by Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
Candidates for the family and women’s health certification examinations need to be prepared to answer a variety of questions about the care of women during pregnancy and childbirth. Here are some sample questions to help you prepare for this portion of the test.
1. The recommended calcium intake for a woman during pregnancy is _________ mg of elemental calcium per day.
A. 500- 750
B. 750- 1,000
Correct answer: D
Increased calcium intake is important to the development of bone and teeth; the required amount can usually be met by ingesting three to four servings of high-quality dairy products per day. Examples of a single dairy serving include 8 ounces of milk, 1 ounce of cheese, 1 cup of yogurt, or 1 cup of calcium-fortified juice. While dietary-source calcium is best, supplementation is sometimes required if a woman is lactose intolerant or is otherwise unable to meet these goals.
2. Maternal iron requirements are greatest during what part of pregnancy?
A. First trimester
B. Second and third trimester
C. Equal throughout pregnancy
Best answer: B
Maternal iron requirements increase in the second and third trimesters of pregnancy, in part due to the fetus’ need to build iron stores. Iron deficiency is the most common form of anemia during pregnancy. This condition most often occurs because a woman is iron deficient when she enters pregnancy, not because she develops deficiency due to increased iron requirements. Pregnancy-related iron requirements, given in terms of elemental iron, are as follows: 30 mg/day in the absence of iron deficiency; 60 mg/day to 100 mg/day with iron deficiency or in a multiple-gestation pregnancy, and 200 mg/day in the presence of iron deficiency anemia. A 325 mg ferrous sulfate tablet contains 65 mg of elemental iron, while most prescription prenatal vitamins contain 30 mg to 65 mg.
3. For a healthy woman with a normal prepregnancy body mass index (BMI), daily caloric requirements during pregnancy are typical baseline caloric needs plus ___ kcal.
4. For a healthy woman with a normal prepregnancy BMI, daily caloric requirements during lactation are typical baseline caloric needs plus ___ kcal.
Question 3 best answer: B, question 4 best answer: B
The expression “eating for two” is often used to describe the dietary needs of a woman during pregnancy. In reality, the expectant mother’s caloric needs increase rather modestly during pregnancy over her baseline requirements and can usually be achieved by the addition of a nutritious snack such as a large glass of low-fat milk and a half a peanut butter sandwich. Caloric requirements during lactation are slightly greater but remain easy to achieve with one or two nutritious snacks in addition to a well-balanced diet.
5. Pica during pregnancy should be considered:
A. A harmless practice common in certain ethnic groups
B. Only problematic if nutritious food sources are left out of the diet and replaced by nonfood substances.
C. A way of providing select micronutrients not usually found in food products
D. Potentially dangerous due in part to contaminants in the nonfood substance.
Best answer: D
Pica is the ingestion of nonfood substances such as clay, cornstarch, laundry starch, dry milk of magnesia, paraffin, coffee grounds or ice. It is most common in select ethnic groups, but pica occurs in all socioeconomic classifications. Certain pica habits are probably harmless (such as sucking on ice chips) and likely do little to replace more nutrition substance. Most other pica forms contain potential risk, since nonfood substances are preferably ingested over more nutritious food sources. The ingestion of clay, starches and paraffin is associated with risk for constipation, bowel obstruction and nutritional deficiency. In particular, many common pica substances can be contaminated with heavy metals such as lead or mercury and other industrial pollutants that are particularly toxic to the mother and the developing fetus. The issue of pica should be raised with all pregnant women. Some women believe that pica is normal. Others are encouraged by well-meaning friends and family members to eat substances like clay as a way to relieve tension. The NP should acknowledge that although pica is considered acceptable by some cultures, the practice is associated with potential health risks for the mother and her baby.
Information obtained from: Fitzgerald M. Childbearing. In: Fitzgerald M. Nurse Practitioner Certification and Practice Preparation
. 3d ed. Philadelphia, Pa.: F. A. Davis; 2010.
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