Nutrition Through the Life Cycle 6th Edition by Judith E. Brown - Test Bank

Nutrition Through the Life Cycle 6th 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 information: ANS = correct answer; DIF = question difficulty; REF = page reference; OBJ = chapter learning objective for question section

 

Learning Objectives

5.1    Cite three specific examples of nutrition-related recommendations intended for women who enter pregnancy obese.

5.2    Define the different types of hypertensive disorders that occur during pregnancy and discuss two components of nutrition care recommended for women with each type.

5.3    Define the different, major types of disorders in carbohydrate metabolism that occur during pregnancy and identify the key components of the nutritional management of each type.

5.4    Describe three differences in nutrient needs and cite two specific considerations for delivery of effective nutritional care for women with multifetal pregnancy.

5.5    Identify the components of nutritional care for women with HIV during pregnancy.

5.6    Identify the consequences of excess alcohol intake during pregnancy and list four factors that affect the relationship between alcohol intake and the outcome of pregnancy.

5.7    Identify three ways in which energy and nutrient needs differ between adults and adolescents during pregnancy.

 

Multiple Choice

 

1. Hypertension is defined as having a blood pressure of _____.
2. ≥120 mm Hg systolic or ≥70 mm Hg diastolic
3. ≥140 mm Hg systolic or ≥90 mm Hg diastolic
4. ≥120 mm Hg systolic or ≥90 mm Hg diastolic
5. ≥140 mm Hg systolic or ≥70 mm Hg diastolic
6. ≥160 mm Hg systolic or ≥110 mm Hg diastolic

 

ANS: b       DIF: Fact-based, easy                         REF: 141                           OBJ: 5.2

 

2. A worldwide leading cause of MATERNAL mortality is:
3. gestational diabetes.
4. hypertensive disorders of pregnancy.
5. AIDS/HIV.
6. multifetal pregnancies.
7. adolescent pregnancy complications.

 

ANS: b       DIF: Fact-based                                  REF: 141                           OBJ: 5.2

 

3. Pregnancies among women with chronic hypertension are associated with higher rates of:
4. placenta abruption.
5. preterm delivery.
6. fetal growth retardation.
7. All of the above

 

ANS: d       DIF: Fact-based                                  REF: 142                           OBJ: 5.2

 

4. Preeclampsia-eclampsia represents a syndrome characterized by all of the following EXCEPT:
5. blood vessel spasms and constriction.
6. increased calcium excretion.
7. oxidative stress and inflammation.
8. platelet aggregation and blood coagulation.
9. insulin resistance.

 

ANS: b       DIF: Fact-based                                  REF: 142                           OBJ: 5.2

 

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?
6. Chronic inflammation
7. Free radical generation
8. Oxidative stress
9. Insulin resistance
10. All of the above

 

ANS: e       DIF: Fact-based, easy                         REF: 139                           OBJ: 5.1

 

6. Maternal organs most affected by small blot clots and reduced blood flow in preeclampsia include all of the following EXCEPT:
7. the placenta.
8. the kidneys.
9. the brain.
10. the appendix.
11. the liver.

 

ANS: d       DIF: Fact-based                                  REF: 142                           OBJ: 5.2

 

7. Women with which of the following characteristics are at increased risk of developing preeclampsia?
8. Obesity
9. Insulin resistance
10. First pregnancy
11. High triglyceride levels
12. All of the above

 

ANS: e       DIF: Fact-based                                  REF: 143                           OBJ: 5.2

 

8. Ideally, when should dietary intervention for preeclampsia begin?
9. Prior to pregnancy
10. Prior to the development of eclampsia
11. Prior to the 20^th week of pregnancy
12. After the 20^th week of pregnancy
13. After diagnosis of preeclampsia

 

ANS: a       DIF: Application-based                       REF: 145                           OBJ: 5.2

 

9. Nutritional and physical activity recommendations that may benefit women at risk for preeclampsia include all of the following EXCEPT:
10. high-dose iron supplements.
11. 5 or more servings of fruits and vegetables daily.
12. moderate exercise.
13. adequate fiber intake
14. adequate vitamin D.

