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Test Bank1 for Chapter 4 – Nutrition during Pregnancy
Key to question information: ANS = correct answer; DIF = question difficulty; REF = page
reference; OBJ = chapter learning objective for question section
Learning Objectives
4.1
4.2
Identify three problem areas related to pregnancy outcomes in the United States.
Describe five physiological changes that normally occur during pregnancy that would be
considered abnormal if they did not occur during pregnancy.
4.3 Define critical periods of growth and development and identify potential consequences of
inadequate energy and nutrient availability during these periods on future health status.
4.4 Identify recommended weight gain ranges for women who enter pregnancy underweight,
normal weight, overweight, and obese.
4.5 Identify three examples of relationships between nutritional status during pregnancy and
long-term health outcomes in offspring.
4.6 Identify four major lessons learned about food availability and pregnancy outcomes from
studies of population groups undergoing famine.
4.7 Provide five examples of how the need for energy and specific nutrients change due to
pregnancy and identify three factors that influence dietary intake during pregnancy that
are not related to food availability.
4.8 Develop a one-day diet for pregnancy based on ChooseMyPlate.gov food intake
recommendations for pregnancy.
4.9 Describe two reasons why pregnant women and their fetuses are particularly vulnerable
to certain foodborne illnesses and effective dietary interventions for three common health
problems during pregnancy.
4.10 Identify and describe the basic components of a nutritional assessment of pregnant
women and three health benefits to women of regular exercise during pregnancy.
4.11 Identify three common health problems during pregnancy and the evidence of the
effectiveness of dietary interventions for their treatment or amelioration.
4.12 Describe the nutrition services components of a model nutrition program during
pregnancy.
Multiple Choice
1. Pre-term birth rate is defined as
a. births <30 weeks gestation/100
b. births <34 weeks gestation/100
c. births <37 weeks gestation/100
d. births <40 weeks gestation/100
ANS: c
DIF: Fact-based, easy
live
live
live
live
births.
births.
births.
births.
REF: 89
OBJ: 4.1
2. The reduction in the U.S. infant mortality rate over the past 20 years has been:
a. increasing at a RAPID rate.
b. increasing at a SLOWER rate than the historical infant mortality rate reductions.
c. due to technological advancements.
d. LARGELY due to high levels of medical care.
e. both b and c
ANS: e
DIF: Fact-based, easy
REF: 89
OBJ: 4.1
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
1
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4-2
3. Approximately what proportion of infants who die within the first year of life die within the
first month after birth?
a. 1/3
b. 2/3
c. 1/2
d. 3/4
e. 5/8
ANS: b
DIF: Application-based, medium
REF: 90
OBJ: 4.1
4. Infants weighing _____ are least likely to die within the first year of life.
a. 5 lbs 11 oz to 6 lbs 5 oz
b. 6 lbs 10 oz to 7 pounds 2 oz
c. 7 lbs 12 oz to 10 lbs
d. 8 lbs 8 oz to 10 lbs 2 oz
ANS: c
DIF: Fact-based, medium
REF: 90
OBJ: 4.1
5. The preferred source of fuel for the fetus is _____.
a. glucose
b. fatty acids
c. proteins
d. cholesterol
e. fiber
ANS: a
DIF: Fact-based, easy
REF: 93
OBJ: 4.2
6. Which statement is NOT correct about hormones and carbohydrate metabolism during
pregnancy?
a. During the second maternal phase, rising levels of hCS and prolactin from the pituitary
gland inhibit the conversion of glucose to glycogen and fat for storage.
b. Insulin resistance builds and increases the reliance on fats for energy during the
second half of pregnancy.
c. Estrogen and progesterone levels increase and stimulate insulin production during the
first half of pregnancy.
d. hCG levels increase to a greater extent in the second phase than in the first phase and
stimulate conversion of glucose to glycogen and fat stores.
ANS: d
DIF: Fact-based, hard
REF: 93-94
OBJ: 4.2
7. How can the change in lipid blood levels that occurs during pregnancy best be described?
a. Cholesterol and triglyceride levels decrease due to the increased water volume in the
blood
b. Cholesterol and triglyceride levels remain the same as pre-pregnancy levels
c. Cholesterol and triglyceride levels increase dramatically from pre-pregnancy levels
d. Cholesterol and triglyceride levels fluctuate daily depending on when the fetus is
building nerve cells
ANS: c
DIF: Fact-based, medium
REF: 95
OBJ: 4.2
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
8. All of the following substances are transported through the placenta easily, with the
exception of _____, which is not transferred at all.
a. water
b. cholesterol
c. oxygen
d. ketones
e. insulin
ANS: e
DIF: Fact-based, medium
REF: 96
OBJ: 4.2
9. When cell size increases due to an accumulation of protein and lipids, the increase is
characterized as _____.
a. hyperplasia
b. hypertrophy
c. differentiation
d. maturation
e. development
ANS: b
DIF: Fact-based, easy
REF: 97|99
OBJ: 4.3
10. A critical period of spinal cord development following conception is:
a. 1-2 weeks after conception.
b. 3-4 weeks after conception.
c. 5-6 weeks after conception.
d. 7-8 weeks after conception.
e. 9-10 weeks after conception.
