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Nutrition And Diet Therapy 11th Edition By Ruth Roth – Test Bank

CHAPTER 3: DIGESTION, ABSORPTION, AND METABOLISM

 

MULTIPLE CHOICE

 

  1. What area of the stomach does the bolus of food first enter?
a. fundus c. body of the stomach
b. pylorus d. duodenum

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. Which of the following is a hormone that triggers the release of gastric juices?
a. gastrin c. trypsin
b. pepsin d. secretin

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. Which hormone causes the release of sodium bicarbonate to neutralize the acidity of chyme?
a. gastrin c. secretin
b. pepsin d. none of the above

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. Projecting from the small intestine are microscopic fingerlike projections known as ____.
a. villi c. capillaries
b. cilia d. both a and b

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Absorption

 

  1. What is the name of the process that takes released energy and builds new substances from simpler ones?
a. anabolism c. oxidation
b. catabolism d. metabolism

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Metabolism

 

  1. Which of the following factors does not contribute to one’s basal metabolic rate (BMR)?
a. lean body mass c. heredity
b. daily activity d. climate

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Basal Metabolic Rate

 

  1. Which statement is true?
a. As lean body mass decreases, so does one’s BMR.
b. As lean body mass decreases, one’s BMR increases.
c. There is no relationship between BMR and lean body mass.
d. BMR is inversely related to lean body mass.

 

 

ANS:  A                    PTS:   1                    DIF:    B                    TOP:   Basal Metabolic Rate

 

  1. Metabolism is the body’s ____.
a. use of energy to conserve nutrients
b. use of food to create energy
c. process whereby food is broken down into smaller parts
d. all of the above

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Metabolism

 

  1. The process of digestion begins in the ____.
a. esophagus c. mouth
b. stomach d. small intestine

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. What term is used to describe the movement caused by rhythmic contractions of the muscular wall of the gastrointestinal tract?
a. mechanical c. peristalsis
b. chemical d. hydrolysis

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. Where does the final chemical digestion of carbohydrates occur?
a. mouth c. esophagus
b. stomach d. small intestine

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. What is the lower end of the esophagus termed?
a. bolus c. ileum
b. cardiac sphincter d. duodenum

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. Which one is NOT a role of hydrochloric acid in the stomach?
a. activate the enzyme pepsin c. destroys antibodies
b. destroys bacteria in food d. aids in the solubility of iron and calcium

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Digestion

 

  1. What do lacteals absorb?
a. glucose and water-soluble vitamins
b. amino acids and enzymes
c. fatty acids, glycerol, and fat-soluble vitamins
d. minerals only

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Absorption

 

  1. After being absorbed into the small intestine, fructose and galactose are then carried to the ____.
a. stomach c. kidney
b. small intestine d. liver

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Absorption

 

  1. ____ is the process that uses released energy to convert substances to simpler products.
a. Aerobic metabolism c. Anaerobic metabolism
b. Catabolism d. Anabolism

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Metabolism

 

  1. What factor might increase someone’s BMR?
a. fever c. lactation
b. pregnancy d. all of the above

 

 

ANS:  D                    PTS:   1                    DIF:    B                    TOP:   Basal Metabolic Rate

 

  1. As people age, the lean body mass _______.
a. increases c. decreases
b. stays the same d. none of the above

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Energy

 

  1. The thermic effect of food includes the energy required to ___________ food.
a. digest c. transport
b. absorb d. all of the above

 

 

ANS:  D                    PTS:   1                    DIF:    C                    TOP:   Energy

 

  1. _____________ is an enzyme that aids in the digestion of fats.
a. Pancreatic amylase c. Salivary amylase
b. Pancreatic lipase d. None of the above

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. The __________ is the end of the stomach nearest the small intestine.
a. fundus c. duodenum
b. cardiac sphincter d. pylorus

 

 

ANS:  D                    PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. _________is an enzyme that aids in the digestion of proteins.
a. Trypsin c. Both a and b
b. Carboxypeptidase d. None of the above

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Digestion

 

SHORT ANSWER

 

  1. Describe the function and the actions of the gallbladder. Include the action of the substances produced by the gallbladder.

 

ANS:

When food enters the small intestine, the gallbladder is triggered by the hormone cholecystokinin (which is produced by intestinal mucosal glands when fats enter) to release bile. Bile is produced in the liver and stored in the gall bladder. Bile aids in digestion by emulsifying fat. This allows the body to absorb fat more easily.

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. What are the activities of absorption that occur in the large intestine? Describe the movement of food residue through the large intestine that results in watery, liquid stools.

