A nurse is performing a nutritional assessment for a client during their first prenatal visit at 12 weeks of gestation. Which of the following findings indicates that the client should be referred to a registered dietician?
The client reports that they take a multivitamin daily.
The client reports a 4.5 kg (10 lb) weight gain since their positive pregnancy test.
The client reports that they are nauseous most mornings.
The client reports that they eat prunes to help manage their constipation.
The Correct Answer is B
Choice A rationale
Taking a multivitamin daily is generally recommended during pregnancy to ensure the mother and baby receive necessary nutrients. It does not indicate a need for referral to a dietitian.
Choice B rationale
A weight gain of 4.5 kg (10 lb) since a positive pregnancy test could be a concern depending on the timeframe. If this weight gain occurred rapidly, it could indicate issues such as fluid retention or inadequate nutrition, which would warrant a referral to a dietitian.
Choice C rationale
Nausea, particularly in the morning, is a common symptom of early pregnancy often referred to as “morning sickness”. It does not typically require dietary intervention unless it is severe (hyperemesis gravidarum), leading to weight loss and dehydration.
Choice D rationale
Eating prunes is a natural method to manage constipation, a common issue during pregnancy due to hormonal changes that slow digestion. This choice does not indicate a need for a dietitian referral.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
While monitoring glucose levels is important in newborn care, it is not specifically related to breastfeeding frequency and voiding patterns.
Choice B rationale
While assessing the newborn’s head and sclera color is part of a comprehensive newborn examination, it is not specifically related to breastfeeding frequency and voiding patterns.
Choice C rationale
While monitoring the newborn’s respiratory rate is crucial in newborn care, it is not specifically related to breastfeeding frequency and voiding patterns.
Choice D rationale
Monitoring intake and output is directly related to breastfeeding frequency and voiding patterns. A newborn who has been breastfeeding 3 to 4 times per day should have passed meconium stool by 36 hours old. The absence of meconium stool could indicate a problem and should be reported to the provider.
Correct Answer is C
Explanation
Choice A rationale
Pale, translucent skin is not typically a characteristic of a postterm newborn. Postterm newborns often have dry, peeling, loose skin.
Choice B rationale
Large deposits of subcutaneous fat are not usually seen in postterm newborns. In fact, these babies may appear abnormally thin, especially if the function of the placenta was severely reduced near the end of the pregnancy.
Choice C rationale
Nails extending over the tips of the fingers is indeed a common characteristic of postterm newborns. This is because the baby has had more time to grow in the womb.
Choice D rationale
A thin covering of fine hair on the shoulders and back is not typically seen in postterm newborns. This characteristic is more commonly associated with preterm babies.
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