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INSTANT DOWNLOAD COMPLETE TEST BANK WITH ANSWERS

 

 

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

 

 

Sample  Questions

 

Test Bank[1] for Chapter 3 – Preconception Nutrition:
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

3.1    Identify the symptoms of premenstrual syndrome and the effect of PMS treatment strategies on fertility status of women with the syndrome.

3.2    Explain the primary mechanisms that underlie the effects of obesity and underweight on fertility in women and men.

3.3    Identify two mechanisms by which a negative energy balance can influence fertility.

3.4    Identify two ways in which good blood glucose control during the periconceptional period can benefit fetal growth and development.

3.5    Cite three key components of the nutritional management of PCOS.

3.6    Identify the major reasons why dietary control of PKU is particularly important during pregnancy.

3.7    Describe three nutritional consequences of untreated celiac disease.

 

Multiple Choice

 

  1. The definition of the periconceptional period is _____.
  2. the developing organism from 8 weeks to the moment of birth
  3. the month before conception
  4. the time period around conception measured in weeks or months
  5. the month after conception
  6. None of the above

 

ANS: c       DIF: Fact-based, easy                          REF: 71                              OBJ: 3.1

 

  1. Premenstrual dysphoric disorder (PMDD) is characterized by:
  2. mood swings.
  3. irritability.
  4. depressed mood.
  5. physical symptoms.
  6. All of the above

 

ANS: e       DIF: Fact-based, medium                    REF: 71                              OBJ: 3.1

 

  1. Which of the following would NOT be used to treat PMS symptoms?
  2. Increased intake of caffeine
  3. Oral contraceptives
  4. Supplements like B6 or calcium
  5. Chasteberry extract
  6. Antidepressants

 

ANS: a       DIF: Fact-based                                   REF: 71-72                        OBJ: 3.1

 

  1. Which of the following would NOT be considered a sign or symptom of premenstrual syndrome?
  2. Swollen glands under the jaw
  3. Fatigue
  4. Abdominal bloating
  5. Mood swings
  6. Anxiety

 

ANS: a       DIF: Fact-based                                   REF: 71                              OBJ: 3.1

 

  1. Symptoms of PMS occur in about _____ of menstruating women.
  2. 10-12%
  3. 27-30%
  4. 34%
  5. 15-25%
  6. 55%

 

ANS: d       DIF: Fact-based                                   REF: 71                              OBJ: 3.1

 

  1. Untreated phenylketonuria in pregnant women can lead to:
  2. increased risk of heart defects in the infant.
  3. infants with microcephaly.
  4. severe mental retardation in children.
  5. All of the above
  6. a and b only

 

ANS: d       DIF: Application-based, hard              REF: 80                              OBJ: 3.6

 

  1. A nutrient that would effectively treat headaches and cramps in a woman with PMS is _____.
  2. vitamin B6
  3. calcium
  4. magnesium
  5. vitamin E

 

ANS: b       DIF: Fact-based, easy                          REF: 72                              OBJ: 3.1

 

  1. _____ is the first therapeutic option for infertility in obese people.
  2. Medication
  3. Weight loss
  4. Hormone therapy
  5. In-vitro fertilization
  6. Surgery

 

ANS: b       DIF: Application-based                        REF: 74                              OBJ: 3.2

 

  1. Excess central body fat is related to _____.
  2. insulin resistance
  3. ovulatory disorders
  4. metabolic syndrome
  5. All of the above

 

ANS: d       DIF: Fact-based, easy                          REF: 72                              OBJ: 3.2

 

  1. An eating disorder that affects fertility is _____.
  2. hypothalamic amenorrhea
  3. anorexia nervosa
  4. bulimia nervosa
  5. celiac disease
  6. b and c
  7. a and b

 

ANS: f        DIF: Application-based, medium         REF: 75                              OBJ: 3.3

 

  1. The onset of hypothalamic amenorrhea is related to:
  2. being underweight, as is seen in anorexia nervosa.
  3. weight loss accompanied by intense exercise, as seen in the female athlete triad.
  4. caloric restriction leading to an energy deficit.
  5. All of the above
  6. a and b only

 

ANS: d       DIF: Fact-based, easy                          REF: 75                              OBJ: 3.3

 

  1. Which of the following is an example of an autoimmune disease?
  2. Phenylketonuria (PKU)
  3. Type 1 diabetes
  4. Type 2 diabetes
  5. The female athlete triad
  6. Polycystic ovary syndrome

 

ANS: b       DIF: Fact-based                                   REF: 77                              OBJ: 3.4

 

  1. _____ during the first 2 months of pregnancy is teratogenic and leads to a two- to three-fold risk of congenital abnormalities.
  2. A high blood glucose level
  3. Type 1 diabetes
  4. Type 2 diabetes
  5. Insulin resistance
  6. Celiac disease

 

ANS: a       DIF: Fact-based                                   REF: 76                              OBJ: 3.4

 

  1. Diet strategies appropriate for people with type 2 diabetes include all of the following EXCEPT:
  2. weight loss if overweight.
  3. increasing fruit and vegetable intake to include plant antioxidants.
  4. low-glycemic index foods that are rich in fiber.
  5. 150 minutes per week of physical activity.
  6. ≤40% of total intake from saturated fats.

 

ANS: e       DIF: Application-based                        REF: 76-78                        OBJ: 3.4

 

  1. The most effective approach for risk reduction in people with diabetes so far is:
  2. drug therapy and weight loss.
  3. drug therapy and exercise.
  4. weight loss and exercise.
  5. behavioral therapy.

 

ANS: c       DIF: Fact-based                                   REF: 78                              OBJ: 3.4

 

  1. What statement below best describes the difference between carbohydrate intake recommendations for persons with insulin resistance such as in metabolic syndrome and those for persons with type 2 diabetes?
  2. Persons with type 2 diabetes should eat more complex carbohydrates than persons with insulin resistance should.
  3. Persons with insulin resistance should eat more complex carbohydrates than persons with type 2 diabetes should.
  4. Carbohydrate intake recommendations for persons with type 2 diabetes are more tailor-made than for persons with insulin resistance.
  5. There is no difference between carbohydrate recommendations.

 

ANS: d       DIF: Application-based, hard              REF: 73|76-77                  OBJ: 3.4

 

  1. Diets that provide low-glycemic index carbohydrates along with _____ of fiber daily are associated with improved blood glucose control.
  2. 15 g
  3. 25-35 g
  4. 14 g per 1000 calories
  5. 38 g
  6. 50 g

 

ANS: c       DIF: Fact-based                                   REF: 77                              OBJ: 3.4

 

  1. Bariatric surgery increases the risk that women will develop deficiencies of:
  2. iron.
  3. zinc.
  4. calcium.
  5. vitamins B6, B12, and D.
  6. All of the above

 

ANS: e       DIF: Fact-based                                   REF: 75                              OBJ: 3.2

 

  1. Which of the following supplements may be recommended to prevent or delay the onset of gestational and type 2 diabetes?
  2. Vitamin D
  3. Vitamin E
  4. Iron
  5. Calcium
  6. a and b

 

ANS: b       DIF: Fact-based                                   REF: 78                              OBJ: 3.4

 

  1. A symptom NOT related to PCOS is _____.
  2. insulin resistance
  3. amenorrhea
  4. infertility
  5. low testosterone levels

 

ANS: d       DIF: Fact-based, medium                    REF: 79                              OBJ: 3.5

 

  1. Clinical signs associated with polycystic ovary syndrome (PCOS) include:
  2. insulin resistance.
  3. infertility.
  4. obesity.
  5. excess abdominal fat.
  6. All of the above

 

ANS: e       DIF: Fact-based                                   REF: 79                              OBJ: 3.5

 

  1. The primary GOAL of the treatment of PCOS is:
  2. to increase insulin sensitivity.
  3. to induce weight loss if overweight.
  4. to regulate blood lipid levels.
  5. to reverse infertility.
  6. to prevent diabetes from developing.

 

ANS: a       DIF: Fact-based                                   REF: 79                              OBJ: 3.5

 

  1. Symptoms of PCOS often improve with a _____ loss of initial body weight.
  2. 2 to 4%
  3. 4 to 6%
  4. 5 to 10%
  5. 10 to 12%
  6. 15%

 

ANS: c       DIF: Fact-based                                   REF: 79                              OBJ: 3.5

 

  1. Dietary recommendations for women with PCOS emphasize:
  2. whole grains, fruits, and vegetables high in antioxidants.
  3. lean sources of protein.
  4. high-glycemic index carbohydrate sources.
  5. All of the above
  6. a and b only

 

ANS: e       DIF: Application-based                        REF: 79                              OBJ: 3.5

 

  1. The two grains persons with celiac disease can safely consume are _____.
  2. corn and rice
  3. oats and wheat
  4. rye and rice
  5. barley and oats

 

ANS: a       DIF: Application-based, hard              REF: 82|84                        OBJ: 3.7

 

  1. Foods to avoid if you have celiac disease include:
  2. oats, corn, wheat, and rye.
  3. wheat, rye, and barley.
  4. wheat, corn, oats, and soy.
  5. wheat, rye, oats, and eggs.
  6. all of the above

 

ANS: b       DIF: Application-based                        REF: 82|84                        OBJ: 3.7

 

  1. Signs and symptoms of celiac disease include all of the following EXCEPT:
  2. iron-deficiency anemia.
  3. bloating.
  4. infertility.
  5. bleeding gums.
  6. weight loss.

