A nurse is providing preconception counseling for a client who is planning a pregnancy.
Which of the following supplements should the nurse recommend to help prevent neural tube defects in the fetus?

The correct answer is choice a. Excessive uterine enlargement.

Choice A rationale:

Hydatidiform mole, also known as a molar pregnancy, often presents with excessive uterine enlargement. This is due to the abnormal growth of trophoblastic tissue, which can cause the uterus to be larger than expected for gestational age.

Choice B rationale:

An irregular fetal heart rate is not typically associated with a hydatidiform mole because there is usually no viable fetus present in this condition.

Choice C rationale:

A rapid decline in human chorionic gonadotropin (hCG) levels is not expected. Instead, hCG levels are usually abnormally high due to the trophoblastic tissue proliferation.

Choice D rationale:

Profuse, clear vaginal discharge is not a characteristic finding of a hydatidiform mole. Instead, vaginal bleeding or discharge that may be brownish and resemble prune juice is more common.

Choice A rationale

Instructing the client to avoid alcohol for 72 hr after treatment is a common instruction given when a client is prescribed certain medications, such as metronidazole, due to the potential for a disulfiram-like reaction. However, this choice does not directly address the client’s symptoms of inflamed labia majora and minora and a large amount of frothy, yellow-green, malodorous discharge.

Choice B rationale

The client’s symptoms are indicative of Trichomoniasis, a sexually transmitted infection caused by a parasite. Metronidazole is a medication commonly used to treat this infection. A single dose of 2 g orally is a typical treatment regimen.

Choice C rationale

An oatmeal sitz bath can help soothe irritated skin and reduce inflammation, but it does not treat the underlying cause of the client’s symptoms.

Choice D rationale

Recommending the client’s partner receive treatment is important in cases of sexually transmitted infections to prevent reinfection. However, this choice does not directly address the client’s immediate need for treatment.