A client at 39 weeks gestation is admitted in early labor. During the focused assessment, the practical nurse (PN) reviews the obstetrical history of the client who states that she has been pregnant five times but has only two living children, both of whom were full-term. The other three pregnancies were miscarriages during the first trimester. Which parity should the PN document for the term, premature, abortion, and living children (TPAL) for this client?

Term 2, Premature 0, Abortion 3, Living 2.

Term 6, Premature 3, Abortion 3, Living 2.

Term 2, Premature 1, Abortion 0, Living 3.

Term 3, Premature 0, Abortion 3, Living 2.

Answer and Explanation

The Correct Answer is A

TPAL stands for Term, Premature, Abortion, and Living children, and it is used to document a client's obstetrical history.

In this case, the client has had a total of 5 pregnancies:

Two pregnancies resulted in full-term (term) births, so the Term value is 2.
Three pregnancies resulted in miscarriages during the first trimester (abortion), so the Abortion value is 3.
The client has two living children, so the Living value is 2.
There is no mention of any premature births, so the Premature value is 0.

Therefore, the appropriate documentation for this client's TPAL is Term 2, Premature 0, Abortion 3, and Living 2.

Nursing Test Bank

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Correct Answer is A

Explanation

Log-rolling is a technique used to safely turn a client who requires immobilization of the spine or has limited mobility. After log-rolling the client to a lateral position, it is important to maintain proper alignment to prevent injury and promote comfort. Placing pillows strategically can help support and maintain the client's alignment in the lateral position.
The other options mentioned are not the immediate interventions following log-rolling:
B. Raising the head of the bed 30 degrees may be indicated for specific medical conditions or interventions, but it is not the immediate intervention after log-rolling.
C. Flexing the legs and placing a blanket between them is a positioning technique used for preventing skin breakdown and pressure ulcers, but it is not the immediate intervention after log-rolling.
D. Measuring the blood pressure and pulse rate is an important nursing assessment, but it is not the immediate intervention after log-rolling.

A. Insert an indwelling catheter to empty the bladder and contract the fundus. B. Check fundal consistency and continue to monitor the lochial ﬂow amount. C. Return the client to bed and maintain bedrest until the lochial ﬂow slows. D. Massage the fundus and avoid direct pressure on the cesarean incision.

Correct Answer is D

Explanation

This is the best action to take for a client who experiences a sudden gush of vaginal blood and clots after a cesarean section. Massaging the fundus helps to stimulate uterine contractions and reduce bleeding. Avoiding direct pressure on the incision prevents pain and wound dehiscence.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Immediately after log-rolling a client to a lateral position, which intervention should the practical nurse (PN) implement?

Correct Answer is A

Explanation

On the first day after a cesarean section, a client who is a primipara is being assisted to the bathroom for the first time. The client experiences a sudden gush of vaginal blood and notices that several blood clots are in the toilet. Which action should the practical nurse (PN) take?

Correct Answer is D

Explanation

The practical nurse (PN) is caring for a client newly diagnosed with diabetes mellitus (DM). Which finding is an early sign of hypoglycemia?

The practical nurse (PN) is assigning tasks to an unlicensed assistive personnel (UAP) who is giving basic care to a group of residents in a long-term care facility. Which client's task should be completed by a PN, rather than the UAP?

Which statement by a mature adult client with advanced prostate cancer best indicates that he has reached a level of acceptance of his prognosis?

The practical nurse (PN) is monitoring the neurological vital signs of a client with a recently closed head injury. Which vital sign trends indicate increased intracranial pressure (ICP) and should be reported to the charge nurse?

A new unlicensed assistive personnel (UAP) is completing an orientation assignment and is caring for an immobilized client who needs a complete bed bath. Which is the best way for the practical nurse (PN) to evaluate this UAP's performance?

A client reports experiencing numbness and tingling in the extremities. Which of the client's serum laboratory values should the practical nurse (PN) prioritize reporting to the healthcare provider?

The practical nurse (PN) receives a report of a stable client who experienced partial-thickness burns over 30% of the body surface area (BSA) 3 days ago. Which complication is most important for the PN to anticipate?