護理師向第二孕期孕婦進行營養指導，下列哪項陳述代表病人已理解？
A nurse is instructing a pregnant client in her second trimester about nutritional needs. Which statement by the client indicates understanding?
- AI should double my caloric intake now that I am in the second trimester我現在應該將熱量攝取量加倍
- BI should avoid all physical exercise to protect the fetus我應該避免所有體育運動以保護胎兒
- CIt is safe to consume small amounts of unpasteurized soft cheeses攝取少量未經巴氏殺菌的軟奶酪是安全的
- DI need to increase my intake of folic acid and iron-rich foods✓ 正解我需要增加葉酸和富含鐵質食物的攝取
懷孕第二孕期（second trimester）是胎兒發育與母體造血需求增加的關鍵時期。正確的營養指導應聚焦於微量營養素的補充，而非盲目增加熱量。葉酸（folic acid）對於預防胎兒神經管缺損至關重要，而鐵質（iron）則隨著胎兒造血需求與母體血容量增加而需求大增。過度攝取熱量不僅無助於胎兒發育，反而增加妊娠糖尿病與巨大兒風險。此外，食物安全是孕期護理重點，未經殺菌的乳製品含有李斯特菌（Listeria），可能導致嚴重感染及流產，必須嚴格避免。適度運動則是建議項目，而非避免。
The second trimester of pregnancy is a critical period of fetal development and increased maternal hematopoietic demand. Correct nutrition guidance should focus on micronutrient supplementation rather than blindly increasing calories. Folic acid is essential for preventing fetal neural tube defects, and iron demand increases substantially with fetal hematopoiesis and increased maternal blood volume. Excessive caloric intake not only fails to support fetal development but also increases the risk of gestational diabetes and macrosomia. In addition, food safety is a key focus in prenatal care: unpasteurized dairy products may contain Listeria, which can cause severe infection and miscarriage, and must be strictly avoided. Moderate exercise is a recommendation, not something to be avoided.