Glendie Dela Cerna

BSN2 A6

Instruction: Enumerate the dimensions of evaluation and explain each briefly.

EFFECTIVENESS- focus is attainment of the objectives

EFFICIENCY- relates to cost whether in terms of money, time, effort, or materials

APPROPRIATENESS - is the ability to solve or correct existing problem situation, a question that involves
professional judgement.

ADEQUACY- pertains to its comprehensiveness whether all necessary activities were performed in order
to realize the intended results.

Check for Understanding

1. Which minerals and vitamins usually are recommended to supplement a pregnant

woman's diet?

a. Fat-soluble vitamins A and D

b. Water-soluble vitamins C and B6

c. Iron and folate

d. Calcium and zinc

ANSWER: C.

RATIONALE: Iron generally should be supplemented, and folic acid supplements often are needed
because folate is so important. Zinc is sometimes supplemented; most women get enough calcium.

2. With regard to nutritional needs during lactation, a maternity nurse should be aware

that:

a. The mother's intake of vitamin C, zinc, and protein now can be lower than during

pregnancy.

b. Caffeine consumed by the mother accumulates in the infant, who therefore may be

unusually active and wakeful.

c. Critical iron and folic acid levels must be maintained.

d. Lactating women can go back to their prepregnant calorie intake

ANSWER: B.

RATIONALE: A lactating woman needs to avoid consuming too much caffeine.

Vitamin C, zinc, and protein levels need to be moderately higher during lactation

than during pregnancy.

3. When counseling a client about getting enough iron in her diet, the maternity nurse

should tell her that:

a. Milk, coffee, and tea aid iron absorption if consumed at the same time as iron.

b. Iron absorption is inhibited by a diet rich in vitamin C.

c. Iron supplements are permissible for children in small doses.

d. Constipation is common with iron supplements.

ANSWER: D.

RATIONALE: With iron supplements, constipation can occur. Coffee, milk When consumed alongside
iron, tea actually inhibits iron absorption. Vitamin C promotes iron absorption. Children who consume
iron can become very ill and even die.

4. Which suggestions should the nurse include when teaching about appropriate weight

gain in pregnancy? Select all that apply.

a. Underweight women should gain 12.5 to 18 kg.

b. Obese women should gain at least 7 to 11.5 kg.

c. Adolescents are encouraged to strive for weight gains at the upper end of the

recommended scale.

d. In twin gestations, the weight gain recommended for a single fetus pregnancy should

simply be doubled.

e. Normal weight women should gain 11.5 to 16 kg.

ANSWER: A., B., C., E.

RATIONALE: Women who are underweight need to gain one of most. Obese women should gaining
weight throughout pregnancy to match the weight of the conceived goods. Due to their ongoing
growth, adolescents' bodies naturally compete with the fetus for nutrients. Though not necessarily by
twice as much, women who are carrying twins must gain more weight (typically 16 to 20 kg). Women
of average weight should gain 11.5 to 16 kg.

5. The nurse is discussing storage of breast milk with a mother whose infant is preterm

and in the special care unit. What statement would indicate that the mother needs
additional teaching?

a. "I can store my breast milk in the refrigerator for 3 months."

b. "I can store my breast milk in the freezer for 3 months."

c. "I can store my breast milk at room temperature for 8 hours."

d. "I can store my breast milk in the refrigerator for 3 to 5 days."

ANSWER: D.

RATIONALE: Breast milk that has just been expressed can be kept in the back of the

for up to four days in a clean refrigerator. It's best to use or freeze the milk within three days, though.

6. With regard to the nutrient needs of breastfed and formula-fed infants, nurses should

understand that:

a. Breastfed infants need extra water in hot climates.

b. During the first 3 months breastfed infants consumes more energy than do formula fed infants.

c. Breastfeeding infants should receive oral vitamin D drops daily at least during the first

2 months.

d. Vitamin K injections at birth are not needed for infants fed on specially enriched

formula.

ANSWER: C.

RATIONALE: From birth to age one, breastfed infants should receive a daily vitamin D supplement that
ranges from 8.5 to 10 mcg as a precaution (SACN, 2016). From four weeks after birth until the age of
five, it is advised that the infant take oral vitamin D drops containing 7–8.5 g daily. It might be too late
to stop the onset of symptoms if you wait until the infant is six months old.

7. All parents are entitled to a birthing environment in which breastfeeding is promoted

and supported. The Baby Friendly Hospital Initiative endorsed by WHO and UNICEF

was founded to encourage institutions to offer optimal levels of care for lactating

mothers. Which instruction is not included in the "Ten Steps to Successful

Breastfeeding for Hospitals"?

a. Give newborns no food or drink other than breast milk.

b. Have a written breastfeeding policy that is communicated to all staff.

c. Help mothers initiate breastfeeding within one half hour of birth.

d. Give artificial teats or pacifiers as necessary.

ANSWER: D.

RATIONALE: The "Ten Steps to a Happy Baby" do not include artificial treats or pacifiers.

Breastfeeding Success in Hospitals

8. Nutrition 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 client, the nurse is able to evaluate the client's nutritional

status by observing a number of physical signs. Which physical sign indicates to the

nurse that the client has unmet nutritional needs?

a. Normal heart rate, rhythm, and blood pressure

b. Bright, clear, and shiny eyes

c. Alert and responsive with good endurance

d. Edema, tender calves, and tingling

ANSWER: D.

RATIONALE: Symptoms of nutrient deficiencies include tingling, edema, and tender calves.

The other choice is all evidence of clients' nutritional needs being met.

9. What are the breast milk composition? Select that all apply

a. Triglycerides

b. Lactose

c. Whey proteins

d. Vitamins, Minerals, and Trace Elements

ANSWER: A., B., C., D.

RATIONALE: 3%–5% of mature human milk is made up of fat, 0.8%–0.0% of which is protein. Lactose
makes up 6.9%–7.2% of the carbohydrates, and the mineral components are expressed as ash at 0.2%.
100ml of the liquid have 60–75 kcal of energy. Compared to mature milk, colostrum has a significantly
higher protein content and a lower carbohydrate content.

10. What deficiencies to be aware of during the complementary feeding stage?

a. Vitamin A and iron

b. A

c. E
d. Vit D

ANSWER: A.

RATIONALE: The primary factor causing childhood blindness is vitamin A deficiency, and

Iodine deficiency can impair a child's ability to learn and lower his or her intellectual capacity needs.