A nurse is providing prenatal care to a pregnant client. At which time would the nurse expect to screen the client for group B streptococcus infection?

Choice A Reason: This is incorrect because Ortolani's sign is a test for hip dysplasia in infants, not a sign of pregnancy. It involves moving the infant's legs to check for a clicking sound in the hip joint.

Choice B Reason: This is incorrect because Chadwick's sign is a bluish or purplish discoloration of the cervix, vagina, and vulva during pregnancy, not a softening of the lower uterine segment. It is caused by increased blood flow to the pelvic area.

Choice C Reason: This is incorrect because Goodell's sign is a softening of the cervix during pregnancy, not a softening of the lower uterine segment. It is caused by increased vascularity and edema of the cervical tissue.

Choice D Reason: This is correct because Hegar's sign is a softening of the lower uterine segment or isthmus during pregnancy. It can be felt by bimanual examination around six to twelve weeks of gestation.

Choice A: 28 weeks' gestation is too early to screen for group B streptococcus infection. Group B streptococcus (GBS) is a type of bacteria that can cause serious infections in newborns if transmitted from the mother during labor and delivery. The optimal time to screen for GBS is between 35 and 37 weeks' gestation.

Choice B: 32 weeks' gestation is also too early to screen for GBS infection. Screening at this time may not reflect the true colonization status of the mother at the time of delivery, as GBS can be transient or intermittent.

Choice C: 16 weeks' gestation is much too early to screen for GBS infection. Screening at this time has no clinical value, as GBS colonization can change throughout pregnancy.

Choice D: 36 weeks' gestation is the appropriate time to screen for GBS infection. Screening at this time can identify mothers who are colonized with GBS and who need intrapartum antibiotic prophylaxis to prevent neonatal sepsis, pneumonia, and meningitis.