Chapter 15 – Life Cycle Nutrition: Pregnancy and Lactation
MULTIPLE CHOICE
1. Which of the following describes the capacity of a man to produce sperm and a woman to periodically
produce a normal egg?
a.
Zygote
b.
Fertility
c.
Conception
d.
Implantation zone
e.
Reproductive competence
2. What is the placenta?
a.
An organ from which the infant receives nourishment
b.
A muscular organ within which the infant develops before birth
c.
The developing infant from the eighth week after conception until birth
d.
The developing infant during its second through eighth week after conception
e.
The sac in which the developing infant is contained prior to birth
3. A newly fertilized egg is known as a(n)
a.
fetus.
b.
ovum.
c.
zygote.
d.
embryo.
e.
blastocyst.
4. A newborn infant at full gestational age has an average length of
a.
15 inches.
b.
17 inches.
c.
20 inches.
d.
22 inches.
e.
2 feet.
5. Gestation is generally divided into equal periods of
a.
10 weeks, called quarters.
b.
8 weeks, called quintiles.
c.
4 months, called semesters.
d.
3 months, called trimesters.
e.
5 weeks, called periods.
6. What name is given to the time period during which irreversible damage to the fetus may occur from
specific events such as malnutrition or exposure to toxins?
a.
Period of maximal sensitivity
b.
Critical period
c.
Fertility period
d.
Conceptual period
e.
Teratogenic period
7. What is the term for the developing infant from the eighth week after conception until birth?
a.
Fetus
b.
Ovum
c.
Zygote
d.
Embryo
e.
Blastocyst
8. At what stage of pregnancy does an embryo show a beating heart and a complete central nervous
system?
a.
8 weeks
b.
12 weeks
c.
16 weeks
d.
20 weeks
e.
24 weeks
9. The neural tube develops into the
a.
umbilical cord.
b.
liver and pancreas.
c.
gastrointestinal tract.
d.
brain and spinal cord.
e.
cardiovascular system.
10. An infant born with incomplete closure of the spinal cord has
a.
spina bifida.
b.
macrosomia.
c.
anencephaly.
d.
FAS.
e.
spinal agenesis.
11. What organ is most affected in anencephaly?
a.
Liver
b.
Heart
c.
Brain
d.
Pancreas
e.
Lungs
12. Which of the following nutrients taken as a prenatal supplement has been found to be associated with a
lower incidence of neural tube defects?
a.
Iron
b.
Folate
c.
Calcium
d.
Cobalamin
e.
Iodine
13. Studies report that folate supplements for women may lower the incidence of neural tube defects of
infants when the vitamin is taken during the
a.
last trimester of pregnancy.
b.
second trimester of pregnancy.
c.
second and third trimesters of pregnancy.
d.
month before conception through the first trimester of pregnancy.
e.
prior to conception but stopping when pregnancy occurs.
14. Approximately what percentage of pregnancies in the United States are unplanned?
a.
10
b.
20
c.
35
d.
50
e.
75
15. The process by which maternal nutrient intake affects the child’s development of diseases later in life
is known as
a.
retrogenetics.
b.
reverse genetics.
c.
fetal programming.
d.
postpartum degenerative expression.
e.
genetic mutation.
16. What is the most reliable indicator of an infant’s future health status?
a.
Infant’s birthweight
b.
Mother’s weight before pregnancy
c.
Mother’s weight gain during pregnancy
d.
Mother’s nutrition status prior to pregnancy
e.
Maternal age
17. What is macrosomia?
a.
A neural tube defect
b.
A high-birthweight infant
c.
Excessive weight gain of the mother
d.
Abnormal cravings for carbohydrate during pregnancy
e.
Abnormal weakness of uterine muscles
18. Which of the following increases the risk of macrosomia?
a.
Folate deficiency
b.
Prepregnancy obesity
c.
Postpregnancy infection
d.
Gestational oxygen deprivation
e.
Very young maternal age
19. What is the recommended range of weight gain, in lbs, during pregnancy for a normal-weight woman?
a.
10–18
b.
19–24
c.
25–35
d.
36–44
e.
45–55
20. What is the recommended range of weight gain, in lbs, during pregnancy for an underweight woman?
a.
15–25
b.
28–40
c.
42–50
d.
55–62
e.
65–80
21. In obese pregnant women, the risk for neural tube defects in the infant is believed to result from
a.
insufficient exercise.
b.
poor glycemic control.
c.
insufficient folate intake.
d.
higher prevalence of cesarean section.
e.
inadequate fetal circulation.
22. Which of the following describes a relationship between body weight and pregnancy?
a.
