A nurse is caring for a pregnant client in labor in a health care facility.
The nurse knows that which sign indicates that the patient is no longer in the first stage of labor?

The correct answer is choice A.

Choice A rationale:

Fetal heart tones detected by ultrasound are a positive sign of pregnancy because they provide direct evidence of a fetus.

Choice B rationale:

Breast tenderness is a presumptive sign of pregnancy, not a positive one, as it can be caused by other conditions such as premenstrual syndrome.

Choice C rationale:

A positive urine pregnancy test is a probable sign of pregnancy, not a positive one, as it measures the presence of hCG, a hormone produced during pregnancy. However, certain medications and medical conditions can also produce hCG.

Choice D rationale:

Fatigue is a presumptive sign of pregnancy, not a positive one, as it can be caused by various other conditions such as stress or illness.

The correct answer is choice D.

Choice A rationale:

While oxytocin sensitivity is important for labor, there is no evidence to suggest that Braxton Hicks contractions increase oxytocin sensitivity.

Choice B rationale:

Prostaglandins play a crucial role in labor by causing the cervix to soften and dilate and the uterus to contract. However, there is no evidence to suggest that Braxton Hicks contractions increase the release of prostaglandins.

Choice C rationale:

While maternal comfort is important during labor, there is no evidence to suggest that Braxton Hicks contractions make maternal breathing easier.

Choice D rationale:

Braxton Hicks contractions help in softening and ripening the cervix, which is an important part of preparing for labor.