Module 4 Unit D Practice Questions Flashcards
In general, how many additional kcals/day do pregnant individuals need during the second trimester, over their prepregnancy diet?
300-350
What is the recommended daily intake of protein during the second trimester of pregnancy?
Approximately 65-75 g/day
What is the recommended daily intake of iron during pregnancy, in the absence of anemia?
Approximately 30 mg/day
A 31 year-old at 14 weeks’ gestation asks how much calcium they should get each day. The clinician should advise:
1,000 mg/day through food sources if possible
Which of these are appropriate recommendations for omega-3 fatty acid intake during pregnancy? [select all that apply]
a) 300 mg DHA/day
b) 500 mg DHA/day
c) Shark or swordfish 3-4 times/week
d) Salmon 2-3 times/week
e) 2,500 mg DHA/day
a) 300 mg DHA/day
b) 500 mg DHA/day
d) Salmon 2-3 times/week
[Recommended intake approximately 200-500 mg DHA/day Fatty, low-mercury fish are good sources, such as Salmon]
True or false? A reasonable recommendation for fiber intake for a patient at 16 weeks’ gestation is 5-10 gram/day.
False
[Recommended intake is 25-30 g/day]
A person at 14 weeks’ gestation reports that she is starting to feel much better with her nausea and vomiting almost gone. She tells the clinician that she usually follows a predominantly plant-based diet but wonders whether that’s safe during her pregnancy. Which of the following are appropriate clinician responses? [select all that apply]
a) Because you had several months of nausea and vomiting, you really need to eat a balanced diet with meat now.
b) I’d like to hear more about the plant-based diet that you usually follow.
c) A plant-based diet can be healthy and safe during pregnancy. Let’s talk about protein sources.
d) I’m quite worried that you won’t get enough iron given what vegetarians usually eat.
b) I’d like to hear more about the plant-based diet that you usually follow.
c) A plant-based diet can be healthy and safe during pregnancy. Let’s talk about protein sources.
[It is important not to assume that vegans and vegetarians are unable to consume adequate protein. The best way to counsel your patient is first to gather more information on the diet they follow.]
What should the clinician recommend to a person at 26 weeks’ gestation regarding Tdap vaccine?
We recommend that you get a Tdap between 27 and 36 weeks, ideally between 27 and 30 weeks
[During the second trimester, clinicians should recommend that all patients get a Tdap vaccine. The CDC recommends that pregnant individuals get a Tdap during the 27th through 36th week of each pregnancy, preferably during the earlier part of that range.]
What should the clinician recommend to a person at 26 weeks’ gestation regarding the influenza vaccine?
We highly recommend that you get an inactivated influenza vaccine by the end of October
[The CDC recommends that pregnant individuals get a flu vaccine by the end of October, regardless of the timing variations from year to year in flu activity.
Pregnant patients must get an inactivated flu vaccine, rather than a live virus vaccine.
Pregnant individuals are more likely to have severe illness from the flu
Also of note, flu shot during pregnancy is also a great way to protect the baby for several months after birth]
A person is finishing a prenatal visit at 22 weeks. According to a traditional visit schedule, when should the person be scheduled to return for the next visit?
26 weeks
[According to the traditional visit schedule that many clinicians in the United States follow, pregnant individuals continue to be seen every 4 weeks until 28 weeks.]
A patient is being seen at 16 weeks’ gestation. Which of the following are appropriate for the clinician to check or arrange at this point in pregnancy? [select all that apply]
a) Check whether the person had selected a second trimester genetic screen. If she did, she will likely need blood drawn today.
b) Check whether the person had selected chorionic villus sampling. If she did, that needs to be scheduled to occur soon.
c) Arrange for the patient to have a fetal anatomy ultrasound in approximately 4 weeks.
d) Schedule her to return to the office for a routine OB visit in 2 weeks.
e) Schedule her to return to the office for a routine OB visit in 4 weeks.
a) Check whether the person had selected a second trimester genetic screen. If she did, she will likely need blood drawn today.
c) Arrange for the patient to have a fetal anatomy ultrasound in approximately 4 weeks.
e) Schedule her to return to the office for a routine OB visit in 4 weeks.
[If the patient had a sequential screen, then the second blood draw is obtained between 15-20 weeks.
According to the traditional visit schedule that many clinicians in the United States follow, pregnant individuals continue to be seen every 4 weeks until 28 weeks. Therefore, she would have a ROBV in 4 weeks (20 wks).
A fetal anatomy scan is performed between 18-22 weeks, therefore, it would also be scheduled at 20 weeks.]
Connecting what you have learned about trauma-informed care and the readings in Battling Over Birth, section 5.2.2 about respecting women’s boundaries and bodily autonomy, which of the following are likely to be successful strategies to reduce barriers to prenatal care? [select all that apply]
a) The clinician enters the relationship aware that many individuals have experienced trauma.
b) Ask all patients to complete a formal trauma questionnaire at the first visit.
c) Frequently remind patients to relax during exams
d) Ask permission before every examination
e) Streamline encounters by minimizing the number of choices patients need to make
a) The clinician enters the relationship aware that many individuals have experienced trauma.
d) Ask permission before every examination
[Many individuals have experienced some degree of trauma that affects the way they interact with their own health, and the system from which they seek care. Having all patients complete a questionnaire at their first visit, before even being able to establish rapport, would not likely fall under the category of respecting people’s boundaries. What is the likelihood that the answers would be accurate?
Frequently reminding patients to relax during exams could be interpreted as patronizing. It would not likely get to the root of problem, nor would it likely yield any resolution.
You would want to individualize your encounters, explore your patient’s preferences and values, and offer choices whenever possible to foster patient autonomy and avoid disempowerment.]
What are sources of potential toxic exposures? (select all that apply)
a) Home
b) Work
c) Hobbies
d) Community
All of them
What advice should the clinician provide to assist a person to identify potential workplace toxins?
Obtain Material Safety Data Sheets
