For each potential prescription from the provider, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client.

Choice A rationale

Blood returning to the right atrium from the pulmonary system is consistent with adult circulation, not fetal circulation. In fetal circulation, blood bypasses the lungs via the ductus arteriosus and foramen ovale since the fetus receives oxygenated blood from the placenta, not the lungs.

Choice B rationale

Blood is returning to the placenta via the umbilical arteries. In fetal circulation, deoxygenated blood is carried from the fetus to the placenta through the umbilical arteries. This is consistent with normal fetal circulation as the placenta is responsible for gas exchange.

Choice C rationale

Blood being shunted to the right side from the left side of the heart is incorrect. In fetal circulation, there is a right-to-left shunt through the foramen ovale, allowing blood to bypass the non-functioning fetal lungs and go directly into systemic circulation.

Choice D rationale

A right-to-left shunt is not seen between the umbilical arteries. Instead, the shunts in fetal circulation are the ductus venosus, ductus arteriosus, and foramen ovale, which help reroute blood away from the fetal lungs and liver.

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.