A nurse is reviewing the electronic medical record of a pregnant client who reports regular use of alcohol.
Which of the following findings should the nurse identify as an indication the client may be at risk for polysubstance use disorder? (Select All that Apply)

Choice A rationale

Avoiding foods with strong aromas can help reduce nausea, as certain smells can trigger the sensation. This strategy is usually effective because olfactory stimuli can have a significant impact on nausea and vomiting during pregnancy.

Choice B rationale

Eating crackers or plain toast in the morning can help manage nausea by stabilizing blood sugar levels before getting out of bed. This simple carbohydrate source can provide quick energy and prevent morning sickness.

Choice C rationale

Drinking a glass of orange juice before getting out of bed is not recommended, as the acidity of the juice can irritate the stomach lining and exacerbate nausea. It is better to have bland, non-acidic foods first.

Choice D rationale

Eating a high-carbohydrate snack before going to sleep can help maintain stable blood sugar levels overnight, potentially reducing morning nausea. Carbohydrates are effective in providing sustained energy and preventing dips in glucose that can trigger nausea.

Choice A rationale

Blood returning to the right atrium from the pulmonary system is consistent with adult circulation, not fetal circulation. In fetal circulation, blood bypasses the lungs via the ductus arteriosus and foramen ovale since the fetus receives oxygenated blood from the placenta, not the lungs.

Choice B rationale

Blood is returning to the placenta via the umbilical arteries. In fetal circulation, deoxygenated blood is carried from the fetus to the placenta through the umbilical arteries. This is consistent with normal fetal circulation as the placenta is responsible for gas exchange.

Choice C rationale

Blood being shunted to the right side from the left side of the heart is incorrect. In fetal circulation, there is a right-to-left shunt through the foramen ovale, allowing blood to bypass the non-functioning fetal lungs and go directly into systemic circulation.

Choice D rationale

A right-to-left shunt is not seen between the umbilical arteries. Instead, the shunts in fetal circulation are the ductus venosus, ductus arteriosus, and foramen ovale, which help reroute blood away from the fetal lungs and liver.