The nurse is teaching a 25 year old pregnant woman about nutrition and weight gain.
Which of the following statements demonstrates the woman understands the teaching?
"A weight gain of 5 pounds per month is a healthy weight gain for the baby and for me.”.
"The normal weight gain for pregnancy is 25-35 pounds (11.5-16 kg) for a woman with a normal BMI.”.
"I should maintain a weight gain of one pound per month so that by gestation week 40, I would have gained 40 pounds (18 kg), which is the minimum healthy weight gain I need for my baby.”.
"Even though I'm obese, I should not be concerned because obesity is not associated with pregnancy loss.”. —
The Correct Answer is B
Choice A rationale
A weight gain of 5 pounds per month, especially in the second and third trimesters, often exceeds the recommended rate for a woman with a normal BMI, which is typically about one pound per week (approximately 4-5 pounds per month) during this period. Excessive weight gain can increase the risk of gestational hypertension, preeclampsia, and macrosomia, potentially complicating both delivery and postpartum recovery for the mother and fetus. The total recommended weight gain is usually 25 to 35 pounds.
Choice B rationale
The recommendation for total weight gain during pregnancy for a woman who has a normal pre-pregnancy body mass index (BMI of 18.5 to 24.9) is 25 to 35 pounds (11.5 to 16 kg). This weight gain is necessary to support the growth of the fetus, placenta, amniotic fluid, increased maternal blood volume, breast tissue, and uterine size. Achieving this range is associated with the best outcomes for both the mother and the newborn, reducing risks like preterm birth.
Choice C rationale
A weight gain of 40 pounds (18 kg) is at the higher end of or exceeds the recommended range for a woman with a normal BMI, suggesting it is not the minimum healthy gain. Furthermore, the rate of gain should be slow in the first trimester (2 to 4 pounds total) and then accelerate to about one pound per week in the second and third trimesters, making one pound per month much too slow after the first trimester.
Choice D rationale
Maternal obesity (BMI ≥ 30) is strongly associated with numerous adverse pregnancy outcomes, including an increased risk of miscarriage (pregnancy loss), stillbirth, gestational diabetes, preeclampsia, and a higher chance of needing a cesarean delivery. Obese women are typically advised to gain less weight, generally 11 to 20 pounds (5 to 9 kg) during the entire pregnancy, and should be monitored closely due to the elevated risks.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Sleeping on the abdomen is contraindicated in later pregnancy as it is physically impossible due to the enlarged uterus and poses a risk of direct pressure on the fetus, which is detrimental to comfort and could potentially impede circulation if pressure were applied.
Choice B rationale
The side-lying position, especially the left side, optimizes uteroplacental perfusion by minimizing pressure from the gravid uterus on the vena cava, preventing supine hypotensive syndrome, and improving maternal cardiac output, which enhances fetal oxygenation and is the recommended sleeping position.
Choice C rationale
Lying on the back, even with knees slightly elevated, allows the heavy uterus to compress the inferior vena cava and aorta (supine hypotensive syndrome), significantly reducing venous return to the heart and decreasing blood flow and oxygen delivery to the fetus, which is not recommended.
Choice D rationale
Elevating the head on pillows primarily helps with maternal heartburn or shortness of breath but does not change the position of the uterus relative to the major blood vessels (aorta and vena cava) and therefore does not effectively address the risk of impaired fetal circulation seen in the supine position.
Correct Answer is C
Explanation
Choice A rationale
Heartburn, or pyrosis, is often caused by the relaxation of the lower esophageal sphincter (LES) due to pregnancy hormones like progesterone and the upward pressure from the enlarging uterus. Substituting other calcium sources for milk is not a primary intervention because milk, while sometimes a temporary buffer, does not address the underlying mechanical and hormonal causes of acid reflux.
Choice B rationale
Fiber-rich foods promote bowel regularity and are essential during pregnancy to prevent constipation, a common discomfort. Reducing fiber is an inappropriate suggestion for managing heartburn; instead, the focus should be on dietary modifications that lessen gastric reflux, such as avoiding spicy or acidic foods.
Choice C rationale
Eating five small meals daily prevents the stomach from becoming overly distended, which is a key contributor to pushing stomach contents, including acid, back up into the esophagus through the relaxed LES. Smaller, more frequent meals, along with maintaining an upright posture after eating, are effective non-pharmacological methods to manage reflux discomfort.
Choice D rationale
Lying down after meals is strongly discouraged for individuals experiencing heartburn, particularly in late pregnancy. The recumbent position allows gravity to assist the reflux of stomach acid into the esophagus, which will intensify the burning sensation. The woman should remain upright for at least two to three hours following food consumption.
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