ANS: b
DIF: Application-based, medium
REF: 98
OBJ: 4.3
11. The recommended daily protein (g) intake for pregnant women is _____.
a. 30 g
b. 71 g
c. 90 g
d. 120 g
ANS: b
DIF: Fact-based, easy
REF: 111
OBJ: 4.7
12. Research is emerging that suggests pregnant women should increase their food sources of
docosahexaenoic acid (DHA). Which of the following foods would provide the most DHA to
pregnant women?
a. 1/2 tuna salad sandwich
b. 1/4 cup granola containing 1 tsp sunflower seed
c. 8-oz glass whole milk
d. 1 cup broccoli
ANS: a
DIF: Application-based, hard
REF: 112
OBJ: 4.7
13. Pregnant women of _____ ethnicity are more likely than those of other ethnicities to have an
eating disorder known as pica.
a. African American
b. White Caucasian
c. Hispanic
d. Hmong
e. Chinese
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4-4
ANS: a
DIF: Fact-based, medium
REF: 122
OBJ: 4.7
14. The first half of pregnancy is considered the “maternal _____,” while the second half of
pregnancy is considered the ”maternal _____.”
a. anatomic phase/catatonic phase
b. catatonic phase/anatomic phase
c. catabolic phase/anabolic phase
d. anabolic phase/catabolic phase
e. hyperplastic phase/hypertrophic phase
ANS: d
DIF: Fact-based
REF: 92
OBJ: 4.2
15. A pregnant woman in the anabolic phase of pregnancy
a. has increased appetite.
b. notices a significant (>1 lb/ week) weight gain.
c. is not hungry and eats less because nutrients aren’t needed until the catabolic phase.
d. has decreased exercise tolerance.
e. both a and d
ANS: e
DIF: Application-based, medium
REF: 92
OBJ: 4.2
16. The changes in maternal physiology affect all parts of the body. Which of the following
would NOT be a normal change in a woman’s gastrointestinal tract during pregnancy?
a. Decreased gastric and intestinal transit time
b. Relaxed gastrointestinal tract muscle tone
c. Heartburn
d. Constipation
e. Nausea
ANS: a
DIF: Fact-based
REF: 93
OBJ: 4.2
17. Hemodilution of nutrients occurs during pregnancy because:
a. women are eating less.
b. blood volume increases so much.
c. amniotic fluid displaces many nutrients.
d. glomerular filtration decreases.
e. maternal organs and tissues grow.
ANS: b
DIF: Fact-based, medium
REF: 92|93
OBJ: 4.2
18. _____ do(es) NOT pose any foodborne bacterial risks in pregnant women.
a. Brie cheese
b. Ready-to-eat deli meats
c. Raw oysters
d. Unpasteurized milk
e. Organic bananas
ANS: e
DIF: Application-based, medium
REF: 130
OBJ: 4.9
19. According to the text, infants weighing _____ at birth are least likely to die within the first
year of life.
a. ~3000-4000 g
b. ~3500-4500 g
c. ~4000-5000 g
d. ~4500-5500 g
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
ANS: b
DIF: Fact-based
REF: 90
OBJ: 4.1
20. Improvements in _____ have corresponded to greater reductions in infant mortality, while
small improvements in infant mortality in the past few decades are largely due to _____.
a. technical advances in medical care; infectious disease control and sanitation
b. infectious disease control and sanitation; the industrial revolution
c. infectious disease control and sanitation; technical advances in medical care
d. vaccination rates: infectious disease control and sanitation
ANS: c
DIF: Fact-based, medium
REF: 88-89
OBJ: 4.1
21. Natality statistics are data that summarize information about:
a. the occurrence of pregnancy complications.
b. infant morbidity.
c. infant mortality.
d. harmful behaviors during pregnancy.
e. all of the above
ANS: e
DIF: Fact-based
REF: 88
OBJ: 4.1
22. Small for gestational age (SGA) is different than low birthweight because:
a. low birth weight is <2500 g (5 lb 8 oz), while SGA is ≤10th %tile for gestational age.
b. SGA is <2500 g (5 lb 8 oz), while low birth weight is ≤10th %tile for gestational age.
c. SGA is <1500 g (3 lb 5 oz), while low birth weight is ≤10th %tile for gestational age.
d. SGA is ≤10th %tile for gestational age, while low birth weight is <1500 g (3 lb 4 oz).
ANS: a
DIF: Application-based
REF: 89|100
OBJ: 4.1|4.3
23. A baby born to a single mom who lost her job and experienced a severe food shortage at the
end of her pregnancy will most likely be classified as
a. very small for gestational age (vSGA).
b. disproportionately small for gestational age (dSGA).
c. proportionately small for gestational age (pSGA).
d. appropriate for gestational age (AGA).
ANS: b
DIF: Application-based, medium
REF: 100-101
OBJ: 4.3
24. Which of the following statements is NOT a national health objective for pregnant women or
newborns?
a. Reduce the rate of fetal and infant deaths
b. Increase abstinence from alcohol during pregnancy
c. Increase the proportion of women who gain weight appropriately during pregnancy
d. Reduce post-term births
e. All of the above ARE national health objectives for pregnant women and newborns
ANS: d
DIF: Fact-based
REF: 91
OBJ: 4.1
25. Why must volume expansion occur BEFORE maternal nutrient stores accumulate?
a. In order to support large gains in fetal weight
b. In order to provide the fetus with sufficient energy, nutrients, and oxygen
c. In order to provide the mother with plenty of fluids
d. In order to dilute the high concentration of nutrients in pregnant women
e. In order to make room for growing organs
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4-6
ANS: b
DIF: Fact-based
REF: 91
OBJ: 4.2
26. Which of the following is a major function of the placenta?
a. Hormone and enzyme production
b. Nutrient and gas exchange between mother and fetus
c. Removal of waste products from the fetus
d. Barrier to drugs and alcohol
e. a, b, and c
f. all of the above
ANS: e
DIF: Fact-based
REF: 95-96
OBJ: 4.2
27. When the nutrient concentration in the fetal blood is greater than the nutrient
concentration in the maternal blood, nutrients will likely be transferred against the
concentration gradient via:
a. passive diffusion.
b. facilitated diffusion.
c. active transport.
d. pinocytosis.
e. exocytosis.
