Nutrition Through the Life Cycle 4th Edition By Judith E. Brown - Test Bank

Nutrition Through the Life Cycle 4th Edition By Judith E. Brown – Test Bank

 

Instant Download – Complete Test Bank With Answers

 

 

Sample Questions Are Posted Below

 

Test Bank[1] for Chapter 5 – Nutrition during Pregnancy:
Conditions and Interventions

 

Key to question types: F = fact-based; A = application; L, M, H = low, medium, high difficulty

 

Multiple Choice

 

Answer      Page #

 

b, F, L        137            1.   Hypertension is defined as having a blood pressure of _____.

1. ≥120 mm Hg systolic or ≥70 mm Hg diastolic
2. ≥140 mm Hg systolic or ≥90 mm Hg diastolic
3. ≥120 mm Hg systolic or ≥90 mm Hg diastolic
4. ≥140 mm Hg systolic or ≥70 mm Hg diastolic
5. ≥160 mm Hg systolic or ≥110 mm Hg diastolic

 

b, F            137            2.   The second leading cause of MATERNAL mortality in the United States is:

1. gestational diabetes.
2. hypertensive disorders of pregnancy.
3. AIDS/HIV.
4. multifetal pregnancies.
5. adolescent pregnancy complications.

 

d, F            138            3.   Pregnancies among women with blood pressure ≥160 (systolic) or ≥110 (diastolic) mm Hg are associated with an increased risk of:

1. fetal death.
2. preterm delivery.
3. fetal growth retardation.
4. all of the above

 

b, F            138            4.   Preeclampsia-eclampsia represents a syndrome characterized by all of the following EXCEPT:

1. blood vessel spasms and constriction.
2. increased calcium excretion.
3. oxidative tissue damage and inflammation.
4. platelet aggregation and blood coagulation.
5. insulin resistance.

 

e, F, L        135            5.   Metabolic effects associated with obesity are closely related to the presence of large amounts of visceral fat. These metabolic effects produce which of the following?

1. Chronic inflammation
2. Free radical generation
3. Oxidative stress
4. Insulin resistance
5. All of the above

 

d, F            138            6.   Maternal organs most affected by small blot clots and reduced blood flow in preeclampsia include all of the following EXCEPT:

1. the placenta.
2. the kidneys.
3. the brain.
4. the appendix.
5. the liver.

 

e, F            138-139     7.   Women with which of the following characteristics are at increased risk of developing preeclampsia?

1. Obesity
2. Insulin resistance
3. First pregnancy
4. High triglyceride levels
5. All of the above

 

a, A            140            8.   Ideally, when should dietary intervention for preeclampsia begin?

1. Prior to pregnancy
2. Prior to the development of eclampsia
3. Prior to the 20^th week of pregnancy
4. After the 20^th week of pregnancy
5. After diagnosis of preeclampsia

 

a, A            140            9.   Nutritional and physical activity recommendations that may benefit women at risk for preeclampsia include all of the following EXCEPT:

1. 3000 mg or more calcium daily.
2. 5 or more servings of fruits and vegetables daily.
3. moderate exercise.
4. consumption of low-glycemic index vs. high-glycemic index carbohydrate foods.
5. adequate vitamin D.

 

c, F, M       139-140     10. Which nutrients appear to reduce or prevent preeclampsia?

1. Calcium and magnesium
2. Calcium and fatty oils (n3 fatty acids)
3. Calcium and vitamin D
4. Fatty oils (n3 fatty acids) and vitamin E
5. Vitamins C and E

 

b, A, L        140            11. Diets characterized by a high intake of _____ have been linked to a decreased risk of preeclampsia.

1. protein-containing foods
2. plant foods
3. salty foods
4. sweet or sugary foods
5. processed foods

 

c, F            136            12. Dumping syndrome is a condition characterized by the abnormally rapid emptying of the stomach and is seen in women:

1. with gestational diabetes.
2. at risk for preeclampsia.
3. following bariatric surgery.
4. that drink more than 4 alcoholic beverages per day.
5. carrying triplets.

 

d, F            142            13. High maternal blood glucose levels cause the fetus to _____.

1. increase insulin output
2. convert glucose into triglycerides and store it as fat
3. potentially develop type 2 diabetes later in life
4. all of the above

 

a, F, L        146            14. About _____ of women with gestational diabetes will develop type 2 diabetes within 2-5 years.

1. 10-15%
2. 20-25%
3. 30-40%
4. 50-60%
5. 75%

 

a, F            142            15. Glucose screening is recommended for women at high risk of developing gestational diabetes during pregnancy. Which of the following would NOT be considered a characteristic of a high-risk woman?

1. Caucasian race
2. Obesity
3. History of glucose intolerance
4. Previous macrosomic infant
5. Diabetes in a mother, father, sister, or brother

 

e, A            142            16. Glucose screens are not recommended for women at low risk of developing gestational diabetes during pregnancy. Low-risk women include:

1. women age <25 years old.
2. those with a normal prepregnancy weight.
3. those with no prior poor obstetrical outcomes.
4. those with normal weight gain during pregnancy.
5. all of the above

 

d, F            143            17. The mainstay of treatment for gestational diabetes is to normalize blood glucose levels with _____.