 

ANS: d       DIF: Fact-based                                   REF: 84                              OBJ: 3.7

 

  1. Which of the following foods is sure to be gluten free?
  2. Corn
  3. Deli meat
  4. Hotdogs
  5. Salad dressings
  6. Bouillon

 

ANS: a       DIF: Application-based                        REF: 81-82                        OBJ: 3.7

 

  1. Judy has been suffering from depression, breast tenderness, muscle pain, anxiety, and headaches for the past 2 months; it is likely she is suffering from:
  2. polycystic ovary syndrome (PCOS).
  3. premenstrual syndrome (PMS).
  4. premenstrual dysphoric disorder (PMDD).
  5. dysmenorrhea.
  6. celiac disease.

 

ANS: c       DIF: Application-based                        REF: 71                              OBJ: 3.1

 

  1. How could having irregular menstrual cycles lead to a lack of early prenatal care for some obese women?
  2. When women don’t menstruate they may feel they are not ovulating and can’t get pregnant, so they don’t get prenatal care
  3. Women may not be aware they are already pregnant because a delay in their menses is normal
  4. Women think an egg will not implant without ovulation
  5. All of the above
  6. a and b only

 

ANS: e       DIF: Application-based                        REF: 73-74                        OBJ: 3.2

 

Use the following information to answer questions 31-33.

Jane and her husband are interested in having a child, but she has had a hard time conceiving. She has met with her OB-GYN to have a physical, labs drawn, and a prenatal check-up in order to determine what the problem is. Lab work and other relevant data for Jane are as follows:    Age: 36

Blood pressure 110/70 mm Hg;          Fasting blood glucose 130 mg/dL;

HDL cholesterol 35 mg/dL;                 Blood triglycerides 175 mg/dL;

Waist circumference = 36”;                 Current weight 150#; Height 5’3”

 

  1. Based on the data above, Jane will likely be diagnosed with:
  2. type 2 diabetes.
  3. metabolic syndrome.
  4. celiac disease.
  5. hypothalamic amenorrhea.
  6. gestational diabetes.

 

ANS: b       DIF: Application-based                        REF: 73                              OBJ: 3.2

 

  1. Which of the following symptoms would indicate that Jane has this diagnosis?
  2. Her blood pressure, weight, and height
  3. Hard time with conception and her age
  4. High fasting blood glucose, blood triglycerides, and HDL cholesterol levels
  5. Her waist circumference, age, and blood pressure
  6. All of the above

 

ANS: c       DIF: Application-based                        REF: 73                              OBJ: 3.2

 

  1. Dietary modifications for this diagnosis would include:
  2. avoiding wheat, rye, oats, and barley.
  3. avoiding aspartame and artificial sweeteners.
  4. avoiding sugar.
  5. including whole grains and fruits and vegetables that are high in antioxidants.
  6. making sure to consume 1000 mg calcium per day.

 

ANS: d       DIF: Application-based                        REF: 73                              OBJ: 3.2

 

  1. The three components of the female athlete triad are:
  2. anemia, anorexia, and osteoporosis.
  3. amenorrhea, anemia, and anorexia.
  4. amenorrhea, disordered eating, and osteoporosis.
  5. disordered eating, anemia, and osteoarthritis.
  6. disordered eating, osteoporosis, and infertility.

 

ANS: c       DIF: Fact-based                                   REF: 75                              OBJ: 3.3

 

  1. When a woman develops “carbohydrate intolerance” during pregnancy, this means that:
  2. she complains of a dislike of carbohydrate-containing foods that commonly occurs during the second trimester of pregnancy.
  3. her pancreas cannot produce insulin, so glucose cannot get into cells.
  4. her blood glucose levels increase abnormally after she eats carbohydrate-containing foods.
  5. All of the above
  6. b and c only

 

ANS: c       DIF: Application-based                        REF: 77                              OBJ: 3.4

 

  1. Which of the following conditions would NOT be seen in higher rates in obese women?
  2. Type 1 diabetes
  3. Infertility
  4. Type 2 diabetes
  5. PCOS
  6. Metabolic syndrome

 

ANS: a       DIF: Application-based                        REF: 72|76-79                  OBJ: 3.2|3.4|3.5

 

  1. Women that have PKU must avoid the essential amino acid phenylalanine and consume a diet low in protein because:
  2. they lack enough stomach acid (HCl) to break down dietary proteins, including phenylalanine.
  3. they are allergic to phenylalanine and other protein-rich foods.
  4. they lack the enzyme necessary to convert phenylalanine to tyrosine.
  5. phenylalanine and protein-rich foods cause an accumulation of acid to build up in the blood.
  6. None of the above is correct.

 

ANS: c       DIF: Fact-based                                   REF: 80                              OBJ: 3.6

 

 

True/False

 

  1. Low levels of sex hormone binding globulin are related to increased availability of testosterone and estrogen in the body.

 

ANS: T       DIF: Fact-based, easy                          REF: 74                              OBJ: 3.2

 

  1. PCOS is easy to diagnose because the signs and symptoms are the same for all women.

 

ANS: F       DIF: Fact-based                                   REF: 79                              OBJ: 3.5

 

  1. The treatment for celiac disease is long-term steroid therapy.

 

ANS: F       DIF: Fact-based                                   REF: 81-82                        OBJ: 3.7

 

  1. All people with type 2 diabetes can manage their glucose levels with diet and exercise only.

 

ANS: F       DIF: Fact-based                                   REF: 77                              OBJ: 3.4

 

 

Matching

 

1.   Rotavirus

2.   Amenorrhea

3.   Insulin resistance

4.   Congenital abnormality

5.   Teratogenic

6.   Glycemic index

7.   PMDD

8.   Periconceptional period

9.   Gestational diabetes

10. Bulimia nervosa

A.   Cell membranes have reduced sensitivity to insulin

B.   The time period around conception

C.   No menstrual cycle

D.   Syndrome characterized by mood swings, irritability, and physical symptoms

E.   Most common cause of diarrhea among children

F.   Exposures that produce malformations in embryos or fetuses

G.   A structural, functional, or metabolic abnormality present at birth

H.   Carbohydrate intolerance first discovered during pregnancy

I.    Rapid uncontrolled eating followed by compensatory behaviors

J.   A measure of the extent to which blood glucose levels are raised

 

Key:

  1. ANS: E DIF: Fact-based                                   REF: 84                              OBJ: 3.7
  2. ANS: C DIF: Fact-based                                   REF: 73                              OBJ: 3.2
  3. ANS: A DIF: Fact-based                                   REF: 72                              OBJ: 3.2
  4. ANS: G DIF: Fact-based                                   REF: 76                              OBJ: 3.4
  5. ANS: F DIF: Fact-based                                   REF: 76                              OBJ: 3.4
  6. ANS: J DIF: Fact-based                                   REF: 76                              OBJ: 3.4
  7. ANS: D DIF: Fact-based                                   REF: 71                              OBJ: 3.1
  8. ANS: B DIF: Fact-based                                   REF: 71                              OBJ: 3.1
  9. ANS: H DIF: Fact-based                                   REF: 77                              OBJ: 3.4
  10. ANS: I DIF: Fact-based REF: 75                              OBJ: 3.3

 

Short Answer

 

  1. A woman with type 2 diabetes taking an oral medication wants to become pregnant. Discuss the dietary recommendations that will promote better pregnancy outcomes and normalize her blood sugars.

 

ANS: See pp. 76-78.

DIF: Application-based, hard                                REF: 76-78                        OBJ: 3.4

 

  1. Discuss how using low-glycemic index foods might help someone with diabetes manage his/her blood glucose levels. List several low-glycemic foods that would be appropriate for someone wishing to incorporate them into his/her diet.

 

ANS: See pp. 76-77.

DIF: Application-based                                          REF: 76-77                        OBJ: 3.4

 

  1. Individuals with metabolic syndrome are at risk for cardiovascular disease and diabetes. How does adjusting their diet reduce their risks? Are there any other lifestyle adjustments that can also help? Outline a one-day diet that incorporates foods that will help reverse the risk factors associated with metabolic syndrome. Be sure to note which foods would be the most beneficial.

 

ANS: See pp. 72-73.

DIF: Application-based                                          REF: 72-73                        OBJ: 3.2

 

  1. Describe the difference between congenital malformations and inborn errors of metabolism. Cite one example of an inborn error of metabolism and describe the best nutrition-related intervention.

 

ANS: See pp. 76, 80-81.

