A nurse is collecting data from a client who has suspected ovarian cancer.
The nurse should recognize that which of the following manifestations supports this diagnosis?

Choice A rationale

At 33 weeks of gestation, an infant is considered moderately preterm, and while many organs are functional, the musculoskeletal system is still in a significant phase of development. Muscle tone is often decreased compared to a full-term infant, and the infant may exhibit a more extended posture rather than the flexed position seen in babies born closer to 40 weeks. The accumulation of muscle mass and the refinement of neuromuscular coordination continue throughout the final weeks of pregnancy.

Choice B rationale

By 33 weeks, the eyes are generally well-developed. The eyelids, which are fused earlier in pregnancy, typically open between weeks 26 and 28. A 33-week infant can blink and has some pupillary response to light, although the visual system continues to mature after birth. The suggestion that the eyes are still in a primary developmental stage is more accurate for extremely preterm infants born before the third trimester begins, rather than at 33 weeks.

Choice C rationale

The skin of a 33-week infant is usually not smooth; it is often thin, translucent, and may still be covered in vernix caseosa and lanugo. Smooth, plump skin is a characteristic of full-term infants who have had more time to accumulate subcutaneous fat. In a preterm infant, the lack of this insulating fat layer makes the skin appear wrinkled or red, and makes the baby much more susceptible to heat loss and temperature instability.

Choice D rationale

The pancreas begins producing insulin as early as the end of the first trimester, around week 10 to 12. By 33 weeks, the fetal pancreas is fully capable of secreting insulin in response to glucose levels in the blood. While preterm infants may struggle with glucose regulation due to immature liver function and limited glycogen stores, the statement that the pancreas is not producing insulin at all is physiologically incorrect for this stage of development.

Choice A rationale

A history of previous pregnancy loss, such as a spontaneous abortion or stillbirth, is not a medical contraindication for a medication abortion using agents like mifepristone and misoprostol. These medications work by blocking progesterone and inducing uterine contractions to expel the products of conception. Past losses do not alter the physiological response to these drugs or increase the risk of complications during a subsequent elective termination performed under medical supervision.

Choice B rationale

Being in the first trimester is the primary indication for a medication abortion, not a contraindication. Medication-induced abortions are typically FDA-approved and most effective when performed within the first ten to eleven weeks of gestation. During this period, the gestational sac is small enough to be reliably expelled through the uterine contractions triggered by misoprostol. The efficacy of the medication regimen is highest when administered early in the pregnancy.

Choice C rationale

A Body Mass Index greater than 30, which classifies a client as obese, is not a contraindication for a medication abortion. While obesity can sometimes affect the metabolism of certain drugs, standard doses of mifepristone and misoprostol remain effective for terminating early pregnancies in these clients. There is no clinical evidence suggesting that a high BMI increases the safety risks or decreases the success rates of the medication abortion protocol significantly.

Choice D rationale

An ectopic pregnancy is an absolute contraindication for a medication abortion because the standard regimen of mifepristone and misoprostol is ineffective for pregnancies located outside the uterine cavity. Mifepristone blocks uterine progesterone receptors, and misoprostol induces uterine contractions, neither of which will resolve a tubal pregnancy. Failure to diagnose an ectopic pregnancy before attempting a medication abortion can lead to life-threatening complications, such as tubal rupture and intra-abdominal hemorrhage.