1. oral medications
2. insulin injections or an insulin pump
3. a low-calorie, high-protein diet
4. medical nutrition therapy focusing on diet and exercise
5. a very low calorie intake

 

c, F, L        143            18. For a majority of women with gestational diabetes, the primary way to achieve healthy infant outcomes is:

1. use of an insulin pump.
2. weight loss.
3. diet and exercise.
4. weekly medical visits and encouragement.

 

d, F            144            19. Sulfonylureas CANNOT be used in pregnancy because:

1. they are toxic to the fetus.
2. they interfere with nutrient absorption.
3. they block gas exchange.
4. they cross the placenta and stimulate fetal insulin production.
5. they reduce blood sugar levels too much.

 

a, F            145            20. The primary outcome goal for women with gestational diabetes is:

1. well-controlled blood glucose levels.
2. to prevent the development of type 2 diabetes later in life.
3. to prevent excessive weight gain.
4. to maintain normal blood pressure.
5. to avoid the use of insulin during pregnancy.

 

c, F            145            21. It is recommended that women with gestational diabetes aim for a range of _____ % fat calories during pregnancy.

1. 10 – 20
2. 20 – 30
3. 30 – 40
4. 40 – 50
5. 60

 

b, A, M       141            22. Normal-weight women with gestational diabetes are different than obese women with gestational diabetes because _____.

1. normal-weight women can eat any food they want and obese women must monitor their food intake
2. normal-weight women appear to have insulin resistance combined with a lack of insulin whereas obese women are just insulin resistant
3. normal-weight women need to eat a higher amount of simple carbohydrates
4. normal-weight women do not need to exercise and watch their diet

 

a, A, M       144            23. What is 50% of the VO₂ max (i.e., heart beats per minute) for a 40-year-old pregnant woman with insulin resistance?

1. 90
2. 120
3. 220
4. 240

 

d, A, M       145            24. The estimated Calorie level for an overweight woman with gestational diabetes weighing 200 lb (91 kg) is _____.

1. 1200 Calories
2. 1820 Calories
3. 2000 Calories
4. 2275 Calories
5. 2500 Calories

 

b, A, M       145            25. Based on the calculated Calorie level for the woman with gestational diabetes in the above question (#24), how many Calories would be in her evening snack?

1. 150 – 200 Calories
2. 220 – 330 Calories
3. 350 – 525 Calories
4. 550 Calories

 

a, F            148            26. The most common type of multifetal pregnancy is:

1. dizygotic (fraternal) twins.
2. monozygotic (identical) twins.
3. triplets.
4. quadruplets.
5. quintuplets.

 

a, F, L        148            27. The majority of twins born are _____.

1. dizygotic
2. monozygotic
3. trizygotic
4. in the same placenta

 

d, F, L        148            28. Three percent of all newborns are from multifetal births. What percent of low-birthweight newborns are from multifetal births?

1. 5%
2. 10%
3. 11%
4. 21%

 

c, F, L        149            29. The mean weight of newborns from a twin pregnancy is _____.

1. 1800 grams
2. 2000 grams
3. 2400 grams
4. 2600 grams

 

e, F            149            30. Risk factors to mothers associated with a multifetal pregnancy include:

1. development of preeclampsia.
2. development of iron deficiency anemia.
3. preterm delivery.
4. cesarean delivery.
5. all of the above

 

d, F, L        150            31. Several studies on weight gain and birth weight have shown that a weight gain of approximately _____ pounds corresponds to healthy-sized triplets.

1. 25
2. 30
3. 40
4. 50
5. 60

 

c, F            151            32. To achieve a 40-pound weight gain, women with twins need to consume approximately _____ more Calories during pregnancy than do women with singleton pregnancies.

1. 15,000
2. 25,000
3. 35,000
4. 45,000
5. 50,000

 

c, F, M       152            33. “Best practice” vitamin and mineral supplement recommendations for women during multifetal pregnancies include which of the following statements?

1. There is no need to take a vitamin and mineral supplement if you are eating enough food
2. Women with twins need to take more iron
3. Women should use a prenatal vitamin and mineral supplement
4. Women with twins need to take twice the recommended amount of a supplement

 

e, F            154            34. Goals for the nutritional management of women with HIV/AIDS include all of the following EXCEPT:

1. maintenance of a positive nitrogen balance.
2. delivery of a healthy newborn.
3. preservation of lean muscle and bone mass.
4. adequate intake of energy and nutrients.
5. all of the above would be considered goals

 

e, A, M       153            35. How can women with HIV/AIDS during pregnancy decrease the risk of developing a foodborne infection?

1. Avoid consumption of honey
2. Avoid drinking unpasteurized milk
3. Make sure all meat is well cooked
4. Follow safe food-handling practices at home
5. All of the above

 

a, F            154            36. The most commonly observed eating disorder in pregnancy is

1. bulimia nervosa.
2. anorexia nervosa.
3. binge eating disorder.
4. emotional overeating.
5. none of the above; women do not ovulate when they have an eating disorder

 

b, A, L        154            37. The best treatment for a pregnant woman with an eating disorder is to _____.