Overweight women bear the greatest number of low-birth-weight infants.
b.
Weight gain during pregnancy is the sole determinant of fetus’s weight at birth.
c.
The increased incidence of neural tube defects of infants born to underweight women is
due primarily to folate insufficiency.
d.
Underweight women who gain 30 lbs during pregnancy tend to birth smaller babies than
heavier women who gain 30 lbs.
e.
Amniotic fluid accounts for nearly 1/3 of pregnancy-associated weight gain.
23. For the normal-weight woman, weight gain ideally follows a pattern of ____ during the first trimester
and ____ per week thereafter.
a.
1 pound; 2 pounds
b.
1½ pounds; 2 pounds
c.
2 pounds; 1 pound
d.
2½ pounds; 2 pounds
e.
3½ pounds; 1 pound
24. Usually, what is the first sign of preeclampsia?
a.
Fall in blood pressure
b.
Elevated blood glucose
c.
A large weight gain over a short time
d.
Chronic episodes of pica over the last 2 trimesters
e.
Mental confusion
25. What is the recommended minimum weight gain, in lbs, of a normal-weight woman who is expected
to bear twins?
a.
22
b.
37
c.
45
d.
55
e.
62
26. What is the minimum recommended weight gain for the obese pregnant woman?
a.
5 lbs
b.
8 lbs
c.
11 lbs
d.
14 lbs
e.
17 lbs
27. The component of weight gain during pregnancy that is similar to the average weight of the infant at
birth is the
a.
placenta.
b.
amniotic sac fluid.
c.
maternal fat stores.
d.
uterus and supporting muscles.
e.
additional blood volume.
28. Which of the following is a characteristic of body weight changes associated with pregnancy?
a.
Weight gain is generally steady throughout pregnancy for normal-weight women.
b.
Most women are unable to lose all of the weight that was gained during pregnancy.
c.
Sudden, large weight gain in pregnancy may signal the development of hypotension.
d.
Overweight pregnant women should gain as much weight as underweight pregnant
women.
e.
Exercise is the best way to lose weight after pregnancy.
29. Jenny has just learned that she is one month pregnant (1st trimester). She has been looking forward to
all the ice cream, chips, and cakes she has seen women on TV and in the movies eating when they are
pregnant. What is the most appropriate advice for Jenny?
a.
She can eat these foods, but only up to 340 kcalories extra per day.
b.
She can eat these foods, but only up to 550 kcalories extra per day.
c.
She does not have increased energy needs in the first trimester and should not indulge
herself.
d.
She should not eat these foods, but rather include one extra serving from each food group
per day.
e.
While she should avoid salty foods like chips, she is free to indulge in all of the other
treats she wants.
30. What is the recommended increase in daily energy intake, in kcal, for the third trimester of
pregnancy?
a.
200
b.
340
c.
450
d.
540
e.
600
31. Which of the following nutrients are required in higher amounts during pregnancy due to their roles in
the synthesis of red blood cells?
a.
Protein and chromium
b.
Folate and vitamin B12
c.
Calcium and vitamin A
d.
Vitamin E and vitamin C
e.
Selenium and iron
32. Of the following nutrient needs, which is considered the most difficult to meet during pregnancy, often
because of low body stores?
a.
Iron
b.
Protein
c.
Vitamin D
d.
Vitamin B6
e.
Essential fatty acids
33. During pregnancy, which of the following nutrients show a dramatic increase in absorption?
a.
Salt and sugar
b.
Protein and fat
c.
Calcium and iron
d.
Thiamin and ascorbic acid
e.
Copper and magnesium
34. Which of the following is a feature of calcium nutrition in pregnancy?
a.
The RDA increases by over 100%.
b.
Calcium absorption increases substantially.
c.
Supplements are required for most women due to the increased needs.
d.
Transfer of calcium from maternal stores to the fetus increases rapidly at the beginning of
the second trimester and falls during the last trimester.
e.
During the last trimester, about 500 mg of calcium are transferred from the mother to the
fetus each day.
35. Which of the following is a characteristic of calcium nutrition in pregnancy?
a.
Calcium intakes usually meet the recommendations.
b.
The RDA for calcium is the same as before pregnancy.
c.
Calcium absorption efficiency is the same as before pregnancy.
d.
Calcification of the fetal skeleton begins during the 14th week of pregnancy.
e.
It is better for pregnant women to take a calcium supplement than to increase dairy intake.
36. The amount of vitamin D needed in pregnancy can be obtained by consumption of fortified milk and
a.
low-mercury fish.
b.
exposure to the sun.
c.
tropical fruit juices.
d.
vitamin D supplements.
e.
tree nuts.
