy and the postpartum period. Women who habitually engaged in vigorous-intensity aerobic activity before pregnancy can continue these activities during pregnancy and the postpartum period. Those who are pregnant should be under the care of a healthcare provider who can monitor the progress of the pregnancy.

The nurse is seeing a client who wishes to conceive a child. The client knows that folate is an essential vitamin preconception. Which foods should the nurse advise this client to consume? Select all that apply.

Spinach Asparagus Lentils Pinto beans

What type of cheeses fall into the category of foods to avoid while pregnant?

Queso blanco Brie Feta

A client states she does not consume coffee in the mornings but would rather consume an energy drink. To replace the limited amount of two to three 8 oz cups of coffee, which energy drinks will be safest to consume 2 of per day during pregnancy? Select all that apply.

Red Bull Full Throttle Mountain Dew

The nurse is providing education to a group of clients who plan to breastfeed after the birth of their infants. In the educational session, the nurse should include which of the following points about breastfeeding which are true? Select all that apply.

Reduces the risk of postpartum hemorrhage Follow pregnancy guidelines for seafood consumption

A pregnant woman is in the third trimester of her second pregnancy. Her primary care provider recommended that she take a multivitamin and mineral supplement for which if which of the following conditions are present?. Select all that apply.

She has iron-deficiency anemia. She smokes half a pack of cigarettes a day. She has HIV but is taking her antiretroviral treatment per protocol.

The nurse suspects that a client in the 10th week of gestation would benefit from a nutritional supplement. Which information in the client's prenatal history did the nurse use to make this clinical determination?

Smokes 5 cigarettes a day

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

The nurse is seeing a client who has been diagnosed with gestational diabetes. The nurse should share which of the following information with this client?

The risk of birth trauma is increased

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.

The nurse is teaching a prenatal course to pregnant adolescents. Which education will this nurse include in the curriculum? Select all that apply.

You may not have adequate nutrient stores because you need large amount of nutrients for your own growth and development. Adolescents are at increased risk for low birth weight (LBW) infants due to their poor intake and status of certain micronutrients, such as folate, iron, and vitamin D.

According to Dietary Reference Intakes (DRIs), pregnant women need to begin adding at least 250 calories during the first trimester. This statement is:

false

The nurse is providing prenatal education to a group of pregnant couples. The nurse should include in the teaching that low-birth-weight (LBW) infants are associated with which of the following later in life? Select all that apply.

cardiovascular disease hypertension dyslipidemia

The nurse is seeing a client who is not taking birth control and is considering pregnancy. Which of the following recommendations should the nurse make for this client?

consume 400 micrograms (ug) per day of folic acid.

A 26-year-old Caucasian woman at 28 weeks gestation with her first pregnancy comes to the clinic. This is her first pregnancy, and she is carrying twins. For four years before pregnancy, her blood pressure ranged from 132/ 84 to 138/88. Her prepregnancy BMI was 24, and she has gained 15 pounds. Which of the following risk factors are present for eclampsia? Select all that apply.

primiparity multiple pregnancy

A woman who is 32 weeks pregnant was diagnosed with gestational diabetes one week ago. The nurse knows that teaching has been effective when the woman states which of the following?

"I should exercise if there are no medical or obstetrical complications."

A woman who is 10 weeks pregnant is experiencing nausea and vomiting. The nurse knows that further teaching is needed if the woman makes which of the following statements?

"I should increase my fiber intake, especially whole-grain breads and cereals."

A pregnant woman in her first trimester is experiencing heartburn, a common complaint during pregnancy. What recommendations can the nurse give to decrease heartburn during pregnancy? Select all that apply.

"Avoid bending over after eating." "Avoid coffee and high-fat foods." "Eat small, frequent meals."

A pregnant woman tells the nurse she enjoys eating many different types of fish. She is currently 6 weeks pregnant and asks the nurse what is recommended to reduce the risk of methyl mercury poisoning during her pregnancy and while she is breastfeeding. Which of the following statements by the nurse are CORRECT? Select all that apply.

"Check with the local authorities for advisories about the safety of fish from local waters." "Fish and seafood are healthful sources of essential fatty acids." "8 to 12 ounces of shrimp, salmon, pollock, and catfish per week are safe during pregnancy and lactation."

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.

"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." "Having twins will significantly make breast feeding more challenging for you."

Despite eating small, frequent meals as suggested, a pregnant client reports continued nausea and vomiting. What additional suggestion should the nurse make?

"Eat dry crackers before getting out of bed."

Which of the following are CORRECT statements made by a pregnant woman with phenylketonuria (PKU)? Select all that apply.

"Eggs, dairy products, and nuts must be eliminated during pregnancy." "Synthetic amino acids must be consumed via medical foods during pregnancy." "Phenylalanine must be provided in the diet."

A pregnant woman has phenylketonuria (PKU). The nurse knows that further teaching is needed when the woman makes which statement?

"I should consume a normal diet during pregnancy."

The nurse evaluates the weight gain of a client in the 26th week of gestation who had a prepregnancy body mass index (BMI) of 27.5. Which weight gain thus far in the pregnancy indicates that teaching has been effective?

9.0 lbs.

Most pregnant women need a total of ________ to 2800 cal/day. Enter the correct number ONLY.

1800

The World Health Organization (WHO) recommends that breastfeeding should continue up to the age of at least _________ years. Enter the correct number ONLY.

2

All women with a body mass index (BMI) of ______ or higher should be counseled about the risks of unhealthy weight to maternal health and future pregnancies. Enter the correct number ONLY.

25

The nurse is seeing a pregnant client who has a BMI of 27. This nurse should encourage this client to limit weight gain to ______ pounds in her pregnancy. Enter the correct number ONLY.

25

A woman is pregnant with twins; her prepregnancy BMI is 30. This woman should gain how much weight in pounds?

25-42 pounds

A client has asked the nurse, "What is the recommended intake for iron during pregnancy?" What is the nurse's correct response?

27 mg/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 to 40 pounds

The recommended dosage of folate for pregnant women is _____ ug. Enter the correct number ONLY.

600

The recommended amount of folic acid to be consumed every day by all pregnant women is how much?

600 ug.

A recent U.S. study found what percentage of women experience excessive gestational weight gain? Enter the correct number ONLY.

73

Women use approximately _____ calories above their normal total daily calorie needs to produce breast milk. Enter the correct number ONLY.

500

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

The nurse is seeing a [pregnant client who reports having constipation. The nurse should recommend which of the following interventions?

drinking at least eight 8-oz glasses of liquid daily

The nurse is seeing a pregnant client who asks what foods to eat to increase intake of folic acid. Which are the following are sources of folic acid? Select all that apply.

fortified breakfast cereals. white bread and rolls made with enriched flour multivitamins

Excessive weight gain during pregnancy increases the risk for which of the following? Select all that apply.

gestational diabetes cesarean delivery complications during delivery

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 mackerel

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.

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.

Current weight gain recommendations for pregnancy are based on prepregnancy weight. This statement is:

false.

The nurse knows that obesity during pregnancy is associated with all of the following EXCEPT:

small for gestational age infant.

All women with a body mass index (BMI) of ______ or lower should be counseled about the risks of unhealthy weight to maternal health and future pregnancies. Enter number to the nearest 1/10th. Enter the correct number ONLY.

18.5

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.

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

The nurse recognizes which of the following factors influence a mother's decision not to breastfeed or to breastfeed for a short duration? Select all that apply.

unsupportive hospital practices lack of knowledge personal beliefs family attitudes