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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
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.
Correct Answer is C
Explanation
A. Induction is not dependent on cervical dilation alone. Even if the client were dilated, the defining factor for induction is that labor has not started spontaneously. Therefore, this option is incorrect.
B. Augmentation refers to stimulating or enhancing labor that has already begun, often using oxytocin or other interventions. Cervical ripening is typically done before induction, so this is not augmentation.
C. Induction of labor is the process of initiating labor artificially in a client who is not in labor, often due to post-term pregnancy, medical complications, or other indications. In this scenario, the client is at 41 weeks gestation and labor has not begun naturally, and cervical ripening medication is being used to prepare the cervix for labor before administering oxytocin to stimulate contractions. This clearly represents labor induction.
D. Augmentation refers specifically to strengthening or regulating contractions in labor that has already started, not initiating labor in a client who is not in labor. Since this client is not in labor yet, augmentation does not apply.
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