 

ANS: a       DIF: Application-based                       REF: 145                           OBJ: 5.2

 

10. Which nutrients appear to reduce or prevent preeclampsia?
11. Calcium and magnesium
12. Calcium and fatty oils (n3 fatty acids)
13. Calcium and vitamin D
14. Fatty oils (n3 fatty acids) and vitamin E
15. Vitamins C and E

 

ANS: c       DIF: Fact-based, medium                   REF: 143-144                    OBJ: 5.2

 

11. Diets characterized by a high intake of _____ have been linked to a decreased risk of preeclampsia.
12. protein-containing foods
13. plant foods
14. salty foods
15. sweet or sugary foods
16. processed foods

 

ANS: b       DIF: Application-based, easy             REF: 144                           OBJ: 5.2

 

12. Dumping syndrome is a condition characterized by the abnormally rapid emptying of the stomach and is seen in women:
13. with gestational diabetes.
14. at risk for preeclampsia.
15. following bariatric surgery.
16. that drink more than 4 alcoholic beverages per day.
17. carrying triplets.

 

ANS: c       DIF: Fact-based                                  REF: 140                           OBJ: 5.1

 

13. High maternal blood glucose levels cause the fetus to _____.
14. increase insulin output
15. convert glucose into triglycerides and store it as fat
16. potentially develop type 2 diabetes later in life
17. All of the above

 

ANS: d       DIF: Fact-based                                  REF: 146                           OBJ: 5.3

 

14. About _____ of women with gestational diabetes will develop type 2 diabetes within 2-5 years.
15. 10-15%
16. 20-25%
17. 30-40%
18. 50-60%
19. 75%

 

ANS: a       DIF: Fact-based, easy                         REF: 149                           OBJ: 5.3

 

15. According to the American Diabetes Association, when should pregnant women without diabetes have their blood glucose tested?
16. 24-28 weeks gestation
17. After the first trimester
18. 6-8 weeks gestation
19. 17 weeks gestation
20. Not at all

 

ANS: a       DIF: Fact-based                                  REF: 147                           OBJ: 5.3

 

16.Elevation of ketone levels can occur if calorie intakes are decreased to what level?

1. <1500 calories daily
2. <1800 calories daily
3. Less than 33% below needs
4. Less than 25% below needs
5. a and c

 

ANS: e       DIF: Application-based                       REF: 147                           OBJ: 5.3

 

17. The mainstay of treatment for gestational diabetes is to normalize blood glucose levels with _____.
18. oral medications
19. insulin injections or an insulin pump
20. a low-calorie, high-protein diet
21. medical nutrition therapy focusing on diet and exercise
22. a very low calorie intake

 

ANS: d       DIF: Fact-based                                  REF: 147                           OBJ: 5.3

 

18. Which type of diabetes is potentially the most hazardous to the mother and fetus?
19. Type 1 diabetes
20. Type 2 diabetes
21. Gestational diabetes
22. They are all equally hazardous.

 

ANS: a       DIF: Fact-based, easy                         REF: 150                           OBJ: 5.3

 

19. Metformin, the only type of oral medication used to treat gestational diabetes, is useful because it:
20. lowers blood glucose levels.
21. stimulates insulin secretion.
22. increases insulin resistance.
23. decreases insulin resistance.
24. stimulates ketone production.

 

ANS: d       DIF: Application-based                       REF: 147                           OBJ: 5.3

 

20. The primary outcome goal for pregnant women with diabetes is:
21. maintenance of blood glucose levels within normal range.
22. to prevent the development of diabetes later in life.
23. to prevent excessive weight gain.
24. to maintain normal blood pressure.
25. to avoid the use of insulin during pregnancy.

 

ANS: a       DIF: Fact-based                                  REF: 150                           OBJ: 5.3

 

21. It is common for women with gestational diabetes to consume _____ % of calories from carbohydrate during pregnancy.
22. 65
23. 50
24. 45
25. 25
26. 60

 

ANS: c       DIF: Fact-based                                  REF: 149                           OBJ: 5.3

 

22. The vanishing twin phenomenon refers to
23. the fact that more triplets and quadruplets are being born because of fertility drugs.
24. the disappearance of embryos within 13 weeks of conception.
25. the decreasing percentage of dizygotic twins in favor of monozygotes.
26. None of the above

 

ANS: b       DIF: Fact-based                                  REF: 153                           OBJ: 5.4

 

23. How many minutes of physical activity are recommended daily for women at risk of preeclampsia?
24. 30
25. 60
26. 90
27. Exercise is not recommended.

