While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of:

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.

Choice A Reason: This is incorrect because ultrasound visualization of the fetus is a positive sign of pregnancy, not a probable sign. A positive sign of pregnancy is a direct and definitive evidence of the presence of a fetus, such as fetal movement felt by the examiner or fetal heart sounds heard by a Doppler device.

Choice B Reason: This is correct because softening of the cervix, also known as Goodell's sign, is a probable sign of pregnancy. A probable sign of pregnancy is a strong indication of pregnancy based on physical changes in the reproductive organs, such as enlargement of the uterus or changes in the shape and consistency of the cervix.

Choice C Reason: This is correct because a positive pregnancy test, which detects human chorionic gonadotropin (hCG) in urine or blood, is a probable sign of pregnancy. However, it is not a conclusive sign, as hCG can also be produced by other conditions such as ectopic pregnancy, molar pregnancy, or trophoblastic tumors.

Choice D Reason: This is correct because absence of menstruation, also known as amenorrhea, is a probable sign of pregnancy. It occurs when ovulation and menstruation cease due to hormonal changes during pregnancy. However, it is not a definitive sign, as amenorrhea can also be caused by other factors such as stress, illness, or hormonal imbalances.

Choice E Reason: This is correct because ballottement, which is a rebounding of the fetus against the examiner's fingers during a pelvic examination, is a probable sign of pregnancy. It can be felt around 16 to 20 weeks of gestation.

Choice F Reason: This is incorrect because auscultation of a fetal heart beat, which can be heard by a fetoscope around 18 to 20 weeks of gestation or by a Doppler device around 10 to 12 weeks of gestation, is a positive sign of pregnancy, not a probable sign.