Review Practice Exercise 6

Maternal Risk Factors > Maternal Newborn

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Practice Exercise 6

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Total Questions : 4

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Question 1:

A nurse is educating a pregnant patient about nutritional deficiencies. Which nutrient deficiency is most associated with neural tube defects?

A. Iron B. Calcium C. Folic acid D. Vitamin D

Answer and Explanation

Choice A:

Iron deficiency causes maternal anemia (Hb <12 g/dL in pregnancy) leading to fatigue, pallor, and low birth weight infants, but it is not linked to neural tube defects.

Choice B:

Calcium deficiency increases maternal risk of osteopenia and may contribute to hypertensive disorders of pregnancy. It does not affect neural tube development.

Choice C:

Folic acid deficiency impairs neural tube closure due to defective DNA synthesis and cell division. This leads to structural anomalies like spina bifida, making it the most associated nutrient deficiency.

Choice D:

Vitamin D deficiency leads to maternal bone demineralization and neonatal rickets. It is not associated with neural tube closure failure.

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Question 2:

What is a common consequence of food insecurity during pregnancy?

A. Macrosomia B. Poor fetal growth C. Placenta previa D. Congenital heart defects

Answer and Explanation

Choice A:

Macrosomia (>4000 g) is typically linked to gestational diabetes mellitus, not food insecurity, as it results from maternal hyperglycemia and excess fetal insulin.

Choice B:

Poor fetal growth occurs when maternal malnutrition and food insecurity limit nutrient supply. This results in IUGR and low birth weight, which are common outcomes of inadequate prenatal nutrition.

Choice C:

Placenta previa, characterized by implantation of the placenta over the cervical os, is an anatomical abnormality unrelated to maternal nutrition or food insecurity.

Choice D:

Congenital heart defects arise from abnormal embryonic development influenced by genetic or teratogenic factors. They are not directly caused by food insecurity.

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Question 3:

Which of the following are potential complications associated with maternal obesity during pregnancy? Select all that apply.

A. Increased risk of gestational diabetes mellitus B. Decreased risk of macrosomia C. Higher incidence of shoulder dystocia D. Reduced likelihood of stillbirth E. Increased risk of preeclampsia

Answer and Explanation

Choice A:

Increased risk of gestational diabetes mellitus occurs because maternal obesity causes insulin resistance and hyperglycemia, leading to abnormal glucose tolerance.

Choice B:

Decreased risk of macrosomia is incorrect because obesity increases, not decreases, the likelihood of fetal overgrowth due to excess maternal glucose and fat transfer.

Choice C:

Higher incidence of shoulder dystocia occurs due to fetal macrosomia, common in pregnancies complicated by maternal obesity and diabetes.

Choice D:

Reduced likelihood of stillbirth is incorrect because obesity increases stillbirth risk. Mechanisms include impaired placental function, chronic hypoxia, and metabolic abnormalities.

Choice E:

Increased risk of preeclampsia is linked to obesity through vascular dysfunction, endothelial injury, and chronic inflammation, which raise maternal blood pressure above normal levels (<120/80 mmHg).

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Question 4:

Which of the following are key nursing interventions for managing nutritional deficiencies in pregnancy? Select all that apply.

A. Educating on daily folic acid supplementation B. Monitoring hemoglobin levels for iron deficiency C. Encouraging high-sugar diets to boost energy D. Providing dietary counseling for iron-rich foods E. Referring to WIC for food-insecure patients

Answer and Explanation

Choice A:

Educating on daily folic acid supplementation prevents neural tube defects by supporting DNA synthesis and neural tissue development.

Choice B:

Monitoring hemoglobin levels detects iron deficiency anemia early, allowing timely intervention to prevent maternal fatigue and fetal growth restriction.

Choice C:

Encouraging high-sugar diets is inappropriate. Excess sugar intake increases risk of gestational diabetes, macrosomia (>4000 g), and neonatal hypoglycemia (<40 mg/dL). It does not correct nutritional deficiencies.

Choice D:

Providing dietary counseling for iron-rich foods ensures adequate iron intake, enhancing hemoglobin production and preventing anemia-related complications.

Choice E:

Referring to WIC supports food-insecure patients by providing access to nutrient-rich foods, reducing risks of growth restriction and preterm birth.

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Total Questions : 4

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Practice Exercise 6

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