Chapter 15: Maternal Nutrition
MULTIPLE CHOICE
1. Which nutrient’s recommended dietary allowance (RDA) is higher during lactation than
during pregnancy?
a. Protein
b. Iron
c. Vitamin A
d. Folic acid
ANS: A
Nutrient needs for energy—protein, calcium, iodine, zinc, B vitamins, and vitamin C—
remain higher during lactation than during pregnancy. The need for iron is not higher
during lactation than during pregnancy. A lactating woman does not have a greater
requirement for vitamin A than a nonpregnant woman. Folic acid requirements are the
highest during the first trimester of pregnancy.
PTS: 1 DIF: Cognitive Level: Understanding
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
2. A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits,
and vegetables. Which dietary requirement is the nurse most concerned about?
a. Calcium
b. Protein
c. Vitamin B12
d. Folic acid
ANS: C
A pregnant woman’s diet is consistent with that followed by a strict vegetarian (vegan).
Vegans consume only plant products. Because vitamin B12 is found in foods of animal
origin, this diet is deficient in vitamin B12. Depending on the woman’s food choices, a
pregnant woman’s diet may be adequate in calcium. Protein needs can be sufficiently met
by a vegetarian diet. The nurse should be more concerned with the woman’s intake of
vitamin B12 attributable to her dietary restrictions. Folic acid needs can be met by enriched
bread products.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. Which statement made by a lactating woman leads the nurse to believe that the client might
have lactose intolerance?
a. “I always have heartburn after I drink milk.”
b. “If I drink more than a cup of milk, I usually have abdominal cramps and
bloating.”
c. “Drinking milk usually makes me break out in hives.”
d. “Sometimes I notice that I have bad breath after I drink a cup of milk.”
, ANS: B
Lactose intolerance, which is an inability to digest milk sugar because of a lack of the
enzyme lactose in the small intestine, is a problem that interferes with milk consumption.
Milk consumption may cause abdominal cramping, bloating, and diarrhea in such people,
although many lactose-intolerant individuals can tolerate small amounts of milk without
symptoms. A woman with lactose intolerance is more likely to experience bloating and
cramping, not heartburn. A client who breaks out in hives after consuming milk is more
likely to have a milk allergy and should be advised to simply brush her teeth after
consuming dairy products.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
4. A client states that she does not drink milk. Which foods should the nurse encourage this
woman to consume in greater amounts to increase her calcium intake?
a. Fresh apricots
b. Canned clams
c. Spaghetti with meat sauce
d. Canned sardines
ANS: D
Sardines are rich in calcium. Fresh apricots, canned clams, and spaghetti with meat sauce
are not high in calcium.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
NURSINGTB.COM
5. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is
this client’s total recommended weight gain during pregnancy?
a. 20 kg (44 lb)
b. 16 kg (35 lb)
c. 12.5 kg (27.5 lb)
d. 10 kg (22 lb)
ANS: C
This woman has a normal BMI and should gain 11.5 to 16 kg during her pregnancy. A
weight gain of 20 kg (44 lb) is unhealthy for most women; a weight gain of 16 kg (35 lb) is
at the high end of the range of weight this woman should gain in her pregnancy; and a
weight gain of 10 kg (22 lb) is appropriate for an obese woman. This woman has a normal
BMI, which indicates that her weight is average.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. A woman has come to the clinic for preconception counseling because she wants to start
trying to get pregnant. Which guidance should she expect to receive?
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 regularly taking.”
, d. “Make sure you include adequate folic acid in your diet.”
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 that she has
been using, discontinuing all contraception at this time may not be appropriate. Advising
this client to lose weight now so that she can gain more during pregnancy is also not
appropriate advice. Depending on the type of medications the woman is taking, continuing
to take them regularly may not be appropriate.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take
the recommended iron supplements?
a. On a full stomach
b. At bedtime
c. After eating a meal
d. With milk
ANS: B
Iron supplements taken at bedtime may reduce GI upset and should be taken at bedtime if
abdominal discomfort occurs when iron supplements are taken between meals. Iron
supplements are best absorbed if they are taken when the stomach is empty. Bran, tea,
coffee, milk, and eggs mayNreUduc
RSeIabNsor
GTption.
B.CO
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. After the nurse completes nutritional counseling for a pregnant woman, she asks the client
to repeat the instructions to assess the client’s understanding. Which statement indicates that
the client understands the role of protein in her pregnancy?
a. “Protein will help my baby grow.”
b. “Eating protein will prevent me from becoming anemic.”
c. “Eating protein will make my baby have strong teeth after he is born.”
d. “Eating protein will prevent me from being diabetic.”
ANS: A
Protein is the nutritional element basic to growth. An adequate protein intake is essential to
meeting the increasing demands of pregnancy. These demands arise from the rapid growth
of the fetus; the enlargement of the uterus, mammary glands, and placenta; the increase in
the maternal blood volume; and the formation of the amniotic fluid. Iron intake prevents
anemia. Calcium intake is needed for fetal bone and tooth development. Glycemic control is
needed in those with diabetes; protein is one nutritional factor to consider for glycemic
control but not the primary role of protein intake.
