A pregnant patient enjoys exercising at a local health spa once a week.
Which patient comment indicates to the nurse that more health teaching is needed?

Choice A rationale

Increasing folic acid intake immediately is recommended because it helps prevent neural tube defects, which can occur very early in pregnancy, often before a woman knows she is pregnant.

Choice B rationale

Starting folic acid intake one week before her period is not sufficient. Folic acid needs to be taken consistently before conception and during early pregnancy to be effective.

Choice C rationale

Waiting until pregnancy is confirmed may be too late to prevent neural tube defects, which form in the early weeks of pregnancy.

Choice D rationale

If she misses her period, it might already be too late to prevent neural tube defects. Consistent intake of folic acid before and during early pregnancy is essential.

Step 1 is to identify the first day of the last menstrual period (LMP), which is October 20.

Step 2 is to count back 3 months from October 20, resulting in July 20.

Step 3 is to add 1 year to July 20, resulting in July 20 of the following year.

Step 4 is to add 7 days to July 20, resulting in July 27.

Final calculated answer: July 27 of the following year.