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 C
Explanation
Circumoral cyanosis, which is bluish discoloration around the mouth, can be a sign of inadequate oxygenation. It suggests that there may be an issue with the infant's respiratory or cardiovascular system, potentially indicating respiratory distress or a cardiac problem. Prompt assessment and intervention are necessary to determine the cause of the cyanosis and ensure the infant's well-being.
A. The six-hour-old infant with a large sacral "stork bite" refers to a common birthmark caused by dilated blood vessels. While it may be important to assess the birthmark and document its presence, it is not an urgent concern requiring immediate attention.
B. The two-day-old infant with a negative Ortolani's sign refers to a specific maneuver used to assess for developmental hip dysplasia or dislocation. A negative Ortolani sign indicates that there is no evidence of hip dislocation. While it is important to assess the infant's hips and document the findings, it does not require immediate attention.
D. The one-day-old infant with a positive Babinski's reflex refers to an abnormal response in which the infant's toes fan out and the big toe dorsiflexes when the sole of the foot is stimulated. While a positive Babinski's reflex can be a normal finding in infants under a certain age, it is important to assess the infant's neurological status. However, it does not require immediate attention compared to the infant with circumoral cyanosis, which indicates potential respiratory or cardiovascular distress.
Correct Answer is B
Explanation
The practical nurse (PN) plays a crucial role in obtaining consent for an invasive examination. The PN should explain the examination to the client, ensuring that the client has a clear understanding of the procedure, its purpose, and any associated risks or benefits. After providing this information, the PN can ask the client to sign the consent form voluntarily, indicating their agreement to undergo the examination.
A. Checking the medical record for the correct signed consent form prior to the examination is a responsibility that typically falls on the healthcare provider who will be performing the procedure, such as a physician or advanced practice nurse. The PN may assist in verifying the presence of a signed consent form, but their primary responsibility lies in explaining the examination to the client and obtaining their consent.
C. While involving family members in the consent process can be important for communication and support, the consent form should be signed by the individual who will undergo the examination. Obtaining the signature of a family member alone is not sufficient for informed consent.
D. Asking if the client understands the exam and the reason for signing the consent form is a crucial step in the consent process. The PN should ensure that the client has a clear understanding and address any questions or concerns they may have before proceeding with obtaining the consent form.
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