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

A rubella titer of 1: indicates the presence of antibodies against the rubella virus, but this does not confirm the absence of a current infection. The titer represents past exposure or vaccination rather than an active infection.

Choice B rationale

A rubella titer of 1: suggests immunity to the rubella virus, making vaccination unnecessary at this time. Vaccination is typically recommended for those without immunity to prevent future infection.

Choice C rationale

A titer of 1: indicates the presence of antibodies sufficient to confer immunity to the rubella virus. This level is generally considered protective, implying the client has either had the infection before or has been vaccinated.

Choice D rationale

A mild rubella infection would not typically be determined solely by the titer level. Clinical symptoms and further diagnostic tests are required to diagnose an active rubella infection accurately.

Choice A rationale

Chromosomal defects are typically assessed using different tests, such as chorionic villus sampling or amniocentesis, rather than an ultrasound at this early stage.

Choice B rationale

Fetal lung maturity cannot be assessed at 9 weeks gestation because the lungs are not yet developed. This assessment is usually done later in pregnancy if preterm delivery is anticipated.

Choice C rationale

At 9 weeks gestation, the primary purpose of an ultrasound is to confirm the presence of a fetal heartbeat, which indicates a viable pregnancy.

Choice D rationale

The position of the fetus in utero is not a concern at this early stage of pregnancy. Fetal positioning becomes relevant later in pregnancy, closer to delivery.