 

ANS: a       DIF: Fact-based                                  REF: 145                           OBJ: 5.2

 

24. The estimated minimum Calorie level for an overweight woman with gestational diabetes weighing 200 lb (91 kg) is _____.
25. 1200 Calories
26. 1820 Calories
27. 2000 Calories
28. 2275 Calories
29. 2500 Calories

 

ANS: d       DIF: Application-based, medium        REF: 149                           OBJ: 5.3

 

25. Based on the calculated Calorie level for the woman with gestational diabetes in the above question (#24), how many Calories would be provided by her evening snack, assuming she had 2 other snacks that day?
26. 150-200 Calories
27. 220-330 Calories
28. 350-525 Calories
29. 550 Calories

 

ANS: b       DIF: Application-based, medium        REF: 149                           OBJ: 5.3

 

26. The most common type of multifetal pregnancy is:
27. twins.
28. triplets.
29. quadruplets.
30. quintuplets.
31. None of the above

 

ANS: a       DIF: Fact-based                                  REF: 152                           OBJ: 5.4

 

27. The majority of twins born are _____.
28. dizygotic
29. monozygotic
30. trizygotic
31. in the same placenta

 

ANS: a       DIF: Fact-based, easy                         REF: 152                           OBJ: 5.4

 

28. What percentage of all newborns are from multifetal births?
29. 3%
30. 5%
31. 11%
32. 21%

 

ANS: a       DIF: Fact-based, easy                         REF: 152                           OBJ: 5.4

 

29. The mean weight of newborns from a twin pregnancy is _____.
30. 1800 grams
31. 2000 grams
32. 2400 grams
33. 2600 grams

 

ANS: c       DIF: Fact-based, easy                         REF: 154                           OBJ: 5.4

 

30. A multifetal pregnancy increases the mother’s risk for:
31. development of preeclampsia.
32. development of iron-deficiency anemia.
33. preterm delivery.
34. cesarean delivery.
35. All of the above

 

ANS: e       DIF: Fact-based                                  REF: 153                           OBJ: 5.4

 

31. Several studies on weight gain and birth weight have shown that a weight gain of approximately _____ pounds corresponds to healthy-sized triplets.
32. 25
33. 30
34. 40
35. 50
36. 60

 

ANS: d       DIF: Fact-based, easy                         REF: 155                           OBJ: 5.4

 

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.
33. 15,000
34. 25,000
35. 35,000
36. 45,000
37. 50,000

 

ANS: c       DIF: Fact-based                                  REF: 156                           OBJ: 5.4

 

33. “Best practice” vitamin and mineral supplement recommendations for women during multifetal pregnancies include which of the following statements?
34. There is no need to take a vitamin and mineral supplement if you are eating enough food.
35. Women with twins need to take more iron.
36. Women should use a prenatal vitamin and mineral supplement.
37. Women with twins need to take twice the recommended amount of a supplement.

 

ANS: c       DIF: Fact-based, medium                   REF: 157                           OBJ: 5.4

 

34. Goals for the nutritional management of women with HIV/AIDS include all of the following interventions EXCEPT:
35. avoidance of high intakes of supplemental vitamins A and D.
36. avoidance of high intakes of supplemental iron.
37. ensuring an adequate intake of calories.
38. treating iron-deficiency anemia with iron supplements.
39. All of the above would be considered goals.

 

ANS: e       DIF: Fact-based                                  REF: 158                           OBJ: 5.5

 

35. How can women with HIV/AIDS during pregnancy decrease the risk of developing a foodborne infection?
36. Avoid consumption of honey
37. Avoid drinking unpasteurized milk
38. Make sure all meat is well cooked
39. Follow safe food-handling practices at home
40. All of the above

 

ANS: e       DIF: Application-based, medium        REF: 158                           OBJ: 5.5

 

36. The most commonly observed eating disorder in pregnancy is
37. bulimia nervosa.
38. anorexia nervosa.
39. binge eating disorder.
40. emotional overeating.
41. None of the above; women do not ovulate when they have an eating disorder

 

ANS: a       DIF: Fact-based                                  REF: 159                           OBJ: 5.5

 

37. The best treatment for a pregnant woman with an eating disorder is to _____.
38. remind her to eat foods that help with weight gain
39. refer her to an eating disorder clinic that uses a team approach to solve nutritional issues
40. bargain with the woman to consume larger food portions but tell her that she can still vomit after eating
41. listen to her express her anxiety and fear of weight gain without commenting negatively

