Which statement shows the client understands approximately how many calories per day she needs over her normal pre-pregnant needs?
I should not increase my calories while I am pregnant.
I will need approximately 500 more calories.
I need to double my calories because I am eating for two.
I will need about 300 more calories.
The Correct Answer is D
Choice A rationale
This statement is incorrect as caloric needs increase during pregnancy to support fetal growth, placental development, and increased maternal metabolic demands. Inadequate caloric intake can lead to poor fetal outcomes, including low birth weight and impaired development.
Choice B rationale
While caloric needs do increase, an additional 500 calories is generally too high for the average pregnancy. The recommended increase is typically lower, focusing on nutrient-dense foods to ensure sufficient energy for both mother and fetus.
Choice C rationale
Doubling caloric intake is excessive and can lead to excessive maternal weight gain, increasing risks for gestational diabetes, preeclampsia, and delivery complications. The concept of "eating for two" is a common misconception that often leads to overconsumption.
Choice D rationale
During the second and third trimesters, the average pregnant woman requires an additional 300 calories per day above her pre-pregnancy needs. This increase provides adequate energy for rapid fetal growth, development, and maternal physiological changes, such as increased blood volume and uterine expansion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
At the end of the first trimester, around 12-14 weeks gestation, the uterus is still relatively low in the pelvis. The symphysis pubis serves as a reliable anatomical landmark for locating the fundus of the uterus at this stage. Placing the Doppler just above this bony prominence allows for optimal transmission of sound waves to detect the fetal heart tones.
Choice B rationale
The right upper quadrant contains structures like the liver, gallbladder, and part of the colon. At the end of the first trimester, the uterus is not typically high enough to extend into this region. Therefore, attempting to locate fetal heart tones in this area would be ineffective and unlikely to yield a clear signal, as the fetus is not yet positioned there.
Choice C rationale
Just above the umbilicus is the general location for assessing fetal heart tones later in pregnancy, typically during the second and third trimesters when the uterus has significantly enlarged and risen out of the pelvis. At the end of the first trimester, the uterus is still too small and low for the fetal heart tones to be consistently heard at this location.
Choice D rationale
The left upper quadrant contains the stomach, spleen, and part of the colon. Similar to the right upper quadrant, the uterus is not positioned high enough in the first trimester to extend into this area. Therefore, attempting to locate fetal heart tones in the left upper quadrant would be inappropriate and unlikely to be successful.
Correct Answer is A
Explanation
Choice A rationale
A fundus that is deviated to the right, boggy, and 2 cm above the umbilicus suggests a distended bladder is displacing the uterus, preventing it from contracting effectively. A full bladder inhibits uterine involution by impeding the muscle fibers from compressing blood vessels, leading to uterine atony and increasing the risk of postpartum hemorrhage. Normal bladder capacity is 300-500 mL.
Choice B rationale
Obtaining a stat hemoglobin level is not the immediate priority. While a boggy uterus can indicate blood loss, the primary issue here is likely bladder distension causing uterine atony. Addressing the cause of the uterine displacement (bladder distension) takes precedence over assessing the degree of blood loss, which would be a secondary consequence. A normal hemoglobin for a woman is typically 12.0 to 15.5 grams per deciliter.
Choice C rationale
Administering methylergometrine is not the first action. Methylergometrine is a uterotonic agent used to promote uterine contractions and prevent postpartum hemorrhage. However, if the uterus is displaced by a full bladder, the medication's effectiveness will be significantly reduced until the bladder is emptied. Treating the underlying cause is crucial before administering uterotonics.
Choice D rationale
Inserting an indwelling urinary catheter is a more invasive intervention than assisting the client to void. While a catheter might be necessary if the client cannot void independently, the initial and least invasive action should always be to encourage spontaneous urination. Catheterization carries risks of urinary tract infection and discomfort, so it's not the first-line intervention.
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