A woman in week 34 of pregnancy reports that she is very uncomfortable because of heartburn. The nurse would suggest that the woman: (Select the one most appropriate answer.

Choice A reason: A fetal heartbeat auscultated with a Doppler or a fetoscope is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. A Doppler is an electronic device that uses sound waves to detect the fetal heart rate, while a fetoscope is a stethoscope-like instrument that amplifies the fetal heart sounds. The fetal heartbeat can be heard as early as 10 to 12 weeks of gestation with a Doppler and 18 to 20 weeks of gestation with a fetoscope.

Choice B reason: Quickening is the first perception of fetal movement by the pregnant woman, usually felt between 16 and 20 weeks of gestation for first-time mothers and 13 to 16 weeks of gestation for experienced mothers. However, quickening is not a positive sign of pregnancy, as it can be subjective and mistaken for other sensations, such as gas, hunger, or muscle spasms².

Choice C reason: Morning sickness is a common symptom of pregnancy that involves nausea and vomiting, usually in the first trimester. However, morning sickness is not a positive sign of pregnancy, as it can be caused by other factors, such as food poisoning, stress, or medication.

Choice D reason: A positive pregnancy test is a probable sign of pregnancy, not a positive sign. A pregnancy test detects the presence of human chorionic gonadotropin (hCG), a hormone produced by the placenta, in the urine or blood of the woman. However, a positive pregnancy test does not guarantee a viable pregnancy, as it can be influenced by the timing, the quality, or the interpretation of the test. A positive pregnancy test can also occur in cases of ectopic pregnancy, molar pregnancy, or miscarriage.

The correct answer is A. You may find that you need to modify your exercise to walking later in your pregnancy, around the seventh month.

Choice A reason: This is the best advice for the woman, as it acknowledges that jogging is safe and beneficial in early pregnancy, but also informs her that she may need to adjust her exercise intensity and duration as her pregnancy progresses. Walking is a low-impact aerobic activity that can be done throughout pregnancy, as long as there are no complications or contraindications. Walking can help maintain cardiovascular fitness, prevent excessive weight gain, and reduce the risk of gestational diabetes and preeclampsia.

Choice B reason: This is not a good advice for the woman, as it implies that jogging is harmful for her joints and that she should stop it immediately. Jogging is not necessarily bad for the joints, as long as the woman wears appropriate shoes, avoids uneven surfaces, and listens to her body. Jogging can also provide many health benefits for the woman and the fetus, such as improved mood, increased energy, and reduced stress².

Choice C reason: This is a false and alarming statement that may discourage the woman from exercising at all. Exercise during pregnancy is not dangerous for the fetus, unless there are specific medical conditions or complications that prevent it. Exercise during pregnancy can actually improve the fetal growth, development, and oxygenation, as well as reduce the risk of preterm birth and low birth weight.

Choice D reason: This is an unrealistic and misleading statement that may cause the woman to overexert herself or ignore the signs of discomfort or fatigue. Exercise during pregnancy may need to be modified according to the woman's changing needs, abilities, and preferences. Some factors that may affect the type, frequency, intensity, and duration of exercise during pregnancy include the trimester, the fetal position, the maternal weight, the environmental temperature, and the presence of any symptoms or complications.