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A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes one pregnancy, terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of thea following describes the client's current status?

40122

20020

40122

30202

None

Answer and Explanation

The Correct Answer is C

The correct answer is: c. 42022

Choice A: 40122

Reason: This choice is incorrect because it indicates 4 pregnancies (correct), 0 term births (correct), 1 preterm birth (correct), 2 abortions (correct), but 2 living children (incorrect). The client has 2 living children, which is correct, but the term and preterm counts are not accurate.

Choice B: 20020

Reason: This choice is incorrect because it indicates 2 pregnancies (incorrect), 0 term births (correct), 0 preterm births (incorrect), 2 abortions (correct), and 0 living children (incorrect). The client has had 4 pregnancies, 1 preterm birth, and 2 living children.

Choice C: 42022

Reason: This choice is correct. It indicates 4 pregnancies (current pregnancy, elective abortion, twins, spontaneous abortion), 0 term births, 2 preterm births (twins at 36 weeks), 2 abortions (elective at 9 weeks, spontaneous at 15 weeks), and 2 living children (twins).

Choice D:

The GTPAL system is used to assess a client's obstetric history:

G (Gravida): The total number of pregnancies, including the current one.
T (Term births): The number of pregnancies carried to at least 37 weeks.
P (Preterm births): The number of pregnancies delivered between 20 and 36 weeks, 6 days.
A (Abortions): The number of pregnancies ending before 20 weeks (spontaneous or elective).
L (Living children): The number of children currently alive.

For this client:

G (Gravida): 4 (one elective abortion, one twin pregnancy, one spontaneous abortion, and the current pregnancy).

T (Term births): 0 (the twin pregnancy was delivered at 36 weeks, which is preterm).
P (Preterm births): 1 (twins delivered at 36 weeks count as one preterm birth).
A (Abortions): 2 (one elective abortion at 9 weeks, one spontaneous abortion at 15 weeks).
L (Living children): 2 (the twins).

Thus, the GTPAL for this client is 4-0-1-2-2.

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Correct Answer is C

Explanation

A: Administering a 500 mL bolus of 5% dextrose in water is not necessary before the epidural administration, and it may not be recommended in active labor as it can increase the risk of fluid overload.

B: The duration of the anesthetic effect of the epidural can vary depending on the medication used, and it is not the nurse's priority during the preparation process.

C: Prior to administering epidural analgesia, the nurse should obtain a 30minute electronic fetal monitoring (EFM) strip to assess the fetal heart rate and monitor for any signs of fetal distress during the procedure.

D: Having the client stand very still with her arms at her side is not practical or necessary for epidural administration and could be uncomfortable for the client during labor.

A. "You will first feel your baby move in week 24 of pregnancy." B. "The sex of the baby is determined by week 8 of pregnancy." C. "The baby's heartbeat can be seen on ultrasound by about 6 weeks and is audible by a Doppler stethoscope as early as 8 or 9 weeks of pregnancy." D. "Very fine hairs, called lanugo, cover your baby's entire body by week 36 of pregnancy."

Correct Answer is C

Explanation

Choice A: Fetal movements, also known as quickening, are usually felt by the mother between weeks 18 and 25 of pregnancy, not specifically at week 24.
Choice B: While the sex of the baby is determined at conception, it is not visually identifiable on ultrasound until around week 16 to 20, depending on the fetus's position and the quality of the ultrasound images.
Choice C: The baby's heartbeat can be visualized on ultrasound as early as 6 weeks of pregnancy. It becomes audible using a Doppler stethoscope around 8 to 9 weeks of pregnancy.
Choice D: Lanugo, the fine hair covering the baby's body, usually appears around weeks 20 to 24 of pregnancy and begins to diminish later in pregnancy, not specifically at week 36.

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Naxlex Comprehensive Predictor Exams

A nurse is preparing a client who is in active labor for epidural analgesia. Which of the following actions should the nurse take?

Correct Answer is C

Explanation

A nurse is teaching about fetal development to a group of clients in the antenatal clinic. Which of the following statements should the nurse include in the teaching?

Correct Answer is C

Explanation

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