Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 14 Maternal Nutrition

1. A pregnant teenage client is diagnosed with iron-deficiency anemia. Which nutrient should the nurse encourage her to take to increase iron absorption?
2. Vitamin A
3. Vitamin C
4. Vitamin D
5. Vitamin E

Page Ref: 294

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The pregnant client cannot tolerate milk or meat. What would the nurse recommend to the client to assist in meeting protein needs?
2. Wheat bread and pasta
3. Ice cream and peanut butter
4. Eggs and tofu
5. Beans and potatoes

Page Ref: 290

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The pregnant client states she does not want "to take all these supplements." What recommendations could the nurse make for the client?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. "Folic acid has been found to be essential for minimizing the risk of neural tube defects."
2. "You do not have to take these supplements if you think you are healthy enough."
3. "Most women do not have adequate intake of iron pre-pregnancy, and iron needs increase with pregnancy."
4. "These medications do the same thing. I will call your physician to cancel one of your medications."
5. "You should take the folic acid, but the vitamins are not that important."

Page Ref: 295

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is planning an early-pregnancy class session on nutrition. Which information should the nurse include?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Protein is important for fetal development.
2. Iron helps both mother and baby maintain the oxygen-carrying capacity of the blood.
3. Calcium prevents constipation at the end of pregnancy.
4. Zinc facilitates synthesis of R N A and D N A.
5. Vitamin A promotes development of the baby's eyes.

Page Ref: 295

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is presenting a preconception counseling class. The nurse instructs the participants that niacin intake should increase during pregnancy to promote metabolic coenzyme activity. The nurse will know that teaching has been effective if a client suggests which food as a source of niacin?
2. Fish
3. Apples
4. Broccoli
5. Milk

Page Ref: 295

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse evaluates the diet of a pregnant client and finds that it is low in zinc. The nurse knows that zinc intake should increase during pregnancy to promote protein metabolism. Which food should the nurse suggest in order to increase intake of zinc?
2. Shellfish
3. Bananas
4. Yogurt
5. Cabbage

Page Ref: 293

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preference, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. In early-pregnancy class, the nurse emphasizes the importance of 8-10 glasses of fluid per day. How many of these should be water?
2. 1 to 2
3. 2 to 4
4. 4 to 6
5. 3 to 5

Page Ref: 296

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network. | N L N Competencies: Knowledge and Science: Translate research into practice in order to promote quality and improve practices. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. What would the nurse do to accurately assess a pregnant client's food intake?
2. Assess her most recent laboratory values.
3. Ask her to complete a nutritional questionnaire.
4. Observe for signs of hunger.
5. Ask about her cooking facilities.

Page Ref: 302

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person, with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Postpartum nutritional status is determined primarily by assessing which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Dietary history
2. Menstrual history
3. Mother's weight
4. Hemoglobin levels
5. Mother's height

Page Ref: 301

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 3 Compare nutritional needs during pregnancy, the postpartum period, and lactation with nonpregnant requirements.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The breastfeeding mother is concerned that her milk production has decreased. The nurse knows that further client teaching is needed based on which statement?
2. "I am drinking a minimum of 8 to 10 glasses of liquid a day."
3. "I have started cutting back on my protein intake."
4. "At least three times a day, I drink a glass of milk."
5. "My calorie intake is higher than during the pregnancy."

Page Ref: 301—302

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 8 Compare nutritional counseling issues for breastfeeding and formula-feeding mothers.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is preparing for a postpartum home visit. The client has been home for a week, is breastfeeding, and experienced a third-degree perineal tear after vaginal delivery. The nurse should assess the client for which of the following?
2. Dietary intake of fiber and fluids
3. Dietary intake of folic acid and prenatal vitamins
4. Return of hemoglobin and hematocrit levels to baseline
5. Return of protein and albumin to predelivery levels

Page Ref: 292

Cognitive Level: Analyzing

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Personal and Professional Development: Identify problems. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 3 Compare nutritional needs during pregnancy, the postpartum period, and lactation with nonpregnant requirements.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Which of the following is important for the development of the central nervous system of the fetus?
2. Calcium and phosphorus
3. Essential fatty acids
4. Iron
5. Vitamin D

Page Ref: 292

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A pregnant client who was of normal pre-pregnancy weight is now 30 weeks pregnant. She asks the nurse what appropriate weight gain for her should be. What is the nurse's best response?
2. "25-35 pounds"
3. "30-40 pounds"
4. "17-18 pounds"
5. "Less than 15 pounds"

