A pregnant patient who avoids dairy products asks the nurse for alternative sources of calcium. Which of the following responses by the nurse is most appropriate?

A. surfactant actually reduces alveolar surface tension, allowing alveoli to expand more easily during inhalation and preventing collapse during exhalation, rather than increasing tension.

B. Surfactant is not primarily for airway lubrication or mucus clearance. Its main role is to lower alveolar surface tension to prevent collapse and facilitate lung compliance.

C. Surfactant production does not peak at 20 weeks. It begins around 24 weeks, with significant amounts produced after 32–34 weeks, which is why preterm infants are at high risk for respiratory distress syndrome.

D. This statement accurately describes the timing of surfactant production, the source (type II alveolar cells), its physiological function, and its clinical significance in preventing respiratory distress in neonates.

A. Progestin-only pills (mini-pill): Although safer than combined oral contraceptives for smokers, this option requires strict daily adherence at the same time each day. Because the client frequently forgets to take daily medications, this method is not ideal for her lifestyle.

B. Combined oral contraceptive pills (COCs): COCs are contraindicated in women under 35 who smoke due to an increased risk of thromboembolic events. Additionally, her difficulty with medication adherence makes this method unreliable and potentially unsafe.

C. Copper intrauterine device (Paragard): The copper IUD is hormone-free, highly effective, and long-acting for up to 10 years. It requires minimal maintenance once inserted, making it an excellent choice for a young woman seeking long-term contraception without daily responsibility.

D. Nexplanon (subdermal implant): This implant provides up to 3 years of highly effective contraception and requires no daily action. It is safe for smokers and ideal for clients preferring a low-maintenance option.

E. Male condoms: Condoms are accessible, protect against sexually transmitted infections, and can be used in combination with another method for dual protection. They are an appropriate recommendation for any sexually active individual.

F. Depo-Provera (DMPA) injection every 3 months: The Depo-Provera injection offers long-acting contraception with infrequent dosing. It is a suitable choice for someone who forgets daily pills and is safe for smokers, though it requires quarterly clinic visits.

G. Fertility awareness methods: These methods require consistent tracking of ovulation signs and daily attention. Given the client’s history of irregular menses and difficulty with daily adherence, this method would be unreliable and inappropriate.