A nurse is teaching a client about dietary recommendations while breastfeeding. Which of the following client statements should the nurse identify as an indication of understanding the teaching?

"I can have up to three glasses of wine per day while breastfeeding."

"I need to drink a glass of fluid each time I nurse and with all meals."

"I should avoid all seafood while I am breastfeeding."

"I need to eat a bland diet while breastfeeding, as babies often react to spicy food."

Answer and Explanation

The Correct Answer is B

Rationale:
A. "I can have up to three glasses of wine per day while breastfeeding.": Alcohol passes into breast milk and can affect the infant’s neurologic development and feeding patterns. Regular alcohol intake should be avoided.

B. "I need to drink a glass of fluid each time I nurse and with all meals.": Adequate hydration supports optimal milk production during breastfeeding. Increasing fluid intake each time the mother nurses or eats helps replace fluids lost through lactation and prevents dehydration.

C. "I should avoid all seafood while I am breastfeeding.": Seafood provides essential omega-3 fatty acids that support the infant’s brain and eye development. The mother should only avoid high-mercury fish such as swordfish and king mackerel.

D. "I need to eat a bland diet while breastfeeding, as babies often react to spicy food.": Most infants tolerate varied maternal diets, including spicy foods, without adverse effects. Restricting flavors unnecessarily limits the mother’s nutrition and is not required.

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Correct Answer is B

Explanation

Rationale:
A. Encourage the client to eat a large meal in the evening: Clients with myasthenia gravis experience progressive muscle weakness, especially later in the day. Eating large evening meals increases the risk of fatigue and aspiration because muscle strength is reduced after activity.

B. Recommend the client eat within 45 min of taking cholinesterase-inhibitor medication: Cholinesterase inhibitors, such as pyridostigmine, enhance neuromuscular transmission and improve muscle strength. Eating within 45 minutes of taking the medication ensures optimal swallowing ability and reduces the risk of aspiration by aligning mealtime with peak effect.

C. Recommend the client extend their neck to facilitate swallowing: Extending the neck actually increases the risk of aspiration by opening the airway. Clients should be instructed to flex the neck slightly forward while swallowing to close the airway and promote safe swallowing mechanics.

D. Encourage the client to contact an occupational therapist to learn techniques of avoiding aspiration: While an occupational therapist can provide helpful adaptive techniques, primary aspiration prevention teaching should come directly from the nurse and speech-language pathologist.

A. Administer betamethasone to the client. B. Administer magnesium sulfate to the client. C. Monitor fetal heart rate every 4 hr. D. Monitor the client's temperature every 2 hr.

Correct Answer is D

Explanation

Rationale:
A. Administer betamethasone to the client: Betamethasone is given to promote fetal lung maturity in preterm labor, typically before 34 weeks of gestation. At 37 weeks, the fetus is considered term, so corticosteroids are not indicated.

B. Administer magnesium sulfate to the client: Magnesium sulfate is used for neuroprotection in preterm labor or for seizure prophylaxis in preeclampsia. Since this client is at term without preeclampsia, magnesium sulfate is not indicated.

C. Monitor fetal heart rate every 4 hr: Continuous or frequent fetal heart rate monitoring is recommended after spontaneous rupture of membranes to detect signs of fetal distress or infection. Monitoring only every 4 hours is insufficient.

D. Monitor the client's temperature every 2 hr: Maternal infection, such as chorioamnionitis, is a significant risk after spontaneous rupture of membranes. Monitoring the client’s temperature every 2 hours allows early detection of infection and timely intervention.

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A nurse is teaching a client about dietary recommendations while breastfeeding. Which of the following client statements should the nurse identify as an indication of understanding the teaching?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is B

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Correct Answer is D

Explanation

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