A nurse is reinforcing nutrition teaching with a client during the first prenatal visit. Which of the following statements by the client indicates understanding of the teaching?

Choice A rationale:
Large amount of bright red vaginal bleeding is the cardinal sign of placenta previa. This is because the placenta is abnormally positioned low in the uterus, covering the cervix partially or completely. When the cervix starts to dilate in preparation for labor, it can detach from the uterine wall, leading to significant bleeding. The blood is typically bright red, indicating fresh bleeding, and can be painless.
Severity of bleeding: The amount of bleeding can vary from spotting to massive hemorrhage, and it may start suddenly or gradually. Even a small amount of bleeding can be a sign of placenta previa and should not be ignored.
Risks of hemorrhage: Prompt recognition and management of bleeding are crucial to prevent potentially life-threatening hemorrhage for both the mother and the fetus.

Choice B rationale:
Severe pain with no bleeding is not a typical presentation of placenta previa. While some women with placenta previa may experience mild abdominal pain or cramping, severe pain without bleeding is more suggestive of placental abruption, a condition where the placenta prematurely separates from the uterine wall.

Choice C rationale:
High-grade fever is not a direct symptom of placenta previa. However, if a woman with placenta previa develops a fever, it could indicate an infection, which can further complicate the condition and require immediate medical attention.

Choice D rationale:
Sudden sharp pain in the lower abdomen can be a sign of placental abruption but is not characteristic of placenta previa.

Choice A rationale:
Consuming any amount of alcohol during pregnancy is not recommended. Alcohol can cross the placenta and harm the developing fetus, potentially leading to fetal alcohol spectrum disorders (FASDs). FASDs can cause a range of physical, mental, and behavioral problems, including intellectual disabilities, learning disabilities, and physical abnormalities. Even small amounts of alcohol can increase the risk of FASDs, and there is no known safe amount of alcohol to consume during pregnancy.

Choice B rationale:
Switching to whole milk during pregnancy can be a beneficial choice for several reasons:
Increased calcium and vitamin D: Whole milk is a rich source of calcium and vitamin D, which are essential for the development of the baby's bones, teeth, and muscles. Calcium also supports the mother's bone health and helps prevent pregnancy-related osteoporosis.
Healthy fats: Whole milk contains healthy fats that are important for fetal brain development and the mother's overall health. These fats also contribute to satiety and can help manage weight gain during pregnancy.
Essential nutrients: Whole milk provides a variety of other essential nutrients, including protein, vitamins A and B12, riboflavin, and zinc. These nutrients support overall health and well-being during pregnancy.

Choice C rationale:
Weight loss during pregnancy is generally not recommended unless specifically advised by a healthcare provider. Pregnancy is a time for growth and nourishment of the baby, and restricting calories or attempting to lose weight can potentially harm the developing fetus. It's important to focus on consuming a healthy, balanced diet and gaining a healthy amount of weight during pregnancy.

Choice D rationale:
Consuming high amounts of caffeine during pregnancy is not recommended. Caffeine can cross the placenta and potentially affect the baby's heart rate and sleep patterns. It's generally advised to limit caffeine intake to less than 200 milligrams per day during pregnancy.