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: Quickening is the first perception of fetal movement by the mother, usually occurring between 16 and 20 weeks of gestation. It is a presumptive sign of pregnancy, as it can be subjective and influenced by other factors such as gas or peristalsis.

Choice B reason: A positive pregnancy test is a probable sign of pregnancy, as it indicates the presence of human chorionic gonadotropin (hCG) in the urine or blood. However, it is not conclusive, as it can be affected by false positives or false negatives, or by other conditions that produce hCG.

Choice C reason: Braxton Hicks contractions are irregular, painless uterine contractions that occur throughout pregnancy. They are a probable sign of pregnancy, as they indicate uterine activity and preparation for labor. However, they are not diagnostic, as they can also occur in non-pregnant women or in response to other stimuli.

Choice D reason: Fetal movement palpated by the nurse-midwife is a positive sign of pregnancy, as it confirms the presence of a living fetus in the uterus. It is an objective and reliable sign that can be detected by a skilled examiner after 20 weeks of gestation.

Choice A reason: Variability refers to the fluctuations in the FHR that are irregular in amplitude and frequency. It reflects the balance between the sympathetic and parasympathetic nervous systems of the fetus. A normal variability is between 6 and 10 beats/min, which indicates a healthy and well-oxygenated fetus.

Choice B reason: Late decelerations are decreases in the FHR that begin after the peak of a contraction and return to the baseline after the contraction ends. They are caused by uteroplacental insufficiency, which means that the placenta is not delivering enough oxygen and nutrients to the fetus. Mild late decelerations are not reassuring and may indicate fetal hypoxia or acidosis².

Choice C reason: FHR should change as a result of fetal activity, such as movement, sleep, or stimulation. A change in the FHR indicates a responsive and well-oxygenated fetus. A lack of change in the FHR may indicate fetal distress or compromise.

Choice D reason: The average baseline rate is the mean FHR rounded to increments of 5 beats/min during a 10-minute window, excluding periods of marked variability, accelerations, or decelerations. A normal baseline rate is between 110 and 160 beats/min. A baseline rate between 100 and 140 beats/min is not necessarily abnormal, but it may indicate fetal bradycardia (slow heart rate) or tachycardia (fast heart rate), depending on the gestational age and other factors.