A clinic nurse is assessing a client with a suspected diagnosis of endometriosis.
Which of the following findings in the client's medical history should the nurse identify as consistent with a diagnosis of endometriosis?

A. Formation of fingers, toes, and facial features

Correct Trimester: 1st Trimester (Conception – 13 weeks)
Explanation:
By the end of the 1st trimester, organogenesis (organ formation) is largely complete.

• Weeks 7–8: Limb buds appear and begin differentiating into arms and legs.

• Weeks 9–12: Fingers, toes, facial features (eyes, nose, lips, ears) become clearly defined.
  This is a critical period for congenital malformations if exposed to teratogens.

B. Fetus can hear and respond to external stimuli

Correct Trimester: 2nd Trimester (14–26 weeks)
Explanation:

• Around 18–20 weeks: The fetus develops the ability to hear sounds.

• External sounds can startle the fetus, and the heartbeat may change in response.

• Mother's voice and music can be recognized at this stage.

C. Increase in body fat reserves

Correct Trimester: 3rd Trimester (27–40 weeks)
Explanation:

• In the final trimester, especially after week 32, fat accumulates under the skin.

• This provides energy and helps with temperature regulation after birth.

• The fetus also gains the most weight during this period.

D. Brain develops most rapidly during this time

Correct Trimester: 3rd Trimester (27–40 weeks)
Explanation:

• Although brain development starts early, the most rapid growth occurs in the third trimester.

• There's a dramatic increase in brain volume, cortical folding, and neural connectivity.

• This trimester is essential for cognitive and motor development.

E. Gender can be determined

Correct Trimester: 2nd Trimester (14–26 weeks)
Explanation:

• By week 18–20, an ultrasound can reliably show external genitalia.

• The sex organs begin forming in the 1st trimester, but become distinct and visible by the 2nd trimester.

• This is when many parents find out the baby's gender via an anatomy scan.

Choice A rationale

A positive rubella serum antibody titer indicates immunity to rubella infection, which is protective during pregnancy. It is not an abnormal finding and does not require immediate reporting. Rubella immunity is important to prevent congenital rubella syndrome in the fetus, a severe condition causing defects such as deafness or cardiac anomalies.

Choice B rationale

Blood pressure of 144/94 mmHg is elevated and indicates gestational hypertension, which could progress to preeclampsia if not managed. Preeclampsia can lead to complications such as eclampsia, placental abruption, or maternal and fetal mortality. Normal blood pressure during pregnancy is less than 140/90 mmHg, making this finding critical to report.

Choice C rationale

Copious leukorrhea is a common physiological change in pregnancy due to increased estrogen levels and vascularity. It is usually benign and protective, preventing infections by maintaining a mildly acidic environment in the vagina. This finding does not warrant immediate concern unless associated with infection symptoms.

Choice D rationale

An O-negative blood type requires administration of Rh immunoglobulin to prevent Rh isoimmunization, but this is routinely managed in pregnancy. It is not an urgent issue unless there are concerns about fetomaternal hemorrhage or alloimmunization, which could harm an Rh-positive fetus.