MATERNAL NUTRITION NCLEX EXAM| EXAM PREP | PRACTICE
QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES |
COMPLETE STUDYGUIDE| GUARANTEED PASS | DOWNLOAD
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1. A nurse is conducting a prenatal intake assessment for a client who is at 8 weeks of
gestation with a pre-pregnancy Body Mass Index (BMI) of 22.4 kg/m². What is the
recommended total weight gain during pregnancy for this client?
A. 11 to 20 pounds (5 to 9 kg)
B. 15 to 25 pounds (7 to 11.5 kg)
C. 25 to 35 pounds (11.5 to 16 kg)
D. 28 to 40 pounds (12.5 to 18 kg)
Answer: C
Rationale: According to the Institute of Medicine (IOM) guidelines, a client with a normal pre-
pregnancy BMI (18.5 to 24.9 kg/m²) should gain between 25 and 35 pounds throughout
pregnancy. A weight gain of 11–20 lbs is recommended for obese clients, 15–25 lbs for
overweight clients, and 28–40 lbs for underweight clients.
2. A client in her first trimester asks the nurse about dietary sources of folate to prevent
neural tube defects. Which food choice indicated by the client demonstrates the best
understanding of high-folate dietary choices?
A. One cup of boiled lentils
B. One medium apple with skin
C. Three ounces of grilled chicken breast
D. One slice of white bread
Answer: A
Rationale: Legumes, particularly lentils, beans, and chickpeas, are exceptionally rich natural
sources of folate (folic acid). One cup of cooked lentils provides over 350 mcg of folate.
Apples, chicken breast, and unfortified white bread contain significantly lower quantities of
folate per serving.
,3. A nurse is reviewing dietary logs for a pregnant client diagnosed with iron-deficiency
anemia. Which beverage should the nurse instruct the client to avoid drinking concurrently
with her oral iron supplements?
A. Orange juice
B. Black tea
C. Tomato juice
D. Water with lemon
Answer: B
Rationale: Black tea contains tannins and polyphenols that bind to non-heme iron and
significantly inhibit its absorption in the gastrointestinal tract. Ascorbic acid (Vitamin C),
found in orange juice, tomato juice, and lemon water, enhances non-heme iron absorption
and should be consumed together with the supplement.
4. A pregnant client at 14 weeks of gestation reports severe morning sickness and difficulty
keeping solid food down. Which clinical measurement provides the most objective
assessment of the client's nutritional risk?
A. Weekly maternal weight trends
B. Reported daily calorie counts
C. Fundal height measurement
D. Serum human chorionic gonadotropin (hCG) levels
Answer: A
Rationale: Serial measurements of maternal weight provide the most reliable objective metric
of nutritional status and fluid volume balance. A weight loss exceeding 5% of pre-pregnancy
weight indicates hyperemesis gravidarum and severe nutritional deficit requiring clinical
intervention.
5. A nulliparous client at 12 weeks of gestation asks how many additional daily calories she
needs to consume during this first trimester. What is the nurse's correct response?
A. 0 additional calories
B. 340 additional calories
,C. 452 additional calories
D. 600 additional calories
Answer: A
Rationale: During the first trimester of pregnancy, energy requirements do not increase
significantly, and no additional daily calories are recommended above baseline requirements.
Energy needs increase by approximately 340 calories per day during the second trimester and
452 calories per day during the third trimester.
6. A client who follows a strict vegan diet is attending her first prenatal visit. The nurse
identifies that this client is at highest risk for which nutrient deficiency?
A. Vitamin C
B. Vitamin B12
C. Vitamin E
D. Potassium
Answer: B
Rationale: Vitamin B12 (cobalamin) is naturally synthesized almost exclusively in animal-
derived foods (meat, dairy, eggs). Strict vegans who do not consume animal products or
fortified foods are at high risk for Vitamin B12 deficiency, which can cause maternal
megaloblastic anemia and neurological damage in the infant.
7. A nurse is providing nutritional counseling to a pregnant client who presents with pica,
specifically craving and consuming ice (pagophagia). Which laboratory test should the
nurse anticipate ordering first?
