Problem: An 21 year old female client with a history of bipolar disorder, stable on lithium for two years, stopped her medication, experienced a manic period during which she was sexually promiscuous, and presents to the clinic stating she is now 7 months pregnant and has not had prenatal care. Her abdomen is distended, and she is wearing maternity clothes. A urine pregnancy test is negative, and a follow up serum pregnancy test is also negative. The client states this is impossible. The PMHNP should: Group of answer choices Refer the client to an obstetrician. Perform pelvic ultrasound to confirm pregnancy laboratory testing results. Refer for psychotherapy. Explore the client's reasons for medication nonadherence. Refer for electroconvulsive therapy.