# A client who may become pregnant asks how to reduce the risk for neural tube defects. Which teaching should the nurse provide?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393684&lang=en  
> language: en  
> subject: Health Promotion/Disease Prevention  
> category: HPM

## Question

A client who may become pregnant asks how to reduce the risk for neural tube defects. Which teaching should the nurse provide?

## Option

1. Take 400 mcg of folic acid daily before pregnancy and during early pregnancy. **✔ Correct answer**
2. Begin folic acid after the first ultrasound confirms pregnancy.
3. Avoid fortified grains because they contain synthetic folate.
4. Take folic acid if morning sickness develops.

**Correct answer: 1**

## Explanation

Folic acid taken before pregnancy and during early pregnancy helps prevent neural tube defects, which can occur early before many people know they are pregnant. CDC recommends 400 mcg daily for people capable of becoming pregnant unless a provider prescribes a different dose. Waiting for ultrasound or symptoms is too late for primary prevention.

## In-depth explanation

Clinical Judgment
Preconception teaching matters because neural tube closure occurs very early in pregnancy.

Memory Tip
Folic acid works best before the positive test.

KR vs US
NCLEX health promotion items often test primary prevention before disease or complication occurs.

## Clinical scenario

Clinical Practice Guide
CDC folic acid guidance states that 400 mcg daily before and during early pregnancy can help prevent neural tube defects.

Caution
Clients with prior neural tube defect pregnancy or certain medications may need provider-specific dosing.

## Key concepts

- **Folic Acid** — A B vitamin used before and during early pregnancy to reduce neural tube defect risk.
- **Neural Tube Defect** — A serious birth defect of the brain or spine related to early neural tube closure problems.
- **Primary Prevention** — Action taken before a condition occurs to reduce risk or prevent disease.

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