A nurse is caring for a young adult client who is discontinuing birth control pills and wishes to start a family. Which of the following statements by the nurse is an appropriate dietary guideline?
Increase your caloric intake before pregnancy to stabilize your metabolism.
Increase your total intake of seafood to 20 ounces per week.
Decrease ascorbic acid in your diet.
Increase folic acid to 400 micrograms per day prior to getting pregnant.
The Correct Answer is D
Choice A reason: Increasing the caloric intake before pregnancy is not an appropriate dietary guideline, as it can lead to excessive weight gain and obesity, which can increase the risk of gestational diabetes, hypertension, and other complications. The nurse should advise the client to maintain a healthy weight and a balanced diet before and during pregnancy.
Choice B reason: Increasing the total intake of seafood to 20 ounces per week is not an appropriate dietary guideline, as it can expose the client to high levels of mercury, which can harm the developing fetus. The nurse should advise the client to limit the intake of seafood to 8 to 12 ounces per week, and avoid fish that are high in mercury, such as shark, swordfish, and king mackerel.
Choice C reason: Decreasing ascorbic acid in the diet is not an appropriate dietary guideline, as it can impair the immune system and the absorption of iron, which are both important for the health of the mother and the fetus. The nurse should advise the client to consume adequate amounts of ascorbic acid, which is found in citrus fruits, tomatoes, broccoli, and other foods.
Choice D reason: Increasing folic acid to 400 micrograms per day prior to getting pregnant is an appropriate dietary guideline, as it can prevent neural tube defects, such as spina bifida and anencephaly, in the fetus. The nurse should advise the client to take a daily prenatal vitamin that contains folic acid, and eat foods that are rich in folate, such as leafy greens, beans, and fortified cereals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Acute stress causes an increase in metabolism, as the body activates the sympathetic nervous system and releases hormones such as adrenaline and cortisol. These hormones increase the heart rate, blood pressure, and oxygen consumption, and mobilize glucose and fatty acids for energy. The nurse should explain to the clients that acute stress can have beneficial effects, such as enhancing alertness, memory, and performance, but it can also have harmful effects, such as impairing digestion, immunity, and growth.
Choice B reason: Stress causes a negative nitrogen balance in the body, not a positive one. Nitrogen balance is the difference between the amount of nitrogen ingested and the amount of nitrogen excreted. A positive nitrogen balance means that the body is retaining more nitrogen than it is losing, which indicates growth, healing, or pregnancy. A negative nitrogen balance means that the body is losing more nitrogen than it is retaining, which indicates malnutrition, illness, or injury. The nurse should inform the clients that stress can cause a negative nitrogen balance, as the body breaks down protein for energy and loses nitrogen through urine, sweat, and wounds.
Choice C reason: Protein requirements increase in times of stress, not decrease. Protein is essential for tissue repair, immune function, and hormone synthesis. The nurse should advise the clients that stress can increase the protein needs of the body, as the body loses protein through catabolism, inflammation, and infection. The nurse should recommend the clients to consume adequate amounts of high-quality protein, such as eggs, milk, cheese, meat, fish, poultry, soy, and nuts.
Choice D reason: Glucose is broken down more quickly during times of stress, not more slowly. Glucose is the main source of energy for the brain and the muscles. The nurse should educate the clients that stress can increase the glucose levels in the blood, as the body releases glucose from the liver and muscles to provide fuel for the stress response. The nurse should also warn the clients that chronic stress can lead to insulin resistance, diabetes, and cardiovascular disease.
Correct Answer is B
Explanation
Choice A reason: Weight gain of 0.45 kg (1 lb) per week is not within the expected reference range for a client who is in the second trimester of pregnancy and has a normal BMI. The recommended weight gain for this client is 0.35 to 0.5 kg (0.8 to 1 lb) per week.
Choice B reason: Intake of 200 extra calories per day is within the expected reference range for a client who is in the second trimester of pregnancy and has a normal BMI. The recommended caloric intake for this client is 2200 to 2900 calories per day, which is about 340 to 450 calories more than the pre-pregnancy intake.
Choice C reason: Intake of 100 extra calories per day is not within the expected reference range for a client who is in the second trimester of pregnancy and has a normal BMI. The recommended caloric intake for this client is 2200 to 2900 calories per day, which is about 340 to 450 calories more than the pre-pregnancy intake.
Choice D reason: Weight gain of 0.91 kg (2 lb) per week is not within the expected reference range for a client who is in the second trimester of pregnancy and has a normal BMI. The recommended weight gain for this client is 0.35 to 0.5 kg (0.8 to 1 lb) per week.
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