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Total Questions : 6

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Question 1:

A nurse is assessing a pregnant client who complains of lower back pain.

Which musculoskeletal change during pregnancy is primarily responsible for this symptom?

Explanation

This is because the growing uterus shifts the center of gravity and causes an increased strain on the back muscles and ligaments.

This can lead to lower back pain during pregnancy.

Choice A is wrong because increased joint laxity is caused by hormonal changes during pregnancy, not by musculoskeletal changes.

Joint laxity can affect the stability of the joints, but not necessarily cause lower back pain.

Choice C is wrong because increased muscle strain is a result of increased spinal curvature, not a cause of it.

Muscle strain can also contribute to lower back pain, but it is not the primary musculoskeletal change during pregnancy.

Choice D is wrong because decreased muscle strength is not a musculoskeletal change during pregnancy, but a possible consequence of reduced physical activity or poor posture.

Muscle strength can affect the support of the spine, but it is not the main factor for lower back pain.

Normal ranges for spinal curvature vary depending on age, sex, and posture, but generally the lumbar lordosis (the inward curve of the lower spine) should be between 20 and 45 degrees.


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Question 2:

A nurse is providing dietary recommendations to a pregnant woman.

Which recommendation should the nurse prioritize?

Explanation

Alcohol can cross the placenta and cause fetal alcohol syndrome, which can result in physical and mental defects in the baby.

Alcohol should be avoided throughout pregnancy and breastfeeding.

Choice A is wrong because drinking 2-3 liters of water per day is a general recommendation for healthy adults, not specific to pregnant women.

However, hydration is important for pregnant women to prevent constipation and urinary tract infections.

Choice B is wrong because limiting caffeine intake to 300 milligrams per day is a moderate recommendation for pregnant women, not a priority.

High caffeine intake can increase the risk of miscarriage and low birth weight.

Choice D is wrong because consuming an extra 300-400 calories per day while breastfeeding is a recommendation for lactating women, not pregnant women.

Pregnant women need an extra 340-450 calories per day in the second and third trimesters.


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Question 3:

A nurse is educating a pregnant client about sources of folic acid.

Which food group is a good source of folic acid that should be included in the client's diet?

Explanation

The correct answer is choice A. Green leafy vegetables are a good source of folate, which is also known as vitamin

B. Folate is important for healthy cell division and fetal growth and development.

It can also help prevent birth defects and lower homocysteine levels, which are associated with heart disease.

Choice B is wrong because lean meats and poultry are not rich in folate, although they do provide other B vitamins, such as B12 and B. Choice C is wrong because dairy products are not a significant source of folate, although they do provide other nutrients, such as calcium and protein.

Choice D is wrong because whole grains are not a natural source of folate, although they may be fortified with folic acid, which is a synthetic form of folate that is better absorbed by the body.

Normal ranges for folate in blood are 2.7–17.0 nanograms per milliliter (ng/mL) for adults and 5.0–21.0 ng/mL for children.


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Question 4:

A nurse is discussing the importance of water intake with a pregnant client.

How many liters of water per day should the nurse recommend for the client?

Explanation

According to the American College of Obstetricians and Gynecologists (ACOG) and the Institute of Medicine, pregnant women should drink on average about 10 8-ounce cups of water or other beverages each day.

This is equivalent to about 2.4 liters of water per day.

However, this amount may vary depending on the individual’s body type, activity level, and weather conditions.

Choice A is wrong because 1-2 liters of water per day is not enough for pregnant women.

They need more water to support their increased metabolism, blood volume, and fetal development.

Choice C is wrong because 3-4 liters of water per day may be too much for some pregnant women.

Drinking too much water can cause hyponatremia, a condition where the sodium level in the blood becomes too low.

This can lead to symptoms such as nausea, headache, confusion, and seizures.

Choice D is wrong because 4-5 liters of water per day is definitely too much for most pregnant women.

This can cause overhydration and hyponatremia, as well as increase the risk of water intoxication, a potentially fatal condition where the brain swells due to excess fluid.

The best way to determine how much water to drink during pregnancy is to monitor the color and frequency of urine, as well as the level of thirst.

The urine should be pale yellow or colorless, and the thirst should be only occasional.


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Question 5:

A nurse is educating a pregnant client about caffeine intake during pregnancy.

What is the recommended limit for caffeine intake per day?

Explanation

According to the American Pregnancy Organization and the American College of Obstetricians Gynecologists, pregnant women should limit their caffeine intake to no more than 200 mg per day.

This is because caffeine can cross the placenta and affect the baby’s health, such as increasing the risk of miscarriage or low birth weight.

Choice B is wrong because 300 milligrams of caffeine per day is above the recommended limit for pregnant women.

Choice C is wrong because 400 milligrams of caffeine per day is twice the recommended limit for pregnant women.

Choice D is wrong because 500 milligrams of caffeine per day is more than twice the recommended limit for pregnant women.

To stay within the safe limit of 200 mg of caffeine per day, pregnant women should be aware of the amount of caffeine in different foods and drinks.

For example, one cup of instant coffee has about 60 mg of caffeine, one mug of tea has about 75 mg of caffeine, one can of soft drink has about 40 mg of caffeine, and one can of energy drink has up to 80 mg of caffeine.

Chocolate and decaffeinated coffee also contain small amounts of caffeine.


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Question 6:

A nurse is providing education to a pregnant client about alcohol consumption during pregnancy.

What is the recommended approach to alcohol intake?

Explanation

According to the CDC1, there is no known safe amount of alcohol use during pregnancy or while trying to get pregnant.

Alcohol can cause problems for the baby throughout pregnancy, including before a woman knows she is pregnant.

Alcohol use in the first three months of pregnancy can cause the baby to have abnormal facial features.

Growth and central nervous system problems (e.g., low birthweight, behavioral problems) can occur from alcohol use anytime during pregnancy.

Alcohol use during pregnancy can also cause fetal alcohol spectrum disorders (FASDs), which are lifelong physical, behavioral, and intellectual disabilities.

Choice B is wrong because limiting alcohol intake to one drink per day is not safe for the baby.

There is no known safe amount of alcohol use during pregnancy.

Choice C is wrong because limiting alcohol intake to two drinks per week is not safe for the baby.

There is no safe time for alcohol use during pregnancy.

Alcohol can cause problems for the baby throughout pregnancy, including before a woman knows she is pregnant.

Choice D is wrong because consuming alcohol only in moderation is not safe for the baby.

All types of alcohol are equally harmful, including all wines and beer.


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