 

ANS: b       DIF: Application-based, easy             REF: 159                           OBJ: 5.5

 

38. What information should be provided by health care professionals when counseling pregnant teens?
39. Information on how to find food and nutrition assistance programs
40. Information on good sources of iron-rich foods
41. Ideas on how to increase the number of milk and milk product servings to four servings/day
42. Ideas on how to buy foods that contain a lot of nutrients in proportion to the calories
43. All of the information above should be provided

 

ANS: e       DIF: Application-based, hard             REF: 161-162                    OBJ: 5.7

 

39. The term fetal alcohol spectrum is now being used to describe:
40. the range of effects alcohol has on fetal growth and development.
41. the number of drinks a woman can safely consume while pregnant.
42. a set of characteristics seen in children with alcoholic mothers.
43. children that have alcoholic fathers.
44. All of the above

 

ANS: a       DIF: Fact-based                                  REF: 160                           OBJ: 5.6

 

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 an average Calorie intake of 2300 Calories per day. Two hours after her 75-g glucose tolerance test began, her blood glucose was 155 mg/dL.

 

40. Mickie’s BMI indicates that she was:
41. underweight going into pregnancy.
42. at a normal weight going into pregnancy.
43. overweight going into pregnancy.
44. obese going into pregnancy.
45. morbidly obese going into pregnancy.

 

ANS: c       DIF: Application-based                       REF: 139                           OBJ: 5.1

 

41. How is Mickie doing with her weight gain so far?
42. Great: she is right on track midpregnancy
43. Fair: she has gained 5 pounds too much at this point
44. Poor: she is gaining too much weight too quickly
45. Horrible: she needs to start cutting back by at least 1000 calories per day

 

ANS: c       DIF: Application-based                       REF: 140                           OBJ: 5.1

 

42. Mickie’s OGTT results mean:
43. she is okay and does not have to be tested for gestational diabetes.
44. she has gestational diabetes.
45. she has borderline diabetes.
46. she has type 2 diabetes.
47. she has preeclampsia.

 

ANS: b       DIF: Application-based                       REF: 147                           OBJ: 5.3

 

43. How many Calories would be a more appropriate goal for Mickie to consume, based on her prepregnancy weight status and OGTT results?
44. 1200 Calories per day
45. 1400 Calories per day
46. 1600 Calories per day
47. 1800 Calories per day
48. 2000 Calories per day

 

ANS: d       DIF: Application-based                       REF: 149                           OBJ: 5.3

 

44. What would be the next step for Mickie?
45. Nothing; she can go home and continue to have routine doctor visits
46. Attempt to normalize blood glucose levels by following a healthy diet and exercising
47. Perform a 50-gram glucose tolerance test while fasting
48. Begin a calorie-controlled diet and return to her doctor in 2 weeks to recheck weight
49. Both c and d

 

ANS: b       DIF: Application-based                       REF: 147                           OBJ: 5.3

 

45. Which of the following statements is TRUE regarding the spectrum of fetal alcohol disorders?
46. For fetal alcohol syndrome to be diagnosed, a specific set of characteristics must be exhibited in the child.
47. Typical maternal characteristics associated with fetal alcohol syndrome or fetal alcohol spectrum disorders are older age and multiple pregnancies.
48. There is no known absolute safe level of alcohol consumption during pregnancy, so women should be counseled that the safest approach is to not drink during pregnancy.
49. With intense early intervention after birth, the behavioral and cognitive abnormalities associated with fetal alcohol spectrum disorders can be completely reversed.
50. a and c only

 

ANS: e       DIF: Fact-based                                  REF: 160                           OBJ: 5.6

 

46. Psychologically, women with eating disorders typically have a hard time when they gain weight in pregnancy due to the fact that they:
47. base their self worth on how much they weigh.
48. are dedicated to keeping their body weight low.
49. are unable to gain weight normally because their metabolism is so low.
50. All of the above are true.
51. a and b only

 

ANS: e       DIF: Application-based                       REF: 159                           OBJ: 5.5

 

47. Which of the following foods would be the best, most nutrient-dense choice for a pregnant adolescent?
48. Cheez-Its and peanut butter
49. Baked potato with low-fat yogurt
50. Grilled cheese sandwich with mayonnaise and orange juice
51. Big Mac and 2% milk
52. All of the above would be good choices