37. In pregnant women unable to meet their calcium needs, a daily supplement providing how many mg of
calcium is advised?
a.
150
b.
300
c.
600
d.
1000
e.
1200
38. Which of the following is one of the recommendations to treat pregnancy-associated heartburn?
a.
Eat many small meals.
b.
Drink fluids only with meals.
c.
Exercise within 30 minutes after eating.
d.
Lie down within 30 minutes after eating.
e.
Recline while eating.
39. Which of the following statements reflects current knowledge of food choices in pregnancy?
a.
A craving for pickles is a strong indicator that the body needs salt.
b.
A craving for milk is a strong indicator that the body needs calcium and/or phosphorus.
c.
Careful and appropriate selection of foods can prevent food cravings for most women.
d.
Cravings and aversions to certain foods are probably the result of altered taste and smell
sensitivities induced by hormones.
e.
Aversions to specific foods often indicate that the woman has a deficient diet.
40. What is the most likely reason for a pregnant woman to crave pickles?
a.
A change in hormones
b.
A hypoglycemic episode
c.
A physiologic need for fluid
d.
A physiologic need for sodium
e.
Cultural expectations that she will crave them
41. Which of the following is the standard classification for a low-birthweight infant?
a.
3 1/2 lbs or less
b.
4 lbs or less
c.
5 1/2 lbs or less
d.
6 1/2 lbs or less
e.
9 lbs or less
42. Which of the following is the standard classification for a very-low-birthweight infant?
a.
3 1/2 lbs or less
b.
4 1/2 lbs or less
c.
5 1/2 lbs or less
d.
6 1/2 lbs or less
e.
7 1/2 lbs or less
43. Which of the following is a feature of the WIC program?
a.
It caps the number of children in the program at 2 million.
b.
It is strictly remedial and available chiefly to women living in the inner city
c.
It offers assistance to all at-risk pregnant women regardless of economic means
d.
It saves an estimated $3 in medical costs in the first two months after birth for every dollar
spent
e.
It serves pregnant and nursing women as well as children up to age 7
44. What is gestational diabetes?
a.
A severe form of type 1 diabetes in newborns.
b.
Abnormal blood glucose maintenance during pregnancy.
c.
Reactive hypoglycemia expressed during the third trimester of pregnancy.
d.
A temporary loss of insulin secretion during the first trimester of pregnancy.
e.
A complication of pre-existing diabetes that can occur during pregnancy.
45. Which of the following is a characteristic of gestational diabetes?
a.
It predicts risk of diabetes for the infant.
b.
It leads to type 2 diabetes in some women.
c.
It occurs in over one-half of normal weight women.
d.
It occurs more often in women with a history of having premature births.
e.
It may be dangerous for the woman but has little impact on the developing fetus.
46. What is the name of the condition characterized by high blood pressureand protein in the urine of a
pregnant woman?
a.
Preeclampsia
b.
Gestational diabetes
c.
Teratogenic hypertension
d.
Pregnancy-induced blood pressure crisis
e.
Malignant renal hypertension syndrome
47. Which of the following is a distinguishing characteristic of eclampsia?
a.
Convulsions by the mother
b.
Convulsions by the newborn
c.
Low blood pressure in the mother
d.
Low blood pressure in the newborn
e.
Poor glycemic control in mother and infant
48. Which of the following is a characteristic associated with adolescent pregnancy?
a.
The recommended weight gain is approximately 35 lbs.
b.
The incidence of stillbirths and preterm births is 5-10% lower compared with adult
women.
c.
The incidence of pregnancy-induced hypertension is 5-10% lower compared with older
women.
d.
The time in labor is usually shorter than for older women because there are fewer
overweight teenagers.
e.
Maternal death rates are 5 to 7 times greater among adolescent mothers in the developed
world.
49. Which of the following recommendations for pregnant women and alcohol intake has been issued by
the U.S. Surgeon General?
a.
They should drink absolutely no alcohol.
b.
They should refrain from drinking hard liquor only.
c.
They are permitted to ingest no more than 2 drinks per day.
d.
They are permitted to ingest small amounts of alcohol during the first 3 months but none
thereafter.
e.
Organic beer and wine is acceptable.
50. Which of the following is a feature of heavy metal intake and pregnancy?
a.
Mercury, but not lead, can easily cross the placenta.
b.
Lead and mercury both damage the fetal nervous system.
c.
Pregnant women are advised to limit consumption of shark and swordfish to no more than
once per week.
d.