DIF: Fact-based, medium                                      REF: 76|80-81                  OBJ: 3.4|3.6

 

  1. A friend was recently diagnosed with polycystic ovary disease. Describe some characteristics of the disease, the first line of therapy, and dietary changes needed. Also, identify two healthy outcomes related to successful treatment.

 

ANS: See pp. 78-79.

DIF: Fact-based, hard                                           REF: 78-79                        OBJ: 3.5

 

  1. Keep track of your diet for one day, making sure to write down EVERYTHING you consume, including condiments. Once you have done this, analyze your foods to see how many of them include grains that would be unacceptable for someone with celiac disease to consume. Then, make substitutions for these foods with an acceptable substitute and write out a new menu. How easy is it to detect these offending grains for someone who is not familiar with nutrition?

 

Websites to check out:

http://www.celiac.org/

http://www.glutenfree.com/

 

ANS: See pp. 81-82.

DIF: Application-based                                          REF: 81-82                        OBJ: 3.7

 

 

 

 

Ready-to-Use Chapter 3 Test

 

Multiple Choice

 

  1. The definition of the periconceptional period is _____.
  2. the developing organism from 8 weeks to the moment of birth
  3. the month before conception
  4. the time period around conception measured in weeks or months
  5. the month after conception
  6. None of the above

 

  1. Premenstrual dysphoric disorder (PMDD) is characterized by:
  2. mood swings.
  3. irritability.
  4. depressed mood.
  5. physical symptoms.
  6. All of the above

 

  1. Which of the following would NOT be used to treat PMS symptoms?
  2. Increased intake of caffeine
  3. Oral contraceptives
  4. Supplements like B6 or calcium
  5. Chasteberry extract
  6. Antidepressants

 

  1. Which of the following would NOT be considered a sign or symptom of premenstrual syndrome?
  2. Swollen glands under the jaw
  3. Fatigue
  4. Abdominal bloating
  5. Mood swings
  6. Anxiety

 

  1. Symptoms of PMS occur in about _____ of menstruating women.
  2. 10-12%
  3. 27-30%
  4. 34%
  5. 15-25%
  6. 55%

 

  1. Untreated phenylketonuria in pregnant women can lead to:
  2. increased risk of heart defects in the infant.
  3. infants with microcephaly.
  4. severe mental retardation in children.
  5. All of the above
  6. a and b only

 

  1. A nutrient that would effectively treat headaches and cramps in a woman with PMS is _____.
  2. vitamin B6
  3. calcium
  4. magnesium
  5. vitamin E

 

  1. _____ is the first therapeutic option for infertility in obese people.
  2. Medication
  3. Weight loss
  4. Hormone therapy
  5. In-vitro fertilization
  6. Surgery

 

  1. Excess central body fat is related to _____.
  2. insulin resistance
  3. ovulatory disorders
  4. metabolic syndrome
  5. All of the above

 

  1. An eating disorder that affects fertility is _____.
  2. hypothalamic amenorrhea
  3. anorexia nervosa
  4. bulimia nervosa
  5. celiac disease
  6. b and c
  7. a and b

 

  1. The onset of hypothalamic amenorrhea is related to:
  2. being underweight, as is seen in anorexia nervosa.
  3. weight loss accompanied by intense exercise, as seen in the female athlete triad.
  4. caloric restriction leading to an energy deficit.
  5. All of the above
  6. a and b only

 

  1. Which of the following is an example of an autoimmune disease?
  2. Phenylketonuria (PKU)
  3. Type 1 diabetes
  4. Type 2 diabetes
  5. The female athlete triad
  6. Polycystic ovary syndrome

 

  1. _____ during the first 2 months of pregnancy is teratogenic and leads to a two- to three-fold risk of congenital abnormalities.
  2. A high blood glucose level
  3. Type 1 diabetes
  4. Type 2 diabetes
  5. Insulin resistance
  6. Celiac disease

 

  1. Diet strategies appropriate for people with type 2 diabetes include all of the following EXCEPT:
  2. weight loss if overweight.
  3. increasing fruit and vegetable intake to include plant antioxidants.
  4. low-glycemic index foods that are rich in fiber.
  5. 150 minutes per week of physical activity.
  6. ≤40% of total intake from saturated fats.

 

  1. The most effective approach for risk reduction in people with diabetes so far is:
  2. drug therapy and weight loss.
  3. drug therapy and exercise.
  4. weight loss and exercise.
  5. behavioral therapy.

 

  1. What statement below best describes the difference between carbohydrate intake recommendations for persons with insulin resistance such as in metabolic syndrome and those for persons with type 2 diabetes?
  2. Persons with type 2 diabetes should eat more complex carbohydrates than persons with insulin resistance should.
  3. Persons with insulin resistance should eat more complex carbohydrates than persons with type 2 diabetes should.
  4. Carbohydrate intake recommendations for persons with type 2 diabetes are more tailor-made than for persons with insulin resistance.
  5. There is no difference between carbohydrate recommendations.

 

  1. Diets that provide low-glycemic index carbohydrates along with _____ of fiber daily are associated with improved blood glucose control.
  2. 15 g
  3. 25-35 g
  4. 14 g per 1000 calories
  5. 38 g
  6. 50 g

 

  1. Bariatric surgery increases the risk that women will develop deficiencies of:
  2. iron.
  3. zinc.
  4. calcium.
  5. vitamins B6, B12, and D.
  6. All of the above

 

  1. Which of the following supplements may be recommended to prevent or delay the onset of gestational and type 2 diabetes?
  2. Vitamin D
  3. Vitamin E
  4. Iron
  5. Calcium
  6. a and b

 

  1. A symptom NOT related to PCOS is _____.
  2. insulin resistance
  3. amenorrhea
  4. infertility
  5. low testosterone levels

 

  1. Clinical signs associated with polycystic ovary syndrome (PCOS) include:
  2. insulin resistance.
  3. infertility.
  4. obesity.
  5. excess abdominal fat.
  6. All of the above

 

  1. The primary GOAL of the treatment of PCOS is:
  2. to increase insulin sensitivity.
  3. to induce weight loss if overweight.
  4. to regulate blood lipid levels.
  5. to reverse infertility.
  6. to prevent diabetes from developing.

 

  1. Symptoms of PCOS often improve with a _____ loss of initial body weight.
  2. 2 to 4%
  3. 4 to 6%
  4. 5 to 10%
  5. 10 to 12%
  6. 15%

 

  1. Dietary recommendations for women with PCOS emphasize:
  2. whole grains, fruits, and vegetables high in antioxidants.
  3. lean sources of protein.
  4. high-glycemic index carbohydrate sources.
  5. All of the above
  6. a and b only

 

  1. The two grains persons with celiac disease can safely consume are _____.
  2. corn and rice
  3. oats and wheat
  4. rye and rice
  5. barley and oats

 

  1. Foods to avoid if you have celiac disease include:
  2. oats, corn, wheat, and rye.
  3. wheat, rye, and barley.
  4. wheat, corn, oats, and soy.
  5. wheat, rye, oats, and eggs.
  6. all of the above

 

  1. Signs and symptoms of celiac disease include all of the following EXCEPT:
  2. iron-deficiency anemia.
  3. bloating.
  4. infertility.
  5. bleeding gums.
  6. weight loss.

 

  1. Which of the following foods is sure to be gluten free?
  2. Corn
  3. Deli meat
  4. Hotdogs
  5. Salad dressings
  6. Bouillon

 

  1. Judy has been suffering from depression, breast tenderness, muscle pain, anxiety, and headaches for the past 2 months; it is likely she is suffering from:
  2. polycystic ovary syndrome (PCOS).
  3. premenstrual syndrome (PMS).
  4. premenstrual dysphoric disorder (PMDD).
  5. dysmenorrhea.
  6. celiac disease.

 

  1. How could having irregular menstrual cycles lead to a lack of early prenatal care for some obese women?
  2. When women don’t menstruate they may feel they are not ovulating and can’t get pregnant, so they don’t get prenatal care
  3. Women may not be aware they are already pregnant because a delay in their menses is normal
  4. Women think an egg will not implant without ovulation
  5. All of the above
  6. a and b only

 

Use the following information to answer questions 31-33.

Jane and her husband are interested in having a child, but she has had a hard time conceiving. She has met with her OB-GYN to have a physical, labs drawn, and a prenatal check-up in order to determine what the problem is. Lab work and other relevant data for Jane are as follows:    Age: 36

Blood pressure 110/70 mm Hg;          Fasting blood glucose 130 mg/dL;

HDL cholesterol 35 mg/dL;                 Blood triglycerides 175 mg/dL;

Waist circumference = 36”;                 Current weight 150#; Height 5’3”

 

  1. Based on the data above, Jane will likely be diagnosed with:
  2. type 2 diabetes.
  3. metabolic syndrome.
  4. celiac disease.
  5. hypothalamic amenorrhea.
  6. gestational diabetes.