 

ANS: b       DIF: Application-based                       REF: 161                           OBJ: 5.7

 

48. Which food would be the most nutrient-dense source of calcium for a pregnant adolescent?
49. Whole milk
50. Low-fat milk (1%)
51. Reduced-fat milk (2%)
52. Skim or non-fat milk
53. None of the above

 

ANS: d       DIF: Application-based                       REF: 161                           OBJ: 5.7

 

 

True/False

 

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

 

ANS: T       DIF: Fact-based, medium                   REF: 142                           OBJ: 5.2

 

2. Preeclampsia develops from insulin resistance.

 

ANS: F       DIF: Application-based                       REF: 141|142                   OBJ: 5.2

 

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

 

ANS: T       DIF: Fact-based                                  REF: 142                           OBJ: 5.2

 

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

 

ANS: T       DIF: Fact-based                                  REF: 143                           OBJ: 5.2

 

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.

 

ANS: F       DIF: Application-based, easy             REF: 143                           OBJ: 5.2

 

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

 

ANS: F       DIF: Fact-based                                  REF: 145                           OBJ: 5.3

 

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

 

ANS: F       DIF: Fact-based                                  REF: 146                           OBJ: 5.3

 

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

 

ANS: F       DIF: Application-based, easy             REF: 147                           OBJ: 5.3

 

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

 

ANS: F       DIF: Fact-based, easy                         REF: 155                           OBJ: 5.4

 

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

 

ANS: F       DIF: Fact-based                                  REF: 152                           OBJ: 5.4

 

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.

 

ANS: T       DIF: Application-based                       REF: 147                           OBJ: 5.3

 

 

Matching

 

1.   Endothelium 2.   Chronic hypertension 3.   Thromboxanes 4.   Cephalopelvic disproportion 5.   Gestational diabetes 6.   Gestational hypertension 7.   Preeclampsia 8.   Placenta abruption 9.   Ketones 10. Type 1 diabetes 11. Dumping syndrome

A.   physiologically active substances that 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.   abnormally rapid emptying of the stomach causing weakness, dizziness, flushing, and nausea 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 separation of the placenta from its attachment to the uterus wall J.   metabolic by-products of the breakdown of fatty acids K.   disease associated with having deficient insulin output and being dependent on exogenous insulin

 

Key:

1. ANS: C DIF: Fact-based                                  REF: 141                           OBJ: 5.2
2. ANS: D DIF: Fact-based                                  REF: 141                           OBJ: 5.2
3. ANS: A DIF: Fact-based                                  REF: 142                           OBJ: 5.2
4. ANS: G DIF: Fact-based                                  REF: 161                           OBJ: 5.7
5. ANS: B DIF: Fact-based                                  REF: 140                           OBJ: 5.1
6. ANS: E DIF: Fact-based                                  REF: 141                           OBJ: 5.2
7. ANS: H DIF: Fact-based                                  REF: 141                           OBJ: 5.2
8. ANS: I DIF: Fact-based                                  REF: 142                           OBJ: 5.2
9. ANS: J DIF: Fact-based                                  REF: 147                           OBJ: 5.3
10. ANS: K DIF: Fact-based REF: 150                           OBJ: 5.3
11. ANS: F DIF: Fact-based REF: 140                           OBJ: 5.1

 

 

Short Answer

 

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?

 

ANS: See pp. 141-145.

DIF: Application-based                                         REF: 141-145                    OBJ: 5.2

 

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

 

ANS: See pp. 146-147.

DIF: Fact-based, medium                                     REF: 146-147                    OBJ: 5.3

 

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?

 

ANS: See pp. 146-149.

DIF: Fact-based                                                    REF: 146-149                    OBJ: 5.3

 

4. Discuss the dietary recommendations for women with gestational diabetes. What are the proportions of daily calorie intake assigned to meals and snacks?

 

ANS: See p. 148-149.

DIF: Application-based, medium                          REF: 148-149                    OBJ: 5.3

 

5. Discuss the 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 improve newborn outcomes. Identify two specific foods from this culture that would support better maternal glucose levels. Identify one unchangeable characteristic.

 

ANS: See p. 146.

DIF: Application-based, medium                          REF: 146                           OBJ: 5.3

 

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?

 

ANS: See pp. 146, 149, 150.

