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 B
Explanation
Choice A Reason: This is incorrect because difficulty in arousing is a sign of magnesium toxicity, which is a serious complication of magnesium sulfate therapy. Magnesium toxicity can cause central nervous system depression, muscle weakness, and cardiac arrest. The nurse should monitor the client's level of consciousness and stop the infusion if the client becomes lethargic or unresponsive.
Choice B Reason: This is correct because deep tendon reflexes 2+ indicate a normal and expected response to magnesium sulfate therapy. Magnesium sulfate is a muscle relaxant that can reduce the risk of seizures in gestational hypertension. The nurse should assess the client's deep tendon reflexes regularly and maintain them at 2+ or slightly diminished.
Choice C Reason: This is incorrect because urinary output of 30 mL per hour is below the normal range of 40 to 80 mL per hour and may indicate renal impairment or dehydration. Magnesium sulfate can cause renal toxicity or fluid retention, which can affect the urinary output. The nurse should monitor the client's urinary output and fluid balance and report any abnormalities to the doctor.
Choice D Reason: This is incorrect because respiratory rate of 10 breaths/minute is below the normal range of 12 to 20 breaths/minute and may indicate respiratory depression. Magnesium sulfate can cause respiratory depression or failure, which can be life-threatening. The nurse should monitor the client's respiratory rate and oxygen saturation and administer oxygen or antidote if needed.
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