The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on February 13th. Which date is most accurate?

Choice A reason: This is incorrect because primary dysmenorrhea is menstrual pain that is not associated with any underlying condition. It usually begins with the onset of menstruation and lasts for a few days. It does not cause pain during intercourse or infertility.

Choice B reason: This is correct because endometriosis is a condition where the endometrial tissue that normally lines the uterus grows outside the uterus, such as on the ovaries, fallopian tubes, or pelvic organs. It causes chronic inflammation, scarring, and adhesions that can result in severe pain during menstruation and intercourse, as well as infertility.

Choice C reason: This is incorrect because secondary dysmenorrhea is menstrual pain that is caused by an underlying condition, such as fibroids, pelvic inflammatory disease, or adenomyosis. It usually develops later in life and lasts longer than primary dysmenorrhea. It may or may not cause pain during intercourse or infertility, depending on the condition.

Choice D reason: This is incorrect because PMS stands for premenstrual syndrome, which is a group of physical and emotional symptoms that occur before menstruation. It may include mood swings, irritability, bloating, headaches, or breast tenderness. It does not cause severe pain during menstruation or intercourse, or infertility.

Choice A reason: Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy. They are a probable sign of pregnancy, not a positive sign.

Choice B reason: Fetal movement palpated by the nurse-midwife is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. It can be detected as early as 16 to 20 weeks of gestation.

Choice C reason: A positive pregnancy test is a probable sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not a definitive sign, as other conditions can cause elevated hCG levels.

Choice D reason: Quickening is the first perception of fetal movement by the mother, which usually occurs between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy, not a positive sign.