Pregnant women are advised to avoid shellfish around the critical period of brain
development but may resume normal intake thereafter.
e.
King mackerel and tilefish are both safe to consume as much as desired.
51. A feature of heavy caffeine use in human pregnancy is that it may
a.
worsen edema.
b.
increase the risk of preterm birth.
c.
increase the risk of birth defects.
d.
increase the risk of stillborn infants.
e.
dampen respiratory function
52. What causes the “let-down reflex”?
a.
Oxytocin
b.
Estrogen
c.
Prepartum amenorrhea
d.
Postpartum amenorrhea
e.
FSH
53. The number of extra kcalories per day needed to produce a normal supply of milk during the first six
months of lactation is approximately
a.
100.
b.
250.
c.
500.
d.
1000.
e.
1500.
54. Which of the following is a feature of lactation?
a.
Breast milk protein content may be enhanced by moderate exercise.
b.
The volume of breast milk may be increased by drinking plenty of fluid.
c.
The iron content of breast milk may be increased by taking iron supplements.
d.
Breast milk quantity but not quality is most affected by nutritional inadequacies.
e.
Breastfeeding is an automatic physiological response.
55. Why might a lactating woman need to take an iron supplement?
a.
To improve the flavor of breast milk
b.
To increase iron content of breast milk
c.
To replace the iron stores she lost during pregnancy
d.
To account for the re-start of menstruation that usually occurs 1-2 months postpartum
e.
To increase the volume of breast milk
56. Which of the following statements describes an association between nutrient intake and lactation?
a.
Milk production is increased by higher fluid intake.
b.
Ingestion of garlic may lead to an off-flavor of the milk.
c.
Inadequate protein intake lowers the protein concentration of the milk.
d.
The energy RDA for milk production calls for an additional 1000 kcalories per day.
e.
Nicotine does not pass into a woman’s breast milk.
57. Which of the following is a characteristic of alcohol intake and lactation?
a.
Alcohol easily enters breast milk.
b.
Alcohol actually stimulates lactation.
c.
Infants drink slightly more breast milk when the mother consumes up to 1 drink per day.
d.
The small amounts of alcohol that are secreted along with breast milk stimulate infant
digestion.
e.
The positive impact of alcohol consumption on the mother outweighs any slight negative
impact on the infant.
58. Which of the following is an effect of alcohol intake in the mother who breastfeeds?
a.
It alters the flavor of the breast milk.
b.
It stimulates lactation.
c.
It passes into the breast milk and stimulates the infant’s acceptance.
d.
It first appears in the breast milk approximately 12 hours after ingestion.
e.
It has no clinically significant impact.
59. What is the benefit of postpartum amenorrhea?
a.
It stimulates milk production.
b.
It conserves iron in the mother.
c.
It stimulates the let-down reflex.
d.
It stimulates the suckling reflex in the infant.
e.
It is a reliable form of birth control.
60. Which of the following statements describes a relationship between alcohol intake and fetal
development?
a.
Birth defects are most severe when the woman drinks around the time of conception.
b.
Infants born with fetal alcohol syndrome typically show immediate signs of brain
impairment.
c.
Eating well and maintaining adequate nutrient stores will prevent alcohol-induced placenta
damage.
d.
Toxicity to the fetus begins to occur when fetal blood alcohol levels rise above maternal
blood alcohol levels.
e.
Most of the fetal abnormalities associated with maternal alcohol consumption can be
corrected after birth.
61. What is the acronym for the food assistance program designed to help nutritionally at-risk children,
infants, and pregnant women?
a.
FAP
b.
WIC
c.
EAT
d.
MOW
e.
ARND
62. What is an acceptable range of weight (lbs) of a healthy newborn infant?
a.
4-4 ½
b.
5-6
c.
6 1/2-8
d.
8 1/2–10
e.
10 1/2–12
63. What is a blastocyst?
a.
The 5-day-old zygote that becomes implanted in the uterine wall
b.
The terminal end of the umbilical cord that attaches to the placenta
c.
Fingerlike projections on the uterine wall that act to separate fetal from maternal tissues
d.
The network of placental blood vessels that exchanges nutrients and waste products from
mother to fetus
e.
The structure that develops in place of the brain in an anencephalic infant
64. Which of the following is a characteristic of low-birth-weight infants?
a.
They show greater prevalence for liver fat infiltration.
b.
They demonstrate catch-up growth within 3 months of birth.
c.
They have an increased risk for insulin resistance later in life.
d.
They have proportionately larger kidneys and greater risks for low blood pressure.
e.
They are more commonly born to upper socioeconomic status women.