Which presumptive sign (felt by the woman) or probable sign (observed by the examiner) of pregnancy is not matched with another possible cause?

Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.

Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.

Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.

Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

Choice A reason: This is not the main reason, as the use of contraceptives for an extended time does not necessarily affect the fertility of a woman. Most contraceptives are reversible and do not cause permanent damage to the reproductive system. However, some contraceptives may take longer to wear off than others, and some may have side effects that can interfere with ovulation or implantation.

Choice B reason: This is the main reason, as the aging process can affect the ovaries and the quality and quantity of the eggs. As a woman ages, her ovarian reserve (the number of eggs in the ovaries) declines, and the eggs become more prone to chromosomal abnormalities. This can reduce the chances of conception and increase the risk of miscarriage or birth defects.

Choice C reason: This is not the main reason, as prepregnancy medical attention is not a prerequisite for achieving pregnancy. However, prepregnancy medical attention can be beneficial for a woman who is older than 35 years, as it can help identify and manage any existing or potential health problems that may affect the pregnancy, such as diabetes, hypertension, or thyroid disorders.

Choice D reason: This is not the main reason, as personal risk behaviors are not specific to a woman who is older than 35 years. Personal risk behaviors are factors that can negatively affect the fertility of any woman, regardless of age. Some examples of personal risk behaviors are smoking, drinking, using drugs, having multiple sexual partners, or having sexually transmitted infections.