Question 1

A woman has come to the clinic for preconception counselling because she wants to start trying to get pregnant in 3 months.Which information should the nurse provide to this woman?

Accepted Answer

A healthy diet before conception is the best way to ensure that adequate nutrients are available for the developing fetus.A woman's folate or folic acid intake is of particular concern in the preconception period.Neural tube defects are more common in infants of women with a poor folic acid intake.Depending on the type of contraception used,discontinuing all contraception may not be an accurate statement.Losing weight is not appropriate advice.Depending on the type of medication the woman is taking,continuing its use may not be an accurate statement.

Question 2

Which should the nurse teach a pregnant woman who is still playing tennis at 32 weeks of gestation?

Accepted Answer

Liberal amounts of fluid should be consumed before,during,and after exercise to avoid dehydration,because dehydration can trigger premature labour.The woman's calorie intake should be sufficient to meet the increased needs of pregnancy and the demands of exercise.

Question 3

Which meal would provide the most absorbable iron?

Accepted Answer

Food sources that are rich in iron include liver,meats,whole-grain or enriched breads and cereals,deep green leafy vegetables,legumes,and dried fruits.The foods in this group are all good sources of iron.In addition,the vitamin C in dried apricots aids absorption.Dairy products and tea are not sources of iron.

Question 4

What should the nurse be aware of with regard to protein in the diet of pregnant women?

Accepted Answer

Good protein sources such as meat,milk,eggs,and cheese have a lot of calcium,B vitamins,and iron.Most women already eat a high-protein diet and do not need to increase their intake.Protein is sufficiently important that specific servings of meat and dairy are recommended.High-protein supplements are not recommended because they have been associated with an increased incidence of preterm births.

Question 5

Which nutrient's recommended dietary allowance (RDA)is higher during lactation than during pregnancy?

Accepted Answer

Needs for energy (kilocalories),protein,calcium,iodine,zinc,the B vitamins (thiamine,riboflavin,niacin,pyridoxine,and vitamin B₁₂),and vitamin C are greater during lactation than during pregnancy.Iron recommendation is lower during lactation than in pregnancy.Folic acid recommendation is lower during lactation than in pregnancy.Vitamin A recommendation is lower during lactation than in pregnancy.

Question 6

To prevent gastrointestinal upset,when should pregnant patients be instructed to take iron supplements?

Accepted Answer

Patients should be instructed to take iron supplements at bedtime.Iron supplements are best absorbed if they are taken when the stomach is empty.Bran,tea,coffee,milk,and eggs may reduce absorption.Iron can be taken at bedtime if abdominal discomfort occurs when it is taken between meals.

Question 7

Which nutritional recommendation about fluids is accurate?

Accepted Answer

The recommended daily intake of liquid is 3 litres.Water,milk,decaffeinated tea,and juices are good sources,although pregnant women should limit their intake of fruit juice,as it can be high in calories and therefore lead to extra weight gain.Artificial sweeteners,including aspartame,have no ill effects on the normal mother or fetus.However,mothers with phenylketonuria should avoid aspartame.No evidence indicates that prenatal fluoride consumption reduces childhood tooth decay.However,it still helps the mother.

Question 8

After the nurse completes nutritional counselling for a pregnant woman,which information from the woman would indicate that she understands the role of protein in her pregnancy?

Accepted Answer

Protein is the nutritional element basic to growth.An adequate protein intake is essential to meeting the increasing demands of pregnancy.These demands arise from the rapid growth of the fetus;the enlargement of the uterus,mammary glands,and placenta;the increase in the maternal blood volume;and the formation of amniotic fluid.Iron intake prevents anemia.Calcium intake is needed for fetal bone and tooth development.Glycemic control is needed in diabetics;protein is one nutritional factor to consider,but this is not the primary role of protein intake.

Question 9

Which would be of most concern with a pregnant woman whose diet consists almost entirely of whole-grain breads and cereals,fruits,and vegetables?

Accepted Answer

This diet is consistent with that followed by a strict vegetarian (vegan).Vegans consume only plant products.Because vitamin B₁₂ is found in foods of animal origin,this diet is deficient in vitamin B₁₂.

Question 10

A 22-year-old woman pregnant with a single fetus has a preconception body mass index (BMI)of 24.When she was seen in the clinic at 14 weeks of gestation,she had gained 2 kg since conception.How would the nurse interpret this?