A. Serum electrolytes
B. Complete blood count (CBC) and serum ferritin
C. Thyroid-stimulating hormone (TSH)
D. Blood urea nitrogen (BUN) and creatinine
Answer: B
Rationale: Pica, the compulsive ingestion of non-nutritive substances such as ice, clay, or
starch, is strongly associated with iron-deficiency anemia. A complete blood count (CBC) and
, serum ferritin level evaluate hemoglobin, hematocrit, and iron storage levels to confirm or
rule out underlying anemia.
8. A client at 28 weeks of gestation asks the nurse about eating seafood during pregnancy.
Which advisory regarding mercury consumption should the nurse reinforce?
A. Avoid all canned light tuna during pregnancy.
B. Consume swordfish or tilefish at least twice per week.
C. Avoid apex predator fish such as king mackerel, shark, and swordfish.
D. Limit total seafood intake to no more than 2 ounces per month.
Answer: C
Rationale: Apex predators (shark, swordfish, king mackerel, tilefish) accumulate high
concentrations of methylmercury, which is neurotoxic to the developing fetal brain. Pregnant
women are advised to avoid these species entirely and consume 8–12 ounces per week of low-
mercury seafood such as salmon, shrimp, or light tuna.
9. A pregnant client with a pre-pregnancy BMI of 31.2 kg/m² (Obesity Class I) presents for
prenatal assessment. What is the recommended total gestational weight gain target for this
client?
A. 5 to 10 pounds (2.2 to 4.5 kg)
B. 11 to 20 pounds (5 to 9 kg)
C. 25 to 35 pounds (11.5 to 16 kg)
D. 28 to 40 pounds (12.5 to 18 kg)
Answer: B
Rationale: According to the Institute of Medicine (IOM) clinical guidelines, women classified
as obese prior to pregnancy (BMI ≥ 30 kg/m²) should gain between 11 and 20 pounds (5 to 9
kg) during gestation to minimize risks of gestational diabetes, preeclampsia, and
macrosomia.
10. A nurse is reviewing dietary instructions with a client diagnosed with gestational
diabetes mellitus (GDM). Which dietary distribution strategy best promotes blood glucose
stabilization?
A. Consuming two large meals per day high in simple carbohydrates
QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES |
COMPLETE STUDYGUIDE| GUARANTEED PASS | DOWNLOAD
INSTANT PDF 2026-2027
1. A nurse is conducting a prenatal intake assessment for a client who is at 8 weeks of
gestation with a pre-pregnancy Body Mass Index (BMI) of 22.4 kg/m². What is the
recommended total weight gain during pregnancy for this client?
A. 11 to 20 pounds (5 to 9 kg)
B. 15 to 25 pounds (7 to 11.5 kg)
C. 25 to 35 pounds (11.5 to 16 kg)
D. 28 to 40 pounds (12.5 to 18 kg)
Answer: C
Rationale: According to the Institute of Medicine (IOM) guidelines, a client with a normal pre-
pregnancy BMI (18.5 to 24.9 kg/m²) should gain between 25 and 35 pounds throughout
pregnancy. A weight gain of 11–20 lbs is recommended for obese clients, 15–25 lbs for
overweight clients, and 28–40 lbs for underweight clients.
2. A client in her first trimester asks the nurse about dietary sources of folate to prevent
neural tube defects. Which food choice indicated by the client demonstrates the best
understanding of high-folate dietary choices?
A. One cup of boiled lentils
B. One medium apple with skin
C. Three ounces of grilled chicken breast
D. One slice of white bread
Answer: A
Rationale: Legumes, particularly lentils, beans, and chickpeas, are exceptionally rich natural
sources of folate (folic acid). One cup of cooked lentils provides over 350 mcg of folate.
Apples, chicken breast, and unfortified white bread contain significantly lower quantities of
folate per serving.
,3. A nurse is reviewing dietary logs for a pregnant client diagnosed with iron-deficiency
anemia. Which beverage should the nurse instruct the client to avoid drinking concurrently
with her oral iron supplements?
A. Orange juice
B. Black tea
C. Tomato juice
D. Water with lemon
Answer: B
Rationale: Black tea contains tannins and polyphenols that bind to non-heme iron and
significantly inhibit its absorption in the gastrointestinal tract. Ascorbic acid (Vitamin C),
found in orange juice, tomato juice, and lemon water, enhances non-heme iron absorption
and should be consumed together with the supplement.
