Final answer:
The most important action by the nurse is to assess for signs of inadequate weight gain, given that the client's 14-pound weight gain by the fifth month of pregnancy is slightly below the recommended range.
Step-by-step explanation:
By the fifth month of pregnancy, a 32-year-old multipara client has gained 14 pounds. Assessing if this weight gain is appropriate requires understanding the pregnancy weight gain recommendations. During a typical pregnancy, an expectant mother requires an additional 300 calories per day. Most women gain about 0.45 kg (approximately 1 lb) per week during the second and third trimesters. Given that the client is in her fifth month, she should have gained roughly 16 to 20 pounds (8-10 weeks at 1 lb per week), which makes her 14-pound weight gain slightly below the recommended range.
Therefore, in the given scenario, the most important action by the nurse is: B. Assess for signs of inadequate weight gain. Encouraging to increase calorie intake or reduce physical activity may not be appropriate without first assessing the client's overall health, current diet and physical activity levels, and potential for any underlying issues that could affect weight gain. Documenting the weight gain in the chart is essential but is a routine task and not necessarily the most important action at this stage.