A nurse is performing a nutritional assessment for a client during their first prenatal visit at 12 weeks of gestation. Which of the following findings indicates that the client should be referred to a registered dietician?
The client reports that they take a multivitamin daily.
The client reports a 4.5 kg (10 lb) weight gain since their positive pregnancy test.
The client reports that they are nauseous most mornings.
The client reports that they eat prunes to help manage their constipation.
The Correct Answer is B
Choice A rationale
Taking a multivitamin daily is generally recommended during pregnancy to ensure the mother and baby receive necessary nutrients. It does not indicate a need for referral to a dietitian.
Choice B rationale
A weight gain of 4.5 kg (10 lb) since a positive pregnancy test could be a concern depending on the timeframe. If this weight gain occurred rapidly, it could indicate issues such as fluid retention or inadequate nutrition, which would warrant a referral to a dietitian.
Choice C rationale
Nausea, particularly in the morning, is a common symptom of early pregnancy often referred to as “morning sickness”. It does not typically require dietary intervention unless it is severe (hyperemesis gravidarum), leading to weight loss and dehydration.
Choice D rationale
Eating prunes is a natural method to manage constipation, a common issue during pregnancy due to hormonal changes that slow digestion. This choice does not indicate a need for a dietitian referral.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Jitteriness is a common sign of hypoglycemia in newborns. Newborns whose mothers had gestational diabetes are at an increased risk of developing hypoglycemia shortly after birth. Other signs of neonatal hypoglycemia can include poor feeding, lethargy, and seizures.
Choice B rationale
Increased muscle tone is not typically associated with hypoglycemia in newborns. However, decreased muscle tone can be a sign of severe hypoglycemia.
Choice C rationale
Abdominal distention is not typically associated with hypoglycemia in newborns. However, it can be a sign of other conditions, such as gastrointestinal obstruction or sepsis.
Choice D rationale
Petechiae, or small red or purple spots on the skin caused by bleeding into the skin, are not typically associated with hypoglycemia in newborns. However, they can be a sign of other conditions, such as infection or a bleeding disorder.
Correct Answer is A
Explanation
Choice A rationale
The instillation of antibiotic ophthalmic ointment is delayed to facilitate bonding between the newborn and the parent. Immediate skin-to-skin contact between the newborn and the parent has been shown to have several benefits, including stabilizing the newborn’s heart rate, temperature, and breathing, stimulating digestion, helping the newborn to sleep, promoting weight gain, and aiding in maternal attachment.
Choice B rationale
The newborn’s weight does not affect the timing of the instillation of antibiotic ophthalmic ointment.
Choice C rationale
Manifestations of infection in the newborn’s eyes would not be immediately apparent following birth, so this would not be a reason to delay the instillation of antibiotic ophthalmic ointment.
Choice D rationale
The mode of delivery, whether vaginal or cesarean, does not affect the timing of the instillation of antibiotic ophthalmic ointment.
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