 

  1. Which of the following symptoms would indicate that Jane has this diagnosis?
  2. Her blood pressure, weight, and height
  3. Hard time with conception and her age
  4. High fasting blood glucose, blood triglycerides, and HDL cholesterol levels
  5. Her waist circumference, age, and blood pressure
  6. All of the above

 

  1. Dietary modifications for this diagnosis would include:
  2. avoiding wheat, rye, oats, and barley.
  3. avoiding aspartame and artificial sweeteners.
  4. avoiding sugar.
  5. including whole grains and fruits and vegetables that are high in antioxidants.
  6. making sure to consume 1000 mg calcium per day.

 

  1. The three components of the female athlete triad are:
  2. anemia, anorexia, and osteoporosis.
  3. amenorrhea, anemia, and anorexia.
  4. amenorrhea, disordered eating, and osteoporosis.
  5. disordered eating, anemia, and osteoarthritis.
  6. disordered eating, osteoporosis, and infertility.

 

  1. When a woman develops “carbohydrate intolerance” during pregnancy, this means that:
  2. she complains of a dislike of carbohydrate-containing foods that commonly occurs during the second trimester of pregnancy.
  3. her pancreas cannot produce insulin, so glucose cannot get into cells.
  4. her blood glucose levels increase abnormally after she eats carbohydrate-containing foods.
  5. All of the above
  6. b and c only

 

  1. Which of the following conditions would NOT be seen in higher rates in obese women?
  2. Type 1 diabetes
  3. Infertility
  4. Type 2 diabetes
  5. PCOS
  6. Metabolic syndrome

 

  1. Women that have PKU must avoid the essential amino acid phenylalanine and consume a diet low in protein because:
  2. they lack enough stomach acid (HCl) to break down dietary proteins, including phenylalanine.
  3. they are allergic to phenylalanine and other protein-rich foods.
  4. they lack the enzyme necessary to convert phenylalanine to tyrosine.
  5. phenylalanine and protein-rich foods cause an accumulation of acid to build up in the blood.
  6. None of the above is correct.

 

 

True/False

 

  1. Low levels of sex hormone binding globulin are related to increased availability of testosterone and estrogen in the body.

 

  1. PCOS is easy to diagnose because the signs and symptoms are the same for all women.

 

  1. The treatment for celiac disease is long-term steroid therapy.

 

  1. All people with type 2 diabetes can manage their glucose levels with diet and exercise only.

 

 

Matching

 

1.   Rotavirus

2.   Amenorrhea

3.   Insulin resistance

4.   Congenital abnormality

5.   Teratogenic

6.   Glycemic index

7.   PMDD

8.   Periconceptional period

9.   Gestational diabetes

10. Bulimia nervosa

A.   Cell membranes have reduced sensitivity to insulin

B.   The time period around conception

C.   No menstrual cycle

D.   Syndrome characterized by mood swings, irritability, and physical symptoms

E.   Most common cause of diarrhea among children

F.   Exposures that produce malformations in embryos or fetuses

G.   A structural, functional, or metabolic abnormality present at birth

H.   Carbohydrate intolerance first discovered during pregnancy

I.    Rapid uncontrolled eating followed by compensatory behaviors

J.   A measure of the extent to which blood glucose levels are raised

 

 

Short Answer

 

  1. A woman with type 2 diabetes taking an oral medication wants to become pregnant. Discuss the dietary recommendations that will promote better pregnancy outcomes and normalize her blood sugars.

 

  1. Discuss how using low-glycemic index foods might help someone with diabetes manage his/her blood glucose levels. List several low-glycemic foods that would be appropriate for someone wishing to incorporate them into his/her diet.

 

  1. Individuals with metabolic syndrome are at risk for cardiovascular disease and diabetes. How does adjusting their diet reduce their risks? Are there any other lifestyle adjustments that can also help? Outline a one-day diet that incorporates foods that will help reverse the risk factors associated with metabolic syndrome. Be sure to note which foods would be the most beneficial.

 

  1. Describe the difference between congenital malformations and inborn errors of metabolism. Cite one example of an inborn error of metabolism and describe the best nutrition-related intervention.

 

  1. A friend was recently diagnosed with polycystic ovary disease. Describe some characteristics of the disease, the first line of therapy, and dietary changes needed. Also, identify two healthy outcomes related to successful treatment.

 

A

  1. Keep track of your diet for one day, making sure to write down EVERYTHING you consume, including condiments. Once you have done this, analyze your foods to see how many of them include grains that would be unacceptable for someone with celiac disease to consume. Then, make substitutions for these foods with an acceptable substitute and write out a new menu. How easy is it to detect these offending grains for someone who is not familiar with nutrition?

 

Websites to check out:

http://www.celiac.org/

http://www.glutenfree.com/

 

 

[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

Test Bank[1] for Chapter 7 – Nutrition during Lactation:
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

7.1    List five common breastfeeding conditions.

7.2    Identify positive and negative impacts of maternal medications on mother’s breast milk.

7.3    Give two examples of herbal galactogogues.

7.4    Describe the impact of alcohol on mother’s milk.

7.5    Explain causes of hyperbilirubinemia and ways to prevent kernicterus.

7.6    List at least two ways health professionals can help the mother of multiples face the challenges of breastfeeding.

7.7    Explain the difference between food allergy and food intolerance.

7.8    Identify at least three factors that contribute to increased readmission rates for late-preterm infants.

7.9    List three benefits of mother’s breast milk for premature infants.

7.10  Demonstrate knowledge of medical contraindications to breastfeeding.

7.11  List 3 guidelines for storage of human milk for home use.

7.12  Review one of the model programs for breastfeeding promotion in the United States.

 

Multiple Choice

 

  1. Which of the following would NOT be considered a common condition that is experienced by a woman who is breastfeeding?
  2. Sore nipples
  3. Engorgement
  4. Mastitis
  5. Plugged ducts
  6. All of the above are common problems.

 

ANS: e       DIF: Fact-based                                   REF: 198-202                    OBJ: 7.1

 

  1. Medications contraindicated during breastfeeding include all of the following EXCEPT:
  2. antineoplastic agents.
  3. radioactive isotopes.
  4. antihistamines.
  5. drugs of abuse.
  6. drugs that suppress lactation.

 

ANS: c       DIF: Fact-based                                   REF: 203                            OBJ: 7.2

 

  1. Which of the following would NOT be considered a simple step to manage nipple pain?
  2. Air-drying breasts after nursing
  3. Rubbing expressed milk or an all-purpose ointment on nipples
  4. Using Vaseline to protect nipples
  5. Using warm compresses

 

ANS: c       DIF: Fact-based                                   REF: 198                            OBJ: 7.1

 

  1. The most important step to prevent sore nipples is to _____.
  2. take a prophylactic dose of antibiotics
  3. make sure the baby is positioned properly
  4. place cabbage leaves on your breasts before nursing
  5. place herbal salve on the nipple area
  6. nurse frequently

 

ANS: b       DIF: Fact-based, easy                          REF: 198                            OBJ: 7.1

 

  1. A mom with a newborn called a nurse practitioner to report that one of her breasts was painful, enlarged, and had a red area. In order to distinguish between two common conditions, what additional information would the practitioner want?
  2. Time of onset
  3. Where is the pain?
  4. Do you have a fever?
  5. Any flu-like symptoms?
  6. All of the above

 

ANS: e       DIF: Application-based, easy              REF: 200                            OBJ: 7.1

 

  1. For a woman experiencing let-down failure, good advice would include all of the following EXCEPT:
  2. getting out of the house for a walk.
  3. changing nursing positions.
  4. playing soothing music.
  5. increasing water consumption and decreasing caffeine.
  6. All of the above are recommended techniques.

 

ANS: e       DIF: Application-based                        REF: 199                            OBJ: 7.1

 

  1. The best way to prevent/cure a plugged duct is to:
  2. use a needle to unblock the duct.
  3. completely empty the breast.
  4. stop nursing and use a breast pump exclusively.
  5. take extra vitamin D.
  6. have a glass of red wine daily.

 

ANS: b       DIF: Application-based                        REF: 200                            OBJ: 7.1

 

  1. All of the following are recommended treatments for plugged ducts EXCEPT _____.
  2. stop breastfeeding until you see a health care provider
  3. gently massage the affected breast
  4. apply warm compresses
  5. change nursing positions
  6. take one tablespoon per day of lecithin

 

ANS: a       DIF: Fact-based, easy                          REF: 200                            OBJ: 7.1

 

  1. If a breastfeeding mother needs to use a specific medication, what should you tell her?
  2. If the hazards are minimal, use the medication after nursing.
  3. Try an oral inhalant vs. an oral medication.
  4. Take the lowest effective dose of the medication for the shortest duration.
  5. All of the above

 

ANS: d       DIF: Application-based                        REF: 204                            OBJ: 7.2

 

  1. Which drugs CANNOT be taken when breastfeeding?
  2. Most oral contraceptives
  3. Acetaminophen
  4. Radioisotope drugs
  5. Cold decongestants

 

ANS: c       DIF: Fact-based, medium                    REF: 203-204                    OBJ: 7.2

 

  1. When is the safest time for a nursing mom to take a drug?
  2. In the morning
  3. After eating a meal
  4. After the infant nurses
  5. Any time is safe to take a drug.
  6. It is never safe for a nursing mom to take drugs.