1. remind her to eat foods that help with weight gain
2. refer her to an eating disorder clinic that uses a team approach to solve nutritional issues
3. bargain with the woman to consume larger food portions but tell her that she can still vomit after eating
4. listen to her anxiety and fear of weight gain without commenting negatively on it

 

e, A, H       156-157     38. What information should be provided by health care professionals when counseling pregnant teens?

1. Information on how to find a food-assistance program
2. Information on good sources of iron-rich foods
3. Ideas on how to increase the number of milk and milk product servings to four servings/day
4. Ideas on how to buy foods that contain a lot of nutrients in proportion to the calories
5. All of the information above should be provided

 

a, F            155            39. The term fetal alcohol spectrum is now being used to describe:

1. the range of effects alcohol has on fetal growth and development.
2. the number of drinks a woman can safely consume while pregnant.
3. a set of characteristics seen in children with alcoholic mothers.
4. children that have alcoholic fathers.
5. all of the above

 

Answer questions 40-44 based on the following information.

 

Mickie is a 37-year-old Hispanic female in her second pregnancy. Her first pregnancy resulted in a healthy baby girl that weighed 9 pounds 3 oz. Her prepregnancy information is as follows: BMI = 28; she is 5’4” tall; and was 165 pounds. She did not manage to take off all the weight she gained before getting pregnant again, and so far at 24 weeks, she has gained 20 pounds and currently weighs 185 pounds. Diet history reveals average Calorie intake of 2300 Calories per day. The results from her 50-g glucose test show that her blood glucose is 145 mg/dL.

 

c, A            145            40. Mickie’s BMI indicates that she was:

1. underweight going into pregnancy.
2. normal weight going into pregnancy.
3. overweight going into pregnancy.
4. obese going into pregnancy.
5. morbidly obese going into pregnancy.

 

c, A            145            41. How is Mickie doing with her weight gain so far?

1. Great, she is right on track midpregnancy
2. Fair, she has gained 5 pounds too much at this point
3. Poor, she is gaining too much weight too quickly
4. Horrible, she needs to start cutting back by at least 1000 calories per day

 

b, A            143            42. Mickie’s fasting blood glucose levels mean:

1. she is okay and does not have to be tested for gestational diabetes.
2. she is at high risk for developing gestational diabetes and needs to have further testing done.
3. she has borderline diabetes.
4. she has type 2 diabetes.
5. she has preeclampsia.

 

d, A            145            43. How many Calories would be a more appropriate goal for Mickie to consume, based on her prepregnancy weight status?

1. 1200 Calories per day
2. 1400 Calories per day
3. 1600 Calories per day
4. 1800 Calories per day
5. 2000 Calories per day

 

b, A            145            44. What would be the next step for Mickie?

1. Nothing, she can go home and continue to have routine doctor visits
2. Take an oral glucose tolerance test (OGTT) to determine if she has gestational diabetes
3. Do another 50-gram glucose test but make sure it is done while fasting
4. Put her on a calorie-controlled diet as indicated in question #43 and see her in 2 weeks to recheck weight
5. Both c and d

 

e, F            155            45. Which of the following statements is TRUE regarding the spectrum of fetal alcohol disorders?

1. For fetal alcohol syndrome to be diagnosed, a specific set of characteristics must be exhibited in the child
2. Typical maternal characteristics associated with fetal alcohol syndrome or fetal alcohol spectrum disorders are older age and multiple pregnancies
3. There is no known absolute safe level of alcohol consumption during pregnancy, so women should be counseled to completely abstain
4. With intense early intervention after birth, the behavioral and cognitive abnormalities associated with fetal alcohol spectrum disorders can be completely reversed
5. a and c only

 

e, A            154            46. Psychologically, women with eating disorders typically have a hard time when they gain weight in pregnancy due to the fact that they:

1. base their self worth on how much they weigh.
2. are dedicated to keeping their body weight low and gaining weight can be a stressor.
3. are unable to gain weight normally because their metabolism is so low.
4. All of the above are true.
5. a and b only

 

b, A            156            47. Which of the following foods would be the best, most nutrient-dense choice for a pregnant adolescent?

1. Cheez-Its and peanut butter
2. Baked potato with low-fat cottage cheese
3. Grilled cheese sandwich with mayonnaise and orange juice
4. Big Mac and 2% milk
5. All of the above would be good choices

 

d, A            157            48. Which food would be the most nutrient-dense source of calcium for a pregnant adolescent?

1. Whole milk
2. Low-fat milk (1%)
3. Reduced-fat milk (2%)
4. Skim or non-fat milk
5. None of the above

 

 

 

True/False

 

Answer      Page #

 

a, F, M       138            1.   Women with gestational hypertension tend to be overweight or obese and have excess central body fat.

1. True
2. False

 

b, A            138            2.   Preeclampsia develops from insulin resistance.