DIF: Application-based, hard                               REF: 146|149|150           OBJ: 5.3

 

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.

 

ANS: See pp. 152-157.

DIF: Application-based, hard                               REF: 152-157                    OBJ: 5.4

 

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?)

 

ANS: See pp. 153-155.

DIF: Application-based                                         REF: 153-155                    OBJ: 5.4

 

 

Ready-to-Use Chapter 5 Test

 

Multiple Choice

 

1. Hypertension is defined as having a blood pressure of _____.
2. ≥120 mm Hg systolic or ≥70 mm Hg diastolic
3. ≥140 mm Hg systolic or ≥90 mm Hg diastolic
4. ≥120 mm Hg systolic or ≥90 mm Hg diastolic
5. ≥140 mm Hg systolic or ≥70 mm Hg diastolic
6. ≥160 mm Hg systolic or ≥110 mm Hg diastolic

 

2. A worldwide leading cause of MATERNAL mortality is:
3. gestational diabetes.
4. hypertensive disorders of pregnancy.
5. AIDS/HIV.
6. multifetal pregnancies.
7. adolescent pregnancy complications.

 

3. Pregnancies among women with chronic hypertension are associated with higher rates of:
4. placenta abruption.
5. preterm delivery.
6. fetal growth retardation.
7. All of the above

 

4. Preeclampsia-eclampsia represents a syndrome characterized by all of the following EXCEPT:
5. blood vessel spasms and constriction.
6. increased calcium excretion.
7. oxidative stress and inflammation.
8. platelet aggregation and blood coagulation.
9. 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?
6. Chronic inflammation
7. Free radical generation
8. Oxidative stress
9. Insulin resistance
10. 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:
7. the placenta.
8. the kidneys.
9. the brain.
10. the appendix.
11. the liver.

 

7. Women with which of the following characteristics are at increased risk of developing preeclampsia?
8. Obesity
9. Insulin resistance
10. First pregnancy
11. High triglyceride levels
12. All of the above

 

8. Ideally, when should dietary intervention for preeclampsia begin?
9. Prior to pregnancy
10. Prior to the development of eclampsia
11. Prior to the 20^th week of pregnancy
12. After the 20^th week of pregnancy
13. After diagnosis of preeclampsia

 

9. Nutritional and physical activity recommendations that may benefit women at risk for preeclampsia include all of the following EXCEPT:
10. high-dose iron supplements.
11. 5 or more servings of fruits and vegetables daily.
12. moderate exercise.
13. adequate fiber intake
14. adequate vitamin D.

 

10. Which nutrients appear to reduce or prevent preeclampsia?
11. Calcium and magnesium
12. Calcium and fatty oils (n3 fatty acids)
13. Calcium and vitamin D
14. Fatty oils (n3 fatty acids) and vitamin E
15. Vitamins C and E

 

11. Diets characterized by a high intake of _____ have been linked to a decreased risk of preeclampsia.
12. protein-containing foods
13. plant foods
14. salty foods
15. sweet or sugary foods
16. processed foods

 

12. Dumping syndrome is a condition characterized by the abnormally rapid emptying of the stomach and is seen in women:
13. with gestational diabetes.
14. at risk for preeclampsia.
15. following bariatric surgery.
16. that drink more than 4 alcoholic beverages per day.
17. carrying triplets.

 

13. High maternal blood glucose levels cause the fetus to _____.
14. increase insulin output
15. convert glucose into triglycerides and store it as fat
16. potentially develop type 2 diabetes later in life
17. All of the above

 

14. About _____ of women with gestational diabetes will develop type 2 diabetes within 2-5 years.
15. 10-15%
16. 20-25%
17. 30-40%
18. 50-60%
19. 75%

 

15. According to the American Diabetes Association, when should pregnant women without diabetes have their blood glucose tested?
16. 24-28 weeks gestation
17. After the first trimester
18. 6-8 weeks gestation
19. 17 weeks gestation
20. Not at all

 

16.Elevation of ketone levels can occur if calorie intakes are decreased to what level?

1. <1500 calories daily
2. <1800 calories daily
3. Less than 33% below needs
4. Less than 25% below needs
5. a and c

 

17. The mainstay of treatment for gestational diabetes is to normalize blood glucose levels with _____.
18. oral medications
19. insulin injections or an insulin pump
20. a low-calorie, high-protein diet
21. medical nutrition therapy focusing on diet and exercise
22. a very low calorie intake

 

18. Which type of diabetes is potentially the most hazardous to the mother and fetus?
19. Type 1 diabetes
20. Type 2 diabetes
21. Gestational diabetes
22. They are all equally hazardous.

