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?

A rubella titer of 1:33 indicates a low level of immunity to rubella, which can be dangerous for a pregnant woman and her fetus.

Rubella is a viral infection that can cause birth defects or miscarriage if contracted during pregnancy.A rubella titer of 1:10 or higher is considered protective.

Choice B is wrong because a non-reactive serologic test for syphilis (STS) means that the patient does not have syphilis, which is a bacterial infection that can also harm the fetus if untreated.

Choice C is wrong because blood type A-negative does not require further assessment unless the patient has antibodies to the Rh factor, which can cause hemolytic disease of the newborn if the fetus is Rh-positive.

This can be prevented by giving the patient Rh immunoglobulin injections during pregnancy and after delivery.

Choice D is wrong because hemoglobin 12.2 gm/dL is within the normal range for a pregnant woman, which is 11 to 14 gm/dL.

Hemoglobin is the protein in red blood cells that carries oxygen.

A low hemoglobin level can indicate anemia, which can affect the oxygen delivery to the fetus and increase the risk of preterm labor or low birth weight.

This is because the first priority for a pregnant woman with acute abdominal pain is to assess the fetal well-being and rule out any obstetric complications such as placental abruption, uterine rupture, or preterm labor.Fetal heart tones can indicate the presence and viability of the fetus and alert the nurse to any signs of fetal distress or hypoxia.

Choice A: Obtain a full history is wrong because it is not the most urgent action.

A full history can provide valuable information about the possible causes of abdominal pain, but it should not delay the assessment of fetal status and maternal vital signs.

Choice B: Examine the cervix for dilation is wrong because it can be harmful in some cases.A digital cervical examination should be avoided until placenta previa is ruled out by ultrasound, as it can cause bleeding and worsen the condition.

Moreover, cervical dilation alone does not indicate the cause or severity of abdominal pain.

Choice D: Palpate for uterine contraction frequency is wrong because it is not the most reliable method to assess labor.Uterine contractions can be measured by external tocodynamometry or internal intrauterine pressure catheter, which can provide more accurate and objective data than manual palpation.

Furthermore, uterine contractions do not necessarily indicate labor, as they can also be caused by other conditions such as dehydration, infection, or irritable uterus.