1. True
2. False

 

a, F            139            3.   Women with preeclampsia are at an increased risk of developing gestational diabetes during pregnancy and type 2 diabetes later in life.

1. True
2. False

 

a, F            139            4.   Women that were born small for gestational age have a higher risk of developing preeclampsia.

1. True
2. False

 

b, A, L        139            5.   If 400 IU vitamin E is likely to prevent preeclampsia, women should double their intake to 800 IU if 400 IU vitamin E does not work.

1. True
2. False

 

b, F            141            6.   Gestational diabetes appears to be caused by a woman’s intake of sugar.

1. True
2. False

 

b, F            142            7.   Research indicates that 75% of women with gestational diabetes in a previous pregnancy will develop it in a subsequent pregnancy.

1. True
2. False

 

b, A, L        143            8.   Health care insurance companies deny medical nutrition therapy (MNT) reimbursement for gestational diabetes because MNT does not reduce poor infant and maternal outcomes.

1. True
2. False

 

b, F, L        152            9.   Because of higher needs, women with multifetal pregnancies can take NUTRIENT SUPPLEMENTS greater than the UL recommendations.

1. True
2. False

 

b, F            148-149     10. Twins at the highest risk of death and malformations have separate amniotic sacs but share the same placenta.

1. True
2. False

 

a, A            143            11. Janis is a 40-year-old woman entering pregnancy with a BMI of 21. At 24 weeks she was given an oral glucose tolerance test to check for gestational diabetes. The results were:

Fasting: 85 mg/dL
1-hour: 185 mg/dL
2-hour: 175 mg/dL
3-hour: 155 mg/dL

Based on this information, Janis has gestational diabetes.

1. True
2. False

 

 

Matching

 

Answer      Page #

 

C	137	1.   Endothelium	A.   physiologically active substances which act to constrict blood vessels, causing blood pressure to increase B.   carbohydrate intolerance with first onset in pregnancy C.   the layer of cells lining the inside of blood vessels D.   blood pressure ≥140 (systolic) or ≥90 (diastolic) mmHg diagnosed before 20th week of pregnancy E.   increased blood pressure diagnosed mid-pregnancy, NOT accompanied by proteinuria F.   the space between the top and bottom eyelid when the eye is open G.   head too large for birth canal H.   increased blood pressure diagnosed after the 20th week of pregnancy in previously normotensive women accompanied by proteinuria I.    the exposed pink or reddish margin of the lip J.   the vertical groove between the bottom of the nose and upper lip K.   disease associated with having deficient insulin output and being dependent on exogenous insulin
D	137	2.   Chronic hypertension
A	138	3.   Thromboxanes
G	156	4.   Cephalopelvic disproportion
B	140	5.   Gestational diabetes
E	137	6.   Gestational hypertension
H	137	7.   Preeclampsia
I	156	8.   Vermillion border
J	156	9.   Philtrum
K	146	10. Type 1 diabetes
F	156	11. Palpebral fissure

 

 

Short Answer/Essay

 

Page #

 

A                137-140     1.   Using the following information, answer questions a-c:

M.M. is an American Indian woman who became pregnant for the first time at the age of 38 after trying for 5 years. M.M. is 5’4” and weighed 180 pounds at her 19th week check-up with the obstetrician. Now, at 24 weeks, she weighs 225 pounds, has proteinuria, and is experiencing severe headaches, nausea and vomiting, and extreme sensitivity to light. On the day of her check-up, her blood pressure was 150/110 mm Hg. Her 24-hour diet history includes a box of Honey Nut Cheerios washed down with a quart of whole milk and Krispy Kreme doughnuts, which seemed to be the only thing she felt she could “keep down.” She claims this is all she has eaten in 24 hours.

 

1. What ONE condition is M.M. likely experiencing signs or symptoms of?
2. What are the 5 signs or symptoms that support your answer to part a?
3. What are 4 specific nutrition recommendations you can give M.M. that might help her with this ONE particular condition you have identified?

 

F, M           142-143     2.   Describe a test that a medical doctor would use to diagnose gestational diabetes in high-risk women. Specify when the test should be done in pregnancy, how long the test takes, and the criteria for a diagnosis.

 

F                141-145     3.   Discuss the primary goals of treatment for gestational diabetes, and the potential adverse outcomes for mother and baby if these goals are not met. What are the risk factors associated with developing gestational diabetes?

 

A, M           145            4.   Identify the recommended proportions of dietary carbohydrates, fat, and protein for women with gestational diabetes. Calculate the grams of each macronutrient needed in a 2200-Calorie diet plan.

 

A, M           140-145     5.   Discuss the types and childhood risks of developing chronic illnesses for children born to Pima Indian mothers with high maternal levels of glucose. Identify two maternal dietary changes that might reduce poor newborn outcomes. Identify two specific foods from this culture that would support better maternal glucose levels. Identify one unchangeable characteristic.

 

A, H           145-146     6.   Define glycemic index. Create one breakfast meal containing foods with high glycemic index values and one breakfast meal with low glycemic index values. Which breakfast meal combination would you like to eat and why?

