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Maternal and Fetal Nutrition (Perry )Maternal Child Nursing Care, 6th Edition

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Maternal and Fetal Nutrition (Perry )Maternal Child Nursing Care, 6th Edition Chapter 09: Exam questions with verified Answers 1. 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 1.8 kg (4 lbs) since conception. How would the nurse interpret this? a. This weight gain indicates possible gestational hypertension. b. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR). c. This weight gain cannot be evaluated until the woman has been observed for several more weeks. d. The woman's weight gain is appropriate for this stage of pregnancy. - ANSWER-ANS: D The statement "The woman's weight gain is appropriate for this stage of pregnancy" is accurate. This woman's BMI is within 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 does not apply to this patient. 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 prepregnancy weight for the woman's height. A commonly used method of evaluating the appropriateness of weight for height is the BMI. Although weight gain does indicate risk for IUGR, this does not apply to this patient. Weight gain should occur at a steady rate throughout the pregnancy. The optimal rate of weight gain also depends on the stage of the pregnancy.

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Maternal and Fetal Nutrition (Perry )Maternal
Child Nursing Care, 6th Edition
Chapter 09: Exam questions with verified Answers



1. 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 1.8 kg (4 lbs) since conception.
How would the nurse interpret this?

a. This weight gain indicates possible gestational hypertension.

b. This weight gain indicates that the woman's infant is at risk for intrauterine growth restriction (IUGR).

c. This weight gain cannot be evaluated until the woman has been observed for several more weeks.

d. The woman's weight gain is appropriate for this stage of pregnancy. - ANSWER-ANS: D

The statement "The woman's weight gain is appropriate for this stage of pregnancy" is accurate. This
woman's BMI is within 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 does not apply to this
patient. 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 prepregnancy weight
for the woman's height. A commonly used method of evaluating the appropriateness of weight for
height is the BMI. Although weight gain does indicate risk for IUGR, this does not apply to this patient.
Weight gain should occur at a steady rate throughout the pregnancy. The optimal rate of weight gain
also depends on the stage of the pregnancy.



.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 in the following situations: (Select all that apply.)

a. preexisting or gestational illness such as diabetes.

b. ethnic or cultural food patterns.

c. obesity.

d. vegetarian diet.

e. allergy to tree nuts. - ANSWER-ANS: A, B, C, D

, The nurse should be especially aware that conditions such as diabetes can require in-depth dietary
planning and evaluation. To prevent issues with hypoglycemia and hyperglycemia and an increased risk
for perinatal morbidity and mortality, this patient would benefit from a referral to a dietitian.
Consultation with a dietitian may ensure that cultural food beliefs are congruent with modern
knowledge of fetal development and that adjustments can be made to ensure that all nutritional needs
are met. The obese pregnant patient may be under the misapprehension that because of her excess
weight little or no weight gain is necessary. According to the Institute of Medicine, a patient with a body
mass index in the obese range should gain at least 7 kg to ensure a healthy outcome. This patient may
require in-depth counseling on optimal food choices. The vegetarian patient needs to have her dietary
intake carefully assessed to ensure that the optimal combination of amino acids and protein intake is
achieved. Very strict vegetarians (vegans) who consume only plant products may also require vitamin B
and mineral supplementation. A patient with a food allergy would not alter that component of her diet
during pregnancy; therefore, no additional consultation is necessary.



.10. A woman has come to the clinic for preconception counseling because she wants to start trying to
get pregnant in 3 months. She can expect the following advice:

a. "Discontinue all contraception now."

b. "Lose weight so that you can gain more during pregnancy."

c. "You may take any medications you have been taking regularly."

d. "Make sure that you include adequate folic acid in your diet." - ANSWER-ANS: D

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 periconception
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 appropriate
advice. Losing weight is not appropriate advice. Depending on the type of medication the woman is
taking, continuing its use may not be appropriate.



.11. To prevent gastrointestinal upset, patients should be instructed to take iron supplements:

a. on a full stomach.

b. at bedtime.

c. after eating a meal.

d. with milk. - ANSWER-ANS: B

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.

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