A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year-old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:
3-2-1-0-3
4-1-1-1-3
4-2-1-3-1
3-1-2-2-3
The Correct Answer is B
Choice A Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one preterm birth (the twins), not two.
Choice B Reason: This option is correct because it accurately reflects the client's obstetric history. GTPAL stands for Gravida, Term, Preterm, Abortions, and Living children. Gravida is the number of pregnancies a woman has had, regardless of outcome. Term is the number of pregnancies that ended at or beyond 37 weeks gestation. Preterm is the number of pregnancies that ended between 20 and 36 weeks gestation. Abortions are the number of pregnancies that ended before 20 weeks gestation, either spontaneously or induced. Living children are the number of children who are alive at present.
The client has had four pregnancies (gravida), one term birth (the son), one preterm birth (the twins), one abortion (the miscarriage), and three living children (the twins and the son).
Choice C Reason: This option is incorrect because it overestimates the number of preterm births (preterm) and underestimates the number of living children (living). The client has had one preterm birth (the twins), not two. The client has three living children (the twins and the son), not one.
Choice D Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of abortions (abortions) and preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one abortion (the miscarriage), not two. The client has had one preterm birth (the twins), not two.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Hemorrhage is the most life-threatening complication of a ruptured ectopic pregnancy, as it can lead to hypovolemic shock and death. The nurse should monitor the client's vital signs, blood loss, and level of consciousness, and administer fluids and blood products as ordered.
Choice B reason: Edema is not a common sign of a ruptured ectopic pregnancy, and it is not a priority over hemorrhage. Edema may be caused by other conditions, such as heart failure, kidney disease, or venous insufficiency.
Choice C reason: Infection is a possible complication of a ruptured ectopic pregnancy, but it is not as urgent as hemorrhage. Infection may manifest as fever, chills, malaise, or foul-smelling vaginal discharge. The nurse should administer antibiotics as ordered and monitor the client's temperature and white blood cell count.
Choice D reason: Jaundice is not a typical symptom of a ruptured ectopic pregnancy, and it is not a priority over hemorrhage. Jaundice may indicate liver dysfunction or hemolytic anemia, which are unrelated to ectopic pregnancy. The nurse should assess the client's skin and sclera color, and check the liver enzymes and bilirubin levels.
Correct Answer is ["A","B","D"]
Explanation
Choice A Reason: This is correct because breast tenderness is a common discomfort during the first trimester of pregnancy. It is caused by hormonal changes that stimulate breast growth and prepare them for lactation. Breast tenderness may also be accompanied by swelling, tingling, or sensitivity.
Choice B Reason: This is correct because urinary frequency is a common discomfort during the first trimester of pregnancy. It is caused by hormonal changes that increase blood flow to the kidneys and bladder, as well as by the growing uterus that puts pressure on the bladder. Urinary frequency may also be associated with increased thirst or urinary tract infections.
Choice C Reason: This is incorrect because backache is not a common discomfort during the first trimester of pregnancy. It usually occurs in later stages of pregnancy, when the weight of the fetus and the uterus shifts the center of gravity and strains the back muscles and ligaments. Backache may also be caused by poor posture, stress, or fatigue.
Choice D Reason: This is correct because cravings are a common discomfort during the first trimester of pregnancy. They are caused by hormonal changes that affect the sense of taste and smell, as well as by emotional or psychological factors. Cravings may vary from person to person and may include foods that are sweet, salty, sour, or spicy.
Choice E Reason: This is incorrect because leg cramps are not a common discomfort during the first trimester of pregnancy. They usually occur in later stages of pregnancy, when there is increased pressure on the nerves and blood vessels that supply the legs. Leg cramps may also be caused by dehydration, electrolyte imbalance, or muscle fatigue.
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