ANS: c
DIF: Application-based
REF: 96
OBJ: 4.2
28. Decreased conversion of glucose to glycogen and fat, lowered maternal utilization of
glucose, and increased liver production of glucose help:
a. ensure the mother does not gain excessive weight during the second half of pregnancy.
b. ensure a constant supply of fat for maternal energy needs.
c. ensure a constant supply of glucose for fetal growth and development.
d. ensure that women do not expend too much energy on metabolism and have plenty of
energy to support fetal growth.
e. promote healthy weight gain for pregnant women.
ANS: c
DIF: Fact-based
REF: 94
OBJ: 4.2
29. Factors associated with reduced fetal growth include all of the following EXCEPT:
a. pre-pregnancy underweight and shortness.
b. high-carbohydrate diets.
c. low weight gain during pregnancy.
d. smoking.
e. poor dietary intake.
ANS: b
DIF: Fact-based
REF: 100
OBJ: 4.3
30. Factors related to the birth of infants who are large for gestational age (LGA) include:
a. pre-pregnancy obesity.
b. excessive weight gain during pregnancy.
c. poorly controlled diabetes in pregnancy.
d. all of the above
e. a and b only
ANS: d
DIF: Fact-based
REF: 101
OBJ: 4.3
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
31. Approximately what proportion of women in the U.S. gain within the recommended weight
ranges during pregnancy?
a. 20%
b. 31%
c. 40%
d. 52%
e. none of the above
ANS: b
DIF: Fact-based
REF: 105
OBJ: 4.4
32. It is recommended that overweight women gain approximately _____ during pregnancy.
a. 5-10 pounds
b. 15-25 pounds
c. 25-35 pounds
d. 28-40 pounds
e. 35-45 pounds
ANS: b
DIF: Fact-based, easy
REF: 105
OBJ: 4.4
33. The recommended weight gain range for normal-weight women is:
a. 5-10 pounds.
b. 15-25 pounds.
c. 25-35 pounds.
d. 28-40 pounds.
e. 35-45 pounds.
ANS: c
DIF: Fact-based, easy
REF: 105
OBJ: 4.4
34. The best weight gain advice for normal-weight women is that:
a. women should gain approximately 0.5 lb/week throughout the pregnancy.
b. women should not gain in the first trimester but gain approximately 1 lb/week in the
other two trimesters.
c. women of different races gain weight at different rates throughout pregnancy.
d. approximately 3-5 lbs should be gained in the first trimester and gradual, consistent
gains thereafter.
ANS: d
DIF: Fact-based, easy
REF: 106
OBJ: 4.4
35. Jane Smith (and her husband) sought medical care for persistent nausea and vomiting
throughout the day. Following a pregnancy test and medical examination, the doctor
determined that she was in the 5th week of pregnancy. Following this report, Jane’s
husband remarked, “You will have to stop eating potato chips and eat more healthy foods.”
What is the best response the doctor could make?
a. “I agree—it is important to eat high-fiber foods.”
b. “I agree—drink lots of water with meals.”
c. “I recommend that you continue to eat foods that you can tolerate and that will help
you gain weight.”
d. “I suggest you eat a very small amount of chips to reduce your salt intake and prevent
high blood pressure problems.”
ANS: c
DIF: Application-based, easy
REF: 132
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OBJ: 4.11
4-8
36. It is recommended that woman consume at least _____ of carbohydrate during pregnancy to
meet fetal needs for glucose.
a. 125 grams per day
b. 150 grams per day
c. 175 grams per day
d. 225 grams per day
e. 250 grams per day
ANS: c
DIF: Fact-based
REF: 111
OBJ: 4.7
37. If taken on an EMPTY stomach, folic acid supplements are nearly _____ bioavailable.
a. 45%
b. 60%
c. 75%
d. 85%
e. 100%
ANS: e
DIF: Fact-based
REF: 113
OBJ: 4.7
38. During pregnancy, as the dose of iron _____ the amount of iron absorbed from supplements
_____.
a. decreases/ increases
b. increases/ decreases
c. doubles/ triples
d. triples/ doubles
ANS: b
DIF: Fact-based
REF: 120
OBJ: 4.7
40. Iron is absorbed best when:
a. you take a separate iron supplement (not in a multi-vitamin).
b. you have a higher need for iron.
c. you eat meat, poultry, or fish.
d. all of the above
e. b and c only
ANS: d
DIF: Fact-based
REF: 120-121
OBJ: 4.7
41. Which of the following fruits and vegetables would supply a large amount of antioxidants?
a. Bananas and green grapes
b. Pumpkin and Swiss chard
c. Blueberries and cranberries
d. a and b
e. b and c
ANS: e
DIF: Application-based
REF: 122
OBJ: 4.7
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
42. Which of the following statements about the fetal origins hypothesis is NOT true?
a. Research shows that lower birthweight is associated with higher risk of adult diseases
such as cardiovascular disease, type 2 diabetes, and hypertension.
b. Both low birthweights (less than 5.5 lb) and high birthweights (more than 10 lb) in
humans are strongly associated with later risk of disease in adulthood .
c. Evidence from animal studies shows the expression of genes that produce insulin
receptors on muscle membranes may be suppressed in response to a low availability of
glucose.
d. The effects of fetal programming on adult disease may be strongly modified by infant
and childhood diets.