 

ANS: c       DIF: Fact-based, medium                    REF: 204                            OBJ: 7.2

 

  1. It will take approximately _____ hour(s) to eliminate the alcohol in one glass of wine from a 120-pound nursing woman.
  2. <1
  3. 2 to 3
  4. 4 to 5
  5. 6 to 7
  6. 12 or more

 

ANS: b       DIF: Application-based, easy              REF: 207                            OBJ: 7.4

 

  1. If a 110-lb nursing woman (50 kg) wants to drink alcohol, how many cans of beer (15 g alcohol/12 oz) can this woman drink and stay within the Institute of Medicine’s alcohol recommendations?
  2. 0
  3. 1
  4. 2
  5. 3

 

ANS: b       DIF: Application-based, hard              REF: 208                            OBJ: 7.4

 

  1. A breastfeeding mother asks you if alcohol can be eliminated from her breast milk by pumping immediately after drinking a few glasses of wine. What would you tell her?
  2. Yes; in fact, discarding your breast milk is a good thing to do if you would like to drink while breastfeeding.
  3. Yes; pumping will help, but you need to pump for the next 24 hours and discard any milk that you collect.
  4. No; your breast milk will still contain alcohol; you will need to wait 1 hour per alcoholic beverage and then pump the milk and discard it to be safe.
  5. No; the alcohol will still be in the breast milk and will clear from the milk as soon as it clears from the blood stream: roughly 2 to 3 hours per drink for a 120-pound woman.
  6. None of the above will help eliminate alcohol from breast milk.

 

ANS: d       DIF: Application-based                        REF: 207                            OBJ: 7.4

 

  1. The recommendation for use of herbal teas in nursing women is:
  2. choose teas using herbs for essence.
  3. choose natural teas.
  4. choose synthetic teas.
  5. choose teas that have traditional uses dating back thousands of years.
  6. choose whatever tea is preferred; all tea is safe.

 

ANS: a       DIF: Fact-based, medium                    REF: 205                            OBJ: 7.3

 

  1. Which of the following herbs is considered “safe” to use during lactation?
  2. Echinacea
  3. St. John’s wort
  4. Fenugreek
  5. Feverfew
  6. Foxglove

 

ANS: c       DIF: Fact-based                                   REF: 202|204-205            OBJ: 7.1|7.3

 

  1. Which of the following would NOT be a symptom of an infant suffering from an excess of caffeine?
  2. Colic
  3. Hyperactivity
  4. Wakefulness
  5. Diarrhea
  6. Fussiness

 

ANS: d       DIF: Fact-based                                   REF: 210                            OBJ: 7.4

 

  1. Which of the following foods has been shown to cause colicky babies?
  2. Red peppers
  3. Chocolate
  4. Garlic
  5. Tomatoes

 

ANS: c       DIF: Fact-based, easy                          REF: 217                            OBJ: 7.7

 

  1. Approximately _____ of term infants will become visibly jaundiced with their serum bilirubin levels exceeding 5 to 7 mg/dL.
  2. 20%
  3. 30%
  4. 40%
  5. 50%
  6. 60%

 

ANS: c       DIF: Fact-based                                   REF: 211                            OBJ: 7.5

 

  1. Hyperbilirubinemia in newborns is caused by _____.
  2. destruction of red blood cells
  3. high blood lipid levels
  4. high maternal intake of vitamin A
  5. labor lasting over 12 hours

 

ANS: a       DIF: Fact-based, medium                    REF: 212                            OBJ: 7.5

 

  1. Which of the following would be considered a minor risk factor for severe hyperbilirubinemia?
  2. Maternal age <25 years
  3. Normal-weight infant of diabetic mother
  4. Gestational age >41 weeks
  5. Formula feeding an infant
  6. Male gender

 

ANS: e       DIF: Fact-based                                   REF: 212                            OBJ: 7.5

 

  1. Breast milk jaundice is believed to be caused by _____.
  2. variability in the infant’s ability to process bilirubin
  3. a component in the mother’s milk increasing bilirubin absorption
  4. infrequent breastfeeding
  5. All of the above

 

ANS: d       DIF: Fact-based, medium                    REF: 215                            OBJ: 7.5

 

  1. The total bilirubin content of an infant’s meconium is _____.
  2. <200 mg
  3. 375 mg
  4. 400 mg
  5. 450 mg

 

ANS: d       DIF: Fact-based, medium                    REF: 215                            OBJ: 7.5

 

  1. What nutrition interventions are recommended for management of early jaundice?
  2. Early and frequent breastfeeding
  3. IV water feedings
  4. Increased formula feedings
  5. Dextrose feedings as a supplement to nursing

 

ANS: a       DIF: Fact-based, easy                          REF: 214                            OBJ: 7.5

 

  1. What is a possible reason that breastfeeding may prevent allergies?
  2. Influence on gut microbial flora
  3. Transfer of maternal immunity
  4. Transfer of maternal fatty acids and IGA in breast milk
  5. Low content of allergens
  6. All of the above

 

ANS: e       DIF: Fact-based                                   REF: 217                            OBJ: 7.7

 

  1. Common pediatric allergens include all of the following EXCEPT:
  2. cow’s milk.
  3. eggs.
  4. peanuts.
  5. soybeans
  6. oats.

 

ANS: e       DIF: Fact-based                                   REF: 217                            OBJ: 7.7

 

  1. Which of the following is considered a benefit of breastfeeding a preterm infant?
  2. Ease of protein digestion
  3. Ease of fat absorption
  4. Improved lactose digestion
  5. Better visual acuity
  6. All of the above

 

ANS: e       DIF: Fact-based                                   REF: 219                            OBJ: 7.9

 

  1. Factors contributing to the rate of transmission of HIV from the mother to an infant while breastfeeding include all of the following EXCEPT:
  2. strain of HIV.
  3. immune status of mother.
  4. viral load.
  5. maternal illness.
  6. All of the above are factors.

 

ANS: e       DIF: Fact-based                                   REF: 221                            OBJ: 7.10

 

  1. How many hours can freshly expressed breast milk be left at room temperature and still be considered safe for a baby?
  2. 1-3 hr @ 78°F
  3. 2-4 hr @ 78°F
  4. 3-5 hr @ 78°F
  5. 4-6 hr @ 78°F
  6. 6-8 hr @ 78°F

 

ANS: e       DIF: Fact-based, medium                    REF: 222                            OBJ: 7.11

 

  1. If nursing mothers want to store expressed milk in a refrigerator, what should the temperature setting be?
  2. <50 degrees F
  3. <39 degrees F
  4. >40 degrees F
  5. 78 degrees F

 

ANS: b       DIF: Fact-based, medium                    REF: 222                            OBJ: 7.11

 

  1. The purpose of a human milk bank is to:
  2. provide a place to donate milk for women whose supply exceeds the demands of their infants.
  3. provide human milk to infants who cannot be breastfed by their mothers.
  4. allow women to “keep their figure” by using a pump instead of allowing the child to nurse.
  5. All of the above
  6. a and b only

 

ANS: e       DIF: Fact-based                                   REF: 222                            OBJ: 7.11

 

  1. The scarcity of human milk banks in North America results from all of the following EXCEPT:
  2. the availability of wet nurses.
  3. a resurgence of tuberculosis.
  4. HIV.
  5. risks related to donors who might use drugs.

 

ANS: a       DIF: Fact-based, easy                          REF: 222                            OBJ: 7.11

 

  1. Milk banks store donated milk in plastic containers because it _____.
  2. expedites shipping
  3. is less costly than glass
  4. keeps white blood cells found in breast milk intact
  5. is easier to express milk into plastic containers

 

ANS: c       DIF: Fact-based, easy                          REF: 222-223                    OBJ: 7.11

 

  1. The energy content of breast milk in women who deliver pre-term infants is _____.
  2. 30-37 kcal/100 mL
  3. 40-48 kcal/100 mL
  4. 58-70 kcal/100 mL
  5. 72-120 kcal/100 mL

 

ANS: c       DIF: Fact-based, medium                    REF: 219                            OBJ: 7.9

 

  1. Once growth is established in preterm infants, the infants’ nutritional needs exceed the content of human milk for which of the following nutrients?
  2. Phosphorus
  3. Calcium
  4. Vitamin D
  5. Vitamin C
  6. All of the above

 

ANS: e       DIF: Fact-based, medium                    REF: 219                            OBJ: 7.9

 

  1. A new mother goes to the mall shopping with her friends. She is gone longer than planned and is not able to nurse her baby until she returns 6 hours later. What is the most likely problem she will have?
  2. A breast infection
  3. Engorgement
  4. Plugged ducts
  5. Sore nipples
  6. Mastitis

 

ANS: b       DIF: Application-based                        REF: 199                            OBJ: 7.1

 

  1. What advice would be helpful for a first-time mom who would like to know how to prevent a decrease in milk production?
  2. Relax and avoid stress.
  3. Breastfeed or pump frequently.
  4. Completely empty your breasts at each feeding, either by nursing or pumping.
  5. All of the above
  6. a and c only

 

ANS: d       DIF: Application-based                        REF: 200|202                    OBJ: 7.1

 

  1. A lactation consultant is observing a new mom breastfeeding and notices that the baby is making smacking and clicking sounds as she sucks. This tells her that:
  2. the baby is eating well and has a strong suckle.
  3. the baby has a cleft palate and should be closely followed.
  4. the baby is not latched on correctly and this may increase the risk of sore nipples.
  5. this is just a noisy baby.
  6. Noise is not an indicator of anything.

