Nutrition and Diet Therapy 12th Edition

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Chapter 10 Nutrition During Pregnancy and Lactation

MULTICHOICE

1. ​What is a normal weight gain during pregnancy for an underweight woman?

(A) ​between 25 and 35 pounds

(B) ​between 28 and 40 pounds

(C) ​at least 40 pounds

(D) ​no more than 35 pounds

Answer : (D)

2. How many additional calories a day should a woman consume during the second and third
trimesters?​

(A) ​second trimester an additional 240 calories, third trimester 350 calories

(B) ​second trimester an additional 440 calories, third trimester 550 calories

(C) ​second trimester an additional 340 calories, third trimester 450 calories

(D) ​no extra calories are needed during pregnancy

Answer : (C)

3. Which of the following nutrients does NOT need to be increased during pregnancy?​

(A) ​protein

(B) ​vitamin C

(C) ​iron

(D) ​vitamin A

Answer : (D)

4. Why is there an increased need for B vitamins during pregnancy?​

(A) ​for development of red blood cells

(B) ​essential for development of infant's bones and teeth

(C) ​to provide an increase of hemoglobin

(D) ​essential for a fetus's collagen development

Answer : (A)

5. _____ is the condition when nausea persists and becomes so severe that it is life-threatening.​

(A) ​Parenteral gravidarum

(B) ​Morning sickness

(C) ​Hyperemesis gravidarum

(D) ​Binge-purge gravidarum

Answer : (C)

6. What two conditions can be relieved by eating high-fiber foods?​

(A) ​morning sickness and weight gain

(B) ​hypertension and heartburn

(C) ​hypertension and anemia

(D) ​constipation and hemorrhoids

Answer : (D)

7. ​How can heartburn be relieved?

(A) ​eating three meals a day

(B) ​eating small, frequent meals

(C) ​drinking three cups of milk a day

(D) ​eating up to 25 g of fiber a day

Answer : (B)

8. _____ is the craving for nonfood substances such as starch or clay.​

(A) ​Pico

(B) ​Anemia

(C) ​Pica

(D) ​Picanemia

Answer : (C)
9. ​Which nutrient is often deficient in women who are diagnosed with megaloblastic anemia?

(A) ​vitamin C

(B) ​folate

(C) ​iron

(D) ​copper

Answer : (B)

10. ​The ingestion of alcohol while pregnant can result in _____.

(A) ​weight gain

(B) ​hypertension

(C) ​spontaneous abortions

(D) ​fetal alcohol syndrome

Answer : (D)

11. The infant's sucking initiates the release of _____ (a hormone), which causes the ejection of milk
into the infant's mouth.​

(A) ​oxytocin

(B) ​aldosterone

(C) ​insulin

(D) ​prolactin

Answer : (A)

12. During lactation, approximately how many extra calories are recommended daily for the first 6
months?​

(A) ​300

(B) ​400

(C) ​500

(D) ​1,000

Answer : (C)

13. Which vitamin, in excess, can cause birth defects?​

(A) ​vitamin C

(B) ​vitamin E

(C) ​vitamin A

(D) ​vitamin D

Answer : (C)

14. Which of the following are pregnant adolescents particularly prone to?​

(A) ​gestational diabetes

(B) ​weight gain

(C) ​pregnancy-induced hypertension

(D) ​abruptio placentae

Answer : (C)

15. ​What is the approximate number of calories in an ounce of human milk?

(A) ​10 calories

(B) ​20 calories

(C) ​30 calories

(D) ​40 calories

Answer : (B)

16. A nursing mother's use of caffeine may cause the following in her infant.​

(A) ​abnormal growth

(B) ​blindness

(C) ​irritability

(D) ​fatigue

Answer : (C)

17. The U.S. Public Health Service and the March of Dimes recommend that all women of
childbearing age take a multivitamin or _____ of folic acid daily.​

(A) ​800 µg
(B) ​800 mg

(C) ​400 mg

(D) ​400 µg

Answer : (D)

18. The need for _____ increases during pregnancy because of the increased blood volume during
pregnancy.​

(A) ​calcium

(B) ​iron

(C) ​zinc

(D) ​selenium

Answer : (B)

19. Pregnancy-induced hypertension is characterized by _____.​

(A) ​hyperemesis gravidarum

(B) ​pica

(C) ​proteinuria

(D) ​eclampsia

Answer : (C)

20. ​Anemia may be caused by _____ deficiency.