ANS: b
DIF: Fact-based
REF: 103-104
OBJ: 4.3
Use the following information to answer questions 43-45:
Jane is 5’7” (1.70 m) and weighs 160 pounds (72.7 kg).
43. What is Jane’s body mass index?
a. 19.7
b. 25.1
c. 31.4
d. 43
ANS: b
DIF: Application-based
REF: 107
OBJ: 4.4
REF: 105|107
OBJ: 4.4
44. Based on her BMI, Jane would be considered:
a. underweight.
b. normal weight.
c. overweight.
d. obese.
e. morbidly obese.
ANS: c
DIF: Application-based
45. Jane becomes pregnant. How many pounds should Jane gain during her pregnancy, based
on her BMI?
a. 11 to 20
b. 15 to 25
c. 25 to 35
d. 28 to 40
e. 35 to 45
ANS: b
DIF: Application-based
REF: 105
OBJ: 4.4
46. Pregnancy increases the absorption of _____ and _____.
a. iron
b. calcium
c. zinc
d. a and b
e. b and c
ANS: d
DIF: Fact-based
REF: 118-119
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OBJ: 4.7
4-10
47. Low weight gain increases the risk of:
a. spina bifida.
b. intrauterine growth retardation (IUGR).
c. a macrosomic baby.
d. cleft palate.
e. rickets.
ANS: b
DIF: Application-based
REF: 100-101
OBJ: 4.3
48. The recommended daily dietary intake of folate during pregnancy is:
a. 200 mcg from fortified food or supplements.
b. 400 mcg from fortified food or supplements.
c. 600 mcg total with 400 mcg from fortified food or supplements.
d. 800 mcg total with 600 mcg from fortified food or supplements.
e. 4000 mcg total in any form.
ANS: c
DIF: Fact-based
REF: 115
OBJ: 4.7
Use the following information and the growth chart provided to answer questions 49
and 50.
Your best friend just had a full-term baby girl that weighed 7 pounds.
49. Plot this infant’s weight at birth on the growth chart and indicate which of the following
percentiles she falls in.
a. 10th
b. 25th
c. 50th
d. 75th
e. 90th
ANS: b
DIF: Application-based
REF: 100-102
OBJ: 4.3
REF: 100-101
OBJ: 4.3
50. Based on your above answer, this baby is:
a. small for gestational age (SGA).
b. large for gestational age (LGA).
c. appropriate for gestational age (AGA).
ANS: c
DIF: Application-based
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
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4-12
True/False
1. If not accompanied by hypertension, edema in pregnancy generally reflects a healthy
expansion of plasma volume.
ANS: T
DIF: Fact-based
REF: 92
OBJ: 4.2
2. Maternal and fetal needs for protein are fulfilled by maternal protein and muscle stores
entering pregnancy.
ANS: F
DIF: Fact-based
REF: 95
OBJ: 4.2
3. Changes in blood lipids during pregnancy are related to maternal dietary intake and should
be monitored on a regular basis.
ANS: F
DIF: Fact-based
REF: 95
OBJ: 4.2
4. Restricting weight gain in pregnancy does NOT increase the risk of infant death and low
birth weight.
ANS: F
DIF: Fact-based
REF: 106
OBJ: 4.4
5. The highest rate of weight gain occurs mid-pregnancy, prior to the time the fetus gains
most of its weight.
ANS: T
DIF: Fact-based
REF: 106
OBJ: 4.4
6. The fetus accounts for approximately 70% of the increased energy needs of pregnancy.
ANS: F
DIF: Fact-based
REF: 110
OBJ: 4.7
7. Infants born to African American mothers are more likely to have a low birthweight than
infants born to Caucasian mothers.
ANS: T
DIF: Fact-based, easy
REF: 90
OBJ: 4.1
8. Within the 40 weeks’ duration of pregnancy, 50% of fetal growth is accomplished in the first
20 weeks.
ANS: F
DIF: Fact-based, easy
REF: 92
OBJ: 4.2
9. The mother stores protein in the maternal anabolic phase of pregnancy.
ANS: F
DIF: Fact-based, easy
REF: 92|95
OBJ: 4.2
10. On average, women who gain within the recommended ranges for weight gain are 2.0
pounds heavier one year after delivery than they were before pregnancy.
ANS: F
DIF: Fact-based, medium
REF: 106
OBJ: 4.4
11. Neural tube defects are among the most preventable types of congenital abnormalities that
exist.
ANS: T
DIF: Fact-based, easy
REF: 114
OBJ: 4.7
© 2014 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part, except for use as permitted in a
license distributed with a certain product or service or otherwise on a password-protected website for classroom use.
full file at http://testbankcorner.eu
12. Women with small increases in plasma volume are more likely to have complications such
as low-birth weight infants.
ANS: T
DIF: Application-based
REF: 92
OBJ: 4.2
Matching
1. Spina bifida
A. Gastric reflux into esophagus
2. Docosahexaenoic acid
(DHA)
B. The compulsion to eat non-food substances
3. Toxoplasmosis
4. Listeria monocytogenes
5. Hyperemesis
gravidarum
C. A bacterium that causes food-borne illness
D. Failure of spinal cord to close
E. Essential fatty acid important in visual acuity
F. Absence of brain or spinal cord
G. Number of pregnancies a woman has experienced.
6. Heartburn
H. Results from a deficiency of iodine during pregnancy
7. Gravida
I.
