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 C
Explanation
Choice A: A clear liquid diet is not appropriate for a client with hyperemesis gravidarum, which is a severe form of nausea and vomiting during pregnancy that can lead to dehydration, electrolyte imbalance, and weight loss. A clear liquid diet does not provide adequate calories, protein, vitamins, or minerals for the client and the fetus.
Choice B: Administration of diethylstilbestrol is not indicated for a client with hyperemesis gravidarum. Diethylstilbestrol is a synthetic estrogen that was used in the past to prevent miscarriage and premature birth, but it was found to cause serious adverse effects such as vaginal cancer, infertility, and birth defects in the offspring.
Choice C: Total parenteral nutrition is the correct choice because it provides a complete and balanced source of nutrients through a central venous catheter. It is used for clients who cannot tolerate oral or enteral feeding due to severe gastrointestinal disorders such as hyperemesis gravidarum. It helps to prevent malnutrition, dehydration, and ketosis in the client and the fetus.
Choice D: Nothing by mouth is not a suitable option for a client with hyperemesis gravidarum. It can worsen the condition by causing starvation, acidosis, and ketosis. It can also increase the risk of aspiration pneumonia if the client vomits.
Correct Answer is {"dropdown-group-1":"D","dropdown-group-2":"C"}
Explanation
Choice A Reason: Preeclampsia is a condition in which a pregnant woman develops high blood pressure and proteinuria (protein in the urine). It can lead to serious complications such as eclampsia, which is seizures caused by preeclampsia, and HELLP syndrome, which is hemolysis, elevated liver enzymes, and low platelets. The main risk factor for preeclampsia is chronic hypertension, which means high blood pressure before pregnancy or before 20 weeks of gestation. Preeclampsia can be detected by measuring the blood pressure and urine protein level. Uric acid is not a reliable indicator of preeclampsia.
Choice B Reason: Gestational diabetes is the correct answer as explained above.
Choice C Reason: Eclampsia is a severe complication of preeclampsia that causes seizures and can be fatal for both the mother and the baby. It usually occurs after 20 weeks of gestation or during labor or postpartum. The main risk factor for eclampsia is preeclampsia, which means high blood pressure and proteinuria during pregnancy. Eclampsia can be prevented by treating preeclampsia with antihypertensive drugs and magnesium sulfate, which is a medication that prevents seizures. Magnesium sulfate can also lower the serum magnesium level, which is the amount of magnesium in the blood. However, magnesium level is not a diagnostic criterion for eclampsia.
Choice D Reason: Placenta previa is a condition in which the placenta covers part or all of the opening of the cervix. It can cause bleeding during pregnancy or delivery and can endanger both the mother and the baby. The main risk factor for placenta previa is previous cesarean section or other uterine surgery, which can cause scarring or damage to the uterine wall. Placenta previa can be detected by ultrasound, which is an imaging test that uses sound waves to create pictures of the uterus and placenta. Hemoglobin is not a relevant factor for placenta previa. Gestational diabetes is a condition in which a woman develops high blood sugar levels during pregnancy. It can cause complications for both the mother and the baby, such as macrosomia, hypoglycemia, and birth trauma. The main risk factor for gestational diabetes is glucose intolerance, which means the body cannot use glucose effectively. Glucose intolerance can be detected by measuring the serum glucose level, which is the amount of glucose in the blood.
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