Exam 2- Maternity

A pregnant client complains of constipation during pregnancy. This is probably caused by

increased levels of the hormone progesterone

If a woman has had preeclampsia and hypertension in a previous pregnancy, then during this pregnancy she should

continue her regular sodium intake

For a woman with a healthy prepregnancy weight, gaining a total of 31 pounds throughout pregnancy would be considered

within the current recommended range for weight gain.

If an obese woman is 6 months pregnant and has gained about 8 lbs so far, her health care provider should recommend that she

continue to gain weight at about the same rate throughout the pregnancy

The nutrient that pregnant women are most likely to need to take in the form of a supplement is

iron

The health care provider would be most concerned if a pregnant woman told him or her that she

has to taste wines to pair with foods for catering events.

If a woman in her last trimester of pregnancy has marked edema, what else should be evaluated?

Blood pressure and urine protein levels

Recommendations for treatment of gestational diabetes include

dietary control.

The best way for a nursing mother to increase her milk supply is to

nurse her infant more often and for longer periods of time

The most potentially harmful situation for an infant is

running out of infant formula and using whole milk for a few days instead

A meal that a family should not share with their 10-month-old infant is

peanut butter and honey sandwich

To prevent baby bottle tooth decay in infants who need a bottle at bedtime, the bottle should not contain

any liquid other than water

The best way to encourage children to consume adequate nutrients with less than 30% of kilocalories from fat is to

include plenty of fruits, vegetables, and whole grains.

If a 2-year-old is drinking four 8-oz cups of milk daily, he or she is probably drinking

too much milk, which may displace other important foods from the diet.

A mother of a toddler tells you that her child drinks several cups of fruit juice each day. How would you respond?

Even though fruit juice contains some micronutrients, intake should be limited because it also has high levels of natural sugar.

If a child does not like a food when he or she tries it for the first time, the

child should be offered the food at least 8 to 10 times at other meals before he or she decides whether he or she likes it

The child most likely to develop type 2 diabetes is the one who

is obese.

An example of a breakfast that would meet the School Breakfast Program requirements would be

toast with peanut butter, banana, and milk.

The person who is most likely to have an inadequate calcium intake is a(n)

adolescent girl who is a competitive gymnast

The best way to reduce the risk of asphyxiation (choking) in toddlers is to make sure that they

sit down while eating and chew foods well.

Lead poisoning may be diagnosed at the same time as

iron deficiency anemia

The lifestyle factor that would contribute most to a childs becoming overweight is

being home alone after school every day.

Interventions for obese children should focus on

healthy lifestyle behaviors

An example of a child who is at high risk for iron deficiency anemia is the child

who lives in an African American low-income family

As adults age, they are likely to want to add _____ to their food.

more salt

Protein needs continue to increase until about age 24 years because

lean body mass continues to increase

One way a 50-year-old individual can help maintain lean body mass and minimize increases in body fat is to

engage in regular exercise, including strength training

In comparison with the iron needs of younger women, those of older women

decrease because of menopause.

If an older adult is confused, he or she may have a deficiency of

water

An older adults nutritional status may decline if he or she has arthritis because

the ability to prepare food may be impaired.

The best way for older adults who live in cold climates to meet their increased need for vitamin D is to

take vitamin D supplements

If an older adult has lost several teeth and complains that foods are bitter or tasteless, he or she may have a deficiency of

zinc

An example of someone who is at high risk for malnutrition and weight loss is a(n)

88-year-old widow who lives alone

In adults older than 80, the greatest dietary concern is

maintaining adequate nutritional status.

An appropriate way to maintain a healthy body weight includes

learning to respond to actual hunger cues.

The person most likely to be eligible for the Supplemental Nutrition Assistance Program (SNAP) is a

single mother with three children who works part time.

The program that would be most helpful for a lonely 75-year-old widow who has been gradually losing weight since her husbands death is the _____ Program.

Senior Nutrition

After going through menopause, a woman may need to pay extra attention to her food and activity habits because she is now at increased risk for

osteoporosis

Alcohol abuse is associated with poor nutritional status because

alcoholic beverages displace healthful foods from the diet.

An example of rationalizing is

using a busy schedule to justify poor food choices.

The breastfeeding client should be taught a safe method to remove her breast from the babys mouth. Which suggestion by the nurse is most appropriate?

Break the suction by inserting your finger into the corner of the infants mouth.

Which woman is most likely to continue breastfeeding beyond 6 months?

