A 20-week gestation pregnant client is being seen in the prenatal clinic for their routine OB care. Click on the image of the abdomen where the nurse would expect the fundal height to be felt. (Only click once)

Select your answer by clicking the desired location on the image below. To move a pin, click another location on the image. To remove a pin, click it once.

Click directly over the umbilicus (belly button), which is the anatomical landmark where the uterine fundus is usually palpated at 20 weeks.

A. Wipe it off at least 15 minutes before the procedure: EMLA cream should be left on the skin for a sufficient amount of time to be effective, and it should not be wiped off too soon. It is typically left on for about 1 hour to ensure adequate numbing.

B. Do not cover it after application to prevent it from discoloring: EMLA cream should be covered with a dressing (such as plastic wrap) after application to help the cream stay in place and improve absorption. It should not be left uncovered.

C. Apply it immediately prior to the painful procedure: EMLA cream needs time to work, and applying it right before the procedure will not provide enough time for numbing. It should be applied at least 1 hour before the procedure for effective pain relief.

D. Apply it at least 1 hour before the procedure: EMLA cream should be applied at least 1 hour before the procedure to allow adequate time for the cream to penetrate the skin and provide effective local anesthesia.

A. Breast tenderness: Breast tenderness is a common early sign of pregnancy due to hormonal changes, particularly increased estrogen and progesterone. It is a presumptive sign because it is not unique to pregnancy and can occur with other conditions as well.

B. Amenorrhea: Amenorrhea, or the absence of menstruation, is one of the most common early signs of pregnancy. It is considered presumptive because it can also be caused by other factors such as stress, illness, or hormonal imbalances.

C. Frequent urination: Frequent urination occurs due to hormonal changes and increased blood volume, which leads to more fluid being processed by the kidneys. It is considered a presumptive sign of pregnancy, though it can also occur with other conditions like urinary tract infections.

D. Positive pregnancy test: A positive pregnancy test detects the hormone human chorionic gonadotropin (hCG), which is a probable sign of pregnancy. It is more definitive than a presumptive sign, but it can sometimes result in false positives due to certain medications or other conditions.

E. Chadwick sign: Chadwick's sign, characterized by the bluish tint of the cervix, vagina, and vulva due to increased blood flow, is a probable sign of pregnancy. It is typically observed by a healthcare provider during a physical examination and suggests pregnancy but is not definitive.

F. Quickening: Quickening is the feeling of fetal movement, which typically occurs between 18 and 20 weeks of pregnancy for first-time mothers. It is a presumptive sign because other conditions, such as gas or muscle spasms, can cause similar sensations.