A nurse is caring for a young adult client who is discontinuing birth control pills and wishes to start a family. Which of the following statements by the nurse is an appropriate dietary guideline?
Increase your caloric intake before pregnancy to stabilize your metabolism.
Increase your total intake of seafood to 20 ounces per week.
Decrease ascorbic acid in your diet.
Increase folic acid to 400 micrograms per day prior to getting pregnant.
The Correct Answer is D
Choice A reason: Increasing the caloric intake before pregnancy is not an appropriate dietary guideline, as it can lead to excessive weight gain and obesity, which can increase the risk of gestational diabetes, hypertension, and other complications. The nurse should advise the client to maintain a healthy weight and a balanced diet before and during pregnancy.
Choice B reason: Increasing the total intake of seafood to 20 ounces per week is not an appropriate dietary guideline, as it can expose the client to high levels of mercury, which can harm the developing fetus. The nurse should advise the client to limit the intake of seafood to 8 to 12 ounces per week, and avoid fish that are high in mercury, such as shark, swordfish, and king mackerel.
Choice C reason: Decreasing ascorbic acid in the diet is not an appropriate dietary guideline, as it can impair the immune system and the absorption of iron, which are both important for the health of the mother and the fetus. The nurse should advise the client to consume adequate amounts of ascorbic acid, which is found in citrus fruits, tomatoes, broccoli, and other foods.
Choice D reason: Increasing folic acid to 400 micrograms per day prior to getting pregnant is an appropriate dietary guideline, as it can prevent neural tube defects, such as spina bifida and anencephaly, in the fetus. The nurse should advise the client to take a daily prenatal vitamin that contains folic acid, and eat foods that are rich in folate, such as leafy greens, beans, and fortified cereals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Administering the feeding by gravity drip is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Gravity drip can cause overfeeding, aspiration, and abdominal distension. The nurse should use an infusion pump to regulate the flow rate and volume of the feeding.
Choice B reason: Flushing the tubing with 10 mL water every 6 hr is an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Flushing the tubing prevents clogging, maintains patency, and hydrates the client. The nurse should also flush the tubing before and after medication administration, and whenever the feeding is interrupted or discontinued.
Choice C reason: Replacing the bag and tubing every 24 hr is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Replacing the bag and tubing every 24 hr does not prevent clogging, and may increase the risk of infection and contamination. The nurse should replace the bag and tubing every 48 hr, or as per facility policy.
Choice D reason: Heating the formula prior to infusion is not an appropriate action for a client who has a small-bore jejunostomy tube and is receiving a high-viscosity formula. Heating the formula can alter its composition, reduce its nutritional value, and increase the risk of bacterial growth. The nurse should use room-temperature formula and store it in a refrigerator when not in use.
Correct Answer is D
Explanation
Choice A reason: Increased cholesterol is not an indication that the weight loss program has been effective, as it is a risk factor for cardiovascular disease and stroke. The nurse should expect the client's cholesterol level to decrease as a result of the weight loss program, as it can lower the production and absorption of cholesterol in the body.
Choice B reason: Increased glycosylated hemoglobin (HbA1c) is not an indication that the weight loss program has been effective, as it is a measure of the average blood glucose level over the past 2 to 3 months. The nurse should expect the client's HbA1c level to decrease as a result of the weight loss program, as it can improve the insulin sensitivity and glucose metabolism of the body.
Choice C reason: Increased LDL (low-density lipoprotein) is not an indication that the weight loss program has been effective, as it is the "bad" cholesterol that can accumulate in the arteries and cause atherosclerosis. The nurse should expect the client's LDL level to decrease as a result of the weight loss program, as it can reduce the synthesis and secretion of LDL in the liver.
Choice D reason: Increased HDL (high-density lipoprotein) is an indication that the weight loss program has been effective, as it is the "good" cholesterol that can remove excess cholesterol from the blood and transport it to the liver for excretion. The nurse should expect the client's HDL level to increase as a result of the weight loss program, as it can enhance the activity and expression of HDL in the body.
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