(A) ​iron

(B) ​folate

(C) ​protein

(D) ​zinc

Answer : (C)

21. Macrosomia refers to birthweight of over _____ pounds.​

(A) ​7

(B) ​8
(C) ​9

(D) ​10

Answer : (C)

ESSAY

22. Weight gain during pregnancy is natural and necessary for the infant to develop normally and
the mother to retain her health. Describe the recommended weight gain. Include variations for these
conditions: adolescent, obesity, multiple infants, underweight, and each trimester. Correlate with
the number of additional calories needed to achieve the desired gain.​

Graders Info :

Average size: 25-35 lb gain; underweight: 28-40 lb gain; twin birth: 35-45 lb gain; obesity: 15 lb
minimum; adolescent: more than 25-35 lb (approximately); first trimester: 2-4 lb, no additional
calories; second and third trimesters: 1 lb per week, 340 calories daily for the second trimester and
450 calories daily for the third trimester.​

23. Discuss four priority nutritional concerns for the pregnant woman. Include nursing interventions
to relieve the symptoms.​

Graders Info :

Nausea: Eat dry crackers or dry toast before rising; eat small, frequent meals; avoid foods with
offensive odors; avoid liquids at mealtime.Constipation and hemorrhoids: High-fiber diet; daily
exercise; drink 13 glasses of liquid per day; respond immediately to the urge to defecate.
Heartburn/indigestion: Eat small, frequent meals; avoid spicy or greasy foods; avoid liquids with
meals; after eating wait at least 1 hour before lying down; wait at least 2 hours before exercising.
Excessive weight gain: Eliminate all food items that are not on the MyPyramid; bake, broil, or boil
rather than frying; use fruits and custards made with fat-free milk; encourage raw vegetables as
snacks; eliminate empty calorie foods.​

24. Describe the physiology associated with pregnancy and anemia. Compare iron deficiency anemia
and folate deficiency anemia.​

Graders Info :

Iron deficiency: During pregnancy, the increased volume of blood creates the need for additional
iron for the hemoglobin for this blood. If the need is not met by the diet or by iron stores in the body,
iron deficiency anemia develops. This is treated by a daily iron supplement.Folate deficiency: A
form of megaloblastic anemia that can occur during pregnancy, it is characterized by too few red
blood cells and by large, immature red blood cells. The need for folic acid increases dramatically
when new red blood cells are being formed.

25. Discuss the concerns that a pregnant teenager will have.​

Graders Info :

The teen mother is still in need of nurturing herself. Economic needs for financial support. Social
need to be a member of the teen group. Psychological need to meet love, belonging, and safety and
security needs. To be an active member of a group. Prenatal health care. Infant care. Nutritional
counseling to fulfill the nutritional needs of her own body. Nutritional counseling to meet infant's
dietary need.​

26. List the benefits of breastfeeding.​

Graders Info :

Breast milk contains the right amount of lactose, water, fatty acids, and amino acids for brain
development, growth, and digestion. No infant would be allergic to the mother's milk; however,
there may be a reaction to something the mother eats. Human milk has 100 ingredients not found in
formula. Breastfed infants have a lower incidence of ear infections, diarrhea, allergies, and hospital
admissions. It is a source of antibodies to diseases such as pneumonia, bronchitis, influenza, German
measles, botulism, and staphylococcal infections. Good for jaw development and growth of straight,
healthy teeth because it is harder to get milk out of a breast than a bottle. The process creates an
emotional attachment between mother and child. It aids in removing excess weight from mother and
stimulates return of uterus to prepregnant state. Breast milk is economical, always the right
temperature, and readily available.​

27. Describe the physical characteristics of an infant born with fetal alcohol syndrome.​

Graders Info :

Physical characteristics may include a small head, short eye slits, a flat midface, and a thin upper lip.
There is usually a growth deficiency, placing the child in the lowest 10th of age norms.​

TRUEFALSE

28. ​It is recommended that pregnant women should always drink an additional 6 oz of fortified milk
per day. _________________________

(A) True

(B) False
Answer : (B)

