Which patient is most at risk for a low-birth-weight infant?

Correct Answer: B

Rationale: The correct answer is B because a low body mass index (<18.5) indicates underweight, which is a risk factor for delivering a low-birth-weight infant. Underweight individuals may have inadequate nutrition and lower reserves for a healthy pregnancy. Choice A is less likely as the patient has a normal prepregnant weight. Choice C's prepregnant weight being above the norm suggests a healthy weight. Choice D's total weight gain in previous pregnancies being 33 lb indicates a healthy weight maintenance during pregnancy.

Correct Answer: C

Rationale: The correct answer is C because weight gain in pregnancy should be individualized based on the patient's prepregnant body mass index (BMI). This is important as it takes into consideration the patient's starting weight and helps to determine a healthy range of weight gain to support both maternal and fetal health. This approach is evidence-based and helps to prevent complications such as gestational diabetes and preeclampsia. Explanation for why the other choices are incorrect: A: This statement is incorrect because not all pregnant women need to gain the same amount of weight. Weight gain recommendations vary based on the patient's BMI. B: This statement is incorrect as it provides a specific number for weight gain, which may not be accurate for all pregnant women. Weight gain should be individualized based on BMI. D: This statement is incorrect because weight gain recommendations are distributed evenly across the trimesters, not necessarily more in the first and second trimesters and less in the third.

Correct Answer: C

Rationale: Rationale: The correct answer is C because for breastfeeding, an additional 500 calories/day are needed compared to pregnancy. The recommended caloric intake during pregnancy is around 2200 calories/day. Therefore, increasing from 2200 to 2530 calories/day aligns with the additional 500 calories necessary for sustaining breastfeeding. Summary: A: Going from 1800 to 2200 calories/day does not provide the extra 500 calories needed for breastfeeding. B: Increasing from 2000 to 2500 calories/day does not account for the original pregnancy intake or the additional calories required for breastfeeding. D: Jumping from 2500 to 2730 calories/day exceeds the additional 500 calories needed for breastfeeding, potentially leading to excessive weight gain.

Correct Answer: B

Rationale: The correct answer is B: 1 lb every week. During the second and third trimesters, a pregnant woman is expected to gain about 1 lb per week on average. This weight gain is important for the healthy development of the baby and to support the mother's changing body. Gaining weight too slowly can lead to complications, while gaining too quickly can also have negative effects. Choices A, C, and D are incorrect because they suggest weight gain rates that are either too low or too high for a healthy pregnancy. It is crucial for the nurse to educate the patient on the importance of appropriate weight gain throughout the remaining trimesters to ensure the well-being of both the mother and the baby.

Correct Answer: A

Rationale: The correct answer is A (20 lb). During pregnancy, the recommended weight gain for a woman with a BMI of 30-39.9 is 11-20 pounds. This range helps reduce the risk of complications associated with excessive weight gain. Option B (25 lb) exceeds this recommended range, while options C (28 lb) and D (40 lb) are even further beyond the healthy weight gain guidelines for a BMI of 32. Thus, advising the patient to gain a maximum of 20 pounds is the most appropriate recommendation to ensure a healthy pregnancy outcome.