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.
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Using a cushion when sitting may provide comfort, but it does not directly address the client's elevated blood pressure or changes in mental status related to chronic kidney disease (CKD).
B. Weighing every morning is crucial in managing CKD, particularly with elevated blood pressure, as it helps monitor fluid retention, which can indicate worsening kidney function or fluid overload. This intervention is essential for assessing the client's condition and adjusting treatment as needed.
C. Performing range of motion exercises is important for maintaining mobility, especially in an immobile client; however, it does not directly address the pressing issues of elevated blood pressure and altered mental status.
D. Documenting abdominal girth can be important for assessing fluid retention, but it is less immediate than daily weight monitoring for a client with CKD showing significant symptoms.
Correct Answer is A
Explanation
A. Checking the medical record for the correct signed consent form is within the PN’s scope of practice. The PN ensures that proper documentation is completed before the procedure.
B. Explaining the examination and obtaining consent is the responsibility of the healthcare provider (e.g., physician or advanced practice nurse) performing the procedure. The PN does not obtain informed consent.
C. Obtaining consent from a family member is only appropriate if the client is legally unable to provide consent (e.g., unconscious or lacks decision-making capacity), and legal documentation is in place.
D. Asking if the client understands the exam is important, but the PN does not provide the detailed explanation required for informed consent. The provider must clarify any concerns.
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