 

ANS:

Some nutrient and water absorption occurs in the large intestine. The colon wall secretes mucus as a protection from the acidic digestive juices in the chyme. The major functions of the large intestine are to absorb water, synthesize some B vitamins and vitamin K, and collect food residue. Undigested food is excreted as feces by way of the rectum. If diarrhea is present, this means the chyme and liquids have moved through the colon too rapidly to be absorbed; therefore, a liquid stool results, with little water or nutrient absorption taking place.

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. Describe the purpose of fiber in the diet. List the best food sources. What effects does metabolism of fiber have on the medical conditions diverticulosis and spastic colon?

 

ANS:

Fiber promotes health of the large intestine by helping soften stools and promoting regular bowel movements. The best sources include corn, wheat, celery, and apple skins. Diverticulosis is present when fiber collects in pouches or sacs that open from the intestine. These become inflamed and cause obstruction, perforation, or bleeding. Irritable bowel syndrome occurs when fiber is an irritant that results in certain signs and symptoms, including constipation, gas, and bloating. These are caused by uncoordinated and inefficient contractions of the large intestine.

 

PTS:   1                    DIF:    B                    TOP:   Absorption

 

  1. Describe the progression of the basal metabolic rate (BMR) throughout the life cycle. What factors, in addition to age, result in a change in the BMR?

 

ANS:

Children require more kilocalories per pound of body weight because they are growing. As people age, the basal metabolic rate decreases. Women require more kilocalories during pregnancy and lactation. BMR increases during fever and for people living and working in extremely hot or cold climates. A person’s BMR resembles that of his or her parents.

 

PTS:   1                    DIF:    B                    TOP:   Basal Metabolic Rate

 

  1. Calculate your basal metabolic rate. Calculate your usual caloric intake. Discuss the implications of your intake versus your metabolic rate.

 

ANS:

The students should easily determine their total energy requirements. If the caloric intake exceeds their BMR, they will gain weight. If it is less, weight loss will occur.

 

PTS:   1                    DIF:    C                    TOP:   Basal Metabolic Rate

 

  1. What is digestion?

 

ANS:

Digestion is the process whereby food is broken down into smaller parts, chemically changed, and moved through the gastrointestinal system.

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. What is the purpose of mechanical digestion?

 

ANS:

Mechanical digestion helps prepare food for chemical digestion by breaking it into smaller pieces.

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

MODIFIED TRUE/FALSE

 

  1. The cardiac sphincter prevents acid from flowing back into the esophagus. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Digestion

 

  1. Digestion is the process whereby food is broken down into smaller parts and is chemically changed. Digestion occurs in the stomach and small intestine only. _________________________

 

ANS:  F, entire gastrointestinal system

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. To be absorbed, nutrients must be in their most complex form. _________________________

 

ANS:  F, simplest

 

PTS:   1                    DIF:    B                    TOP:   Absorption

 

  1. The hydrochloric acid that is secreted by the stomach lining makes iron and calcium more soluble. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Metabolism

 

  1. The inner wall of the small intestine is smooth. _________________________

 

ANS:  F, contains folds called villi

 

PTS:   1                    DIF:    A                   TOP:   Absorption

 

  1. A mouthful of food ready to be swallowed is called chyme. _________________________

 

ANS:  F, bolus

 

PTS:   1                    DIF:    C                    TOP:   Digestion

 

  1. Acid reflux disease is caused by malfunction of the pyloric sphincter. _____________________

 

ANS:  F, cardiac sphincter

 

PTS:   1                    DIF:    B                    TOP:   Digestion

 

  1. One kilocalorie is equal to 4.184 kilojoules. _______________________

 

ANS:  T                                                     PTS:   1                    DIF:    A

TOP:   Energy

 

CASE

 

Joe Brian, 6’3” tall and 265 pounds, came to the physician with complaints of indigestion, heartburn, a bloated feeling, and occasional vomiting. He states that he sometimes wakes up with the taste of vomit in his mouth. He also complains of chest pain and states, “Sometimes I feel like I am having a heart attack.” After performing an endoscopy, the physician diagnoses a hiatal hernia with esophageal reflux and esophagitis. The physician prescribes a histamine receptor antagonist and antacids before meals and at bedtime.

 

  1. Describe the pathology that occurs when a hiatal hernia exists. Correlate each symptom with the medical diagnosis and describe the cause.