Page Ref: 288

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 1 Describe the recommended levels of weight gain during pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A client presents to the antepartum clinic with a history of a 20-pound weight loss. Her pregnancy test is positive. She is concerned about gaining the weight back, and asks the nurse if she can remain on her diet. What is the nurse's best response?
2. "As long as you supplement your diet with the prenatal vitamin, the amount of weight you gain in pregnancy is not significant."
3. "I understand that gaining weight after such an accomplishment might not appeal to you but weight gain during pregnancy is important for proper fetal growth."
4. "Dieting during pregnancy is considered child neglect."
5. "Excessive weight gain in pregnancy is due to water retention, so weight loss following birth will not be an issue."

Page Ref: 288

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 1 Describe the recommended levels of weight gain during pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The prenatal clinic nurse is caring for a 15-year-old client who is at 8 weeks' gestation. The client asks the nurse why she is supposed to gain so much weight. What is the best response by the nurse?
2. "Gaining 25-35 pounds is recommended for healthy fetal growth."
3. "It's what your certified nurse-midwife recommended for you."
4. "Inadequate weight gain delays lactation after delivery."
5. "Weight gain is important to ensure that you get enough vitamins."

Page Ref: 288

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patient or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is planning an educational session for pregnant vegans. What information should the nurse include?
2. Eating beans and rice provides complete protein needs.
3. Soy is not a good source of protein for vegans.
4. Rice contains a high level of vitamin B12.
5. Vegan diets are excessively high in iron.

Page Ref: 296

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 4 Plan adequate prenatal vegetarian diets based on the nutritional requirements of pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A pregnant client who is a lacto-vegetarian asks the nurse for assistance with her diet. What instruction should the nurse give?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. "Protein is important; therefore, the addition of one serving of meat a day is necessary."
2. "A daily supplement of vitamin B12 is important."
3. "The high fiber in a vegetarian diet is dangerous for pregnant women."
4. "Eggs are important to add to your diet. Eat six eggs per week."
5. "Milk products contain protein, but they are very low in iron."

Page Ref: 296

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 4 Plan adequate prenatal vegetarian diets based on the nutritional requirements of pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A pregnant client confides to the nurse that she is eating laundry starch daily. The nurse should assess the client for which of the following?
2. Alopecia
3. Weight loss
4. Iron deficiency anemia
5. Fecal impaction

Page Ref: 299

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan, and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | N L N Competencies: Personal and Professional Development: Identify problems. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 5 Explain the ways in which various physical, psychosocial, and cultural factors can affect nutritional intake and status in the nursing care management of pregnant women.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The kosher diet followed by many Jewish people forbids the eating of what foods?
2. Pig products and shellfish
3. Dairy products
4. All animal products
5. Dairy products and eggs

Page Ref: 298

Cognitive Level: Remembering

Client Need/Sub: Health Promotion and Maintenance: Lifestyle Choices

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅰ. 5. Apply knowledge of social and cultural factors to the care of diverse populations. | N L N Competencies: Relationship-Centered Care: Appreciate the patient as a whole person with his or her own life story and ideas about the meaning of health or illness. | Nursing/Integrated Concepts: Nursing Process: Assessment.

Learning Outcome: 5 Explain the ways in which various physical, psychosocial, and cultural factors can affect nutritional intake and status in the nursing care management of pregnant women.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is working with a pregnant 14-year-old. Which statement indicates that additional education is required?
2. "Because I am still growing, I need more calories than a pregnant adult."
3. "I need to eat fruit and vegetables every day to get enough vitamins."
4. "My favorite food is pizza, and I eat it once a week."
5. "Because I don't eat breakfast, I'll have to eat more at supper."

Page Ref: 300

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. When preparing nutritional instruction, which pregnant client would the nurse consider the highest priority?
2. 40-year-old gravida 2
3. 22-year-old primigravida
4. 35-year-old gravida 4
5. 15-year-old nulligravida

Page Ref: 300

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the health care team. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Which statement is best to include when teaching a pregnant adolescent about her nutritional needs in pregnancy?
2. "It is important to eat iron-rich foods like meat every day."
3. "Calcium and milk aren't needed until the third trimester."
4. "Folic acid intake is the key to having a healthy baby."
5. "You just need to pay attention to what you eat now."

