Exhibits

Question 2(B) Complete the following sentence by using the lists of options. The nurse should first

dropdown

before performing a heel stick, followed by

dropdown

.

Choice A rationale

Folic acid, a B vitamin (B9), is essential for DNA synthesis and cell division, critical processes during early fetal development, but it is not primarily responsible for preventing fetal bleeding. The prevention of bleeding is primarily linked to adequate Vitamin K and factors necessary for the coagulation cascade and platelet function. Therefore, this statement indicates a misunderstanding of folic acid's specific role.

Choice B rationale

While folic acid supports general cell health, including rapid cell division in the immune system, its most direct and critical role in early pregnancy is the prevention of neural tube defects. Strengthening the immune system is a function often more directly associated with nutrients like Vitamin C, Vitamin D, or other micronutrients, indicating an incomplete understanding of its primary prenatal benefit.

Choice C rationale

Folic acid's primary action is in cellular proliferation and differentiation, specifically in neural tissue. Bone strength relies primarily on the adequate intake and absorption of calcium and Vitamin D, which regulate bone mineralization. Therefore, linking folic acid directly to bone strength demonstrates a fundamental misunderstanding of its primary physiological function during early gestation.

Choice D rationale

Folic acid is vital for the development and closure of the fetal neural tube during the first 28 days of gestation, significantly reducing the risk of neural tube defects (NTDs) like spina bifida and anencephaly. This statement accurately reflects the most critical and evidence-based reason for adequate periconceptional and early prenatal folic acid supplementation, indicating correct understanding.

Choice A rationale

Applying warm, moist packs is generally used to promote circulation and relieve discomfort associated with an already-formed thrombus or thrombophlebitis, not as a primary prophylactic measure. Prevention centers on enhancing venous return and inhibiting clot formation, whereas heat application may slightly increase local vasodilation and is not the most effective primary preventative method in the immediate postpartum period.

Choice B rationale

Elastic stockings (anti-embolism stockings) apply external graduated compression to the legs. This compression aids in increasing the velocity of venous blood flow and reducing venous stasis, particularly in the lower extremities, thereby reducing the risk of Deep Vein Thrombosis (DVT) and subsequent thrombophlebitis, especially important when the client is at rest or in bed.

Choice C rationale

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are used primarily for pain management and reducing inflammation. While some NSAIDs possess mild antiplatelet effects, this is not their primary indication, nor is it a sufficiently robust measure to be considered a key intervention for preventing thrombophlebitis in the postpartum period, which necessitates focused mechanical or pharmacological prophylaxis.

Choice D rationale

Ambulation is crucial as it promotes muscle contraction of the lower extremities (the skeletal muscle pump), which mechanically compresses the deep veins and forces blood back toward the heart. This action significantly increases venous return, prevents venous stasis, and activates endogenous fibrinolysis, making early and frequent ambulation a cornerstone of thrombophlebitis prevention.