 

ANS: c       DIF: Application-based                        REF: 198                            OBJ: 7.1

 

  1. Large doses of St. John’s wort decrease prolactin levels in women. This could potentially:
  2. reduce oxytocin levels.
  3. cause breast milk to taste like maple syrup.
  4. cause a woman to become constipated.
  5. reduce breast milk supply.
  6. cause depression in some women.

 

ANS: d       DIF: Fact-based                                   REF: 206                            OBJ: 7.3

 

  1. Your best friend had a baby 3 months ago and is anxious to go “out on the town” with her friends. She is still breastfeeding, but would like to be able to have some drinks. What advice would you give her?
  2. It is okay to drink while nursing because it actually helps babies sleep.
  3. It is okay to drink while nursing because it increases breast milk production.
  4. Pump your milk immediately after drinking and it will be eliminated from your body.
  5. Pump milk before going out and use that until the alcohol has been cleared from your system.
  6. Drink only beer because babies tolerate it.

 

ANS: d       DIF: Application-based                        REF: 207|208                    OBJ: 7.4

 

  1. Delayed breastfeeding can lead to jaundice because
  2. it produces a state of partial starvation.
  3. it can lead to decreased passage of meconium.
  4. it causes an increase in bilirubin concentration.
  5. All of the above

 

ANS: d       DIF: Fact-based                                   REF: 214                            OBJ: 7.5

 

  1. How could the situation in question #41 be resolved?
  2. Make sure mother and baby were nursing correctly and for an adequate length of time.
  3. Check the mother’s milk supply to make sure she is producing enough milk to feed her baby.
  4. Monitor infants for stooling.
  5. Initiate breastfeeding early.
  6. All of the above

 

ANS: e       DIF: Application-based                        REF: 214                            OBJ: 7.5

 

  1. You are at a nice restaurant and would like to order seafood for dinner; however, you are breastfeeding. Which of the following would have the lowest amount of mercury and be safest for you to eat?
  2. Calamari
  3. Swordfish
  4. Shark
  5. Tuna
  6. King mackerel

 

ANS: a       DIF: Application-based                        REF: 211                            OBJ: 7.4

 

  1. A friend of yours has just given birth to twins and is planning to return to work full time when they are 3 months old. She has a nanny and feels confident that she will be able to breastfeed as well as work 50 hours per week. Which of the following will present a major challenge with this plan?
  2. Fatigue and sleep deprivation
  3. Lack of time to nurse or pump
  4. Milk production capacity
  5. All of the above
  6. a and b only

 

ANS: e       DIF: Application-based                        REF: 216                            OBJ: 7.6

 

  1. Which of the following foods would a pediatrician recommend a nursing mother with no history of food allergies in the family restrict?
  2. Peanuts and tree nuts
  3. Wheat
  4. Soy
  5. Eggs
  6. None of the above

 

ANS: e       DIF: Application-based                        REF: 217                            OBJ: 7.7

 

  1. What would be the best thing to do if you suspected your breastfed baby was responding adversely to milk in your diet?
  2. Switch to a lactose-free formula and see if the symptoms go away.
  3. Eliminate milk from your diet and monitor the baby for changes.
  4. Eliminate strong-flavored vegetables, onions, and garlic from your diet because they can cause the same problems in babies.
  5. All of the above would be good things to do.
  6. a and c only

 

ANS: b       DIF: Application-based                        REF: 217                            OBJ: 7.7

 

 

True/False

 

  1. Physicians typically are well trained to counsel women on breastfeeding.

 

ANS: F       DIF: Fact-based, easy                          REF: 223                            OBJ: 7.12

 

  1. The vast majority of women experience SIGNIFICANT problems with breastfeeding.

 

ANS: F       DIF: Fact-based                                   REF: 198                            OBJ: 7.1

 

  1. A woman with mastitis should continue to nurse her baby.

 

ANS: T       DIF: Fact-based, easy                          REF: 200                            OBJ: 7.1

 

  1. It is necessary to STOP nursing with mastitis.

 

ANS: F       DIF: Fact-based                                   REF: 200                            OBJ: 7.1

 

  1. Women should discontinue ALL medications while breastfeeding.

 

ANS: F       DIF: Application-based, hard              REF: 202                            OBJ: 7.2

 

  1. For women with a family history of peanut allergy, exclusive breastfeeding is recommended for 4 months.

 

ANS: T       DIF: Application-based, easy              REF: 216-217                    OBJ: 7.7

 

  1. A nursing mom should avoid cauliflower because it has the potential to cause gas in her baby.

 

ANS: F       DIF: Application-based, easy              REF: 217                            OBJ: 7.7

 

  1. Medicinal herbs have been shown to be a safe alternative to drugs during lactation.

 

ANS: F       DIF: Fact-based                                   REF: 205                            OBJ: 7.3

 

  1. Drinking one cup of coffee results in hyperactivity in all infants.

 

ANS: F       DIF: Fact-based, medium                    REF: 210                            OBJ: 7.4

 

  1. Alcohol is not transferred through breast milk.

 

ANS: F       DIF: Fact-based                                   REF: 207                            OBJ: 7.4

 

  1. Alcohol has been found to be a “galactologue” that facilitates milk let-down and helps aid milk insufficiency.

 

ANS: F       DIF: Fact-based                                   REF: 207                            OBJ: 7.4

 

  1. It is better to smoke and breastfeed than to smoke and NOT breastfeed.

 

ANS: T       DIF: Application-based                        REF: 209                            OBJ: 7.4

 

  1. Neonatal jaundice is a life-threatening condition that requires immediate medical intervention.

 

ANS: F       DIF: Fact-based                                   REF: 211                            OBJ: 7.5

 

 

Matching

 

1.   Mastitis

2.   Engorgement

3.   Plugged ducts

4.   Letdown failure

5.   Hyperactive letdown

6.   Fenugreek

7.   Echinacea

8.   Hyperbilirubinemia

9.   Cabbage leaves

10. Sore nipples

A.   Mild discomfort after nursing

B.   Inflammation of the breast

C.   May act as galactogogue

D.   Used to enhance immune system

E.   Elevated levels of bilirubin

F.   Blockage of milk, which may be caused by milk stasis

G.   May help reduce discomfort and swelling in breasts

H.   Milk is not ejected from breasts

I.    Breast milk streams too quickly from breast at the onset of feeding

J.   When the breasts become overfilled

 

Key:

  1. ANS: B DIF: Fact-based                                   REF: 200                            OBJ: 7.1
  2. ANS: J DIF: Fact-based                                   REF: 199                            OBJ: 7.1
  3. ANS: F DIF: Fact-based                                   REF: 199                            OBJ: 7.1
  4. ANS: H DIF: Fact-based                                   REF: 198                            OBJ: 7.1
  5. ANS: I DIF: Fact-based                                   REF: 199                            OBJ: 7.1
  6. ANS: C DIF: Fact-based                                   REF: 202                            OBJ: 7.1
  7. ANS: D DIF: Fact-based                                   REF: 206                            OBJ: 7.3
  8. ANS: E DIF: Fact-based                                   REF: 211                            OBJ: 7.5
  9. ANS: G DIF: Fact-based                                   REF: 199                            OBJ: 7.1
  10. ANS: A DIF: Fact-based REF: 198                            OBJ: 7.1

 

 

Short Answer

 

  1. A nursing mom of a 2-week-old infant seeks health advice regarding the use of echinacea to ward off any colds brought home by her two school-aged children. Discuss the two key questions you should ask to analyze whether echinacea is safe. Also, name three other factors that must be considered.

 

ANS: See pp. 204-206.

DIF: Application-based, medium                           REF: 204-206                    OBJ: 7.3

 

  1. A breastfeeding mom called her health care provider after a neighbor told her that eating eggs could cause an infant to develop egg allergies. Discuss two possible reasons why breastfeeding prevents food allergies and identify two conditions demonstrating how breastfeeding influences food allergies.

 

ANS: See pp. 216-217.

DIF: Application-based, medium                           REF: 216-217                    OBJ: 7.7

 

  1. A social marketing program targeting physicians has shown that accurate, appropriate counseling and encouragement by physicians can improve initiation and duration of breastfeeding rates. Give two examples of ways physicians can offer encouragement and accurate counseling to a single mom wanting to breastfeed but also wanting to continue smoking cigarettes.

