A nurse is reviewing documentation for a newly admitted pregnant client. Which of the following findings constitutes a clinically positive sign of pregnancy. confirming the presence of a fetus rather than indicating a probable or presumptive state?

Subjective report of quickening at 18 weeks gestation in a multiparous client

A positive serum hCG level and Goodell's sign on pelvic exam

Visualization of the gestational sac by ultrasound at 5 weeks gestation

Fetal heart tones auscultated by Doppler at 11 weeks gestation