A nurse is providing teaching about nutrition to a client at her first prenatal visit. Which of the following statements by the nurse should be included in the teaching?

Choice A Reason: This is incorrect because ultrasound visualization of the fetus is a positive sign of pregnancy, not a probable sign. A positive sign of pregnancy is a direct and definitive evidence of the presence of a fetus, such as fetal movement felt by the examiner or fetal heart sounds heard by a Doppler device.

Choice B Reason: This is correct because softening of the cervix, also known as Goodell's sign, is a probable sign of pregnancy. A probable sign of pregnancy is a strong indication of pregnancy based on physical changes in the reproductive organs, such as enlargement of the uterus or changes in the shape and consistency of the cervix.

Choice C Reason: This is correct because a positive pregnancy test, which detects human chorionic gonadotropin (hCG) in urine or blood, is a probable sign of pregnancy. However, it is not a conclusive sign, as hCG can also be produced by other conditions such as ectopic pregnancy, molar pregnancy, or trophoblastic tumors.

Choice D Reason: This is correct because absence of menstruation, also known as amenorrhea, is a probable sign of pregnancy. It occurs when ovulation and menstruation cease due to hormonal changes during pregnancy. However, it is not a definitive sign, as amenorrhea can also be caused by other factors such as stress, illness, or hormonal imbalances.

Choice E Reason: This is correct because ballottement, which is a rebounding of the fetus against the examiner's fingers during a pelvic examination, is a probable sign of pregnancy. It can be felt around 16 to 20 weeks of gestation.

Choice F Reason: This is incorrect because auscultation of a fetal heart beat, which can be heard by a fetoscope around 18 to 20 weeks of gestation or by a Doppler device around 10 to 12 weeks of gestation, is a positive sign of pregnancy, not a probable sign.

Choice A Reason: This is incorrect because sickle-cell anemia is a genetic disorder that affects the shape and function of red blood cells. It does not affect the AFP level, which is a protein produced by the fetus and placenta. Sickle-cell anemia can be detected by other prenatal tests, such as hemoglobin electrophoresis or DNA analysis.

Choice B Reason: This is incorrect because cardiac defects are structural abnormalities of the heart or blood vessels that affect the blood flow and oxygen delivery to the fetus. They may cause an increased AFP level, not a decreased one, as they can lead to fetal distress or edema. Cardiac defects can be detected by other prenatal tests, such as fetal echocardiography or ultrasound.

Choice C Reason: This is correct because Down syndrome is a chromosomal disorder that results from an extra copy of chromosome 21. It causes various physical and mental developmental delays and defects in the fetus. It is associated with a decreased AFP level, as well as decreased levels of human chorionic gonadotropin (hCG) and unconjugated estriol (uE3). Down syndrome can be confirmed by other prenatal tests, such as amniocentesis or chorionic villus sampling (CVS).

Choice D Reason: This is incorrect because respiratory disorders are problems that affect the breathing and gas exchange of the fetus. They may cause an increased AFP level, not a decreased one, as they can lead to fetal distress or edema. Respiratory disorders can be detected by other prenatal tests, such as fetal biophysical profile (BPP) or nonstress test (NST).