A woman who avoids using bottles

In which condition is breastfeeding contraindicated?

Human immunodeficiency virus infection

Which type of formula should not be diluted before being administered to an infant?

Ready to use

How many kilocalories per kilogram (kcal/kg) of body weight does a full-term formula-fed infant need each day?

100 to 110

How many milliliters per kilogram (mL/kg) of fluids does a newborn need daily for the first 3 to 5 days of life?

60 to 100

Which is the hormone necessary for milk production?

Prolactin

Which recommendation should the nurse make to a client to initiate the milk ejection reflex?

Place the infant to the breast

Which is the first step in assisting the breastfeeding mother?

Assess the womans knowledge of breastfeeding

Which is an important consideration in positioning a newborn for breastfeeding?

Placing the infant at nipple level facing the breast

The client should be taught that when her infant falls asleep after feeding for only a few minutes, she should do which of the following?

Unwrap and gently arouse the infant.

To prevent breast engorgement, what should the new breastfeeding mother be instructed to do?

Breast-feed frequently and for adequate lengths of time.

What is the difference between the aseptic and terminal methods of sterilization?

The terminal method sterilizes the prepared formula at the same time it sterilizes the equipment

How many ounces will an infant who is on a 4-hour feeding schedule need to consume at each feeding to meet daily caloric needs?

3.5

A new mother is concerned because her 1-day-old newborn is taking only 1 oz at each feeding. What should the nurse explain?

The infants stomach capacity is small at birth but will expand within a few days.

As the nurse assists a new mother with breastfeeding, the mother asks, If formula is prepared to meet the nutritional needs of the newborn, what is in breast milk that makes it better? The nurses best response is that it contains:

important immunoglobulins.

What should the nurse explain when responding to the question, Will I produce enough milk for my baby as she grows and needs more milk at each feeding?

The mothers milk supply will increase as the infant demands more at each feeding.

Which should the nurse recommend to the postpartum client to prevent nipple trauma?

Position the infant so the nipple is far back in the mouth.

A breastfeeding client who was discharged yesterday calls to ask about a tender hard area on her right breast. What should be the nurses first response?

Try massaging the area and apply heat; it is probably a plugged duct.

Which is an important consideration about the storage of breast milk?

Can be kept refrigerated for 48 hours

What is the most serious consequence of propping an infants bottle?

Aspiration

A new mother asks why she has to open a new bottle of formula for each feeding. What is the nurses best response?

Bacteria can grow rapidly in warm milk.

A new mother asks whether she should feed her newborn colostrum because it is not real milk. The nurses best answer includes which information?

Colostrum is high in antibodies, protein, vitamins, and minerals.

A newborn infant weighs 7 pounds, 2 ounces, on the fifth day of life. How much water should be given to the newborn based on required fluid needs?

Fluid replacement should be based on weight and calculated in the range of 60 to 100 mL/kg.

A mother is breastfeeding her newborn infant but is experiencing signs of her breasts feeling tender and full in between infant feedings. She asks if there are any suggestions that you can provide to help alleviate this physical complaint. The best nursing response would be to:

have the client put the infant to her breast more frequently

A mother is attempting to breastfeed her infant in the hospital setting. The infant is sleepy and displays some audible swallowing, the maternal nipples are flat, and the breasts are soft. The nurse has attempted to teach the mother positioning on one side, and now the mother wants to place the infant to the breast on the other side. Based on LATCH scores, the nurse would designate a score of:

6 and further teach and assist the mother in feeding activities

A mother conveys concern over the fact that she is not sure if her newborn child is getting enough nutrients from breastfeeding. This is the babys first clinic visit after birth. What information can you provide that will help alleviate her fears about nutrient status for her newborn?

Monitor the infants output; as long as at least six or more diapers are changed in a 24-hour period, that should be sufficient.

A breastfeeding mother asks the postpartum nurse if any supplementation is necessary once her breast milk comes in. What is the nurses best response?

Breast milk is low in vitamin D and supplementation with 400 IU is recommended.

A new mother is preparing for discharge. She plans on bottle feeding her baby. Which statement indicates to the nurse that the mom needs more information about bottle feeding?

I should encourage my baby to consume the entire amount of formula prepared for each feeding.

A client who is receiving a pitocin (Oxytocin) infusion for the augmentation of labor is experiencing a contraction pattern of more than eight contractions in a 10-minute period. Which intervention would be a priority?