 

19. Metformin, the only type of oral medication used to treat gestational diabetes, is useful because it:
20. lowers blood glucose levels.
21. stimulates insulin secretion.
22. increases insulin resistance.
23. decreases insulin resistance.
24. stimulates ketone production.

 

20. The primary outcome goal for pregnant women with diabetes is:
21. maintenance of blood glucose levels within normal range.
22. to prevent the development of diabetes later in life.
23. to prevent excessive weight gain.
24. to maintain normal blood pressure.
25. to avoid the use of insulin during pregnancy.

 

21. It is common for women with gestational diabetes to consume _____ % of calories from carbohydrate during pregnancy.
22. 65
23. 50
24. 45
25. 25
26. 60

 

22. The vanishing twin phenomenon refers to
23. the fact that more triplets and quadruplets are being born because of fertility drugs.
24. the disappearance of embryos within 13 weeks of conception.
25. the decreasing percentage of dizygotic twins in favor of monozygotes.
26. None of the above

 

23. How many minutes of physical activity are recommended daily for women at risk of preeclampsia?
24. 30
25. 60
26. 90
27. Exercise is not recommended.

 

24. The estimated minimum Calorie level for an overweight woman with gestational diabetes weighing 200 lb (91 kg) is _____.
25. 1200 Calories
26. 1820 Calories
27. 2000 Calories
28. 2275 Calories
29. 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 provided by her evening snack, assuming she had 2 other snacks that day?
26. 150-200 Calories
27. 220-330 Calories
28. 350-525 Calories
29. 550 Calories

 

26. The most common type of multifetal pregnancy is:
27. twins.
28. triplets.
29. quadruplets.
30. quintuplets.
31. None of the above

 

27. The majority of twins born are _____.
28. dizygotic
29. monozygotic
30. trizygotic
31. in the same placenta

 

28. What percentage of all newborns are from multifetal births?
29. 3%
30. 5%
31. 11%
32. 21%

 

29. The mean weight of newborns from a twin pregnancy is _____.
30. 1800 grams
31. 2000 grams
32. 2400 grams
33. 2600 grams

 

ANS: c       DIF: Fact-based, easy                         REF: 154                           OBJ: 5.4

 

30. A multifetal pregnancy increases the mother’s risk for:
31. development of preeclampsia.
32. development of iron-deficiency anemia.
33. preterm delivery.
34. cesarean delivery.
35. 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.
32. 25
33. 30
34. 40
35. 50
36. 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.
33. 15,000
34. 25,000
35. 35,000
36. 45,000
37. 50,000

 

33. “Best practice” vitamin and mineral supplement recommendations for women during multifetal pregnancies include which of the following statements?
34. There is no need to take a vitamin and mineral supplement if you are eating enough food.
35. Women with twins need to take more iron.
36. Women should use a prenatal vitamin and mineral supplement.
37. 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 interventions EXCEPT:
35. avoidance of high intakes of supplemental vitamins A and D.
36. avoidance of high intakes of supplemental iron.
37. ensuring an adequate intake of calories.
38. treating iron-deficiency anemia with iron supplements.
39. 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?
36. Avoid consumption of honey
37. Avoid drinking unpasteurized milk
38. Make sure all meat is well cooked
39. Follow safe food-handling practices at home
40. All of the above

 

36. The most commonly observed eating disorder in pregnancy is
37. bulimia nervosa.
38. anorexia nervosa.
39. binge eating disorder.
40. emotional overeating.
41. 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 _____.
38. remind her to eat foods that help with weight gain
39. refer her to an eating disorder clinic that uses a team approach to solve nutritional issues
40. bargain with the woman to consume larger food portions but tell her that she can still vomit after eating
41. listen to her express her anxiety and fear of weight gain without commenting negatively

 

38. What information should be provided by health care professionals when counseling pregnant teens?
39. Information on how to find food and nutrition assistance programs
40. Information on good sources of iron-rich foods
41. Ideas on how to increase the number of milk and milk product servings to four servings/day
42. Ideas on how to buy foods that contain a lot of nutrients in proportion to the calories
43. All of the information above should be provided

 

39. The term fetal alcohol spectrum is now being used to describe:
40. the range of effects alcohol has on fetal growth and development.
41. the number of drinks a woman can safely consume while pregnant.
42. a set of characteristics seen in children with alcoholic mothers.
43. children that have alcoholic fathers.
44. 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 an average Calorie intake of 2300 Calories per day. Two hours after her 75-g glucose tolerance test began, her blood glucose was 155 mg/dL.