29. During pregnancy, the mother needs additional calories, vitamins, and minerals. It is advisable
for the mother to take extra amounts of all vitamins and minerals. _________________________​

(A) True

(B) False

Answer : (B)

30. Nausea associated with pregnancy, or morning sickness, is a benign condition.

_________________________​

(A) True

(B) False

Answer : (B)

31. Smoking during pregnancy may affect the intellectual and behavioral development of the fetus
as it grows up. _________________________​

(A) True

(B) False

Answer : (A)

32. Women with smaller-sized breasts will be unable to produce enough milk to satisfy an infant.
_________________________​

(A) True

(B) False

Answer : (B)

33. Research has shown that a lack of an intake of folate during pregnancy may result in neural tube
defects for the baby. _________________________​

(A) True

(B) False

Answer : (B)

34. During pregnancy, most of the weight gain occurs during the first trimester of pregnancy.
___________________

(A) True

(B) False

Answer : (B)

35. A pregnant adolescent should gain the same weight as a mature woman of the same size.
_____________________​

(A) True

(B) False

Answer : (B)

36. ​Overweight women should not lose weight during pregnancy. _________________________

(A) True

(B) False

Answer : (A)

37. When the mother drinks alcohol, it enters the fetal blood stream in the same concentration as it
does the mother's. ______________________​

(A) True

(B) False

Answer : (A)

ESSAY

38. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"How long do the experts recommend breastfeeding? I want to go back to work and I don't think I
could do that pumping at work."

Graders Info :

"The American Academy of Pediatrics recommends breast milk for the first 6-12 months of life. Some
women are not able to do that and it would be perfectly acceptable for you to breastfeed the child
for any time period you desire. A beginning with breast milk would be a great beginning."​

39. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"If I breastfeed, will I have to be on a special diet?"​

Graders Info :

"No, your dietary needs will be met if you continue as you are doing now, eating a nutritious diet
that is adequate for calories, vitamins, and minerals."​

40. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"How many extra calories a day will I need to breastfeed?"​

Graders Info :

The Institute of Medicine suggests an increase of 500 calories a day for the first 6 months of
breastfeeding and 400 calories a day for 7-9 months. This is less than the actual need because it is
assumed that some fat has been stored during pregnancy and can be used for milk production. The
precise number of calories the mother needs depends on the size of the infant and its appetite and
on the size and activities of the mother.​

41. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"If I eat all those additional calories, how will I ever lose all of the extra weight I have gained?"​

Graders Info :

"Studies have shown that if you choose nutrient-dense foods, you will gradually lose the weight.
There may be a significant weight loss in the first month of lactation."​

42. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"Will I have to stop drinking coffee if I breastfeed?"​

Graders Info :

​"Excessive consumption of caffeine during lactation may cause irritability and wakefulness in the
infant."

43. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"Are there other important contraindications to breastfeeding that I need to know?"​

Graders Info :

​"Alcohol reduces the amount of milk produced. Caffeine causes irritability and wakefulness in the
infant. Women who smoke produce less milk. Smoking exerts harmful effects on infants and
mothers. Women who test positive for HIV should not breastfeed their infants. Breastfeeding
mothers should not take oral contraceptives. It reduces the volume and the protein content of the
milk. Other drugs may affect the infant and should be evaluated by the physician."

44. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

"Tell me why I should breastfeed." ​

Graders Info :

"An infant grows faster the first year than at any other time. Their growth reflects their nutritional
well-being. Breast milk excels as a source of nutrients for the young infant. With the exception of
vitamin D and fluoride, breast milk provides all the nutrients a healthy infant needs for the first 4-6
months of life. Breast milk offers the infant protection against infection from viruses, bacteria, and
other pathogens that cannot be achieved any other way. Breastfed children are less likely to develop
stomach and intestinal disorders and middle ear infections, and are less likely to develop wheezing." ​

45. M
​ s. Jayce, 6 months pregnant with her first child, visits you at the clinic. She wants to bottle-
feed her baby; however, some coworkers have told her it is much better to breastfeed. She wants
your opinion and has several questions for you to answer.

