NURS 4403 Chapter 09: Maternal and Fetal Nutrition
MULTIPLE CHOICE
1. A 22-year-old woman pregnant with a single fetus has a preconception body
... [Show More] mass index (BMI) of 24. When she was seen in the clinic at 14 weeks of gestation, she had gained 1.8 kg (4 lb) since conception. How would the nurse interpret this?
a. This weight gain indicates possible gestational hypertension.
b. This weight gain indicates that the woman’s infant is at risk for intrauterine growth restriction (IUGR).
c. This weight gain cannot be evaluated until the woman has been observed for several more weeks.
d. The woman’s weight gain is appropriate for this stage of pregnancy.
2. Which meal would provide the most absorbable iron?
a. Toasted cheese sandwich, celery sticks, tomato slices, and a grape drink
b. Oatmeal, whole wheat toast, jelly, and low-fat milk
c. Black bean soup, wheat crackers, orange sections, and prunes
d. Red beans and rice, cornbread, mixed greens, and decaffeinated tea
3. Which nutrient’s recommended dietary allowance (RDA) is higher during lactation than during pregnancy?
a. Energy (kcal) c. Vitamin A
b. Iron d. Folic acid
4. A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits, and vegetables. The nurse would be most concerned about this woman’s intake of:
a. Calcium. c. Vitamin B12.
b. Protein. d. Folic acid.
5. A pregnant woman experiencing nausea and vomiting should:
a. Drink a glass of water with a fat-free carbohydrate before getting out of bed in the morning.
b. Eat small, frequent meals (every 2 to 3 hours).
c. Increase her intake of high-fat foods to keep the stomach full and coated.
d. Limit fluid intake throughout the day.
6. A pregnant woman reports that she is still playing tennis at 32 weeks of gestation. The nurse would be most concerned that during and after tennis matches this woman consumes:
a. Several glasses of fluid.
b. Extra protein sources such as peanut butter.
c. Salty foods to replace lost sodium.
d. Easily digested sources of carbohydrate.
7. Which statement made by a lactating woman would lead the nurse to believe that the woman 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.”
8. A pregnant woman’s diet history indicates that she likes the following list of foods. The nurse would encourage this woman to consume more of which food to increase her calcium intake?
a. Fresh apricots c. Spaghetti with meat sauce
b. Canned clams d. Canned sardines
9. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 18.0. The nurse knows that this woman’s total recommended weight gain during pregnancy should be at least:
a. 20 kg (44 lb). c. 12.5 kg (27.5 lb).
b. 16 kg (35 lb). d. 10 kg (22 lb).
10. A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman:
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.
11. A woman has come to the clinic for preconception counseling because she wants to start trying to get pregnant in 3 months. She can expect the following advice:
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 taking regularly.”
d. “Make sure that you include adequate folic acid in your diet.”
12. To prevent gastrointestinal upset, clients should be instructed to take iron supplements:
a. On a full stomach. c. After eating a meal.
b. At bedtime. d. With milk.
13. Women with an inadequate weight gain during pregnancy are at higher risk of giving birth to an infant with:
a. Spina bifida. c. Diabetes mellitus.
b. Intrauterine growth restriction. d. Down syndrome.
14. After you complete your nutritional counseling for a pregnant woman, you ask her to repeat your instructions so you can assess her understanding of the instructions given. Which statement indicates that she 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.”
15. Pregnant adolescents are at high risk for because of lower body mass indices (BMIs) and “fad” dieting.
a. Obesity c. Low-birth-weight babies
b. Diabetes d. High-birth-weight babies
16. Maternal nutritional status is an especially significant factor of the many factors that influence the outcome of pregnancy because:
a. It is very difficult to adjust because of people’s ingrained eating habits.
b. It is an important preventive measure for a variety of problems.
c. Women love obsessing about their weight and diets.
d. A woman’s preconception weight becomes irrelevant.
17. Which statement regarding acronyms in nutrition is accurate?
a. Dietary reference intakes (DRIs) consist of recommended dietary allowances
(RDAs), adequate intakes (AIs), and upper limits (ULs).
b. RDAs are the same as ULs except with better data.
c. AIs offer guidelines for avoiding excessive amounts of nutrients.
d. They all refer to green leafy vegetables, whole grains, and fruit.
18. With regard to protein in the diet of pregnant women, nurses should be aware that:
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.
19. Which nutritional recommendation about fluids is accurate?
a. A woman’s daily intake should be eight to ten glasses (2.3 L) of water, milk, or juice.
b. Coffee should be limited to no more than two 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 child’s risk of tooth decay.
20. Which minerals and vitamins usually are recommended to supplement a pregnant woman’s diet?
a. Fat-soluble vitamins A and D c. Iron and folate
b. Water-soluble vitamins C and B6 d. Calcium and zinc
21. Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother?
a. Zinc c. Folic acid
b. Vitamin D d. Vitamin A
22. With regard to nutritional needs during lactation, a maternity nurse should be aware that:
a. The mother’s intake of vitamin C, zinc, and protein now can 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 calorie intake.