 

ANS:

At the lower end of the esophagus is the cardiac sphincter, which prevents stomach acid from flowing back into the esophagus. When a hiatal hernia is present, the stomach protrudes through the opening and allows acidic content to flow back into the esophagus. After meals, the client should be positioned upright to prevent regurgitation that occurs with the reflux of the acidic content. The condition also causes pain and a bloating sensation. Treatment aims at preventing acid from being in contact with the esophageal tissue, which could predispose to cancer.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

  1. What additional symptoms that may occur should the client be made aware of? What are the complications of a hiatal hernia?

 

ANS:

Chronic irritation from the acids may result in cancer. If the hernia is unmanageable with medical treatment, surgery may be performed.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Describe the relationship between the symptom “heartburn” and the heart.

 

ANS:

The stomach acidity causes pain that is located in close proximity to the heart, thus “heartburn.” There is no direct relation to the heart.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. What is the goal of the initial medical treatment?

 

ANS:

Alleviating the symptoms.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. What is the focus of nursing care?

 

ANS:

To facilitate client education related to the lack of knowledge regarding the disease process. To teach behaviors, including dietary approaches, to relieve pain/discomfort from regurgitation of acidic gastric contents.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. What nursing measures will the nurse perform?

 

ANS:

Include diet instructions, meal plans, and foods to avoid. Describe positioning after meals and physical activity. Evaluate the client’s height and weight and describe the impact on his medical condition. Explain the relationship between the diagnoses and caffeine.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. What assessment data will be monitored to evaluate if the goals have been met?

 

ANS:

Evaluate the symptoms, indigestion, pain, heartburn, and bloating. Evaluate weight to determine if this remains a factor in the symptoms. Monitor caffeine intake. Have client keep a food and exercise diary that can be used to document progress.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

Mary Moore, who is three months pregnant with her fourth child, comes to the clinic for her monthly prenatal visit. You are doing client education regarding her nutritional status. She is 5’4” tall and currently weighs165 pounds. She is planning on breast-feeding her baby.

 

  1. Determine her current recommended body weight based on her height and sex.

 

ANS:

111–146 pounds

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Determine the number of additional calories she will need to ingest for proper nutrition for the fetus.

 

ANS:

An increase of 300 calories is recommended.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. How many additional calories will be needed for lactation? What other substances need to be ingested in adequate amounts?

 

ANS:

Five hundred (500) extra calories a day and increased amounts of fluids

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Is it appropriate for a pregnant woman to go on a weight loss program? Describe the rationale for your answer.

 

ANS:

A pregnant woman must increase caloric intake by 300 calories daily. Moderate exercise in the form of walking or swimming is recommended. A weight loss program is not recommended. The only weight adjustments that should occur are when the person changes prepregnancy bad food habits and begins to eat a well-balanced diet with appropriate calories and nutrients.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

  1. Ms. Moore tells you that she always ate the same whether she was pregnant or not. She also says that she never took vitamins or iron with her other pregnancies and that she doesn’t see the need now. How will you teach her the importance of these dietary measures?

 

ANS:

Keep in mind the general health, culture, religion, likes, and dislikes of the woman. Explain the needed changes in terms of the effect on the fetus. Emphasize and explain the need for increased nutrients such as iron and folic acid. Offer supporting literature from credible sources as needed. There is information available regarding the need for supplementation that may have not been available with her past pregnancies.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

  1. What additional assessment data will you need before planning her dietary goals and nursing measures?

 

ANS:

Health history, physical examination data, family health history, usual dietary intake, cultural or religious beliefs that affect diet, socioeconomic status, activity or physical exercise, blood tests including hemoglobin and hematocrit, and vital signs.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. List one dietary goal with nursing measures.

 

ANS:

Demonstrate progressive, moderate weight gain, not to exceed 3–5 pounds the first trimester and one pound per week during the second and third trimesters. Diet education including foods with quality nutritional value; eat variety; avoid empty calories; increase fluids; avoid rich, highly-spiced and fried foods, etcetera. Have normal bowel elimination. Increase fluid intake; encourage intake of fresh fruits and vegetables; add high fiber foods; moderate exercise; avoid laxatives and enemas.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

  1. What nutrients, vitamins, and minerals will she need to increase in order to sustain a good nutritional status? List foods that are good sources.