Accepted Answer

The woman's weight gain is appropriate for this stage of pregnancy is an accurate statement.This woman's BMI is in the normal range.During the first trimester,the average total weight gain is only 1 to 2 kg.Although weight gain does indicate possible gestational hypertension,it is not a definitive diagnosis.The desirable weight gain during pregnancy varies among women.The primary factor to consider in making a weight gain recommendation is the appropriateness of the pre-pregnancy weight for the woman's height.A commonly used method of evaluating the appropriateness of weight for height is the BMI.This woman has gained the appropriate amount of weight for her size at this point in her pregnancy.Although weight gain does indicate risk for IUGR,it does not apply to this patient.

Question 11

What condition are infants born to women with an inadequate weight gain during pregnancy at higher risk of experiencing?

Accepted Answer

Both normal-weight and underweight women with inadequate weight gain have an increased risk of giving birth to an infant with adverse effects on growth and development such as IUGR.Spina bifida,diabetes mellitus,and Down syndrome are not associated with inadequate maternal weight gain.

Question 12

A 27-year-old pregnant woman had a preconception body mass index (BMI)of 18.0.Which would be within normal range for her total recommended weight gain during pregnancy?

Accepted Answer

This woman has an underweight BMI and should gain 12.5 to 18 kg during pregnancy.A weight gain of 21 kg would be unhealthy for most women.A weight gain of 19 kg is slightly above the range of weight this woman should gain in her pregnancy.A weight gain of 12 kg is below the range of weight this woman should gain in her pregnancy.

Question 13

Which statement made by a lactating woman would lead the nurse to believe that the woman might have a lactose intolerance?

Accepted Answer

Abdominal cramps and bloating are consistent with lactose intolerance.One problem that can interfere with milk consumption is lactose intolerance,which is the inability to digest milk sugar because of a lack of the enzyme lactose in the small intestine.Milk consumption may cause abdominal cramping,bloating,and diarrhea in such people,although many lactose-intolerant individuals can tolerate small amounts of milk without symptoms.

Question 14

A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn.What should the nurse suggest to the woman?

Accepted Answer

Eating small,frequent meals may help with heartburn,nausea,and vomiting.Substituting other calcium sources for milk,lying down after eating,and reducing fibre intake are inappropriate dietary suggestions for all pregnant women and do not alleviate heartburn.

Question 15

Which statement about acronyms in nutrition is accurate?

Accepted Answer

DRIs consist of RDAs,AIs,and ULs.AIs are similar to RDAs,except that they deal with nutrients about which data are insufficient for certainty (RDA status).ULs are guidelines for avoiding excesses of nutrients for which excess is toxic.Green,leafy vegetables;whole grains;and fruit are important,but they are not the whole nutritional story.

Question 16

What are pregnant adolescents at high risk for,related to their lower body mass indices (BMIs)and "fad" dieting practices?

Accepted Answer

Adolescents tend to have lower BMIs because they are still developing and may follow unsafe nutritional practices.In addition,the fetus and still-growing mother may compete for nutrients.These factors,along with inadequate weight gain,lend themselves to a higher incidence of low-birth-weight babies.Maternal obesity and diabetes,and high birth weight of babies are conditions associated with higher BMIs.

Question 17

Why is maternal nutritional status an especially significant factor that may influence the outcome of pregnancy?

Accepted Answer

Maternal nutritional status is a significant factor because it is potentially alterable and because good nutrition before and during pregnancy can help prevent a variety of problems.Nutritional status draws much attention for its all-around effect on a healthy pregnancy and birth.We cannot assume that it is very difficult to adjust because of ingrained habits.The statement that all women love obsessing about their weight and diets does not apply to most women.A woman's preconception weight should be her desirable body weight before pregnancy,therefore,it is not relevant.

Question 18

Consuming more of which food will increase calcium intake?

Accepted Answer

Sardines are rich in calcium.Fresh apricots,canned clams,and spaghetti with meat sauce are not high in calcium.

Question 19

How should the nurse advise a pregnant woman who is experiencing nausea and vomiting?

Accepted Answer

Eating small,frequent meals is a correct suggestion for a woman experiencing nausea and vomiting.A pregnant woman experiencing nausea and vomiting should avoid consuming fluids early in the day or when nauseated but should compensate by drinking fluids at other times.A pregnant woman experiencing nausea and vomiting should reduce her intake of fried and other fatty foods.

Question 20

Which minerals and vitamins usually are recommended to supplement a pregnant woman's diet?

Accepted Answer

Iron generally should be supplemented,and folic acid supplements often are needed because folate is so important to the health of the fetus.Fat-soluble vitamins should be supplemented as a medical prescription,as vitamin D might be for lactose-intolerant women.Water-soluble vitamin C sometimes is consumed in excess naturally;vitamin B? is prescribed only if the woman has a very poor diet.Zinc sometimes is supplemented.Most women get enough calcium.

Quiz 12: Maternal and Fetal Nutrition