23. While taking a diet history, the nurse might be told that the expectant mother has cravings for ice chips, cornstarch, and baking soda. This represents a nutritional problem known as:
a. Preeclampsia. c. Pica.
b. Pyrosis. d. Purging.
24. When counseling a client about getting enough iron in her diet, the maternity nurse should tell her that:
a. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.
b. Iron absorption is inhibited by a diet rich in vitamin C.
c. Iron supplements are permissible for children in small doses.
d. Constipation is common with iron supplements.
25. The labor and delivery nurse is preparing a bariatric patient for an elective cesarean birth. Which piece of “specialized” equipment is unnecessary 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
26. To help a woman reduce the severity of nausea caused by morning sickness, the nurse might suggest that she:
a. Try a tart food or drink such as lemonade or salty foods such as potato chips.
b. Drink plenty of fluids early in the day.
c. Brush her teeth immediately after eating.
d. Never snack before bedtime.
27. Three servings of milk, yogurt, or cheese plus two servings of meat, poultry, or fish adequately supply the recommended amount of protein for a pregnant woman. Many patients are concerned about the increased levels of mercury in fish and may be afraid to include this source of nutrients in their diet. Sound advice by the nurse to assist the client in determining which fish is safe to consume would include:
a. Canned white tuna is a preferred choice.
b. Avoid shark, swordfish, and mackerel.
c. Fish caught in local waterways are the safest.
d. Salmon and shrimp contain high levels of mercury.
28. Nutrition is one of the most significant factors influencing the outcome of a pregnancy. It is an alterable and important preventive measure for various potential problems, such as low birth weight and prematurity. While completing the physical assessment of the pregnant client, the nurse can evaluate the client’s nutritional status by observing a number of physical signs. Which sign would indicate that the client has unmet nutritional needs?
a. Normal heart rate, rhythm, and blood pressure
b. Bright, clear, shiny eyes
c. Alert, responsive, and good endurance
d. Edema, tender calves, and tingling
29. Which pregnant woman should restrict her weight gain during pregnancy?
a. Woman pregnant with twins
b. Woman in early adolescence
c. Woman shorter than 62 inches or 157 cm
d. Woman who was 20 pounds overweight before pregnancy
30. The major source of nutrients in the diet of a pregnant woman should be composed of:
a. Simple sugars c. Fiber
b. Fats d. Complex carbohydrates
31. A pregnant woman’s diet may not meet her need for folates. A good source of this nutrient is:
a. Chicken c. Potatoes
b. Cheese d. Green leafy vegetables
32. When providing care to the prenatal patient, the nurse understands that pica is defined as:
a. Intolerance of milk products c. Ingestion of nonfood substances
b. Iron deficiency anemia d. Episodes of anorexia and vomiting
33. The most important reason for evaluating the pattern of weight gain in pregnancy is to:
a. Prevent excessive adipose tissue deposits
b. Identify potential nutritional problems or complications of pregnancy
c. Assess the need to limit caloric intake in obese women
d. Determine cultural influences on the woman’s diet
34. If a patient’s normal prepregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy?
a. 5 c. 25
b. 10 d. 30
35. A pregnant patient would like to know a good food source of calcium other than dairy products. Your best answer is:
a. Legumes c. Lean meat
b. Yellow vegetables d. Whole grains
36. To determine the cultural influence on a patient’s diet, the nurse should first:
a. Evaluate the patient’s weight gain during pregnancy
b. Assess the socioeconomic status of the patient
c. Discuss the four food groups with the patient
d. Identify the food preferences and methods of food preparation common to that culture
37. Identify a goal of a patient with the following nursing diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to diet choices inadequate to meet nutrient requirements of pregnancy.
a. Gain a total of 30 lb.
b. Take daily supplements consistently.
c. Decrease intake of snack foods.
d. Increase intake of complex carbohydrates.
38. In teaching the pregnant adolescent about nutrition, the nurse should:
a. Emphasize the need to eliminate common teen snack foods because they are too high in fat and sodium.
b. Determine the weight gain needed to meet adolescent growth and add 35 lb.
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.
MULTIPLE RESPONSE
39. Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a client to a registered dietitian for in-depth nutritional counseling in the following situations (Select all that apply).
a. Preexisting or gestational illness such as diabetes
b. Ethnic or cultural food patterns
c. Obesity
d. Vegetarian diet
e. Allergy to tree nuts
COMPLETION
40. A newly pregnant patient visits her provider’s office for the first prenatal appointment. To estimate accurate weight gain throughout the pregnancy, the nurse will be evaluating the appropriateness of weight for height using the body mass index (BMI). The patient weighs 51 kg and is 1.57 m tall.
The BMI is: [Show Less]