# 一位計劃初次懷孕的個案詢問如何降低神經管缺陷的風險。個案的哪一項陳述表示正確理解？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=497753&lang=zh-tw  
> language: zh-TW  
> subject: Health Promotion/Disease Prevention  
> category: HPM

## 題目

一位計劃初次懷孕的個案詢問如何降低神經管缺陷的風險。個案的哪一項陳述表示正確理解？

## 選項

1. 我計畫在第一次居家驗孕呈陽性時開始補充葉酸
2. 受孕後，我會依靠綠葉蔬菜，而不服用每日葉酸補充劑
3. 若臨床醫師確認近親曾有神經管缺陷，我會服用葉酸
4. 我會在受孕前及懷孕初期每天服用400微克葉酸 **✔ 正確答案**

**正確答案: 4**

## 解析

神經管發育開始得很早，通常在確認懷孕之前。可能懷孕的個案應在受孕前及懷孕初期每天攝取400微克葉酸，使用補充劑或強化食品，並搭配多樣化飲食。

## 深入解析

快速解答
在受孕前及懷孕初期每天服用400微克葉酸。提前開始可在神經管形成時建立足夠的葉酸濃度。

為什麼這是正確的
大腦和脊髓在懷孕最初幾週開始發育。由於可能尚未確認懷孕，等待陽性檢測結果可能錯過預防時機；來自補充劑和強化食品的葉酸提供經證實能降低風險的形式。

簡單比喻或心智圖像
葉酸就像在施工開始前將建材送達。在最早結構形成後才送達可能為時已晚；此比喻不取代針對有特殊風險因子個案的個別化較高劑量指引。

記憶掛鉤
葉酸優先：在受孕前開始，因為神經管在許多個案知道自己懷孕前就已形成。

NCLEX 決策規則
針對一般風險的孕前衛教，選擇在懷孕前及懷孕初期每天補充葉酸。不要延遲至確認懷孕，並將曾有患病妊娠或其他高風險狀況的個案轉介進行個別化劑量建議。

為什麼其他選項是錯的
在陽性檢測後才開始可能對最早期的發育來說太晚。營養飲食仍然重要，但不能取代經證實的葉酸來源，且此建議廣泛適用，而非僅限於有家族史的個案。參考文獻

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]CDC: About Folic AcidCenters for Disease Control and Prevention

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