Stop the pitocin infusion.

The nurse is teaching a postpartum client different holds for breastfeeding. Which of the following figures depicts the football hold frequently used for clients who have had a cesarean birth?

For the football or clutch hold

Late in pregnancy, the clients breasts should be assessed by the nurse to identify any potential concerns related to breastfeeding. Which of the following nipple conditions make it necessary to intervene before birth. (Select all that apply.)

Flat nipples

Inverted nipples

Nipples that contract when compressed

Which interventions may relieve symptoms of colic in the infant? (Select all that apply.)

Burping infant frequently during feedings

Feeding infant placed in an upright position

Providing chamomile tea to infant

For which infant should the nurse anticipate the use of soy formula? (Select all that apply.)

Infant with galactosemia

Infant with lactase deficiency

Infant with a malabsorption disorder

A new mother asks the nurse, How will I know early signs of hunger in my baby? The nurses best response is which of the following? (Select all that apply.)

Rooting

Lip smacking

Sucking on the hands

A woman in the 34th week of pregnancy says to the nurse, "I still feel like having intercourse with my husband." The woman's pregnancy has been uneventful. The nurse responds based on the understanding that:

it is safe to have intercourse at this time.

On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:

Chadwick's sign.

A nurse is teaching a pregnant couple about childbirth education. The nurse determines that the teaching was successful when the couple makes which statement?

"We'll know what to do to actively take part in our child's birth."

When assessing a woman at follow-up prenatal visits, the nurse would anticipate which procedure to be performed?

fundal height measurement

When preparing a woman for an amniocentesis, the nurse would instruct her to perform which action?

Empty the bladder.

A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year-old son 6. born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:

4 1 1 1 3.

A client's last menstrual period was April 11. Using Nagele's rule, her estimated date of birth (EDB) would be:

January 18.

During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as:

reactive pattern.

A client's maternal serum alpha-fetoprotein (MSAFP) level was unusually elevated at 17 weeks. The nurse suspects which condition?

open spinal defects

When the nurse is assessing a pregnant woman in her last trimester, which question would be most appropriate to use to gather information about weight gain and fluid retention?

"How swollen do your ankles appear before you go to bed?

A pregnant woman in the 36th week of gestation reports that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention is appropriate for the nurse to suggest?

"Try elevating your legs when you sit."

A pregnant woman needs an update in her immunizations. Which vaccination would the nurse ensure that the woman receives?

hepatitis b

A pregnant woman is flying across the country to visit her family. After teaching the woman about traveling during pregnancy, which statement indicates that the teaching was successful?

"I'll get up and walk around the airplane about every 2 hours."

Which statement would the nurse include when teaching a pregnant woman about chorionic villi sampling?

"You'll have an ultrasound first and then the test."

A biophysical profile has been completed on a pregnant woman. The nurse interprets which score as normal?

9

A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomfort as common during the first trimester? Select all that apply.

urinary frequency

breast tenderness

cravings

A nurse is reviewing the medical record of a pregnant woman and notes that she is gravid II. The nurse interprets this to indicate the number of:

pregnancies.

A nurse measures a pregnant woman's fundal height and finds it to be 28 cm. The nurse interprets this to indicate that the client is at how many weeks' gestation?

28 weeks' gestation

A pregnant woman has a rubella titer drawn on her first prenatal visit. The nurse explains that this test measures:

immunity to German measles.

A nurse is working with a pregnancy woman to schedule follow-up visits for her pregnancy. Which statement by the woman indicates that she understands the scheduling?

"From now until I'm 28 weeks, I'll be coming once a month."

A nurse is describing the various birth methods to pregnant couples. Which information would the nurse include as part of the Lamaze method?

use of specific breathing and relaxation techniques

After teaching a group of prospective new parents about the different perinatal education methods, the nurse determines that the teaching was successful when the parents identify which method as the Bradley method?

partner-coached method

A pregnant woman in her second trimester tells the nurse, "I've been passing a lot of gas and feel bloated." Which suggestion would be helpful for the woman? Select all that apply.

"Watch how much beans and onions you eat."

"Try exercising a little more."

"Some say that eating mints can help."

"Cut down on your intake of cheeses."

When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes which goal as the primary one?

Provide knowledge and skills to actively participate in birth and parenting.

During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute) and irregular, with bilateral crackles in the lower lung bases. The nurse would develop a plan of care identifying interventions to promote which area as the priority?

gas exchange