8. Pica
A parasitic infection that can impair fetal brain development
J. Severe nausea and vomiting during pregnancy
9. Hypothyroidism
10. Anencephaly
Key:
1. ANS:
2. ANS:
3. ANS:
4. ANS:
5. ANS:
6. ANS:
7. ANS:
8. ANS:
9. ANS:
10. ANS:
D
E
I
C
J
A
G
B
H
F
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
DIF:
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
Fact-based
REF:
REF:
REF:
REF:
REF:
REF:
REF:
REF:
REF:
REF:
114
113
130
130
132
133
105
122
121
114
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
OBJ:
4.7
4.7
4.9
4.9
4.11
4.11
4.4
4.7
4.7
4.7
Short Answer
1. A Native Alaskan pregnant woman had a Hgb <11.0 and serum ferritin <15. Recommend
appropriate amounts of iron supplementation and discuss the absorption rates based on
supplemental iron amounts and type. If this woman experiences side effects taking one iron
tablet/day, what other choices are available?
ANS: See pp. 118-121.
DIF: Application-based, hard
REF: 118-121
OBJ: 4.7
2. Using knowledge about the placenta and nutrient transfer, defend the statement, “The fetus
is not a parasite.” Please cite one nutrient example that does not support this statement.
ANS: See pp. 96-97.
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4-14
DIF: Application-based, hard
REF: 96-97
OBJ: 4.2
3. Identify three foods that contain the highly bioavailable form of folate and two foods that
provide folic acid through fortification. Create a one-day meal plan in which the
recommended amounts of dietary folate equivalents (DFE) are available. Be sure to identify
the appropriate amount of folic acid supplementation needed.
ANS: See pp. 113-115.
DIF: Application-based, hard
REF: 113-115
OBJ: 4.7
4. A normal-weight woman in the second half of her pregnancy brought in a food diary.
Identify any food groups that are missing from this woman’s diet or not adequately
represented based on the MyPlate recommendations. Would you recommend any
vitamin/mineral supplementation for this woman? Why or why not? Identify and discuss
two of the ten principles of a good diet that were met by this woman.
Food Record for Saturday:
Breakfast, at home: 6 oz coffee, bowl of Frosted Flakes with 4 oz 2% milk.
Morning break, at work: ½ blueberry muffin with 6 oz decaf coffee.
Lunch, at work: 2 oz mozzarella cheese, 8 Saltine crackers, 12 oz lemon-lime soda, and an
apple.
Supper, at home: 2 6” round pancakes with maple syrup and 2 1-oz sausage links. 8 oz of
chocolate milk (2%).
Evening snack: 12 oz Chocolate Blizzard Shake from Dairy Queen.
ANS: See pp. 123-129.
DIF: Application-based, hard
REF: 123-129
OBJ: 4.8
5. a) Explain the adjustments in maternal metabolism during pregnancy for the following
macronutrients: carbohydrate, protein, and fat.
b) HOW and WHY do these changes occur and what effect do they have on the mother and
the fetus?
ANS: See pp. 93-95.
DIF: Fact-based
REF: 93-95
OBJ: 4.2
6. Briefly explain the meaning of the statement, “critical periods represent a one-way street.”
How do deficits or excesses during these periods affect fetal growth and development?
ANS: See pp. 97-99.
DIF: Fact-based
REF: 97-99
OBJ: 4.3
7. Your best friend has just found out she is pregnant. She has been told by her obstetrician
to take 30 mg of iron (ferrous gluconate) per day along with a prenatal vitamin to help
prevent anemia. After taking it for 2 weeks, she is complaining of heartburn, cramps, and
constipation. What 3 suggestions would you make for her that might help with these side
effects? Would you suggest she continue with the same supplement or try something else?
Why or why not? Plan a one-day diet that would provide between 25 and 30 mg of iron and
would be appropriate for a pregnant woman.
ANS: See pp. 118-121.
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DIF: Application-based
REF: 118-121
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OBJ: 4.7
4-16
Ready-to-Use Chapter 4 Test
Multiple Choice
1. Pre-term birth rate is defined as
a. births <30 weeks gestation/100
b. births <34 weeks gestation/100
c. births <37 weeks gestation/100
d. births <40 weeks gestation/100
live
live
live
live
births.
births.
births.
births.
2. The reduction in the U.S. infant mortality rate over the past 20 years has been:
a. increasing at a RAPID rate.
b. increasing at a SLOWER rate than the historical infant mortality rate reductions.
c. due to technological advancements.
d. LARGELY due to high levels of medical care.
e. both b and c
3. Approximately what proportion of infants who die within the first year of life die within the
first month after birth?
a. 1/3
b. 2/3
c. 1/2
d. 3/4
e. 5/8
4. Infants weighing _____ are least likely to die within the first year of life.
a. 5 lbs 11 oz to 6 lbs 5 oz
b. 6 lbs 10 oz to 7 pounds 2 oz
c. 7 lbs 12 oz to 10 lbs
d. 8 lbs 8 oz to 10 lbs 2 oz
5. The preferred source of fuel for the fetus is _____.
a. glucose
b. fatty acids
c. proteins
d. cholesterol
e. fiber
6. Which statement is NOT correct about hormones and carbohydrate metabolism during
pregnancy?
a. During the second maternal phase, rising levels of hCS and prolactin from the pituitary
gland inhibit the conversion of glucose to glycogen and fat for storage.
b. Insulin resistance builds and increases the reliance on fats for energy during the
second half of pregnancy.
c. Estrogen and progesterone levels increase and stimulate insulin production during the
first half of pregnancy.
d. hCG levels increase to a greater extent in the second phase than in the first phase and
stimulate conversion of glucose to glycogen and fat stores.