 

A, H           147-151     7.   Identify the ideal weight range for newborns of twin pregnancies that poses the lowest risk of death. Also, identify the median weights of twins currently being born at 37, 38, and 39 weeks. Discuss possible nutrition and health care interventions that could support achieving ideal weight goals for newborns.

 

A                148-150     8.   Your 35-year-old sister is pregnant and has just found out she is going to have twins. A) What advice can you give her on how much weight to gain assuming a NORMAL prepregnancy BMI? B) What are 4 potential complications associated with a multi-fetal pregnancy? (I.e., is she at a higher risk for anything?)

 

 

Ready-to-Use Chapter 5 Test

 

Multiple Choice

 

_____   1.   Hypertension is defined as having a blood pressure of _____.

1. ≥120 mm Hg systolic or ≥70 mm Hg diastolic
2. ≥140 mm Hg systolic or ≥90 mm Hg diastolic
3. ≥120 mm Hg systolic or ≥90 mm Hg diastolic
4. ≥140 mm Hg systolic or ≥70 mm Hg diastolic
5. ≥160 mm Hg systolic or ≥110 mm Hg diastolic

 

_____   2.   The second leading cause of MATERNAL mortality in the United States is:

1. gestational diabetes.
2. hypertensive disorders of pregnancy.
3. AIDS/HIV.
4. multifetal pregnancies.
5. adolescent pregnancy complications.

 

_____   3.   Pregnancies among women with blood pressure ≥160 (systolic) or ≥110 (diastolic) mm Hg are associated with an increased risk of:

1. fetal death.
2. preterm delivery.
3. fetal growth retardation.
4. all of the above

 

_____   4.   Preeclampsia-eclampsia represents a syndrome characterized by all of the following EXCEPT:

1. blood vessel spasms and constriction.
2. increased calcium excretion.
3. oxidative tissue damage and inflammation.
4. platelet aggregation and blood coagulation.
5. insulin resistance.

 

_____   5.   Metabolic effects associated with obesity are closely related to the presence of large amounts of visceral fat. These metabolic effects produce which of the following?

1. Chronic inflammation
2. Free radical generation
3. Oxidative stress
4. Insulin resistance
5. All of the above

 

_____   6.   Maternal organs most affected by small blot clots and reduced blood flow in preeclampsia include all of the following EXCEPT:

1. the placenta.
2. the kidneys.
3. the brain.
4. the appendix.
5. the liver.

 

_____   7.   Women with which of the following characteristics are at increased risk of developing preeclampsia?

1. Obesity
2. Insulin resistance
3. First pregnancy
4. High triglyceride levels
5. All of the above

 

_____   8.   Ideally, when should dietary intervention for preeclampsia begin?

1. Prior to pregnancy
2. Prior to the development of eclampsia
3. Prior to the 20^th week of pregnancy
4. After the 20^th week of pregnancy
5. After diagnosis of preeclampsia

 

_____   9.   Nutritional and physical activity recommendations that may benefit women at risk for preeclampsia include all of the following EXCEPT:

1. 3000 mg or more calcium daily.
2. 5 or more servings of fruits and vegetables daily.
3. moderate exercise.
4. consumption of low-glycemic index vs. high-glycemic index carbohydrate foods.
5. adequate vitamin D.

 

_____   10. Which nutrients appear to reduce or prevent preeclampsia?

1. Calcium and magnesium
2. Calcium and fatty oils (n3 fatty acids)
3. Calcium and vitamin D
4. Fatty oils (n3 fatty acids) and vitamin E
5. Vitamins C and E

 

_____   11. Diets characterized by a high intake of _____ have been linked to a decreased risk of preeclampsia.

1. protein-containing foods
2. plant foods
3. salty foods
4. sweet or sugary foods
5. processed foods

 

_____   12. Dumping syndrome is a condition characterized by the abnormally rapid emptying of the stomach and is seen in women:

1. with gestational diabetes.
2. at risk for preeclampsia.
3. following bariatric surgery.
4. that drink more than 4 alcoholic beverages per day.
5. carrying triplets.

 

_____   13. High maternal blood glucose levels cause the fetus to _____.

1. increase insulin output
2. convert glucose into triglycerides and store it as fat
3. potentially develop type 2 diabetes later in life
4. all of the above

 

_____   14. About _____ of women with gestational diabetes will develop type 2 diabetes within 2-5 years.

1. 10-15%
2. 20-25%
3. 30-40%
4. 50-60%
5. 75%

 

_____   15. Glucose screening is recommended for women at high risk of developing gestational diabetes during pregnancy. Which of the following would NOT be considered a characteristic of a high-risk woman?

