Test Bank for Maternity Nursing Pt 3

14. Which nutritional recommendation about fluids is accurate? a. A woman’s daily intake should be eight to 10 glasses (2.3 L) of water, milk, and/or juice. b. Coffee should be limited to no more than 2 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. ANS: A Feedback A Eight to 10 glasses is the standard for fluids; however, they should be the right fluids. B All beverages containing caffeine, including tea, cocoa, and some soft drinks, should be avoided or drunk only in limited amounts. C Artificial sweeteners, including aspartame, have no ill effects on the normal mother or fetus. However, mothers with phenylketonuria should avoid aspartame. D No evidence indicates that prenatal fluoride consumption reduces childhood tooth decay. However, it still helps the mother. DIF: Cognitive Level: Comprehension REF: 245 OBJ: Client Needs: Physiologic Integrity 15. TOP: Nursing Process: Planning Which vitamins or minerals can lead to congenital malformations of the fetus if taken in excess by the mother? a. Zinc b. Vitamin D c. Folic acid d. Vitamin A ANS: D Feedback A Zinc is vital to good maternity and fetal health but is highly unlikely to be consumed in excess. B Vitamin D is vital to good maternity and fetal health but is highly unlikely to be consumed in excess. C Folic acid is vital to good maternity and fetal health but is highly unlikely to be consumed in excess. D Vitamin A taken in excess causes a number of problems. An analog of vitamin A appears in prescribed acne medications, which must not be taken during pregnancy. DIF: Cognitive Level: Comprehension REF: 249 OBJ: Client Needs: Health Promotion and Maintenance Process: Planning 16. a. TOP: Nursing 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: Preeclampsia. b. Pyrosis. c. Pica. d. Purging. ANS: C Feedback A Preeclampsia is a complication of pregnancy. B Pyrosis is more commonly known as heartburn. C The consumption of foods low in nutritional value or of nonfood substances (e.g., dirt, laundry starch) is called pica. D Purging consists of self-induced vomiting. DIF: Cognitive Level: Knowledge REF: 251 OBJ: Client Needs: Health Promotion and Maintenance Process: Diagnosis 17. TOP: Nursing 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. ANS: A Feedback A Interestingly, some women can tolerate tart or salty foods when they are nauseous. B The woman should avoid drinking too much when nausea is most likely, but she should be sure to make up the fluid levels later in the day when she feels better. C The woman should avoid brushing her teeth immediately after eating. D A small snack of cereal and milk or yogurt before bedtime may help the stomach in the morning. DIF: Cognitive Level: Knowledge OBJ: Client Needs: Physiologic Integrity 18. REF: 259 TOP: Nursing Process: Planning Three servings of milk, yogurt, or cheese plus two servings of meat, poultry, or fish will adequately supply the recommended amount of protein for the 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 patient 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. ANS: B Feedback A High levels of mercury can harm the developing nervous system of the fetus. It is essential for the nurse to assist the patient in understanding the differences between numerous sources of this product. A pregnant patient can eat as much as 12 ounces a week of canned light tuna; however, canned white, albacore, or tuna steaks contain higher levels of mercury and should be limited to no more than 6 ounces per week. B As a precaution, the pregnant patient should avoid eating all of these and the less common tilefish. Additional information on levels of mercury in commercially caught fish is available at www.cfsan.fda.gov. C This is a common misconception. Pregnant women and mothers of young children should check with local advisories about the safety of fish caught by families and friends in nearby bodies of water. If no information is available, these fish sources should be avoided or limited to less than 6 ounces or be the only fish consumed that week. D Commercially caught fish that are low in mercury include salmon, shrimp, pollock, or catfish. The pregnant patient may eat up to 12 ounces per week. DIF: Cognitive Level: Comprehension REF: 245 OBJ: Client Needs: Health Promotion and Maintenance Process: Planning 19. TOP: Nursing Nutrition is one of the most significant factors in influencing the outcome of a pregnancy. It is an alterable and important preventive measure for a variety of potential problems such as low birth weight and prematurity. While completing the physical assessment of the pregnant patient, the nurse can evaluate the patient’s nutritional status by observing a number of physical signs. Which sign would indicate that the patient 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 ANS: D Feedback A The malnourished pregnant patient may display rapid heart rate, abnormal rhythm, enlarged heart, and elevated blood pressure. B A patient receiving adequate nutrition will have bright, shiny eyes with no sores and moist, pink membranes. Pale or red membranes, dryness, infection, dull appearance of the cornea, or blue sclerae are all signs of poor nutrition. C This patient is well nourished. Cachexia, listlessness, and tiring easily would be indications of poor nutritional status. D The physiologic changes of pregnancy may complicate the interpretation of physical findings. Lower extremity edema often occurs when caloric and protein deficiencies are present; however, it may also be a common physical finding during the third trimester. It is essential that the nurse complete a thorough health history and physical assessment and request further laboratory testing if indicated. DIF: Cognitive Level: Analysis OBJ: Client Needs: Physiologic Integrity REF: 256 TOP: Nursing Process: Assessment MULTIPLE RESPONSE 1. Most women with uncomplicated pregnancies can use the nurse as their primary source for nutritional information. The nurse or midwife should refer a patient to a registered dietitian for in-depth nutritional counseling when which of the following exist(s)? (Choose all that apply.) a. Preexisting or gestational illness such as diabetes b. Ethnic or cultural food patterns c. Obesity d. Vegetarian diets