A nurse in a clinic is teaching pregnant women about the recommended folic acid supplements. Which of the following defects can occur in the fetus as a result of folic acid deficiency?

Iron deficiency anemia

Poor bone formation

Abnormal fetal growth

Neural tube defects

Answer and Explanation

The Correct Answer is D

A. Iron deficiency anemia results from insufficient iron intake, increased maternal iron requirements, or blood loss, not from folic acid deficiency. Although folic acid and iron are both important for maternal and fetal health, the specific deficiency effects differ. Iron is primarily critical for hemoglobin synthesis, whereas folic acid supports DNA synthesis and cell division.

B. Bone development depends mainly on adequate calcium, phosphorus, and vitamin D. A folic acid deficiency does not directly affect skeletal formation in the fetus, as its primary role is in nucleic acid metabolism and cellular replication.

C. While severe folic acid deficiency may indirectly contribute to growth issues, it is not the main or hallmark consequence. Fetal growth restriction is more closely associated with placental insufficiency, maternal malnutrition, or other systemic conditions rather than isolated folic acid deficiency.

D. Folic acid deficiency is strongly linked to neural tube defects (NTDs) such as spina bifida and anencephaly. The neural tube closes within the first 3–4 weeks of gestation, often before pregnancy is confirmed, making preconception and early pregnancy supplementation critical. Recommended daily intake for women of childbearing age is 400–800 mcg, which significantly reduces the risk of NTDs. Folic acid’s role in DNA synthesis, cell division, and tissue growth is essential for proper neural tube development.

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Correct Answer is C

Explanation

A. One cm above the symphysis pubis is typical immediately postpartum (within a few hours) for a fundus that has already begun involuting, but by 26 hours, the uterus is expected to have risen slightly above the umbilicus, so this is too low for this timeframe.

B. Midline at the umbilicus occurs approximately 12 hours postpartum, when the uterus has involuted upward to the level of the umbilicus. At 26 hours, the fundus is expected to have slightly involuted from the umbilicus, but still slightly above it.

C. Midline, 1 cm above the umbilicus is the expected location about 24 hours postpartum. The uterus remains firm and midline but gradually descends approximately 1 cm per day as involution continues. This finding is considered normal for a client 26 hours after delivery.

D. Midline, 2 cm above the umbilicus would be expected closer to immediately postpartum, not 26 hours later. By this time, the fundus has already begun to descend as part of the normal involution process.

A. All women, regardless of risk factors B. Women who have had a sexually transmitted infection (STI) C. Women who have had more than one sexual partner D. Woman who are monogamous with their partner

Correct Answer is A

Explanation

A. Routine prenatal HIV screening is recommended for all pregnant women, regardless of identified risk factors. Universal testing helps identify undiagnosed HIV early, allowing for timely antiretroviral therapy, which significantly reduces the risk of maternal-to-child transmission. This approach avoids missed diagnoses that can occur when testing is based only on perceived risk.
B. Women with a history of STIs are at increased risk for HIV and should be tested; however, limiting testing only to this group would miss many cases. Therefore, this option is incomplete and not the most appropriate answer.
C. Having multiple sexual partners increases the risk for HIV infection, but prenatal HIV testing is not limited to women with this risk factor. Universal screening is recommended instead.
D. Even women who are monogamous may be at risk if their partner is infected or has other risk factors. For this reason, monogamy does not eliminate the need for prenatal HIV testing.

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A nurse in a clinic is teaching pregnant women about the recommended folic acid supplements. Which of the following defects can occur in the fetus as a result of folic acid deficiency?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who delivered vaginally 26 hours ago. When palpating the client's abdomen, where should the nurse expect to find the uterine fundus during her assessment?

Correct Answer is C

Explanation

Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)?

Correct Answer is A

Explanation

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