1. Caucasian race
2. Obesity
3. History of glucose intolerance
4. Previous macrosomic infant
5. Diabetes in a mother, father, sister, or brother

 

_____   16. Glucose screens are not recommended for women at low risk of developing gestational diabetes during pregnancy. Low-risk women include:

1. women age <25 years old.
2. those with a normal prepregnancy weight.
3. those with no prior poor obstetrical outcomes.
4. those with normal weight gain during pregnancy.
5. all of the above

 

_____   17. The mainstay of treatment for gestational diabetes is to normalize blood glucose levels with _____.

1. oral medications
2. insulin injections or an insulin pump
3. a low-calorie, high-protein diet
4. medical nutrition therapy focusing on diet and exercise
5. a very low calorie intake

 

_____   18. For a majority of women with gestational diabetes, the primary way to achieve healthy infant outcomes is:

1. use of an insulin pump.
2. weight loss.
3. diet and exercise.
4. weekly medical visits and encouragement.

 

_____   19. Sulfonylureas CANNOT be used in pregnancy because:

1. they are toxic to the fetus.
2. they interfere with nutrient absorption.
3. they block gas exchange.
4. they cross the placenta and stimulate fetal insulin production.
5. they reduce blood sugar levels too much.

 

_____   20. The primary outcome goal for women with gestational diabetes is:

1. well-controlled blood glucose levels.
2. to prevent the development of type 2 diabetes later in life.
3. to prevent excessive weight gain.
4. to maintain normal blood pressure.
5. to avoid the use of insulin during pregnancy.

 

_____   21. It is recommended that women with gestational diabetes aim for a range of _____ % fat calories during pregnancy.

1. 10 – 20
2. 20 – 30
3. 30 – 40
4. 40 – 50
5. 60

 

_____   22. Normal-weight women with gestational diabetes are different than obese women with gestational diabetes because _____.

1. normal-weight women can eat any food they want and obese women must monitor their food intake
2. normal-weight women appear to have insulin resistance combined with a lack of insulin whereas obese women are just insulin resistant
3. normal-weight women need to eat a higher amount of simple carbohydrates
4. normal-weight women do not need to exercise and watch their diet

 

_____   23. What is 50% of the VO₂ max (i.e., heart beats per minute) for a 40-year-old pregnant woman with insulin resistance?

1. 90
2. 120
3. 220
4. 240

 

_____   24. The estimated Calorie level for an overweight woman with gestational diabetes weighing 200 lb (91 kg) is _____.

1. 1200 Calories
2. 1820 Calories
3. 2000 Calories
4. 2275 Calories
5. 2500 Calories

 

_____   25. Based on the calculated Calorie level for the woman with gestational diabetes in the above question (#24), how many Calories would be in her evening snack?

1. 150 – 200 Calories
2. 220 – 330 Calories
3. 350 – 525 Calories
4. 550 Calories

 

_____   26. The most common type of multifetal pregnancy is:

1. dizygotic (fraternal) twins.
2. monozygotic (identical) twins.
3. triplets.
4. quadruplets.
5. quintuplets.

 

_____   27. The majority of twins born are _____.

1. dizygotic
2. monozygotic
3. trizygotic
4. in the same placenta

 

_____   28. Three percent of all newborns are from multifetal births. What percent of low-birthweight newborns are from multifetal births?

1. 5%
2. 10%
3. 11%
4. 21%

 

_____   29. The mean weight of newborns from a twin pregnancy is _____.

1. 1800 grams
2. 2000 grams
3. 2400 grams
4. 2600 grams

 

_____   30. Risk factors to mothers associated with a multifetal pregnancy include:

1. development of preeclampsia.
2. development of iron deficiency anemia.
3. preterm delivery.
4. cesarean delivery.
5. all of the above

 

_____   31. Several studies on weight gain and birth weight have shown that a weight gain of approximately _____ pounds corresponds to healthy-sized triplets.

1. 25
2. 30
3. 40
4. 50
5. 60

 

_____   32. To achieve a 40-pound weight gain, women with twins need to consume approximately _____ more Calories during pregnancy than do women with singleton pregnancies.

1. 15,000
2. 25,000
3. 35,000
4. 45,000
5. 50,000

 

_____   33. “Best practice” vitamin and mineral supplement recommendations for women during multifetal pregnancies include which of the following statements?

1. There is no need to take a vitamin and mineral supplement if you are eating enough food
2. Women with twins need to take more iron
3. Women should use a prenatal vitamin and mineral supplement
4. Women with twins need to take twice the recommended amount of a supplement

 

_____   34. Goals for the nutritional management of women with HIV/AIDS include all of the following EXCEPT:

1. maintenance of a positive nitrogen balance.
2. delivery of a healthy newborn.
3. preservation of lean muscle and bone mass.
4. adequate intake of energy and nutrients.
5. all of the above would be considered goals

 

_____   35. How can women with HIV/AIDS during pregnancy decrease the risk of developing a foodborne infection?

1. Avoid consumption of honey
2. Avoid drinking unpasteurized milk
3. Make sure all meat is well cooked
4. Follow safe food-handling practices at home
5. All of the above

 

_____   36. The most commonly observed eating disorder in pregnancy is

1. bulimia nervosa.
2. anorexia nervosa.
3. binge eating disorder.
4. emotional overeating.
5. none of the above; women do not ovulate when they have an eating disorder

 

