Question 1

The nurse is counseling a client with a body mass index (BMI) of 22 who is concerned about additional weight gain during pregnancy. Which approach should the nurse take?&#10;A) &#34;At your current weight you should expect to see a weight gain less than 20 lbs. during your pregnancy.&#34;&#10;B) &#34;At your current weight you should expect to see a weight gain 15-25 lbs. during your pregnancy.&#34;&#10;C) &#34;At your current weight you should expect to see a weight gain 28-40 lbs. during your pregnancy.&#34;&#10;D) &#34;At your current weight you should expect to see a weight gain 25-35 lbs. during your pregnancy.&#34;

Accepted Answer

It is recommended that a client with a normal body mass index (BMI) gain between 25-35 lbs. during pregnancy. Inadequate maternal weight gain is a health risk, often associated with small-for-gestational age, or low-birth-weight infant. Therefore it is important to counsel clients on desired weight gain in relation to their pre-pregnancy BMI in order to assure essential fetal growth and appropriate infant birth weight. It is recommended that underweight clients (BMI less than 19.8) gain 28-40 lbs., whereas clients that are overweight (BMI 26-29) gain 15 - 25 lbs.

Question 2

The nurse is counseling a woman about the consumption of herbal supplements during pregnancy. Which statement is appropriate for the nurse to make?&#10;A) It is safe to ingest herbal supplements during pregnancy since they are natural substances&#10;B) The Food and Drug Administration (FDA) has established guidelines about the safety of herbal use during pregnancy&#10;C) It is important that you quit taking any botanical, vitamin, or mineral supplements during your pregnancy, but you can resume taking them after the baby is born&#10;D) Dietary supplements during pregnancy have not been well researched so it is important to discuss ingestion of specific supplements with your healthcare provider

Accepted Answer

The use of dietary supplements during pregnancy is not well studied. Herbs and other botanicals especially have not been well researched regarding safety. Some botanical supplements are characterized as uterine stimulants or lead to altered blood clotting, which are dangerous complications during pregnancy, while others can cause drug interactions or are teratogens or mutagens. The client the supplements with the healthcare provider because herbal supplements are not currently regulated by the Food and Drug Administration (FDA). Although herbal supplements are natural substances, many may be considered harmful to consume during pregnancy. The client should collaborate with the nurse to help determine which dietary supplements are safe versus harmful for the individual. A consultation with the health-care provider is needed to determine if the supplements may be continued during the pregnancy.

Question 3

The nurse is assessing a client during the first prenatal visit. For which reason should the nurse conduct an additional assessment with this client?&#10;A) BMI of 21&#10;B) Maternal age 31 years&#10;C) History of diabetes for 10 years&#10;D) Drinking 1 small cup of coffee/day

Accepted Answer

Maternal diabetes places both the mother and infant at risk during pregnancy. Uncontrolled diabetes during pregnancy is associated with increased risk for miscarriages, stillbirth, macrosomia, obstetric complications, and intrauterine developmental and growth abnormalities. Maternal age of 31 is not considered a risk factor. BMI of 21 is within normal limits. The American College of Obstetricians and Gynecologists recommends that pregnant women limit caffeine intake to 200 mg/day because of health risks associated with intake higher than that amount

Question 4

A client who is pregnant with twins is concerned about the amount of weight to gain during the pregnancy. Which response should the nurse make to this client? (Select all that apply.)&#10;A) &#34;You should plan on gaining a.5 pounds each week.&#34;&#10;B) &#34;You can expect to gain between 35 and 45 pounds during this pregnancy.&#34;&#10;C) &#34;You need to eat about 300 extra calories each day when compared to what you ate prior to becoming pregnant.&#34;&#10;D) &#34;Let's talk about some nutrient-dense foods that will help your babies develop well.&#34;&#10;E) &#34;It is important to avoid eating seafood with high levels of mercury.&#34;

Accepted Answer

All women who are pregnant should be encouraged to eat foods with high levels of nutrients and avoid seafood that contains high levels of mercury. Women pregnant with twins can expect to gain 35-45 pounds during their pregnancies. Clients who are pregnant with twins need to eat 500-952 extra kilocalories each day, when compared to what they ate prior to becoming pregnant. Clients who are pregnant with twins should eat approximately 150-500 kilocalories more than a client pregnant with one baby. Women who are pregnant with one baby require 350-452 extra kilocalories each day. Women who are pregnant with triplets should gain approximately 1.5 pounds each week and can expect to gain 50 pounds.
All women who are pregnant should be encouraged to eat foods with high levels of nutrients and avoid seafood that contains high levels of mercury. Women pregnant with twins can expect to gain 35-45 pounds during their pregnancies. Clients who are pregnant with twins need to eat 500-952 extra kilocalories each day, when compared to what they ate prior to becoming pregnant. Clients who are pregnant with twins should eat approximately 150-500 kilocalories more than a client pregnant with one baby. Women who are pregnant with one baby require 350-452 extra kilocalories each day. Women who are pregnant with triplets should gain approximately 1.5 pounds each week and can expect to gain 50 pounds.
All women who are pregnant should be encouraged to eat foods with high levels of nutrients and avoid seafood that contains high levels of mercury. Women pregnant with twins can expect to gain 35-45 pounds during their pregnancies. Clients who are pregnant with twins need to eat 500-952 extra kilocalories each day, when compared to what they ate prior to becoming pregnant. Clients who are pregnant with twins should eat approximately 150-500 kilocalories more than a client pregnant with one baby. Women who are pregnant with one baby require 350-452 extra kilocalories each day. Women who are pregnant with triplets should gain approximately 1.5 pounds each week and can expect to gain 50 pounds.