 

ANS: See p. 209.

DIF: Application-based, hard                                REF: 209                            OBJ: 7.4

 

  1. The following statement was made in the chapter: “Any decision to limit a mother’s breastfeeding must be justified by the fact that the risk to her baby clearly outweighs the benefits of breastfeeding.” Name two risks in a baby that would motivate you to stop breastfeeding. What are two minimal risks that would NOT motivate you to stop breastfeeding?

 

ANS: See pp. 200-204, 220-221.

DIF: Application-based, medium                           REF: 200-204|220-221
OBJ: 7.1|7.2|7.10

 

  1. If a nursing mom was started on a new medication, what signs or symptoms would she look for to determine whether it was affecting her baby?

 

ANS: See pp. 202-204.

DIF: Application-based, medium                           REF: 202-204                    OBJ: 7.2

 

  1. Explain a) the importance of breastfeeding for premature infants, and b) how the composition of breast milk compares to that of the mother of a full-term infant. Are there any health concerns related to breastfeeding a preterm infant? Discuss.

 

ANS: See pp. 218-220.

DIF: Fact-based                                                     REF: 218-220                    OBJ: 7.8|7.9

 

  1. “Anyone can be a milk bank donor.” Is this statement true? Describe a milk bank and how they go about selecting women to provide milk.

 

ANS: See pp. 221-223.

DIF: Application-based                                          REF: 221-223                    OBJ: 7.11

 

  1. Your best friend has just started to breastfeed her twin sons and has developed a reddish hard spot on her left breast. a) What is happening to her? b) Is it necessary that she stop breastfeeding? Explain why or why not, and then outline a plan for her in order to decrease the pain and allow her to continue breastfeeding. c) When would it become imperative that she stop breastfeeding?

 

ANS: See pp. 199-200.

DIF: Application-based                                          REF: 199-200                    OBJ: 7.1

 

 

Ready-to-Use Chapter 7 Test

 

Multiple Choice

 

  1. Which of the following would NOT be considered a common condition that is experienced by a woman who is breastfeeding?
  2. Sore nipples
  3. Engorgement
  4. Mastitis
  5. Plugged ducts
  6. All of the above are common problems.

 

  1. Medications contraindicated during breastfeeding include all of the following EXCEPT:
  2. antineoplastic agents.
  3. radioactive isotopes.
  4. antihistamines.
  5. drugs of abuse.
  6. drugs that suppress lactation.

 

  1. Which of the following would NOT be considered a simple step to manage nipple pain?
  2. Air-drying breasts after nursing
  3. Rubbing expressed milk or an all-purpose ointment on nipples
  4. Using Vaseline to protect nipples
  5. Using warm compresses

 

  1. The most important step to prevent sore nipples is to _____.
  2. take a prophylactic dose of antibiotics
  3. make sure the baby is positioned properly
  4. place cabbage leaves on your breasts before nursing
  5. place herbal salve on the nipple area
  6. nurse frequently

 

  1. A mom with a newborn called a nurse practitioner to report that one of her breasts was painful, enlarged, and had a red area. In order to distinguish between two common conditions, what additional information would the practitioner want?
  2. Time of onset
  3. Where is the pain?
  4. Do you have a fever?
  5. Any flu-like symptoms?
  6. All of the above

 

  1. For a woman experiencing let-down failure, good advice would include all of the following EXCEPT:
  2. getting out of the house for a walk.
  3. changing nursing positions.
  4. playing soothing music.
  5. increasing water consumption and decreasing caffeine.
  6. All of the above are recommended techniques.

 

  1. The best way to prevent/cure a plugged duct is to:
  2. use a needle to unblock the duct.
  3. completely empty the breast.
  4. stop nursing and use a breast pump exclusively.
  5. take extra vitamin D.
  6. have a glass of red wine daily.

 

  1. All of the following are recommended treatments for plugged ducts EXCEPT _____.
  2. stop breastfeeding until you see a health care provider
  3. gently massage the affected breast
  4. apply warm compresses
  5. change nursing positions
  6. take one tablespoon per day of lecithin

 

  1. If a breastfeeding mother needs to use a specific medication, what should you tell her?
  2. If the hazards are minimal, use the medication after nursing.
  3. Try an oral inhalant vs. an oral medication.
  4. Take the lowest effective dose of the medication for the shortest duration.
  5. All of the above

 

  1. Which drugs CANNOT be taken when breastfeeding?
  2. Most oral contraceptives
  3. Acetaminophen
  4. Radioisotope drugs
  5. Cold decongestants

 

  1. When is the safest time for a nursing mom to take a drug?
  2. In the morning
  3. After eating a meal
  4. After the infant nurses
  5. Any time is safe to take a drug.
  6. It is never safe for a nursing mom to take drugs.

 

  1. It will take approximately _____ hour(s) to eliminate the alcohol in one glass of wine from a 120-pound nursing woman.
  2. <1
  3. 2 to 3
  4. 4 to 5
  5. 6 to 7
  6. 12 or more

 

  1. If a 110-lb nursing woman (50 kg) wants to drink alcohol, how many cans of beer (15 g alcohol/12 oz) can this woman drink and stay within the Institute of Medicine’s alcohol recommendations?
  2. 0
  3. 1
  4. 2
  5. 3

 

  1. A breastfeeding mother asks you if alcohol can be eliminated from her breast milk by pumping immediately after drinking a few glasses of wine. What would you tell her?
  2. Yes; in fact, discarding your breast milk is a good thing to do if you would like to drink while breastfeeding.
  3. Yes; pumping will help, but you need to pump for the next 24 hours and discard any milk that you collect.
  4. No; your breast milk will still contain alcohol; you will need to wait 1 hour per alcoholic beverage and then pump the milk and discard it to be safe.
  5. No; the alcohol will still be in the breast milk and will clear from the milk as soon as it clears from the blood stream: roughly 2 to 3 hours per drink for a 120-pound woman.
  6. None of the above will help eliminate alcohol from breast milk.

 

  1. The recommendation for use of herbal teas in nursing women is:
  2. choose teas using herbs for essence.
  3. choose natural teas.
  4. choose synthetic teas.
  5. choose teas that have traditional uses dating back thousands of years.
  6. choose whatever tea is preferred; all tea is safe.

 

  1. Which of the following herbs is considered “safe” to use during lactation?
  2. Echinacea
  3. St. John’s wort
  4. Fenugreek
  5. Feverfew
  6. Foxglove

 

  1. Which of the following would NOT be a symptom of an infant suffering from an excess of caffeine?
  2. Colic
  3. Hyperactivity
  4. Wakefulness
  5. Diarrhea
  6. Fussiness

 

  1. Which of the following foods has been shown to cause colicky babies?
  2. Red peppers
  3. Chocolate
  4. Garlic
  5. Tomatoes

 

  1. Approximately _____ of term infants will become visibly jaundiced with their serum bilirubin levels exceeding 5 to 7 mg/dL.
  2. 20%
  3. 30%
  4. 40%
  5. 50%
  6. 60%

 

  1. Hyperbilirubinemia in newborns is caused by _____.
  2. destruction of red blood cells
  3. high blood lipid levels
  4. high maternal intake of vitamin A
  5. labor lasting over 12 hours

 

  1. Which of the following would be considered a minor risk factor for severe hyperbilirubinemia?
  2. Maternal age <25 years
  3. Normal-weight infant of diabetic mother
  4. Gestational age >41 weeks
  5. Formula feeding an infant
  6. Male gender

 

  1. Breast milk jaundice is believed to be caused by _____.
  2. variability in the infant’s ability to process bilirubin
  3. a component in the mother’s milk increasing bilirubin absorption
  4. infrequent breastfeeding
  5. All of the above

 

  1. The total bilirubin content of an infant’s meconium is _____.
  2. <200 mg
  3. 375 mg
  4. 400 mg
  5. 450 mg

 

  1. What nutrition interventions are recommended for management of early jaundice?
  2. Early and frequent breastfeeding
  3. IV water feedings
  4. Increased formula feedings
  5. Dextrose feedings as a supplement to nursing

 

  1. What is a possible reason that breastfeeding may prevent allergies?
  2. Influence on gut microbial flora
  3. Transfer of maternal immunity
  4. Transfer of maternal fatty acids and IGA in breast milk
  5. Low content of allergens
  6. All of the above

 

  1. Common pediatric allergens include all of the following EXCEPT:
  2. cow’s milk.
  3. eggs.
  4. peanuts.
  5. soybeans
  6. oats.

 

  1. Which of the following is considered a benefit of breastfeeding a preterm infant?
  2. Ease of protein digestion
  3. Ease of fat absorption
  4. Improved lactose digestion
  5. Better visual acuity
  6. All of the above

 

  1. Factors contributing to the rate of transmission of HIV from the mother to an infant while breastfeeding include all of the following EXCEPT:
  2. strain of HIV.
  3. immune status of mother.
  4. viral load.
  5. maternal illness.
  6. All of the above are factors.