_____   37. The best treatment for a pregnant woman with an eating disorder is to _____.

1. remind her to eat foods that help with weight gain
2. refer her to an eating disorder clinic that uses a team approach to solve nutritional issues
3. bargain with the woman to consume larger food portions but tell her that she can still vomit after eating
4. listen to her anxiety and fear of weight gain without commenting negatively on it

 

_____   38. What information should be provided by health care professionals when counseling pregnant teens?

1. Information on how to find a food-assistance program
2. Information on good sources of iron-rich foods
3. Ideas on how to increase the number of milk and milk product servings to four servings/day
4. Ideas on how to buy foods that contain a lot of nutrients in proportion to the calories
5. All of the information above should be provided

 

_____   39. The term fetal alcohol spectrum is now being used to describe:

1. the range of effects alcohol has on fetal growth and development.
2. the number of drinks a woman can safely consume while pregnant.
3. a set of characteristics seen in children with alcoholic mothers.
4. children that have alcoholic fathers.
5. all of the above

 

Answer questions 40-44 based on the following information.

 

Mickie is a 37-year-old Hispanic female in her second pregnancy. Her first pregnancy resulted in a healthy baby girl that weighed 9 pounds 3 oz. Her prepregnancy information is as follows: BMI = 28; she is 5’4” tall; and was 165 pounds. She did not manage to take off all the weight she gained before getting pregnant again, and so far at 24 weeks, she has gained 20 pounds and currently weighs 185 pounds. Diet history reveals average Calorie intake of 2300 Calories per day. The results from her 50-g glucose test show that her blood glucose is 145 mg/dL.

 

_____   40. Mickie’s BMI indicates that she was:

1. underweight going into pregnancy.
2. normal weight going into pregnancy.
3. overweight going into pregnancy.
4. obese going into pregnancy.
5. morbidly obese going into pregnancy.

 

_____   41. How is Mickie doing with her weight gain so far?

1. Great, she is right on track midpregnancy
2. Fair, she has gained 5 pounds too much at this point
3. Poor, she is gaining too much weight too quickly
4. Horrible, she needs to start cutting back by at least 1000 calories per day

 

_____   42. Mickie’s fasting blood glucose levels mean:

1. she is okay and does not have to be tested for gestational diabetes.
2. she is at high risk for developing gestational diabetes and needs to have further testing done.
3. she has borderline diabetes.
4. she has type 2 diabetes.
5. she has preeclampsia.

 

_____   43. How many Calories would be a more appropriate goal for Mickie to consume, based on her prepregnancy weight status?

1. 1200 Calories per day
2. 1400 Calories per day
3. 1600 Calories per day
4. 1800 Calories per day
5. 2000 Calories per day

 

_____   44. What would be the next step for Mickie?

1. Nothing, she can go home and continue to have routine doctor visits
2. Take an oral glucose tolerance test (OGTT) to determine if she has gestational diabetes
3. Do another 50-gram glucose test but make sure it is done while fasting
4. Put her on a calorie-controlled diet as indicated in question #43 and see her in 2 weeks to recheck weight
5. Both c and d

 

_____   45. Which of the following statements is TRUE regarding the spectrum of fetal alcohol disorders?

1. For fetal alcohol syndrome to be diagnosed, a specific set of characteristics must be exhibited in the child
2. Typical maternal characteristics associated with fetal alcohol syndrome or fetal alcohol spectrum disorders are older age and multiple pregnancies
3. There is no known absolute safe level of alcohol consumption during pregnancy, so women should be counseled to completely abstain
4. With intense early intervention after birth, the behavioral and cognitive abnormalities associated with fetal alcohol spectrum disorders can be completely reversed
5. a and c only

 

_____   46. Psychologically, women with eating disorders typically have a hard time when they gain weight in pregnancy due to the fact that they:

1. base their self worth on how much they weigh.
2. are dedicated to keeping their body weight low and gaining weight can be a stressor.
3. are unable to gain weight normally because their metabolism is so low.
4. All of the above are true.
5. a and b only

 

_____   47. Which of the following foods would be the best, most nutrient-dense choice for a pregnant adolescent?

1. Cheez-Its and peanut butter
2. Baked potato with low-fat cottage cheese
3. Grilled cheese sandwich with mayonnaise and orange juice
4. Big Mac and 2% milk
5. All of the above would be good choices

 

_____   48. Which food would be the most nutrient-dense source of calcium for a pregnant adolescent?

1. Whole milk
2. Low-fat milk (1%)
3. Reduced-fat milk (2%)
4. Skim or non-fat milk
5. None of the above

 

 

True/False

 

_____   1.   Women with gestational hypertension tend to be overweight or obese and have excess central body fat.

1. True
2. False

 

_____   2.   Preeclampsia develops from insulin resistance.

1. True
2. False

 

_____   3.   Women with preeclampsia are at an increased risk of developing gestational diabetes during pregnancy and type 2 diabetes later in life.

1. True
2. False

 

_____   4.   Women that were born small for gestational age have a higher risk of developing preeclampsia.

1. True
2. False

 

_____   5.   If 400 IU vitamin E is likely to prevent preeclampsia, women should double their intake to 800 IU if 400 IU vitamin E does not work.