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7. How can the change in lipid blood levels that occurs during pregnancy best be described?
a. Cholesterol and triglyceride levels decrease due to the increased water volume in the
blood
b. Cholesterol and triglyceride levels remain the same as pre-pregnancy levels
c. Cholesterol and triglyceride levels increase dramatically from pre-pregnancy levels
d. Cholesterol and triglyceride levels fluctuate daily depending on when the fetus is
building nerve cells
8. All of the following substances are transported through the placenta easily, with the
exception of _____, which is not transferred at all.
a. water
b. cholesterol
c. oxygen
d. ketones
e. insulin
9. When cell size increases due to an accumulation of protein and lipids, the increase is
characterized as _____.
a. hyperplasia
b. hypertrophy
c. differentiation
d. maturation
e. development
10. A critical period of spinal cord development following conception is:
a. 1-2 weeks after conception.
b. 3-4 weeks after conception.
c. 5-6 weeks after conception.
d. 7-8 weeks after conception.
e. 9-10 weeks after conception.
11. The recommended daily protein (g) intake for pregnant women is _____.
a. 30 g
b. 71 g
c. 90 g
d. 120 g
12. Research is emerging that suggests pregnant women should increase their food sources of
docosahexaenoic acid (DHA). Which of the following foods would provide the most DHA to
pregnant women?
a. 1/2 tuna salad sandwich
b. 1/4 cup granola containing 1 tsp sunflower seed
c. 8-oz glass whole milk
d. 1 cup broccoli
13. Pregnant women of _____ ethnicity are more likely than those of other ethnicities to have an
eating disorder known as pica.
a. African American
b. White Caucasian
c. Hispanic
d. Hmong
e. Chinese
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4-18
14. The first half of pregnancy is considered the “maternal _____,” while the second half of
pregnancy is considered the ”maternal _____.”
a. anatomic phase/catatonic phase
b. catatonic phase/anatomic phase
c. catabolic phase/anabolic phase
d. anabolic phase/catabolic phase
e. hyperplastic phase/hypertrophic phase
15. A pregnant woman in the anabolic phase of pregnancy
a. has increased appetite.
b. notices a significant (>1 lb/ week) weight gain.
c. is not hungry and eats less because nutrients aren’t needed until the catabolic phase.
d. has decreased exercise tolerance.
e. both a and d
16. The changes in maternal physiology affect all parts of the body. Which of the following
would NOT be a normal change in a woman’s gastrointestinal tract during pregnancy?
a. Decreased gastric and intestinal transit time
b. Relaxed gastrointestinal tract muscle tone
c. Heartburn
d. Constipation
e. Nausea
17. Hemodilution of nutrients occurs during pregnancy because:
a. women are eating less.
b. blood volume increases so much.
c. amniotic fluid displaces many nutrients.
d. glomerular filtration decreases.
e. maternal organs and tissues grow.
18. _____ do(es) NOT pose any foodborne bacterial risks in pregnant women.
a. Brie cheese
b. Ready-to-eat deli meats
c. Raw oysters
d. Unpasteurized milk
e. Organic bananas
19. According to the text, infants weighing _____ at birth are least likely to die within the first
year of life.
a. ~3000-4000 g
b. ~3500-4500 g
c. ~4000-5000 g
d. ~4500-5500 g
20. Improvements in _____ have corresponded to greater reductions in infant mortality, while
small improvements in infant mortality in the past few decades are largely due to _____.
a. technical advances in medical care; infectious disease control and sanitation
b. infectious disease control and sanitation; the industrial revolution
c. infectious disease control and sanitation; technical advances in medical care
d. vaccination rates: infectious disease control and sanitation
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21. Natality statistics are data that summarize information about:
a. the occurrence of pregnancy complications.
b. infant morbidity.
c. infant mortality.
d. harmful behaviors during pregnancy.
e. all of the above
22. Small for gestational age (SGA) is different than low birthweight because:
a. low birth weight is <2500 g (5 lb 8 oz), while SGA is ≤10th %tile for gestational age.
b. SGA is <2500 g (5 lb 8 oz), while low birth weight is ≤10th %tile for gestational age.
c. SGA is <1500 g (3 lb 5 oz), while low birth weight is ≤10th %tile for gestational age.
d. SGA is ≤10th %tile for gestational age, while low birth weight is <1500 g (3 lb 4 oz).
23. A baby born to a single mom who lost her job and experienced a severe food shortage at the
end of her pregnancy will most likely be classified as
a. very small for gestational age (vSGA).
b. disproportionately small for gestational age (dSGA).
c. proportionately small for gestational age (pSGA).
d. appropriate for gestational age (AGA).
