When obtaining a reproductive health history from a female patient, the nurse should:.

Choice A rationale:
Pulmonary stenosis is characterized by a systolic ejection murmur best heard at the upper left sternal border. It does not typically produce a continuous machinery-like murmur. Pulmonary stenosis results from narrowing at the pulmonary valve, obstructing blood flow from the right ventricle to the pulmonary artery.
Choice B rationale:
A continuous machinery-like murmur is characteristic of patent ductus arteriosus (PDA). PDA is a congenital heart defect where the ductus arteriosus, a fetal blood vessel that should close after birth, remains open, allowing continuous blood flow between the aorta and pulmonary artery. This murmur is often best heard in the left infraclavicular region.
Choice C rationale:
Ventricular septal defect (VSD) typically produces a harsh holosystolic murmur heard best at the lower left sternal border. VSD is a hole in the septum separating the ventricles, allowing blood to flow from the higher-pressure left ventricle to the lower-pressure right ventricle.
Choice D rationale:
Coarctation of the aorta causes a murmur due to increased blood flow across the aortic valve. However, this murmur is not continuous and is usually systolic and best heard in the back over the left scapula.

Choice A rationale:

With good control of maternal glucose levels, sudden and unexplained stillbirth is no longer a major concern. While controlling maternal glucose levels is important in diabetic pregnancies, it does not eliminate all risks, including the risk of stillbirth. However, the most significant cause of perinatal loss in diabetic pregnancies is congenital malformations. Poorly controlled diabetes during pregnancy can lead to structural abnormalities in the fetus, increasing the risk of perinatal loss.

Choice B rationale:

The most important cause of perinatal loss in diabetic pregnancy is congenital malformations. This is the correct answer. Poorly controlled diabetes increases the risk of congenital malformations in the fetus, making it a significant concern in diabetic pregnancies. Proper management of diabetes and prenatal care are essential to reduce this risk.

Choice C rationale:

Infants of mothers with diabetes have the same risks for respiratory distress syndrome because of careful monitoring. Infants of mothers with diabetes are at an increased risk of respiratory distress syndrome due to delayed lung maturation. Careful monitoring is essential, but it does not eliminate this risk. Proper management and timely interventions are necessary to minimize the impact of respiratory distress syndrome in these infants.

Choice D rationale:

At birth, the neonate of a diabetic mother is no longer at any greater risk. Infants of diabetic mothers are at increased risk for various complications, both during and after birth. These risks include hypoglycemia, respiratory distress syndrome, and hypocalcemia, among others. Close monitoring and appropriate interventions are required to ensure the well-being of the newborn.