Chapter 10: Nutrition during Pregnancy and Lactation Nursing School Test Banks

Chapter 10: Nutrition during Pregnancy and Lactation
Test Bank

MULTIPLE CHOICE

1. Nutritional needs during pregnancy are affected by
a. the mothers age.
b. the sex of the infant.
c. the mothers food cravings.
d. whether the mother works.
ANS: A
Nutritional needs during pregnancy are affected by the mothers age along with height and prepregnancy weight.

DIF: Cognitive Level: Application REF: 174-175 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

2. A pregnant womans energy needs must be met in order to
a. spare vitamins.
b. spare adipose stores.
c. prevent fetal deformity.
d. spare protein.
ANS: D
Adequate energy is necessary to spare protein. If inadequate kilocalories from energy are provided, then protein will be used for energy. Protein increase is approximately 50% more than the average adult requirement.

DIF: Cognitive Level: Knowledge REF: 174-175 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

3. Daily kilocalorie needs during the second trimester exceed normal requirements by approximately _____ kcal.
a. 100
b. 200
c. 340
d. 500
ANS: C
The national standard recommends an increase of 340 kcal/day during the second trimester and approximately 450 kcal/day during the third trimester of pregnancy.

DIF: Cognitive Level: Knowledge REF: 174 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

4. The amount of extra protein required by pregnant women compared with nonpregnant women is approximately _____ g/day.
a. 10
b. 15
c. 25
d. 30
ANS: C
Protein intake should increase 25 g/day during pregnancy on top of nonpregnancy needs. This increase is approximately 50% more than the average adult requirements.

DIF: Cognitive Level: Knowledge REF: 175
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

5. Increased protein is necessary in pregnancy for
a. preventing gestational diabetes.
b. sparing carbohydrates for energy needs.
c. growing maternal tissues.
d. preventing pregnancy-induced hypertension.
ANS: C
Increased protein is necessary in pregnancy for sparing carbohydrates for energy, rapid growth of the fetus, development of the placenta, growth of maternal tissues, increased maternal blood volume, and amniotic fluid.

DIF: Cognitive Level: Knowledge REF: 174-175 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

6. A good source of calcium during pregnancy is
a. orange juice drink.
b. lean ground beef.
c. milk.
d. baked beans.
ANS: C
Calcium is essential for fetal development of bones and teeth as well as for the mothers own body needs. Milk or milk substitute products and generous amounts of green vegetables and enriched or whole grains are good sources of calcium.

DIF: Cognitive Level: Application REF: 175 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

7. A good source of iron during pregnancy would be
a. watermelon
b. orange juice
c. macaroni and cheese
d. lean ground beef
ANS: D
Iron is distributed primarily in meat, eggs, vegetables, and fortified cereals.

DIF: Cognitive Level: Knowledge REF: 175-176
TOP: Nursing Process: Application
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

8. Iron needs increase during pregnancy because of
a. maternal constipation.
b. increased maternal blood volume.
c. increased maternal metabolic rate.
d. poor iron absorption during pregnancy.
ANS: B
Iron needs are increased during pregnancy for increased hemoglobin synthesis required for the greater maternal blood volume as well as for the babys necessary prenatal storage of iron.

DIF: Cognitive Level: Knowledge REF: 175-176 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

9. Adequate folate in the periconceptional period helps prevent
a. cretinism.
b. mental retardation.
c. neural tube defects.
d. gestational diabetes.
ANS: C
Folate builds mature red blood cells throughout pregnancy and is particularly needed during the early periconceptional period to ensure healthy embryonic tissue development and prevent malformation of the neural tube.

DIF: Cognitive Level: Knowledge REF: 177 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

10. The B-complex vitamins are required in greater amounts during pregnancy because
a. fetal demands for the vitamins are high.
b. more hemoglobin is synthesized.
c. the vitamins are excreted in greater quantities.
d. metabolic activities increase.
ANS: D
The B vitamins are needed in increased amounts because of their vital role as coenzyme factors in energy production and protein metabolism.

DIF: Cognitive Level: Knowledge REF: 176 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

11. Daily intake of vitamin C should be increased during pregnancy because it
a. is an important factor in tissue growth.
b. plays an important role in protein synthesis.
c. is necessary for the energy-producing pathways.
d. is important in development of bones in the fetus.
ANS: A
Vitamins A and C are needed in higher amounts during pregnancy because they are both important factors of tissue growth.