24. Which of the following statements is NOT a national health objective for pregnant women or
newborns?
a. Reduce the rate of fetal and infant deaths
b. Increase abstinence from alcohol during pregnancy
c. Increase the proportion of women who gain weight appropriately during pregnancy
d. Reduce post-term births
e. All of the above ARE national health objectives for pregnant women and newborns
25. Why must volume expansion occur BEFORE maternal nutrient stores accumulate?
a. In order to support large gains in fetal weight
b. In order to provide the fetus with sufficient energy, nutrients, and oxygen
c. In order to provide the mother with plenty of fluids
d. In order to dilute the high concentration of nutrients in pregnant women
e. In order to make room for growing organs
26. Which of the following is a major function of the placenta?
a. Hormone and enzyme production
b. Nutrient and gas exchange between mother and fetus
c. Removal of waste products from the fetus
d. Barrier to drugs and alcohol
e. a, b, and c
f. all of the above
27. When the nutrient concentration in the fetal blood is greater than the nutrient
concentration in the maternal blood, nutrients will likely be transferred against the
concentration gradient via:
a. passive diffusion.
b. facilitated diffusion.
c. active transport.
d. pinocytosis.
e. exocytosis.
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4-20
28. Decreased conversion of glucose to glycogen and fat, lowered maternal utilization of
glucose, and increased liver production of glucose help:
a. ensure the mother does not gain excessive weight during the second half of pregnancy.
b. ensure a constant supply of fat for maternal energy needs.
c. ensure a constant supply of glucose for fetal growth and development.
d. ensure that women do not expend too much energy on metabolism and have plenty of
energy to support fetal growth.
e. promote healthy weight gain for pregnant women.
29. Factors associated with reduced fetal growth include all of the following EXCEPT:
a. pre-pregnancy underweight and shortness.
b. high-carbohydrate diets.
c. low weight gain during pregnancy.
d. smoking.
e. poor dietary intake.
30. Factors related to the birth of infants who are large for gestational age (LGA) include:
a. pre-pregnancy obesity.
b. excessive weight gain during pregnancy.
c. poorly controlled diabetes in pregnancy.
d. all of the above
e. a and b only
31. Approximately what proportion of women in the U.S. gain within the recommended weight
ranges during pregnancy?
a. 20%
b. 31%
c. 40%
d. 52%
e. none of the above
32. It is recommended that overweight women gain approximately _____ during pregnancy.
a. 5-10 pounds
b. 15-25 pounds
c. 25-35 pounds
d. 28-40 pounds
e. 35-45 pounds
33. The recommended weight gain range for normal-weight women is:
a. 5-10 pounds.
b. 15-25 pounds.
c. 25-35 pounds.
d. 28-40 pounds.
e. 35-45 pounds.
34. The best weight gain advice for normal-weight women is that:
a. women should gain approximately 0.5 lb/week throughout the pregnancy.
b. women should not gain in the first trimester but gain approximately 1 lb/week in the
other two trimesters.
c. women of different races gain weight at different rates throughout pregnancy.
d. approximately 3-5 lbs should be gained in the first trimester and gradual, consistent
gains thereafter.
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35. Jane Smith (and her husband) sought medical care for persistent nausea and vomiting
throughout the day. Following a pregnancy test and medical examination, the doctor
determined that she was in the 5th week of pregnancy. Following this report, Jane’s
husband remarked, “You will have to stop eating potato chips and eat more healthy foods.”
What is the best response the doctor could make?
a. “I agree—it is important to eat high-fiber foods.”
b. “I agree—drink lots of water with meals.”
c. “I recommend that you continue to eat foods that you can tolerate and that will help
you gain weight.”
d. “I suggest you eat a very small amount of chips to reduce your salt intake and prevent
high blood pressure problems.”
36. It is recommended that woman consume at least _____ of carbohydrate during pregnancy to
meet fetal needs for glucose.
a. 125 grams per day
b. 150 grams per day
c. 175 grams per day
d. 225 grams per day
e. 250 grams per day
37. If taken on an EMPTY stomach, folic acid supplements are nearly _____ bioavailable.
a. 45%
b. 60%
c. 75%
d. 85%
e. 100%
38. During pregnancy, as the dose of iron _____ the amount of iron absorbed from supplements
_____.
a. decreases/ increases
b. increases/ decreases
c. doubles/ triples
d. triples/ doubles
40. Iron is absorbed best when:
a. you take a separate iron supplement (not in a multi-vitamin).
b. you have a higher need for iron.
c. you eat meat, poultry, or fish.
d. all of the above
e. b and c only
41. Which of the following fruits and vegetables would supply a large amount of antioxidants?
a. Bananas and green grapes
b. Pumpkin and Swiss chard
c. Blueberries and cranberries
d. a and b
e. b and c
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4-22
42. Which of the following statements about the fetal origins hypothesis is NOT true?
a. Research shows that lower birthweight is associated with higher risk of adult diseases
such as cardiovascular disease, type 2 diabetes, and hypertension.
b. Both low birthweights (less than 5.5 lb) and high birthweights (more than 10 lb) in
humans are strongly associated with later risk of disease in adulthood .
c. Evidence from animal studies shows the expression of genes that produce insulin
receptors on muscle membranes may be suppressed in response to a low availability of
glucose.
d. The effects of fetal programming on adult disease may be strongly modified by infant
and childhood diets.
Use the following information to answer questions 43-45:
Jane is 5’7” (1.70 m) and weighs 160 pounds (72.7 kg).
43. What is Jane’s body mass index?
a. 19.7
b. 25.1
c. 31.4
d. 43
44. Based on her BMI, Jane would be considered:
a. underweight.
b. normal weight.
c. overweight.
d. obese.
e. morbidly obese.
45. Jane becomes pregnant. How many pounds should Jane gain during her pregnancy, based
on her BMI?
a. 11 to 20
b. 15 to 25
c. 25 to 35
d. 28 to 40
e. 35 to 45
46. Pregnancy increases the absorption of _____ and _____.
a. iron
b. calcium
c. zinc
d. a and b
e. b and c
47. Low weight gain increases the risk of:
a. spina bifida.
b. intrauterine growth retardation (IUGR).
c. a macrosomic baby.
d. cleft palate.
e. rickets.
