Preconception CounselingPreconception Counseling

1. Which of the following is the most appropriate first step in preconception counseling for a woman with a history of diabetes? A. Initiate insulin therapy B. Recommend folic acid supplementation C. Perform a hemoglobin A1C test D. Advise weight loss Answer: C. Perform a hemoglobin A1C test Rationale: Before beginning preconception counseling, it is important to assess the current metabolic control of diabetes. A hemoglobin A1C test provides an indication of blood glucose levels over time, helping to assess whether diabetes is well-controlled. ________________________________________ 2. Which vitamin supplementation is most commonly recommended for women who are planning to conceive? A. Vitamin D B. Folic acid C. Iron D. Calcium Answer: B. Folic acid Rationale: Folic acid supplementation is crucial for women planning to conceive to reduce the risk of neural tube defects in the developing fetus. ________________________________________ 3. A nurse is counseling a woman with a history of hypertension. What is the most appropriate intervention in preconception counseling? A. Recommend lifestyle changes to manage blood pressure B. Increase her intake of sodium C. Advise her to stop taking antihypertensive medications D. Recommend immediate pregnancy Answer: A. Recommend lifestyle changes to manage blood pressure Rationale: Managing hypertension before conception is important for reducing the risk of complications such as preeclampsia. Lifestyle changes such as exercise and dietary modifications should be encouraged. ________________________________________ 4. A woman with a history of mental health disorders is planning to conceive. Which of the following is the most appropriate nursing action? A. Discontinue her psychiatric medications B. Counsel her about the risks of untreated mental health disorders during pregnancy C. Advise her to avoid all psychotropic medications during pregnancy D. Recommend in vitro fertilization as the best option Answer: B. Counsel her about the risks of untreated mental health disorders during pregnancy Rationale: Untreated mental health conditions can negatively affect both the mother and the fetus. The nurse should provide counseling on the risks and discuss the management options with her healthcare provider. ________________________________________ 5. Which of the following lifestyle modifications is most recommended for women who are planning pregnancy? A. Smoking cessation B. Increased caffeine intake C. Weight gain D. High-fat diet Answer: A. Smoking cessation Rationale: Smoking cessation is a crucial lifestyle modification to reduce the risk of complications such as low birth weight, preterm birth, and congenital anomalies. ________________________________________ 6. Which of the following is an appropriate recommendation for women planning pregnancy who are over the age of 35? A. Delay conception until they are over 40 B. Increase folic acid intake to 4 mg daily C. Perform genetic counseling D. Avoid physical activity during pregnancy Answer: C. Perform genetic counseling Rationale: Women over 35 are at an increased risk for chromosomal abnormalities, so genetic counseling is recommended for preconception planning. ________________________________________ 7. A woman with a history of recurrent miscarriages is planning to conceive. Which of the following would be an appropriate recommendation? A. Consider genetic counseling B. Discontinue all prenatal vitamins C. Avoid conception for 6 months D. Start progesterone therapy immediately Answer: A. Consider genetic counseling Rationale: Women with a history of recurrent miscarriages may benefit from genetic counseling to assess any underlying genetic causes of pregnancy loss. ________________________________________ 8. Which of the following is the best advice for a woman with a BMI of 30 who is planning to conceive? A. Lose weight through extreme dieting B. Maintain a healthy weight and engage in regular exercise C. Start a high-protein diet D. Avoid all physical activity until conception Answer: B. Maintain a healthy weight and engage in regular exercise Rationale: A BMI of 30 is considered overweight and can increase the risk of complications during pregnancy. It is recommended that women aim for a healthy weight through balanced diet and exercise. ________________________________________ 9. Preconception counseling should include a discussion of: A. Environmental exposures and workplace hazards B. Birth control methods only C. Financial planning D. Only the health of the mother Answer: A. Environmental exposures and workplace hazards Rationale: Preconception counseling includes addressing environmental exposures and workplace hazards that may affect the health of the woman and fetus. ________________________________________ 10. What is the recommended daily dosage of folic acid for women planning to conceive? A. 0.4 mg B. 1.0 mg C. 3.0 mg D. 5.0 mg Answer: A. 0.4 mg Rationale: The recommended daily dosage of folic acid for women planning to conceive is 0.4 mg to prevent neural tube defects. 11. A woman with a history of epilepsy is planning to conceive. Which of the following is the most important preconception counseling point? A. Discontinue all seizure medications B. Ensure folic acid supplementation C. Increase seizure medication dosage D. Avoid all physical activity during pregnancy Answer: B. Ensure folic acid supplementation Rationale: Women with epilepsy are at increased risk for neural tube defects. Ensuring adequate folic acid supplementation (typically 4 mg daily) before conception is essential to reduce this risk. ________________________________________