4. A pregnant client at 14 weeks of gestation reports severe morning sickness and difficulty
keeping solid food down. Which clinical measurement provides the most objective
assessment of the client's nutritional risk?
A. Weekly maternal weight trends
B. Reported daily calorie counts
C. Fundal height measurement
D. Serum human chorionic gonadotropin (hCG) levels
Answer: A
Rationale: Serial measurements of maternal weight provide the most reliable objective metric
of nutritional status and fluid volume balance. A weight loss exceeding 5% of pre-pregnancy
weight indicates hyperemesis gravidarum and severe nutritional deficit requiring clinical
intervention.
5. A nulliparous client at 12 weeks of gestation asks how many additional daily calories she
needs to consume during this first trimester. What is the nurse's correct response?
A. 0 additional calories
B. 340 additional calories
,C. 452 additional calories
D. 600 additional calories
Answer: A
Rationale: During the first trimester of pregnancy, energy requirements do not increase
significantly, and no additional daily calories are recommended above baseline requirements.
Energy needs increase by approximately 340 calories per day during the second trimester and
452 calories per day during the third trimester.
6. A client who follows a strict vegan diet is attending her first prenatal visit. The nurse
identifies that this client is at highest risk for which nutrient deficiency?
A. Vitamin C
B. Vitamin B12
C. Vitamin E
D. Potassium
Answer: B
Rationale: Vitamin B12 (cobalamin) is naturally synthesized almost exclusively in animal-
derived foods (meat, dairy, eggs). Strict vegans who do not consume animal products or
fortified foods are at high risk for Vitamin B12 deficiency, which can cause maternal
megaloblastic anemia and neurological damage in the infant.
7. A nurse is providing nutritional counseling to a pregnant client who presents with pica,
specifically craving and consuming ice (pagophagia). Which laboratory test should the
nurse anticipate ordering first?
A. Serum electrolytes
B. Complete blood count (CBC) and serum ferritin
C. Thyroid-stimulating hormone (TSH)
D. Blood urea nitrogen (BUN) and creatinine
Answer: B
Rationale: Pica, the compulsive ingestion of non-nutritive substances such as ice, clay, or
starch, is strongly associated with iron-deficiency anemia. A complete blood count (CBC) and
, serum ferritin level evaluate hemoglobin, hematocrit, and iron storage levels to confirm or
rule out underlying anemia.
8. A client at 28 weeks of gestation asks the nurse about eating seafood during pregnancy.
Which advisory regarding mercury consumption should the nurse reinforce?
A. Avoid all canned light tuna during pregnancy.
B. Consume swordfish or tilefish at least twice per week.
C. Avoid apex predator fish such as king mackerel, shark, and swordfish.
D. Limit total seafood intake to no more than 2 ounces per month.
Answer: C
Rationale: Apex predators (shark, swordfish, king mackerel, tilefish) accumulate high
concentrations of methylmercury, which is neurotoxic to the developing fetal brain. Pregnant
women are advised to avoid these species entirely and consume 8–12 ounces per week of low-
mercury seafood such as salmon, shrimp, or light tuna.
9. A pregnant client with a pre-pregnancy BMI of 31.2 kg/m² (Obesity Class I) presents for
prenatal assessment. What is the recommended total gestational weight gain target for this
client?
A. 5 to 10 pounds (2.2 to 4.5 kg)
B. 11 to 20 pounds (5 to 9 kg)
C. 25 to 35 pounds (11.5 to 16 kg)
D. 28 to 40 pounds (12.5 to 18 kg)
Answer: B
Rationale: According to the Institute of Medicine (IOM) clinical guidelines, women classified
as obese prior to pregnancy (BMI ≥ 30 kg/m²) should gain between 11 and 20 pounds (5 to 9
kg) during gestation to minimize risks of gestational diabetes, preeclampsia, and
macrosomia.
10. A nurse is reviewing dietary instructions with a client diagnosed with gestational
diabetes mellitus (GDM). Which dietary distribution strategy best promotes blood glucose
stabilization?
A. Consuming two large meals per day high in simple carbohydrates