PTS: 1 DIF: Cognitive Level: Analyzing
MULTIPLE CHOICE
1. Which nutrient’s recommended dietary allowance (RDA) is higher during lactation than
during pregnancy?
a. Protein
b. Iron
c. Vitamin A
d. Folic acid
ANS: A
Nutrient needs for energy—protein, calcium, iodine, zinc, B vitamins, and vitamin C—
remain higher during lactation than during pregnancy. The need for iron is not higher
during lactation than during pregnancy. A lactating woman does not have a greater
requirement for vitamin A than a nonpregnant woman. Folic acid requirements are the
highest during the first trimester of pregnancy.
PTS: 1 DIF: Cognitive Level: Understanding
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
2. A pregnant woman’s diet consists almost entirely of whole grain breads and cereals, fruits,
and vegetables. Which dietary requirement is the nurse most concerned about?
a. Calcium
b. Protein
c. Vitamin B12
d. Folic acid
ANS: C
A pregnant woman’s diet is consistent with that followed by a strict vegetarian (vegan).
Vegans consume only plant products. Because vitamin B12 is found in foods of animal
origin, this diet is deficient in vitamin B12. Depending on the woman’s food choices, a
pregnant woman’s diet may be adequate in calcium. Protein needs can be sufficiently met
by a vegetarian diet. The nurse should be more concerned with the woman’s intake of
vitamin B12 attributable to her dietary restrictions. Folic acid needs can be met by enriched
bread products.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
3. Which statement made by a lactating woman leads the nurse to believe that the client might
have lactose intolerance?
a. “I always have heartburn after I drink milk.”
b. “If I drink more than a cup of milk, I usually have abdominal cramps and
bloating.”
c. “Drinking milk usually makes me break out in hives.”
d. “Sometimes I notice that I have bad breath after I drink a cup of milk.”
, ANS: B
Lactose intolerance, which is an inability to digest milk sugar because of a lack of the
enzyme lactose in the small intestine, is a problem that interferes with milk consumption.
Milk consumption may cause abdominal cramping, bloating, and diarrhea in such people,
although many lactose-intolerant individuals can tolerate small amounts of milk without
symptoms. A woman with lactose intolerance is more likely to experience bloating and
cramping, not heartburn. A client who breaks out in hives after consuming milk is more
likely to have a milk allergy and should be advised to simply brush her teeth after
consuming dairy products.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity
4. A client states that she does not drink milk. Which foods should the nurse encourage this
woman to consume in greater amounts to increase her calcium intake?
a. Fresh apricots
b. Canned clams
c. Spaghetti with meat sauce
d. Canned sardines
ANS: D
Sardines are rich in calcium. Fresh apricots, canned clams, and spaghetti with meat sauce
are not high in calcium.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
NURSINGTB.COM
5. A 27-year-old pregnant woman had a preconceptual body mass index (BMI) of 19. What is
this client’s total recommended weight gain during pregnancy?
a. 20 kg (44 lb)
b. 16 kg (35 lb)
c. 12.5 kg (27.5 lb)
d. 10 kg (22 lb)
ANS: C
This woman has a normal BMI and should gain 11.5 to 16 kg during her pregnancy. A
weight gain of 20 kg (44 lb) is unhealthy for most women; a weight gain of 16 kg (35 lb) is
at the high end of the range of weight this woman should gain in her pregnancy; and a
weight gain of 10 kg (22 lb) is appropriate for an obese woman. This woman has a normal
BMI, which indicates that her weight is average.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
6. A woman has come to the clinic for preconception counseling because she wants to start
trying to get pregnant. Which guidance should she expect to receive?
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 regularly taking.”
, d. “Make sure you include adequate folic acid in your diet.”
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 that she has
been using, discontinuing all contraception at this time may not be appropriate. Advising
this client to lose weight now so that she can gain more during pregnancy is also not
appropriate advice. Depending on the type of medications the woman is taking, continuing
to take them regularly may not be appropriate.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance
7. To prevent gastrointestinal (GI) upset, when should a pregnant client be instructed to take
the recommended iron supplements?
a. On a full stomach
b. At bedtime
c. After eating a meal
d. With milk
ANS: B
Iron supplements taken at bedtime may reduce GI upset and should be taken at bedtime if
abdominal discomfort occurs when iron supplements are taken between meals. Iron
supplements are best absorbed if they are taken when the stomach is empty. Bran, tea,
coffee, milk, and eggs mayNreUduc
RSeIabNsor
GTption.
B.CO
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
8. After the nurse completes nutritional counseling for a pregnant woman, she asks the client
to repeat the instructions to assess the client’s understanding. Which statement indicates that
the client understands the role of protein in her pregnancy?
a. “Protein will help my baby grow.”
b. “Eating protein will prevent me from becoming anemic.”
c. “Eating protein will make my baby have strong teeth after he is born.”
d. “Eating protein will prevent me from being diabetic.”
ANS: A
Protein is the nutritional element basic to growth. An adequate protein intake is essential to
meeting the increasing demands of pregnancy. These demands arise from the rapid growth
of the fetus; the enlargement of the uterus, mammary glands, and placenta; the increase in
the maternal blood volume; and the formation of the amniotic fluid. Iron intake prevents
anemia. Calcium intake is needed for fetal bone and tooth development. Glycemic control is
needed in those with diabetes; protein is one nutritional factor to consider for glycemic
control but not the primary role of protein intake.
PTS: 1 DIF: Cognitive Level: Analyzing
