Which of the following agents are considered to be teratogens to the developing fetus? Select all that apply.

Choice A reason: This is a harmful action that will not strengthen the client's self-concept. A sedentary lifestyle may lead to physical and mental health problems, such as obesity, diabetes, depression, and low self-esteem. The nurse should encourage the client to adopt a healthy lifestyle that includes physical activity, nutrition, and rest.

Choice B reason: This is an ineffective action that will not strengthen the client's self-concept. Closed-ended questions and statements are those that can be answered with a yes or no, or a short response. They do not allow the client to express their thoughts, feelings, and opinions. The nurse should use open-ended questions and statements that invite the client to elaborate and share their perspective.

Choice C reason: This is the best answer. Effective coping skills are those that help the client to manage stress, emotions, and challenges in a positive and adaptive way. They include relaxation techniques, problem-solving strategies, social support, and positive self-talk. The nurse should encourage the client to use these skills to enhance their self-concept and well-being.

Choice D reason: This is a counterproductive action that will not strengthen the client's self-concept. Avoiding discussing the client's fears or anxieties may make them feel isolated, misunderstood, or ashamed. The nurse should create a safe and supportive environment where the client can openly discuss their concerns and receive empathy and guidance.

Choice A reason: This is a correct answer. Second-hand smoke is the smoke that is exhaled by a smoker or emitted by a burning cigarette, cigar, or pipe. It contains many harmful chemicals that can cross the placenta and affect the developing fetus. Second-hand smoke can increase the risk of low birth weight, preterm birth, congenital anomalies, and sudden infant death syndrome (SIDS) .

Choice B reason: This is a correct answer. Drugs including alcohol are substances that can alter the mood, perception, or behavior of the user. They can also cross the placenta and affect the developing fetus. Drugs including alcohol can cause fetal alcohol spectrum disorders (FASDs), neonatal abstinence syndrome (NAS), growth restriction, brain damage, and birth defects .

Choice C reason: This is a correct answer. Infections are diseases that are caused by microorganisms, such as bacteria, viruses, fungi, or parasites. They can also cross the placenta and affect the developing fetus. Infections can cause miscarriage, stillbirth, preterm labor, congenital infections, and congenital anomalies .

Choice D reason: This is a correct answer. Metabolic conditions are disorders that affect the body's ability to produce or use energy, such as diabetes, thyroid disease, or phenylketonuria (PKU). They can also cross the placenta and affect the developing fetus. Metabolic conditions can cause macrosomia, hypoglycemia, congenital hypothyroidism, or intellectual disability .

Choice E reason: This is not a correct answer. Processed foods are foods that have been altered from their natural state, such as canned, frozen, or packaged foods. They may contain additives, preservatives, or artificial flavors or colors. They do not cross the placenta and affect the developing fetus directly, but they may affect the mother's nutrition and health. Processed foods may increase the risk of obesity, hypertension, or gestational diabetes, which can indirectly affect the fetal development .