 

ANS:

Calcium, 3–4 cups of milk; most vitamins need to be increased, fresh fruits and vegetables; protein, fish, eggs, cheese, milk, meats; water, ten glasses daily.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

CHAPTER 11: NUTRITION DURING PREGNANCY AND LACTATION

 

MULTIPLE CHOICE

 

  1. What is a normal weight gain during pregnancy for an underweight woman?
a. between 25 and 35 pounds c. at least 40 pounds
b. between 28 and 40 pounds d. no more than 35 pounds

 

 

ANS:  B                    PTS:   1                    DIF:    A

TOP:   Weight Gain during Pregnancy

 

  1. 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
c. second trimester an additional 340 calories, third trimester 450 calories
d. no extra calories are needed during pregnancy

 

 

ANS:  C                    PTS:   1                    DIF:    A

TOP:   Weight Gain during Pregnancy

 

  1. Which of the following nutrients does not need to be increased during pregnancy?
a. Protein c. iron
b. vitamin C d. vitamin A

 

 

ANS:  D                    PTS:   1                    DIF:    B

TOP:   Nutritional Needs during Pregnancy

 

  1. 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

 

 

ANS:  A                    PTS:   1                    DIF:    C

TOP:   Nutritional Needs during Pregnancy

 

  1. _____ is the condition when nausea persists and becomes so severe that it is life-threatening.
a. Parenteral gravidarum c. Hyperemesis gravidarum
b. Morning sickness d. Binge-purge gravidarum

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Concerns during Pregnancy

 

  1. What two conditions can be relieved by eating high-fiber foods?
a. morning sickness and weight gain c. hypertension and anemia
b. hypertension and heartburn d. constipation and hemorrhoids

 

 

ANS:  D                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. How can heartburn be relieved?
a. eating three meals a day c. drinking three cups of milk a day
b. eating small, frequent meals d. eating up to 25 grams of fiber a day

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. _____ is the craving for nonfood substances such as starch or clay.
a. Pico c. Pica
b. Anemia d. Picanemia

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Concerns during Pregnancy

 

  1. Which nutrient is often deficient in women who are diagnosed with megaloblastic anemia?
a. vitamin C c. Iron
b. folate d. Copper

 

 

ANS:  B                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. The ingestion of alcohol while pregnant can result in _____.
a. weight gain c. spontaneous abortions
b. hypertension d. fetal alcohol syndrome

 

 

ANS:  D                    PTS:   1                    DIF:    A                    TOP:   Concerns during Pregnancy

 

  1. The infant’s sucking initiates the release of _____ (a hormone), which causes the ejection of milk into the infant’s mouth.
a. oxytocin c. Insulin
b. aldosterone d. Prolactin

 

 

ANS:  A                    PTS:   1                    DIF:    A                    TOP:   Lactation

 

  1. During lactation, approximately how many extra calories are recommended daily?
a. 300 c. 500
b. 400 d. 1,000

 

 

ANS:  C                    PTS:   1                    DIF:    A                    TOP:   Lactation

 

  1. Which vitamin, in excess, can cause birth defects?
a. vitamin C c. vitamin A
b. vitamin E d. vitamin D

 

 

ANS:  C                    PTS:   1                    DIF:    B

TOP:   Nutritional Needs during Pregnancy

 

  1. Which of the following are pregnant adolescents particularly prone to?
a. gestational diabetes c. pregnancy-induced hypertension
b. weight gain d. abruptio placentae

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. What is the approximate number of calories in an ounce of human milk?
a. 10 cal c. 30 cal
b. 20 cal d. 40 cal

 

 

ANS:  B                    PTS:   1                    DIF:    A                    TOP:   Lactation

 

  1. A nursing mother’s use of caffeine may cause the following in her infant.
a. abnormal growth c. irritability
b. blindness d. fatigue

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. 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 c. 400 mg
b. 800 mg d. 400 µg

 

 

ANS:  D                    PTS:   1                    DIF:    B

TOP:   Nutritional Needs during Prepregnancy

 

  1. The need for _____ increases during pregnancy because of the increased blood volume during pregnancy.
a. Calcium c. Zinc
b. Iron d. selenium

 

 

ANS:  B                    PTS:   1                    DIF:    B

TOP:   Nutritional Needs during Pregnancy

 

  1. Pregnancy-induced hypertension is characterized by _____.
a. hyperemesis gravidarum c. Proteinuria
b. pica d. all of the above

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

  1. Anemia may be caused by _____ deficiency.
a. iron c. both a and b
b. folate d. none of the above

 

 

ANS:  C                    PTS:   1                    DIF:    C                    TOP:   Concerns during Pregnancy

 

  1. Macrosomia refers to birthweight of over _____ pounds.
a. 7 c. 9
b. 8 d. 10

 

 

ANS:  C                    PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

SHORT ANSWER

 

  1. 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.

