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Renal agenesis results in oligohydramnios, not polyhydramnios. Absence of fetal kidneys prevents urine production, reducing amniotic fluid volume.

Oligohydramnios is the opposite of polyhydramnios, defined as AFI <5 cm or single deepest pocket <2 cm. It is not a condition associated with increased amniotic fluid.

Fetal growth restriction may be associated with oligohydramnios due to placental insufficiency, not polyhydramnios.

Presence of a four-chamber heart is a normal finding. It indicates appropriate cardiac development and does not suggest aneuploidy.

Normal bilateral kidneys confirm renal development and normal amniotic fluid production. This finding is not associated with chromosomal abnormalities.

A full stomach bubble is a normal ultrasound finding indicating fetal swallowing, which rules out gastrointestinal obstruction. It does not increase chromosomal abnormality risk.

HIPAA protects patient health information confidentiality but does not specifically prevent discrimination based on genetic testing results. It focuses on privacy and security standards for health records.

The Americans with Disabilities Act (ADA) prevents discrimination against individuals with physical or mental disabilities but does not cover genetic predispositions in individuals not yet symptomatic.

The Affordable Care Act (ACA) prevents insurance denial due to preexisting conditions but does not specifically regulate employer or insurer use of genetic test results for predictive purposes.

Maternal age 25 years is below the advanced maternal age threshold of 35 years, where the risk of nondisjunction and chromosomal abnormalities such as trisomy 21 significantly rises. Without family history, this does not warrant genetic counseling.

Normal first-trimester combined screening (nuchal translucency, free beta-hCG, and PAPP-A) indicates low risk for aneuploidy, and therefore does not necessitate referral for genetic counseling unless other risk factors are present.

A routine, uncomplicated pregnancy without risk factors does not require genetic counseling, as the likelihood of chromosomal abnormalities or inherited disease is not elevated.

History of gestational diabetes increases maternal risk for type 2 diabetes and macrosomia in the fetus, but does not elevate the risk for chromosomal abnormalities, so it is not an indication for diagnostic prenatal testing.

Previous preterm delivery raises concern for maternal or uterine factors such as infection, cervical insufficiency, or preeclampsia, but does not alter the chromosomal risk for the fetus, making diagnostic genetic testing unnecessary.

Maternal obesity increases risk of gestational diabetes, hypertensive disorders, and neural tube defects due to altered folate metabolism, but it is not in itself an indication for invasive prenatal genetic testing unless combined with abnormal screening.

Attempting to persuade undermines client autonomy and may be perceived as coercive. Nurses are obligated to provide information but not pressure clients into testing.

Telling the client they are putting their baby at unnecessary risk is judgmental, undermines trust, and violates the principle of nonmaleficence. It may also cause undue guilt or anxiety.

Referring the client to another healthcare provider solely because they declined testing constitutes abandonment and violates professional responsibility to provide ongoing care.

Down syndrome (trisomy 21) is associated with decreased maternal serum and amniotic fluid AFP due to reduced fetal protein production, not elevation.

Trisomy 18 is also associated with decreased AFP, along with multiple structural anomalies, but not with elevations.

Cystic fibrosis affects chloride transport and mucus viscosity, not AFP metabolism or leakage, and does not elevate amniotic fluid AFP.

Telling the patient what decision to make violates autonomy and the core principle of non-directiveness, creating coercion rather than informed choice.

Providing information only about positive test results is incomplete and biased, undermining informed decision-making and the ethical obligation to present full information.

Focusing on preventing the birth of a child with a disability imposes a value judgment and directive counseling, directly contradicting non-directiveness principles.

Fetal red blood cells are present in extremely low quantities in maternal blood and are rapidly cleared; they do not contribute meaningfully to cfDNA.

Maternal placental trophoblasts are maternal in origin and do not release fetal DNA fragments, so they are not the source of cfDNA used in NIPT.

Fetal neuronal cells do not release DNA into maternal circulation in detectable amounts, making them irrelevant for cfDNA analysis.

Maternal serum alpha-fetoprotein (MSAFP) is a screening tool for neural tube defects and abdominal wall defects, not for chromosomal aneuploidies like trisomy 13.

Nuchal translucency (NT) scan is an early first-trimester screening method indicating risk for trisomy 21 and 18, but it cannot provide a definitive diagnosis for trisomy 13.

Non-invasive prenatal testing (NIPT) can detect trisomy 13 with high sensitivity, but it is still considered a screening test and may require confirmatory diagnostic testing for a definitive result.