The nurse is calculating the estimated date of confinement (EDC) using Nagele's rule for a client whose last menstrual period started on December 1. Which date is most accurate?

Choice A rationale:
Cough. While a cough can be a side effect of inhaled steroids, it is not a significant concern compared to other potential risks. Long-term use of inhaled steroids can lead to slowed growth in children, making choice C the correct answer.
Choice B rationale:
Osteoporosis. Osteoporosis is a potential side effect of long-term use of inhaled steroids. These medications can affect bone density and increase the risk of osteoporosis, especially in individuals who are already at risk due to other factors such as age, gender, or family history.
Choice C rationale:
Slowed growth. Long-term use of inhaled steroids can lead to slowed growth in children. It's important for healthcare providers to monitor the growth of children with asthma who are taking these medications regularly. If slowed growth is observed, healthcare providers might consider adjusting the treatment plan.
Choice D rationale:
Cushing's syndrome. Cushing's syndrome is a rare but serious side effect of long-term steroid use. It is characterized by a collection of signs and symptoms caused by prolonged exposure to high levels of cortisol (a steroid hormone). While it's a potential risk, slowed growth is a more common concern in children taking long-term inhaled steroids.

Choice A rationale:

Identification of fetal heartbeat (Choice A) is a positive sign of pregnancy. This can be detected using a Doppler device or ultrasound, confirming the presence of a living fetus.

Choice B rationale:

Palpation of fetal outline (Choice B) is another positive sign of pregnancy. Experienced healthcare providers can palpate the fetus through the abdominal wall, feeling its shape and movements.

Choice D rationale:

Verification of fetal movement (Choice D) is also a positive sign of pregnancy. Feeling fetal movements, known as quickening, is an indication of a viable pregnancy.

Choice E rationale:

A positive human chorionic gonadotropin (hCG) test (Choice E) confirms pregnancy. hCG is a hormone produced by the placenta and is present in the blood and urine of pregnant women.

Choice C rationale:

Visualization of the fetus (Choice C) through methods like ultrasound is a positive sign of pregnancy, but it is not typically used for diagnosis in early pregnancy. Palpation of fetal outline and identification of fetal heartbeat are more reliable positive signs.