 

ANS:

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 calorie; second and third trimesters: 1 lb per week, 340 cal daily for the second trimester and 450 calories daily for the third trimester.

 

PTS:   1                    DIF:    B                    TOP:   Weight Gain during Pregnancy

 

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

 

ANS:

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 thirteen 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 one hour before lying down; wait at least two 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.

 

PTS:   1                    DIF:    C                    TOP:   Concerns during Pregnancy

 

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

 

ANS:

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.

 

PTS:   1                    DIF:    C                    TOP:   Concerns during Pregnancy

 

  1. Discuss the concerns that a pregnant teenager will have.

 

ANS:

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.

 

PTS:   1                    DIF:    B                    TOP:   Pregnancy during Adolescence

 

  1. List the benefits of breast-feeding.

 

ANS:

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. Breast-fed 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.

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

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

 

ANS:

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.

 

PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

MODIFIED TRUE/FALSE

 

  1. It is recommended that pregnant women should always drink an additional six ounces of regular fortified milk per day. _________________________

 

ANS:  F, two servings (16 ounces) of fat-free milk

 

PTS:   1                    DIF:    B                    TOP:   Fulfillment of Nutritional Needs during Pregnancy

 

  1. 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. _________________________

 

ANS:  F, not advisable

 

PTS:   1                    DIF:    B                    TOP:   Fulfillment of Nutritional Needs during Pregnancy

 

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

 

ANS:  F, could be life-threatening

 

PTS:   1                    DIF:    B                    TOP:   Concerns during Pregnancy

 

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

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Concerns during Pregnancy

 

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

 

ANS:  F, will be able

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

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

 

ANS:  F, prepregnancy

 

PTS:   1                    DIF:    B                    TOP:   Nutritional Needs during Prepregnancy

 

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

 

ANS:  F, second and third

 

PTS:   1                    DIF:    B                    TOP:   Weight Gain during Pregnancy

 

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

 

ANS:  F, more

 

PTS:   1                    DIF:    B                    TOP:   Weight Gain during Pregnancy

 

  1. Overweight women should not lose weight during pregnancy. _________________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Concerns during Pregnancy

 

  1. When the mother drinks alcohol, it enters the fetal blood stream in the same concentration as it does the mother’s. ______________________

 

ANS:  T                                                     PTS:   1                    DIF:    B

TOP:   Concerns during Pregnancy

 

CASE

 

Ms. Jayce, six 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 breast-feed. She wants your opinion and has several questions for you to answer.

 

  1. “How long do the experts recommend breast-feeding? I want to go back to work and I don’t think I could do that pumping at work.”

 

ANS:

“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 breast-feed the child for any time period you desire. A beginning with breast milk would be a great beginning.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

  1. “If I breast-feed, will I have to be on a special diet?”

 

ANS:

“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.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

  1. “How many extra calories a day will I need to breast-feed?”

 

ANS:

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.

 

PTS:   1                    DIF:    A                   TOP:   Lactation

 

  1. “If I eat all those additional calories, how will I ever lose all of the extra weight I have gained?”

 

ANS:

“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.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

  1. “Will I have to stop drinking coffee if I breast-feed?”

 

ANS:

“Excessive consumption of caffeine during lactation may cause irritability and wakefulness in the infant.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

  1. “Are there other important contraindications to breast-feeding that I need to know?”

 

ANS:

“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 breast-feed their infants. Breast-feeding 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.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

  1. “Tell me why I should breast-feed.”

 

ANS:

“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 four to six months of life. Breast milk offers the infant protection against infection from viruses, bacteria, and other pathogens that cannot be achieved any other way. Breast-fed children are less likely to develop stomach and intestinal disorders and middle ear infections, and are less likely to develop wheezing.”

 

PTS:   1                    DIF:    C                    TOP:   Lactation

 

  1. 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?

 

ANS:

“Ms. Jayce, I have only given you some general information about breast-feeding. 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.”

 

PTS:   1                    DIF:    B                    TOP:   Lactation

 

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.

 

  1. List risk indicators for which to be alert.

 

ANS:

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.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

  1. Identify the components of a nutritional assessment.

 

ANS:

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, etcetera), presence of or history of eating disorders, and obstetric or gynecological factors that impact the nutritional status

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

  1. Identify some common nutrition-related outcomes.

 

ANS:

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 breast-feeding or bottle-feeding.

 

PTS:   1                    DIF:    B                    TOP:   Care Planning

 

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

 

ANS:

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, etc.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning

 

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

 

ANS:

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.

 

PTS:   1                    DIF:    C                    TOP:   Care Planning