1. True
2. False

 

_____   6.   Gestational diabetes appears to be caused by a woman’s intake of sugar.

1. True
2. False

 

_____   7.   Research indicates that 75% of women with gestational diabetes in a previous pregnancy will develop it in a subsequent pregnancy.

1. True
2. False

 

_____   8.   Health care insurance companies deny medical nutrition therapy (MNT) reimbursement for gestational diabetes because MNT does not reduce poor infant and maternal outcomes.

1. True
2. False

 

_____   9.   Because of higher needs, women with multifetal pregnancies can take NUTRIENT SUPPLEMENTS greater than the UL recommendations.

1. True
2. False

 

_____   10. Twins at the highest risk of death and malformations have separate amniotic sacs but share the same placenta.

1. True
2. False

 

_____   11. Janis is a 40-year-old woman entering pregnancy with a BMI of 21. At 24 weeks she was given an oral glucose tolerance test to check for gestational diabetes. The results were:

Fasting: 85 mg/dL
1-hour: 185 mg/dL
2-hour: 175 mg/dL
3-hour: 155 mg/dL

Based on this information, Janis has gestational diabetes.

1. True
2. False

 

 

Matching

 

_____	1.   Endothelium	A.   physiologically active substances which act to constrict blood vessels, causing blood pressure to increase B.   carbohydrate intolerance with first onset in pregnancy C.   the layer of cells lining the inside of blood vessels D.   blood pressure ≥140 (systolic) or ≥90 (diastolic) mmHg diagnosed before 20th week of pregnancy E.   increased blood pressure diagnosed mid-pregnancy, NOT accompanied by proteinuria F.   the space between the top and bottom eyelid when the eye is open G.   head too large for birth canal H.   increased blood pressure diagnosed after the 20th week of pregnancy in previously normotensive women accompanied by proteinuria I.    the exposed pink or reddish margin of the lip J.   the vertical groove between the bottom of the nose and upper lip K.   disease associated with having deficient insulin output and being dependent on exogenous insulin
_____	2.   Chronic hypertension
_____	3.   Thromboxanes
_____	4.   Cephalopelvic disproportion
_____	5.   Gestational diabetes
_____	6.   Gestational hypertension
_____	7.   Preeclampsia
_____	8.   Vermillion border
_____	9.   Philtrum
_____	10. Type 1 diabetes
_____	11. Palpebral fissure

 

 

Short Answer/Essay

 

1. Using the following information, answer questions a-c:

   M.M. is an American Indian woman who became pregnant for the first time at the age of 38 after trying for 5 years. M.M. is 5’4” and weighed 180 pounds at her 19th week check-up with the obstetrician. Now, at 24 weeks, she weighs 225 pounds, has proteinuria, and is experiencing severe headaches, nausea and vomiting, and extreme sensitivity to light. On the day of her check-up, her blood pressure was 150/110 mm Hg. Her 24-hour diet history includes a box of Honey Nut Cheerios washed down with a quart of whole milk and Krispy Kreme doughnuts, which seemed to be the only thing she felt she could “keep down.” She claims this is all she has eaten in 24 hours.

 

1. What ONE condition is M.M. likely experiencing signs or symptoms of?
2. What are the 5 signs or symptoms that support your answer to part a?
3. What are 4 specific nutrition recommendations you can give M.M. that might help her with this ONE particular condition you have identified?

 

2. Describe a test that a medical doctor would use to diagnose gestational diabetes in high-risk women. Specify when the test should be done in pregnancy, how long the test takes, and the criteria for a diagnosis.

 

3. Discuss the primary goals of treatment for gestational diabetes, and the potential adverse outcomes for mother and baby if these goals are not met. What are the risk factors associated with developing gestational diabetes?

 

4. Identify the recommended proportions of dietary carbohydrates, fat, and protein for women with gestational diabetes. Calculate the grams of each macronutrient needed in a 2200-Calorie diet plan.

 

5. Discuss the types and childhood risks of developing chronic illnesses for children born to Pima Indian mothers with high maternal levels of glucose. Identify two maternal dietary changes that might reduce poor newborn outcomes. Identify two specific foods from this culture that would support better maternal glucose levels. Identify one unchangeable characteristic.

 

6. Define glycemic index. Create one breakfast meal containing foods with high glycemic index values and one breakfast meal with low glycemic index values. Which breakfast meal combination would you like to eat and why?

 

7. Identify the ideal weight range for newborns of twin pregnancies that poses the lowest risk of death. Also, identify the median weights of twins currently being born at 37, 38, and 39 weeks. Discuss possible nutrition and health care interventions that could support achieving ideal weight goals for newborns.

 

8. Your 35-year-old sister is pregnant and has just found out she is going to have twins. A) What advice can you give her on how much weight to gain assuming a NORMAL prepregnancy BMI? B) What are 4 potential complications associated with a multi-fetal pregnancy? (I.e., is she at a higher risk for anything?)

 

[1] by Susan Gollnick of California Polytechnic State University; see the end of this document for a ready-to-use version of this test (without answers) for easy printing or cutting/pasting