 

40. Mickie’s BMI indicates that she was:
41. underweight going into pregnancy.
42. at a normal weight going into pregnancy.
43. overweight going into pregnancy.
44. obese going into pregnancy.
45. morbidly obese going into pregnancy.

 

41. How is Mickie doing with her weight gain so far?
42. Great: she is right on track midpregnancy
43. Fair: she has gained 5 pounds too much at this point
44. Poor: she is gaining too much weight too quickly
45. Horrible: she needs to start cutting back by at least 1000 calories per day

 

42. Mickie’s OGTT results mean:
43. she is okay and does not have to be tested for gestational diabetes.
44. she has gestational diabetes.
45. she has borderline diabetes.
46. she has type 2 diabetes.
47. she has preeclampsia.

 

43. How many Calories would be a more appropriate goal for Mickie to consume, based on her prepregnancy weight status and OGTT results?
44. 1200 Calories per day
45. 1400 Calories per day
46. 1600 Calories per day
47. 1800 Calories per day
48. 2000 Calories per day

 

44. What would be the next step for Mickie?
45. Nothing; she can go home and continue to have routine doctor visits
46. Attempt to normalize blood glucose levels by following a healthy diet and exercising
47. Perform a 50-gram glucose tolerance test while fasting
48. Begin a calorie-controlled diet and return to her doctor in 2 weeks to recheck weight
49. Both c and d

 

45. Which of the following statements is TRUE regarding the spectrum of fetal alcohol disorders?
46. For fetal alcohol syndrome to be diagnosed, a specific set of characteristics must be exhibited in the child.
47. Typical maternal characteristics associated with fetal alcohol syndrome or fetal alcohol spectrum disorders are older age and multiple pregnancies.
48. There is no known absolute safe level of alcohol consumption during pregnancy, so women should be counseled that the safest approach is to not drink during pregnancy.
49. With intense early intervention after birth, the behavioral and cognitive abnormalities associated with fetal alcohol spectrum disorders can be completely reversed.
50. 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:
47. base their self worth on how much they weigh.
48. are dedicated to keeping their body weight low.
49. are unable to gain weight normally because their metabolism is so low.
50. All of the above are true.
51. a and b only

 

47. Which of the following foods would be the best, most nutrient-dense choice for a pregnant adolescent?
48. Cheez-Its and peanut butter
49. Baked potato with low-fat yogurt
50. Grilled cheese sandwich with mayonnaise and orange juice
51. Big Mac and 2% milk
52. All of the above would be good choices

 

48. Which food would be the most nutrient-dense source of calcium for a pregnant adolescent?
49. Whole milk
50. Low-fat milk (1%)
51. Reduced-fat milk (2%)
52. Skim or non-fat milk
53. None of the above

 

 

True/False

 

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

 

2. Preeclampsia develops from insulin resistance.

 

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

 

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

 

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.

 

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

 

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

 

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

 

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

 

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

 

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.

 

 

Matching

 

1.   Endothelium 2.   Chronic hypertension 3.   Thromboxanes 4.   Cephalopelvic disproportion 5.   Gestational diabetes 6.   Gestational hypertension 7.   Preeclampsia 8.   Placenta abruption 9.   Ketones 10. Type 1 diabetes 11. Dumping syndrome

A.   physiologically active substances that 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.   abnormally rapid emptying of the stomach causing weakness, dizziness, flushing, and nausea 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 separation of the placenta from its attachment to the uterus wall J.   metabolic by-products of the breakdown of fatty acids K.   disease associated with having deficient insulin output and being dependent on exogenous insulin

 

 

Short Answer

 

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. 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. Discuss the dietary recommendations for women with gestational diabetes. What are the proportions of daily calorie intake assigned to meals and snacks?

 

5. Discuss the 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 improve 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 and Tawni Holmes of University of Central Oklahoma; see the end of this document for a ready-to-use version of this test (without answers) for easy printing or cutting/pasting