 

  1. How many hours can freshly expressed breast milk be left at room temperature and still be considered safe for a baby?
  2. 1-3 hr @ 78°F
  3. 2-4 hr @ 78°F
  4. 3-5 hr @ 78°F
  5. 4-6 hr @ 78°F
  6. 6-8 hr @ 78°F

 

  1. If nursing mothers want to store expressed milk in a refrigerator, what should the temperature setting be?
  2. <50 degrees F
  3. <39 degrees F
  4. >40 degrees F
  5. 78 degrees F

 

  1. The purpose of a human milk bank is to:
  2. provide a place to donate milk for women whose supply exceeds the demands of their infants.
  3. provide human milk to infants who cannot be breastfed by their mothers.
  4. allow women to “keep their figure” by using a pump instead of allowing the child to nurse.
  5. All of the above
  6. a and b only

 

  1. The scarcity of human milk banks in North America results from all of the following EXCEPT:
  2. the availability of wet nurses.
  3. a resurgence of tuberculosis.
  4. HIV.
  5. risks related to donors who might use drugs.

 

  1. Milk banks store donated milk in plastic containers because it _____.
  2. expedites shipping
  3. is less costly than glass
  4. keeps white blood cells found in breast milk intact
  5. is easier to express milk into plastic containers

 

  1. The energy content of breast milk in women who deliver pre-term infants is _____.
  2. 30-37 kcal/100 mL
  3. 40-48 kcal/100 mL
  4. 58-70 kcal/100 mL
  5. 72-120 kcal/100 mL

 

  1. Once growth is established in preterm infants, the infants’ nutritional needs exceed the content of human milk for which of the following nutrients?
  2. Phosphorus
  3. Calcium
  4. Vitamin D
  5. Vitamin C
  6. All of the above

 

  1. A new mother goes to the mall shopping with her friends. She is gone longer than planned and is not able to nurse her baby until she returns 6 hours later. What is the most likely problem she will have?
  2. A breast infection
  3. Engorgement
  4. Plugged ducts
  5. Sore nipples
  6. Mastitis

 

  1. What advice would be helpful for a first-time mom who would like to know how to prevent a decrease in milk production?
  2. Relax and avoid stress.
  3. Breastfeed or pump frequently.
  4. Completely empty your breasts at each feeding, either by nursing or pumping.
  5. All of the above
  6. a and c only

 

  1. A lactation consultant is observing a new mom breastfeeding and notices that the baby is making smacking and clicking sounds as she sucks. This tells her that:
  2. the baby is eating well and has a strong suckle.
  3. the baby has a cleft palate and should be closely followed.
  4. the baby is not latched on correctly and this may increase the risk of sore nipples.
  5. this is just a noisy baby.
  6. Noise is not an indicator of anything.

 

  1. Large doses of St. John’s wort decrease prolactin levels in women. This could potentially:
  2. reduce oxytocin levels.
  3. cause breast milk to taste like maple syrup.
  4. cause a woman to become constipated.
  5. reduce breast milk supply.
  6. cause depression in some women.

 

  1. Your best friend had a baby 3 months ago and is anxious to go “out on the town” with her friends. She is still breastfeeding, but would like to be able to have some drinks. What advice would you give her?
  2. It is okay to drink while nursing because it actually helps babies sleep.
  3. It is okay to drink while nursing because it increases breast milk production.
  4. Pump your milk immediately after drinking and it will be eliminated from your body.
  5. Pump milk before going out and use that until the alcohol has been cleared from your system.
  6. Drink only beer because babies tolerate it.

 

  1. Delayed breastfeeding can lead to jaundice because
  2. it produces a state of partial starvation.
  3. it can lead to decreased passage of meconium.
  4. it causes an increase in bilirubin concentration.
  5. All of the above

 

  1. How could the situation in question #41 be resolved?
  2. Make sure mother and baby were nursing correctly and for an adequate length of time.
  3. Check the mother’s milk supply to make sure she is producing enough milk to feed her baby.
  4. Monitor infants for stooling.
  5. Initiate breastfeeding early.
  6. All of the above

 

  1. You are at a nice restaurant and would like to order seafood for dinner; however, you are breastfeeding. Which of the following would have the lowest amount of mercury and be safest for you to eat?
  2. Calamari
  3. Swordfish
  4. Shark
  5. Tuna
  6. King mackerel

 

  1. A friend of yours has just given birth to twins and is planning to return to work full time when they are 3 months old. She has a nanny and feels confident that she will be able to breastfeed as well as work 50 hours per week. Which of the following will present a major challenge with this plan?
  2. Fatigue and sleep deprivation
  3. Lack of time to nurse or pump
  4. Milk production capacity
  5. All of the above
  6. a and b only

 

  1. Which of the following foods would a pediatrician recommend a nursing mother with no history of food allergies in the family restrict?
  2. Peanuts and tree nuts
  3. Wheat
  4. Soy
  5. Eggs
  6. None of the above

 

  1. What would be the best thing to do if you suspected your breastfed baby was responding adversely to milk in your diet?
  2. Switch to a lactose-free formula and see if the symptoms go away.
  3. Eliminate milk from your diet and monitor the baby for changes.
  4. Eliminate strong-flavored vegetables, onions, and garlic from your diet because they can cause the same problems in babies.
  5. All of the above would be good things to do.
  6. a and c only

 

 

True/False

 

  1. Physicians typically are well trained to counsel women on breastfeeding.

 

  1. The vast majority of women experience SIGNIFICANT problems with breastfeeding.

 

  1. A woman with mastitis should continue to nurse her baby.

 

  1. It is necessary to STOP nursing with mastitis.

 

  1. Women should discontinue ALL medications while breastfeeding.

 

  1. For women with a family history of peanut allergy, exclusive breastfeeding is recommended for 4 months.

 

  1. A nursing mom should avoid cauliflower because it has the potential to cause gas in her baby.

 

  1. Medicinal herbs have been shown to be a safe alternative to drugs during lactation.

 

  1. Drinking one cup of coffee results in hyperactivity in all infants.

 

  1. Alcohol is not transferred through breast milk.

 

  1. Alcohol has been found to be a “galactologue” that facilitates milk let-down and helps aid milk insufficiency.

 

  1. It is better to smoke and breastfeed than to smoke and NOT breastfeed.

 

  1. Neonatal jaundice is a life-threatening condition that requires immediate medical intervention.

 

 

Matching

 

1.   Mastitis

2.   Engorgement

3.   Plugged ducts

4.   Letdown failure

5.   Hyperactive letdown

6.   Fenugreek

7.   Echinacea

8.   Hyperbilirubinemia

9.   Cabbage leaves

10. Sore nipples

A.   Mild discomfort after nursing

B.   Inflammation of the breast

C.   May act as galactogogue

D.   Used to enhance immune system

E.   Elevated levels of bilirubin

F.   Blockage of milk, which may be caused by milk stasis

G.   May help reduce discomfort and swelling in breasts

H.   Milk is not ejected from breasts

I.    Breast milk streams too quickly from breast at the onset of feeding

J.   When the breasts become overfilled

 

 

Short Answer

 

  1. A nursing mom of a 2-week-old infant seeks health advice regarding the use of echinacea to ward off any colds brought home by her two school-aged children. Discuss the two key questions you should ask to analyze whether echinacea is safe. Also, name three other factors that must be considered.

 

  1. A breastfeeding mom called her health care provider after a neighbor told her that eating eggs could cause an infant to develop egg allergies. Discuss two possible reasons why breastfeeding prevents food allergies and identify two conditions demonstrating how breastfeeding influences food allergies.

 

  1. A social marketing program targeting physicians has shown that accurate, appropriate counseling and encouragement by physicians can improve initiation and duration of breastfeeding rates. Give two examples of ways physicians can offer encouragement and accurate counseling to a single mom wanting to breastfeed but also wanting to continue smoking cigarettes.

 

  1. The following statement was made in the chapter: “Any decision to limit a mother’s breastfeeding must be justified by the fact that the risk to her baby clearly outweighs the benefits of breastfeeding.” Name two risks in a baby that would motivate you to stop breastfeeding. What are two minimal risks that would NOT motivate you to stop breastfeeding?

 

  1. If a nursing mom was started on a new medication, what signs or symptoms would she look for to determine whether it was affecting her baby?

 

  1. Explain a) the importance of breastfeeding for premature infants, and b) how the composition of breast milk compares to that of the mother of a full-term infant. Are there any health concerns related to breastfeeding a preterm infant? Discuss.

 

  1. “Anyone can be a milk bank donor.” Is this statement true? Describe a milk bank and how they go about selecting women to provide milk.

 

  1. Your best friend has just started to breastfeed her twin sons and has developed a reddish hard spot on her left breast. a) What is happening to her? b) Is it necessary that she stop breastfeeding? Explain why or why not, and then outline a plan for her in order to decrease the pain and allow her to continue breastfeeding. c) When would it become imperative that she stop breastfeeding?

 

 

 

[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