# A client planning pregnancy asks how to reduce the risk of neural tube defects. Which teaching should the nurse include?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=397287&lang=en  
> language: en  
> subject: Health Promotion/Disease Prevention  
> category: HPM

## Question

A client planning pregnancy asks how to reduce the risk of neural tube defects. Which teaching should the nurse include?

## Option

1. Avoid all carbohydrates during the first trimester.
2. Begin prenatal care only after fetal movement is felt.
3. Take folic acid as recommended before pregnancy and during early pregnancy. **✔ Correct answer**
4. Use herbal supplements instead of prescribed prenatal vitamins.

**Correct answer: 3**

## Explanation

Folic acid before conception and in early pregnancy reduces the risk of neural tube defects. Waiting until fetal movement delays preventive care. Extreme dietary restriction and unverified herbal substitutes are not appropriate recommendations.

## In-depth explanation

Clinical Judgment
Use the client cues, timing, labs, and safety risks to select the response that best fits Preconception folic acid teaching.

Memory Tip
Match the strongest cue cluster to the safest nursing judgment.

KR vs US
NCLEX items reward cue-based priority thinking rather than isolated recall.

## Clinical scenario

Clinical Practice Guide
For Preconception folic acid teaching, compare the complete cue pattern with the client's current stability, ordered data, and expected nursing scope.

Caution
Do not choose an action from one isolated cue when the full scenario changes priority or safety.

## Key concepts

- **Folic Acid** — A B vitamin important for early fetal neural tube development.
- **Neural Tube Defect** — A birth defect involving incomplete closure of the brain or spinal cord structures.
- **Preconception Care** — Health planning before pregnancy to reduce risks.

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