Ms. Jayce states, "Well, you have given me a lot of information to think about. I will continue to think
about this. If my labor is not very difficult, I'll probably be able to make up my mind then." What is
the appropriate response from the nurse? ​

Graders Info :

"Ms. Jayce, I have only given you some general information about breastfeeding. There are some
predelivery preparations you must make. I am going to refer you to a lactation specialist who can
prepare you for successful lactation, if that is your choice." ​

46. You are assigned to complete nutritional assessments of pregnant women at a family planning
clinic. After the examinations and interviews are completed, you will meet with the women as a
group to answer questions or to begin prenatal education. You will need to identify the women who
are at nutritional risk during pregnancy. ​

List risk indicators for which to be alert. ​

Graders Info :

Women who ordinarily consume an inadequate diet; are lactose intolerant; are carrying multiple
fetuses; smoke cigarettes or use other tobacco; use alcohol or illegal drugs; are underweight or
overweight; gain excess weight; have an insufficient weight gain; lack nutritional knowledge; are
economically deprived (poverty); are adolescents or teenagers; have a preexisting chronic illness;
have had frequent pregnancies; have low hemoglobin and hematocrit. ​

47. You are assigned to complete nutritional assessments of pregnant women at a family planning
clinic. After the examinations and interviews are completed, you will meet with the women as a
group to answer questions or to begin prenatal education. You will need to identify the women who
are at nutritional risk during pregnancy. ​

Identify the components of a nutritional assessment. ​

Graders Info :

Review of the health records; physical exam; laboratory analyses; interview to determine usual food
and beverage intake, food allergies or intolerances, usual medications taken, adequacy of income to
determine availability of food, medical history, cultural influences on dietary intake (religious or
ethical), presence of any nutrition-related discomforts of pregnancy (morning sickness, constipation,
heartburn, etc.), presence of or history of eating disorders, and obstetric or gynecological factors
that impact the nutritional status ​

48. You are assigned to complete nutritional assessments of pregnant women at a family planning
clinic. After the examinations and interviews are completed, you will meet with the women as a
group to answer questions or to begin prenatal education. You will need to identify the women who
are at nutritional risk during pregnancy. ​

Identify some common nutrition-related outcomes. ​

Graders Info :

The woman will achieve an appropriate weight gain during pregnancy; consume appropriate
nutrients; use nursing measures to cope with nutrition-related discomforts; avoid consuming alcohol,
illegal drugs, caffeine, and tobacco; prepare for successful breastfeeding or bottlefeeding.​
49. You are assigned to complete nutritional assessments of pregnant women at a family planning
clinic. After the examinations and interviews are completed, you will meet with the women as a
group to answer questions or to begin prenatal education. You will need to identify the women who
are at nutritional risk during pregnancy. ​

Describe the role of the nurse versus that of the registered dietitian in prenatal dietary education. ​

Graders Info :

The nurse can adequately educate the mother in making food choices and meal planning during
pregnancy and lactation. Registered dietitians, however, may need to educate women in planning
dietary modifications for women on special therapeutic diets. The registered dietitian can also
calculate the patients specific calorie needs during the pregnancy based on height, weight, age,
activity, weight gain needed by trimester, and so on. ​

50. You are assigned to complete nutritional assessments of pregnant women at a family planning
clinic. After the examinations and interviews are completed, you will meet with the women as a
group to answer questions or to begin prenatal education. You will need to identify the women who
are at nutritional risk during pregnancy. ​

Several women in the group are members of varied cultures. Identify potential dietary problems
associated with the different cultures. ​

Graders Info :

Chinese: Use of large amounts of grease in cooking; limited use of milk and milk products; diet
often low in protein and calories; use of soy sauce, which is high in sodium.Polish: Sodium in pork,
sausage, and pickles; limited fruits and raw vegetables; large consumption of sweets; and a tendency
to overcook vegetables.
Italian: Tendency to overcook vegetables; limited use of grains; high use of olive oil; and insufficient
servings from milk groups.
Hispanic: Limited meats, milk, and milk products; average use of sugar; and large amounts of
grease or lard.
Japanese: Excess use of sodium from soy sauce, pickles, salty seaweed, and monosodium glutamate
(MSG); and insufficient use of milk.
African American: Extensive use of frying foods with shortening or oils; high consumption of
gravies, salt pork, bacon drippings, or lard; limited milk; and excess intake of sugars.
​