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 ["A","D","E"]
Explanation
Since the pregnant woman is vegetarian and does not eat meat, the practical nurse (PN) should provide alternative sources of iron-rich foods. Lentils and black beans are excellent vegetarian sources of iron and can be added to soups to increase iron intake (option a).
Oatmeal is a good choice for breakfast as it is often fortified with iron (option d). This can help supplement iron intake in the diet.
Green leafy vegetables, such as spinach, kale, and broccoli, are also rich in iron and should be increased in the client's diet (option e).
Option b, which suggests eating red meat just until the anemia is resolved, is not appropriate for a vegetarian client.
Option c, taking two prenatal vitamins with iron daily, is not necessary unless specifically advised by the healthcare provider. It is important to follow the prescribed dosage of medication and supplements as directed by the healthcare provider.

Correct Answer is A
Explanation
The practical nurse (PN) who hears adventitious breath sounds while auscultating the lungs of an older adult who is receiving an IV of 5% dextrose in water (DW) at 100 mL/hour should report the findings to the charge nurse.
Adventitious breath sounds can be indicative of respiratory problems such as fluid accumulation or infection in the lungs. In this case, it is important for the PN to report the findings to the charge nurse to ensure appropriate action is taken to assess and manage the client's respiratory status.
incorrect:
B- Reviewing the last balance of intake and output is important for overall assessment but may not directly address the concern of adventitious breath sounds. It can provide additional information about the client's fluid balance, but it is not the next immediate action in response to the abnormal lung sounds.
C- Slowing the DSW infusion rate to 50 mL/hour is not the most appropriate action to take based solely on the presence of adventitious breath sounds. The abnormal lung sounds may be an indication of an underlying respiratory issue that needs further evaluation and intervention.
Adjusting the infusion rate without a comprehensive assessment and appropriate medical orders could potentially overlook the underlying cause.
D- Documenting the findings and monitoring the client is necessary, but it should not be the sole action taken. Reporting the findings to the charge nurse is crucial to ensure prompt assessment and appropriate intervention.
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