Page Ref: 300

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The school nurse is planning a class about nutrition for pregnant teens, several of whom have been diagnosed with iron-deficiency anemia. In order to increase iron absorption, the nurse would encourage the teens to consume more of what beverage?
2. Gatorade
3. Orange juice
4. Milk
5. Green tea

Page Ref: 293—294

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The pregnant teen who was prescribed prenatal vitamins at her initial prenatal visit states that she does not like to take them. How should the nurse respond?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. "Folic acid has been found to be essential for minimizing the risk of neural tube defects."
2. "You do not have to take these supplements if you think you are healthy enough."
3. "These medications do the same thing. I will call your doctor to cancel one of your medications."
4. "You can trust your doctor to know what you need."
5. "You need the supplements because your dietary intake may not be adequate for fetal development."

Page Ref: 300

Cognitive Level: Applying

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. C. 4. Seek learning opportunities with patients who represent all aspects of human diversity. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 7 Describe basic factors a nurse should consider when offering nutritional counseling to a pregnant adolescent.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is preparing a prenatal class about infant feeding methods. The maternal nutritional requirements for breastfeeding and formula-feeding will be discussed. What statement should the nurse include?
2. "Breastfeeding requires a continued high intake of protein and calcium."
3. "Formula-feeding mothers should protect their health with a lot of calcium."
4. "Producing breast milk requires calories, but any source of food is fine."
5. "Formula-feeding mothers need a high protein intake to avoid fatigue."

Page Ref: 301—302

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 8 Compare nutritional counseling issues for breastfeeding and formula-feeding mothers.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Women with eating disorders who become pregnant are at risk for a variety of complications including which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Premature birth
2. Too many nutrients available for the fetus
3. Miscarriage
4. High birth weight
5. Perinatal mortality

Page Ref: 299

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards: Q S E N Competencies: Ⅴ. B. 4. Communicate observations or concerns related to hazards and errors to patients, families, and the healthcare team. | A A C N Essentials Competencies: Ⅸ. 12. Create a safe environment that results in high-quality patient outcomes. | N L N Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning.

Learning Outcome: 5 Explain the ways in which various physical, psychosocial, and cultural factors can affect nutritional intake and status in the nursing care management of pregnant women.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Carbohydrates provide the body's primary source of energy as well as fiber necessary for proper bowel functioning. If the carbohydrate intake is not adequate, the body will use which of the following for energy?
2. Iron
3. Protein
4. Vitamin C
5. Vitamin D

Page Ref: 292

Cognitive Level: Understanding

Client Need/Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅰ. 1. Integrate theories and concepts from liberal education into nursing practice. | N L N Competencies: Knowledge and Science: Translate research into practice in order to promote quality and improve practices. | Nursing/Integrated Concepts: Nursing Process: Implementation.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. Before becoming pregnant, a patient had a B M I of 28.5 and weighed 150 l b s. What should be the minimum weight of this patient upon delivery?

Page Ref: 288

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning: Nursing Process.

Learning Outcome: 1 Describe the recommended levels of weight gain during pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A patient who is 12 weeks pregnant is counseled to increase her protein intake by an additional 40 grams per day. If each gram of protein is 4 calories, how many additional calories per day should this patient ingest to reach the recommended 300 calories more per day during the pregnancy?

Page Ref: 292

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning: Teaching/Learning.

Learning Outcome: 1 Describe the recommended levels of weight gain during pregnancy.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. The nurse is instructing a pregnant patient on the importance of increasing her dietary intake of vitamin E. Which foods should the nurse recommend to meet this dietary need?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Milk
2. Eggs
3. Liver
4. Green salads
5. Whole grain bread

Page Ref: 294

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A patient asks if seafood is permitted during pregnancy. Which foods should the nurse encourage the patient to consume during this time?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Shrimp
2. Catfish
3. Salmon
4. Swordfish
5. Canned light tuna

Page Ref: 293

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 2 Explain the significance of specific nutrients in the diet of the pregnant woman.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.

1. A breastfeeding mother is instructed to increase her daily caloric intake an additional 500 calories each day. If her daily intake of protein is 65 grams at 4 calories per gram, how many calories will this patient need to ingest to reach the recommended daily intake?

Page Ref: 301

Cognitive Level: Applying

Client Need/Sub: Health Promotion and Maintenance

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning; Teaching/Learning.

Learning Outcome: 8 Compare nutritional counseling issues for breastfeeding and formula-feeding mothers.

M N L L O: Demonstrate understanding of maternal nutrition during pregnancy.