A 38-year-old primigravida returns to the clinic at 16 weeks gestation for an alpha-fetoprotein test.She asks a nurse, "Why do lI need this test?".Which response would be most appropriate for the nurse to make?

The correct answer is choice C.Adolescents need more protein than older pregnant women because they are still growing themselves and need to support the growth of the baby and the placenta.Protein can be found in meat, poultry, fish, eggs, dairy products, beans, nuts, and fortified cereals.

Choice A is wrong because adolescents need more supplemental iron than older women, not less.This is because they have lower iron stores due to rapid growth and menstruation.Iron deficiency can cause anemia and increase the risk of infections and bleeding.Iron can be found in meat, poultry, fish, eggs, dairy products, beans, nuts, and fortified cereals.

Choice B is wrong because adolescents need more carbohydrates than older women, not less.Carbohydrates provide energy for the mother and the baby and spare protein for other functions.Carbohydrates can be found in grains, fruits, vegetables, and dairy products.

Choice D is wrong because adolescents need the same amount of vitamin C as older pregnant women, which is 85 milligrams per day.Vitamin C helps with wound healing, collagen formation, iron absorption, and immune function.Vitamin C can be found in citrus fruits, tomatoes, peppers, broccoli, potatoes, and fortified juices.

The correct answer is choice B. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.

A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.

Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.

Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.

Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.