An 18-year-old pregnant adolescent in her third trimester has dyspepsia despite previous treatment with Maalox. A safe choice for the nurse practitioner to prescribe is:

Rationale: A. Ranitidine HCl (Zantac), a histamine-2 receptor antagonist, is considered safe for use in pregnancy for treating dyspepsia and gastroesophageal reflux, particularly when antacids alone are insufficient. It reduces gastric acid production without significant risk to the fetus. B. Sodium bicarbonate is generally avoided in pregnancy due to the risk of systemic alkalosis and fluid overload. C. Sodium citrate and citric acid (Bicitra) are typically used to alkalinize urine or prevent aspiration during anesthesia, not for routine dyspepsia management in pregnancy. D. Aluminum, magnesium, and simethicone (Gelusil) are generally safe in moderation, but they are less effective than H2 blockers for persistent symptoms and may cause constipation or diarrhea depending on the formulation.