Needs of Maternal and Reproductive Health Clients

Needs of Maternal and Reproductive Health Clients Related

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Which patient has correctly increased her caloric intake from her recommended pregnancy intake to the amount necessary to sustain breastfeeding in the first 6 postpartum months?

  • A. From 1800 to 2200 calories per day
  • B. From 2000 to 2500 calories per day
  • C. From 2200 to 2530 calories per day
  • D. From 2500 to 2730 calories per day
Correct Answer: C

Rationale: Rationale: The correct answer is C because for breastfeeding, an additional 500 calories/day are needed compared to pregnancy. The recommended caloric intake during pregnancy is around 2200 calories/day. Therefore, increasing from 2200 to 2530 calories/day aligns with the additional 500 calories necessary for sustaining breastfeeding.

Summary:
A: Going from 1800 to 2200 calories/day does not provide the extra 500 calories needed for breastfeeding.
B: Increasing from 2000 to 2500 calories/day does not account for the original pregnancy intake or the additional calories required for breastfeeding.
D: Jumping from 2500 to 2730 calories/day exceeds the additional 500 calories needed for breastfeeding, potentially leading to excessive weight gain.

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A pregnant woman comes to the prenatal clinic for an initial visit. In reviewing her childbearing history, the client indicated that she has delivered premature twins, one full-term baby, and has had no abortions. Which GTPAL should the nurse document in this client's record?

  • A. 3-1-2-0-3
  • B. 4-1-2-0-3
  • C. 2-1-2-1-2
  • D. 3-1-1-0-3
Correct Answer: D

Rationale: (D) describes the correct GTPAL. The client has been pregnant 3 times including the current pregnancy (G-3). She had one full-term infant (T-1). She also had a preterm (P-1) twin pregnancy (a multifetal gestation is considered one birth when calculating parity). There were no abortions (A-0), so this client has a total of 3 living children.

Which nursing intervention is an independent function of the professional nurse?

  • A. Administering oral analgesics
  • B. Requesting diagnostic studies
  • C. Teaching the patient perineal care
  • D. Providing wound care to a surgical incision
Correct Answer: C

Rationale: Teaching is an independent nursing function, whereas administering medications or requesting diagnostic studies are dependent functions requiring physician orders.

The nurse is reviewing a list of foods high in folic acid with a patient who is considering becoming pregnant. The nurse determines that the patient understands the teaching when the patient states she will include which list of foods in her diet?

  • A. Peaches, yogurt, and tofu
  • B. Strawberries, milk, and tuna
  • C. Asparagus, lemonade, and chicken breast
  • D. Spinach, orange juice, and fortified bran flakes
Correct Answer: D

Rationale: The correct answer is D. Spinach, orange juice, and fortified bran flakes are high in folic acid, which is essential for pregnant women to prevent neural tube defects in the fetus. Spinach is rich in folate, the natural form of folic acid. Orange juice is often fortified with folic acid, and fortified bran flakes also contain high levels of folic acid.

A, B, and C are incorrect choices because they do not contain foods that are particularly high in folic acid. While peaches, yogurt, tofu, strawberries, milk, tuna, asparagus, lemonade, and chicken breast are all nutritious choices, they are not as rich in folic acid as the foods listed in option D. It is crucial for the patient to focus on foods with high folic acid content to support a healthy pregnancy.

A client at 39-weeks gestation is admitted to the labor and delivery unit in active labor. The client's cervix is dilated 7 cm, 100% effaced, and the fetus is at +1 station. The client begins to push forcefully with contractions. What action should the nurse take?

  • A. Encourage the client to pant-blow during contractions.
  • B. Assist the client to push with contractions.
  • C. Prepare for an immediate delivery.
  • D. Notify the healthcare provider.
Correct Answer: A

Rationale: Pant-blow breathing helps prevent premature pushing before full dilation, reducing the risk of cervical edema.

A patient with a BMI of 32 has a positive pregnancy test. What is the maximum number of pounds that the nurse will advise the patient gain during the pregnancy?

  • A. 20 lb
  • B. 25 lb
  • C. 28 lb
  • D. 40 lb
Correct Answer: A

Rationale: The correct answer is A (20 lb). During pregnancy, the recommended weight gain for a woman with a BMI of 30-39.9 is 11-20 pounds. This range helps reduce the risk of complications associated with excessive weight gain. Option B (25 lb) exceeds this recommended range, while options C (28 lb) and D (40 lb) are even further beyond the healthy weight gain guidelines for a BMI of 32. Thus, advising the patient to gain a maximum of 20 pounds is the most appropriate recommendation to ensure a healthy pregnancy outcome.

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