A nurse explains cervical changes during labor. Which client statement indicates a correct understanding?

A. Deep red or orange vegetables, such as carrots, red peppers, and sweet potatoes, are excellent sources of vitamin A, beta-carotene, and fiber, but they are not significant sources of calcium. While they contribute to overall nutritional intake, relying on them for calcium needs during pregnancy would be inadequate.
B. White breads and rice primarily provide carbohydrates and some B vitamins if enriched. They contain minimal amounts of calcium and are not effective alternatives for meeting daily calcium requirements, which are about 1,000 mg per day for most pregnant adults.
C. Meat, poultry, and fish are rich in protein, iron, and other essential nutrients. Certain types of fish, such as canned salmon and sardines with bones, are high in calcium. However, typical servings of meat, poultry, or fish without edible bones do not provide enough calcium to meet daily needs, making them less reliable for this purpose.
D. Dark green leafy vegetables such as kale, collard greens, bok choy, and broccoli are rich in calcium and can serve as excellent alternatives for clients who do not consume dairy products. These vegetables provide bioavailable calcium that supports fetal skeletal development and helps maintain maternal bone health during pregnancy. Encouraging the inclusion of a variety of these vegetables, along with other calcium-fortified foods (e.g., plant-based milks or juices), helps ensure adequate calcium intake without relying on milk.

A. Normal reflexes and absence of headache are not consistent with severe preeclampsia. Severe preeclampsia often includes hyperreflexia, headache, visual disturbances, and other neurologic symptoms due to increased vascular resistance and cerebral edema.

B. Trace protein in urine is characteristic of mild preeclampsia, not severe preeclampsia. Severe cases typically demonstrate marked proteinuria (+2 to +4 on dipstick or >5 g/24 hours) alongside other systemic symptoms.

C. A blood pressure of 107/70 mm Hg with trace proteinuria is within normal limits and does not reflect preeclampsia, let alone severe preeclampsia. Severe preeclampsia requires significantly elevated blood pressure and other signs of end-organ involvement.

D. Blood pressure 170/110 mm Hg and +3 proteinuria represents the classic presentation of severe preeclampsia. Severe preeclampsia is defined by systolic BP ≥160 mm Hg or diastolic BP ≥110 mm Hg on two occasions and proteinuria ≥+3 on dipstick or ≥5 g/24 hours. These findings indicate significant vascular and renal involvement, requiring prompt monitoring and management to prevent complications such as eclampsia, HELLP syndrome, and maternal or fetal compromise.