DIF: Cognitive Level: Knowledge REF: 176-177 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

12. Drinking 3 to 4 cups of milk a day during pregnancy is recommended because it is a good source of
a. folate.
b. iron.
c. vitamin D.
d. vitamin C.
ANS: C
Milk is a good source of vitamin D along with calcium, phosphorus, and magnesium for fetal development of bones and teeth as well as for the mothers own bodily needs.

DIF: Cognitive Level: Application REF: 175
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

13. Appropriate snack choices for a pregnant woman with morning sickness may include
a. a meal of hot soup and Gatorade.
b. lemonade with added sugar and peppermint sticks.
c. a glass of hot decaffeinated tea.
d. whole-wheat toast with a small amount of light butter and a small piece of fruit.
ANS: D
Small, frequent meals and snacks that are fairly dry and consisting mostly of easily digested energy foods (e.g., carbohydrates), mostly cold foods, with liquids between meals, are recommended for women with morning sickness.

DIF: Cognitive Level: Application REF: 179-180
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

14. A condition of severe, prolonged, and persistent vomiting during pregnancy is called
a. hyperemesis gravidarum.
b. placenta previa.
c. gestational diabetes.
d. preeclampsia.
ANS: A
Hyperemesis gravidarum is morning sickness in early pregnancy that progresses from a mild state to a severe and prolonged state requiring medical treatment.

DIF: Cognitive Level: Knowledge REF: 179 TOP: Nursing Process: Diagnosis
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

15. A food choice to help alleviate constipation during pregnancy is
a. figs.
b. chocolate.
c. white bread.
d. saltines.
ANS: D
Helpful remedies for constipation include high-fiber foods such as whole grains, vegetables, dried fruits, and other fruits and juices.

DIF: Cognitive Level: Application REF: 180
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

16. An acceptable ending pregnancy weight for a normal-weight woman whose prepregnancy weight is 125 lb is _____ lb.
a. 130 to 135
b. 135 to 145
c. 145 to 150
d. 150 to 160
ANS: D
Weight gain for a normal-weight woman with a body mass index of 19.8 to 26 is 25 to 35 lb. Thus, 125 lb + 25 to 35 lb = 150 lb to 160 lb.

DIF: Cognitive Level: Application REF: 177-178
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

17. Total weight gain during the first trimester should be approximately _____ lbs.
a. 1 to 2
b. 2 to 4
c. 6 to 10
d. 10 to 15
ANS: B
Recommended weight gain in the first trimester of pregnancy is approximately 2 to 4 lbs.

DIF: Cognitive Level: Knowledge REF: 177-178 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

18. A pregnancy is considered high risk if the mother
a. is 16 years old.
b. is vegetarian.
c. works full time.
d. exercises 4 or 5 times per week.
ANS: A
Nutritional risk factors at the onset of pregnancy include age 18 years or younger or 35 years or older; frequent pregnancies; poor obstetric history or poor fetal performance; poverty; bizarre or trendy food habits; abuse of nicotine, alcohol, or drugs; chronic disease with therapeutic diet; and weight less than 85% or more than 120% of normal.

DIF: Cognitive Level: Application REF: 180
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

19. A pregnant adolescent is at risk because she
a. does not know how to care for herself.
b. has not established good eating habits.
c. is still in a growth stage of development.
d. will not know about the pregnancy until after the fetal organs have formed.
ANS: C
A pregnant adolescent is at risk because adolescence itself is a stage of growth. The physiologic demands of the pregnancy can compromise the teenagers needs for her own unfinished growth and development.

DIF: Cognitive Level: Knowledge REF: 180-181
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

20. A very overweight pregnant woman older than 30 years of age is at high risk for
a. anemia.
b. gestational diabetes.
c. edema.
d. phenylketonuria.
ANS: B
Risk factors for women who are more than 120% of standard weight or who have a body mass index of more than 26 include gestational diabetes. During pregnancy, there is an increased metabolic workload along with an increased volume of blood and its load of metabolites, including glucose. Some of this extra glucose spills over into the urine.

