On the first prenatal visit, examination of the woman's internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse documents this finding as:

Choice A Reason: Trisomy numeric abnormality. Down syndrome is a genetic disorder that occurs when a person has three copies of chromosome 21 instead of two. This extra chromosome causes various physical and mental features that vary from person to person. Down syndrome is also called trisomy 21 because it involves three copies of chromosome 21.

Choice B Reason: Multifactorial inheritance is incorrect because it refers to a type of genetic disorder that results from the interaction of multiple genes and environmental factors. Examples of multifactorial disorders include cleft lip or palate, neural tube defects, diabetes, hypertension, and some types of cancer.

Choice C Reason: X-linked recessive inheritance is incorrect because it refers to a type of genetic disorder that affects males more than females because it is caused by a mutation on the X chromosome. Females have two X chromosomes, so they can be carriers or affected depending on whether they inherit one or two copies of the mutated gene. Males have one X chromosome and one Y chromosome, so they are always affected if they inherit the mutated gene from their mother. Examples of X-linked recessive disorders include hemophilia, color blindness, and Duchenne muscular dystrophy.

Choice D Reason: Chromosomal deletion is incorrect because it refers to a type of genetic disorder that occurs when a part of a chromosome is missing or deleted. This can cause various physical and mental problems depending on the size and location of the deletion. Examples of chromosomal deletion

Choice A Reason: This is incorrect because hemoconcentration by hypertension is a condition where the blood volume decreases and the blood pressure increases, leading to a higher hemoglobin level. A normal hemoglobin level for a pregnant woman in her second trimester is 10.5 to 14 g/dL. A hemoglobin level of 11 g/dL is within the normal range, not indicative of hemoconcentration.

Choice B Reason: This is incorrect because a multiple gestation pregnancy is a pregnancy with more than one fetus, such as twins or triplets. A multiple gestation pregnancy can cause a lower hemoglobin level due to increased blood volume and increased demand for iron. A hemoglobin level of 11 g/dL is not suggestive of a multiple gestation pregnancy.

Choice C Reason: This is incorrect because greater-than-expected weight gain is not directly related to the hemoglobin level. Weight gain during pregnancy depends on various factors such as pre-pregnancy weight, nutrition, physical activity, and genetics. A hemoglobin level of 11 g/dL does not reflect the weight status of the pregnant client.

Choice D Reason: This is correct because iron-deficiency anemia is a common type of anemia that occurs when the body does not have enough iron to produce enough red blood cells. Iron-deficiency anemia can cause a low hemoglobin level and affect the oxygen delivery to the tissues and the fetus. A hemoglobin level of 11 g/dL may indicate iron-deficiency anemia, especially if the client has other symptoms such as fatigue, weakness, pale skin, or cravings for non-food items. The nurse should confirm the diagnosis with further tests and recommend iron supplements and dietary changes to treat the condition.