The pregnancy test for a 15-year-old female is positive. Which test(s) are NOT usually performed during the first trimester of pregnancy?

Rationale:
A. A capillary lead level of 15 μg/dL is above the reference level of concern; it is not considered normal, so rescreening in a year is inappropriate.
B. Capillary (fingerstick) lead measurements can be affected by contamination and are used for initial screening. Elevated results should always be confirmed with a venous blood sample before taking further action.
C. Chelation therapy is reserved for significantly elevated venous lead levels (typically ≥45 μg/dL in children); it is not indicated at this stage without confirmation.
D. Home inspection for lead contamination is important if elevated lead levels are confirmed, but the first step after an abnormal capillary reading is to confirm with a venous sample.

Rationale:
A. Discussing suspected abuse with the caregivers could place the child at further risk and is not the first legal step.
B. Reporting suspected abuse to child protective services (CPS) is the nurse practitioner’s primary legal responsibility. Mandatory reporting laws require healthcare providers to notify authorities when child abuse is suspected, regardless of certainty.
C. Referring the family to support groups may be helpful later but does not fulfill the legal obligation to report.
D. Assisting the family with resources and support is appropriate after reporting, but the immediate priority is to ensure the child’s safety through mandatory reporting.