Question 5

A pregnant client follows a vegan eating plan. Which vitamin supplement should the nurse emphasize as essential for this client during the pregnancy?&#10;A) B1&#10;B) B2&#10;C) B6&#10;D) B12

Accepted Answer

A pregnant client who consumes exclusively a vegan diet should be encouraged to supplement with vitamin B12. Vitamin B12 is found most in animal products such as meat, dairy, and eggs. Those consuming a vegan diet do not consume animal products, and the vitamin is not in most nonanimal source, therefore it is recommended that a vegan supplement be added. Taking too little of vitamin B12 can lead to anemia and nervous system disorders. In addition, vitamin B12 deficiency interferes with the cellular use of folate; supplementation would further reduce the risk of neural tube defects. Vitamins B1 and B6 are found in grains and enriched flours. Vitamin B2 is found in green leafy vegetables.

Question 6

The nurse compares the nutrient requirements of an adolescent with those of a pregnant client. Which nutrient should the nurse identify as having different requirements for these populations?&#10;A) Iron&#10;B) Calcium&#10;C) Folic acid&#10;D) Vitamin C

Accepted Answer

An adolescent requires 1,300 mg calcium/day as linear height and bone mass gains are crucial in this age span. Recommended calcium intake for a healthy pregnancy adult is 1,000 mg/day. Recommended daily intake of iron, folic acid and vitamin C are the same in both adolescents and adults.

Question 7

The nurse prepares to assess a group of clients arriving for prenatal care. Which client should the nurse identify as having the greatest need for nutrition counseling during the first prenatal visit?&#10;A) A client with phenylketonuria&#10;B) A client entering a third pregnancy&#10;C) A 42-year-old client with a BMI of 22&#10;D) The vegan client who has had preconception counseling

Accepted Answer

Phenylalanine crosses the placenta and leads to higher levels in the fetus than the mother. Maintenance of maternal phenylalanine levels within and acceptable range during pregnancy is associated with greatly diminished risk of poor infant outcomes. The nurse should reinforce nutritional teaching the vegan client received before becoming pregnant. Although the 42-year-old client is advanced for maternal age, a BMI of 22 is considered a healthy weight and the client should be encouraged to maintain a healthy diet.

Question 8

A pregnant client reports the desire to eat non-food items. For which health problem should the nurse prepare teaching for this client?&#10;A) Pica&#10;B) Geophagia&#10;C) Pagophagia&#10;D) Amylophagia

Accepted Answer

Pica is the term used to describe the consumption of nonfood items. It is often associated with a decreased iron deficiency during pregnancy, but is also a cultural practice which has been practiced for centuries. There are specific classifications of pica which are associated with specific substances eaten. Geophagia is the consumption of soil, dirt, or baked clay. Pagophagia is the consumption of ice and freezer frost. Amylophagia is the consumption of laundry starch, corn starch, or other similar starches.

Question 9

The nurse prepares nutritional material for a pregnant client with preeclampsia. What should the nurse include when teaching this client?&#10;A) &#34;Restrict sodium intake.&#34;&#10;B) &#34;Increase the intake of fluids.&#34;&#10;C) &#34;Avoid consuming simple sugars.&#34;&#10;D) &#34;Increase the amount of calcium in your diet.&#34;

Accepted Answer

Dietary interventions for preeclampsia include calcium supplementation. It is unclear whether or not limiting sodium intake would have an impact on preeclampsia. There is no need to increase fluid intake. Simple sugars may not be of much nutritional value, but there is no evidence to support restriction.

Question 10

The nurse notes that a pregnant client arriving for an initial prenatal visit has a BMI of 35. For which complication is this client at risk for developing during the pregnancy?&#10;A) Macrosomia&#10;B) Placenta previa&#10;C) Gestational diabetes&#10;D) Chromosomal defects

Accepted Answer

Women who are obese before pregnancy are at additional risk of pregnancy complications, such as gestational diabetes. Infants of obese mothers are at high risk to develop macrosomia. Obese clients are at no greater risk for developing placenta previa than women of a lower BMI. Obese clients are not at a high risk for chromosomal defects.

Question 11

A client in the first trimester of pregnancy is experiencing persistent nausea throughout the day. What should the nurse recommend to this client?&#10;A) Consume noncarbonated beverages&#10;B) Increase foods with a high fat content&#10;C) Eat large meals frequently throughout the day&#10;D) Eat dry toast and crackers before getting out of bed

Accepted Answer

The answer of A client in the first trimester of...

Question 12

A pregnant client is planning to breastfeed after delivery. How many additional calories per day should the nurse instruct the client to consume during the first 6 months of breastfeeding?&#10;A) 430 kcal&#10;B) 500 kcal&#10;C) 630 kcal&#10;D) 730 kcal

Accepted Answer

The answer of A pregnant client is planning to breastfeed...

Question 13

The nurse provides nutritional teaching to a client who is breastfeeding. Which client statement indicates that additional instruction is required?&#10;A) &#34;I need to increase my intake of iron.&#34;&#10;B) &#34;I should drink at least 8-10 glasses of fluid/day.&#34;&#10;C) &#34;I need to make sure I have enough calcium in my diet.&#34;&#10;D) &#34;I need make sure I have and adequate intake of vitamin B12.&#34;

Accepted Answer

The answer of The nurse provides nutritional teaching to a...

Deck 14: Pregnancy and Lactation