48. The recommended daily dietary intake of folate during pregnancy is:
a. 200 mcg from fortified food or supplements.
b. 400 mcg from fortified food or supplements.
c. 600 mcg total with 400 mcg from fortified food or supplements.
d. 800 mcg total with 600 mcg from fortified food or supplements.
e. 4000 mcg total in any form.
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Use the following information and the growth chart provided to answer questions 49
and 50.
Your best friend just had a full-term baby girl that weighed 7 pounds.
49. Plot this infant’s weight at birth on the growth chart and indicate which of the following
percentiles she falls in.
a. 10th
b. 25th
c. 50th
d. 75th
e. 90th
50. Based on your above answer, this baby is:
a. small for gestational age (SGA).
b. large for gestational age (LGA).
c. appropriate for gestational age (AGA).
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4-24
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True/False
1. If not accompanied by hypertension, edema in pregnancy generally reflects a healthy
expansion of plasma volume.
2. Maternal and fetal needs for protein are fulfilled by maternal protein and muscle stores
entering pregnancy.
3. Changes in blood lipids during pregnancy are related to maternal dietary intake and should
be monitored on a regular basis.
4. Restricting weight gain in pregnancy does NOT increase the risk of infant death and low
birth weight.
5. The highest rate of weight gain occurs mid-pregnancy, prior to the time the fetus gains
most of its weight.
6. The fetus accounts for approximately 70% of the increased energy needs of pregnancy.
7. Infants born to African American mothers are more likely to have a low birthweight than
infants born to Caucasian mothers.
8. Within the 40 weeks’ duration of pregnancy, 50% of fetal growth is accomplished in the first
20 weeks.
9. The mother stores protein in the maternal anabolic phase of pregnancy.
10. On average, women who gain within the recommended ranges for weight gain are 2.0
pounds heavier one year after delivery than they were before pregnancy.
11. Neural tube defects are among the most preventable types of congenital abnormalities that
exist.
12. Women with small increases in plasma volume are more likely to have complications such
as low-birth weight infants.
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4-26
Matching
1. Spina bifida
A. Gastric reflux into esophagus
2. Docosahexaenoic acid
(DHA)
B. The compulsion to eat non-food substances
3. Toxoplasmosis
4. Listeria monocytogenes
5. Hyperemesis
gravidarum
6. Heartburn
7. Gravida
8. Pica
9. Hypothyroidism
C. A bacterium that causes food-borne illness
D. Failure of spinal cord to close
E. Essential fatty acid important in visual acuity
F. Absence of brain or spinal cord
G. Number of pregnancies a woman has experienced.
H. Results from a deficiency of iodine during pregnancy
I.
A parasitic infection that can impair fetal brain development
J. Severe nausea and vomiting during pregnancy
10. Anencephaly
Short Answer
1. A Native Alaskan pregnant woman had a Hgb <11.0 and serum ferritin <15. Recommend
appropriate amounts of iron supplementation and discuss the absorption rates based on
supplemental iron amounts and type. If this woman experiences side effects taking one iron
tablet/day, what other choices are available?
2. Using knowledge about the placenta and nutrient transfer, defend the statement, “The fetus
is not a parasite.” Please cite one nutrient example that does not support this statement.
3. Identify three foods that contain the highly bioavailable form of folate and two foods that
provide folic acid through fortification. Create a one-day meal plan in which the
recommended amounts of dietary folate equivalents (DFE) are available. Be sure to identify
the appropriate amount of folic acid supplementation needed.
4. A normal-weight woman in the second half of her pregnancy brought in a food diary.
Identify any food groups that are missing from this woman’s diet or not adequately
represented based on the MyPlate recommendations. Would you recommend any
vitamin/mineral supplementation for this woman? Why or why not? Identify and discuss
two of the ten principles of a good diet that were met by this woman.
Food Record for Saturday:
Breakfast, at home: 6 oz coffee, bowl of Frosted Flakes with 4 oz 2% milk.
Morning break, at work: ½ blueberry muffin with 6 oz decaf coffee.
Lunch, at work: 2 oz mozzarella cheese, 8 Saltine crackers, 12 oz lemon-lime soda, and an
apple.
Supper, at home: 2 6” round pancakes with maple syrup and 2 1-oz sausage links. 8 oz of
chocolate milk (2%).
Evening snack: 12 oz Chocolate Blizzard Shake from Dairy Queen.
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5. a) Explain the adjustments in maternal metabolism during pregnancy for the following
macronutrients: carbohydrate, protein, and fat.
b) HOW and WHY do these changes occur and what effect do they have on the mother and
the fetus?
6. Briefly explain the meaning of the statement, “critical periods represent a one-way street.”
How do deficits or excesses during these periods affect fetal growth and development?
7. Your best friend has just found out she is pregnant. She has been told by her obstetrician
to take 30 mg of iron (ferrous gluconate) per day along with a prenatal vitamin to help
prevent anemia. After taking it for 2 weeks, she is complaining of heartburn, cramps, and
constipation. What 3 suggestions would you make for her that might help with these side
effects? Would you suggest she continue with the same supplement or try something else?
Why or why not? Plan a one-day diet that would provide between 25 and 30 mg of iron and
would be appropriate for a pregnant woman.
full file at http://testbankcorner.eu