Safe sex practices include avoiding the exchange of body fluids. The most essential component of counseling related to the prevention of sexually transmitted infections and human immunodeficiency virus is discussion of condom use. Nurses can help motivate clients to use condoms by initiating a discussion about which of the following?

Choice A reason: This is not an appropriate response by the nurse, as an ultrasound is not a screening tool for spina bifida. Spina bifida is a birth defect that occurs when the spine and spinal cord do not form properly. It can be detected by a blood test that measures the level of alpha-fetoprotein (AFP) or by a detailed ultrasound that shows the spine and the brain.

Choice B reason: This is not an appropriate response by the nurse, as an ultrasound is not necessary to determine if there is more than one fetus. Multiple fetuses can be detected by other methods, such as listening to the fetal heartbeats, measuring the fundal height, or feeling the fetal movements.

Choice C reason: This is an appropriate response by the nurse, as an ultrasound assists in identifying the location of the placenta and fetus. This is important for an amniocentesis, which is a procedure that involves inserting a needle through the abdomen and the uterus to collect a sample of amniotic fluid. The ultrasound helps to guide the needle and avoid injuring the placenta or the fetus.

Choice D reason: This is not an appropriate response by the nurse, as an ultrasound is not useful for estimating fetal age at 36 weeks of gestation. Fetal age can be estimated by an ultrasound in the first trimester, when the fetus is growing at a predictable rate and has distinct features. However, in the third trimester, the fetus grows at different rates and has more variations in size and shape. Therefore, an ultrasound is less accurate and reliable for estimating fetal age at this stage.

Choice A reason: Assessing the fetal heart rate pattern is the priority nursing action following an amniotomy because it can indicate the well-being of the fetus and the presence of any complications, such as cord compression, prolapse, or infection.

Choice B reason: Observing the color and consistency of fluid is an important nursing action following an amniotomy, but it is not the priority. It can provide information about the gestational age, the presence of meconium, or the risk of infection.

Choice C reason: Assessing the client's temperature is an important nursing action following an amniotomy, but it is not the priority. It can help detect signs of infection, such as chorioamnionitis, which can affect both the mother and the fetus.

Choice D reason: Evaluating the client for the presence of chills and increased tenderness using palpation is an important nursing action following an amniotomy, but it is not the priority. It can also help detect signs of infection, such as chorioamnionitis, which can cause fever, abdominal pain, and uterine contractions.