A 20-year-old gravida 1 para 0 presents to the prenatal clinic with a chief complaint that she feels like she is pregnant. Which are presumptive signs of pregnancy? Select all that apply.

Correct Answer: A

Rationale: The correct answer is A: Linea nigra. Linea nigra is a presumptive sign of pregnancy, which refers to a dark line that appears on the abdomen. This sign is caused by hormonal changes during pregnancy. Breast tenderness (B) and leukorrhea (C) are actually probable signs of pregnancy, not presumptive signs. Chadwick's sign (D) is also a probable sign, not a presumptive sign. Presumptive signs are subjective symptoms reported by the patient and are not definitive indicators of pregnancy.

Correct Answer: C

Rationale: The correct answer is C: Chadwick's sign. Chadwick's sign refers to the bluish coloration of the cervix due to increased vascularity in early pregnancy. This is a positive sign of pregnancy, indicating the presence of hormonal changes and increased blood flow to the cervix. Quickening is the first fetal movements felt by the mother, typically around 18-20 weeks gestation. Goodell's sign refers to the softening of the cervix, not discoloration. Hegar's sign is the softening of the lower uterine segment, also not related to discoloration. Chadwick's sign specifically describes the bluish discoloration of the cervix due to increased blood flow, making it the correct answer in this scenario.

Correct Answer: A

Rationale: The correct answer is A: pelvic dystocia. Prominent ischial spines indicate a contracted pelvis, which can obstruct the baby's passage during labor, leading to pelvic dystocia. Pelvic dystocia involves the bony pelvis causing difficulty in the descent of the fetus. Choices B, C, and D are incorrect because fetal dystocia refers to issues related to the fetus, contraction dystocia involves ineffective contractions, and uterine dystocia pertains to abnormalities of the uterus itself, none of which are indicated by prominent ischial spines.

Correct Answer: B

Rationale: Amniotomy can cause chorioamnionitis, as the procedure involves breaking the amniotic sac which increases the risk of introducing bacteria into the uterus. This can lead to infection of the fetal membranes, causing chorioamnionitis. Choices A, C, and D are incorrect as amniotomy does not directly cause a six-hour decrease of labor, elevated blood pressure, or second stage labor dystocia.

Correct Answer: D

Rationale: The correct answer is D: polyhydramnios. Polyhydramnios is a condition characterized by an excessive amount of amniotic fluid surrounding the fetus. This can occur due to various reasons such as fetal malformations, multiple gestations, or maternal diabetes. The excess fluid can lead to complications such as preterm labor or fetal malpresentation. A: Amniotic fluid embolism is a rare and life-threatening condition where amniotic fluid enters the maternal bloodstream, causing an allergic reaction. B: Gestational diabetes is a condition where high blood sugar levels develop during pregnancy, but it is not directly related to the amount of amniotic fluid. C: Oligohydramnios is the opposite of polyhydramnios, characterized by a deficiency of amniotic fluid, which can also lead to complications.