DIF: Cognitive Level: Knowledge REF: 180
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

21. During pregnancy, women should be encouraged not to
a. exercise.
b. have sexual intercourse.
c. drink alcoholic beverages.
d. drink decaffeinated coffee.
ANS: C
Social habits of alcohol, cigarette, and drug use can cause fetal damage and are contraindicated during pregnancy. Extensive, habitual use of alcohol leads to the well-documented fetal alcohol syndrome.

DIF: Cognitive Level: Knowledge REF: 182-183
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

22. The most common cause of anemia during pregnancy is
a. folic acid deficiency.
b. lack of intrinsic factor.
c. iron deficiency.
d. vitamin C deficiency.
ANS: C
Iron-deficiency anemia is most common during pregnancy.

DIF: Cognitive Level: Knowledge REF: 175-176 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

23. Of the following, the best source of folate would be
a. fruit juices.
b. green leafy vegetables.
c. whole grains.
d. citrus fruits.
ANS: B
Folate is found in food sources such as green leafy vegetables, legumes, yeast, chicken, beef, and liver.

DIF: Cognitive Level: Application REF: 177
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

24. The finding of glycosuria during a routine laboratory test may suggest that the woman has
a. anemia.
b. gestational diabetes.
c. phenylketonuria.
d. hypertension.
ANS: B
Gestational diabetes presents with glycosuria or sugar spilling over into the urine. Other predisposing factors include age 30 years and older; those who are overweight and have a history of previously unexplained stillbirths; delivery of large babies weighing 9 lbs or more; habitual abortions; births of babies with multiple congenital defects; and family history of diabetes or ethnicity associated with a high incidence of diabetes.

DIF: Cognitive Level: Knowledge REF: 185
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

25. High blood pressure and the accumulation of protein in the urine may be signs of
a. preeclampsia.
b. hyperemesis.
c. alcoholism.
d. gestational diabetes.
ANS: A
High blood pressure can be fatal to the mother and fetus. If symptoms progress with the accumulation of proteinuria, the condition is referred to as preeclampsia.

DIF: Cognitive Level: Application REF: 185
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

26. Three important factors that support adequate lactation are
a. diet, exercise, and vitamin supplements.
b. intake of dairy products, fluids, and rest.
c. diet, fluids, and rest and relaxation.
d. intake of bland foods and adequate fluids.
ANS: C
Successful lactation requires an adequate diet, including energy and nutrients for both the process and product, adequate fluid for adequate milk production, and rest and relaxation to enhance the production and letdown reflexes of breast-feeding.

DIF: Cognitive Level: Knowledge REF: 186-189 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

27. Nutrition counselors should encourage pregnant teenagers to
a. avoid fast food.
b. eat foods from all the basic food groups.
c. drink fat-free (skim) rather than whole milk.
d. eat foods high in dietary fiber.
ANS: B
Pregnant teens should consume foods from all five basic foods groups to support fetal development as well as their own growth and development needs.

DIF: Cognitive Level: Application REF: 181-182
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

28. Advantages of breast-feeding for the mother include
a. less fluid retention.
b. rapid weight loss.
c. fewer maternal infections.
d. convenience and economy.
ANS: D
The advantages of breast-feeding include benefits to both mother and baby, such as the ability of human milk to meet the unique needs of the infant and convenience and economy.

DIF: Cognitive Level: Knowledge REF: 190-191 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

29. During pregnancy, intake of caffeine for a 132-lb woman should be
a. avoided.
b. limited to 100 mg of coffee per day.
c. limited to 300 mg of coffee per day.
d. unlimited in quantity.
ANS: C
During pregnancy, caffeine intake should be limited. The overall conclusion is that moderate amounts of caffeine (5 to 6 mg/kg/day) throughout the day do not have negative effects on reproduction or fetal health. Thus, 60 kg (132 lb) 5 = 300 mg of caffeine/day.

DIF: Cognitive Level: Application REF: 183-184
TOP: Nursing Process: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

30. The best food choice that provides a source of folate is
a. spinach.
b. lemonade.
c. corn chips.
d. sausage patty.
ANS: A
Food sources of folate include enriched flour and grains, green leafy vegetables, legumes, soybeans, wheat germ, orange juice, asparagus, and broccoli.

DIF: Cognitive Level: Application REF: 177
TOP: Nursing Process: Implementation
MSC: NCLEX: Physiological Integrity: Physiological Adaptation, Health Promotion and Maintenance

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