A nurse in a prenatal clinic is reviewing the medical record of a client who is at 28 weeks of gestation. The client's history reveals one pregnancy terminated by elective abortion at 9 weeks; the birth of twins at 36 weeks; and a spontaneous abortion at 15 weeks of gestation. According to the GTPAL system, which of the following describes her present parity?
4-0-0-2-2
4-2-0-2-2
4-0-2-2-2
4-0-1-2-2
The Correct Answer is D
G (Gravida) — Total number of pregnancies, including the current one.
Elective abortion at 9 weeks
Birth of twins at 36 weeks
Spontaneous abortion at 15 weeks
Current pregnancy at 28 weeks So, G = 4.
T (Term births) — Number of pregnancies carried to 37 weeks or beyond.
-
- She hasn't had any pregnancies reach full term. So, T = 0.
P (Preterm births) — Number of pregnancies delivered between 20 and 36 weeks.
-
- Twins born at 36 weeks. So, P = 1.
A (Abortions) — Number of pregnancies ending before 20 weeks (spontaneous or elective).
-
- Elective abortion at 9 weeks
- Spontaneous abortion at 15 weeks So, A = 2.
L (Living children) — Number of living children.
-
- The twins are living children. So, L = 2.
Putting it all together, her GTPAL notation is G4 T0 P1 A2 L2.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The client's symptoms are suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervical opening. Placenta previa can cause painless, bright red bleeding in the third trimester, especially after sexual intercourse or a pelvic exam. The bleeding can be life-threatening for both the mother and the fetus, and the condition requires immediate evaluation and management. An ultrasound is the best diagnostic tool to confirm the location of the placenta and rule out other causes of bleeding, such as placental abruption or uterine rupture.The other options are not relevant to the client's situation and would not be indicated by an ultrasound.Fetal lung maturity is not a concern for a client who is at 38 weeks of gestation, as most fetuses have developed sufficient surfactant production by this time. Fetal lung maturity can be assessed by amniocentesis or by measuring the lecithin/sphingomyelin ratio in the amniotic fluid.Frequency and duration of contractions are not present in the client's case, as she has no signs of labor. Contractions can be monitored by external or internal tocodynamometry or by palpation.d. Rh incompatibility is a condition where the mother's blood type is Rh-negative and the fetus's blood type is Rh- positive, which can cause hemolytic disease of the newborn. Rh incompatibility can be detected by blood tests and prevented by administering Rh immunoglobulin to the mother during pregnancy and after delivery.
Correct Answer is B
Explanation
b. Apply an external fetal monitor.
The nurse should apply an external fetal monitor to assess the fetal heart rate and activity, as well as the presence and intensity of contractions. Placenta previa is a condition where the placenta covers part or all of the cervical opening, which can cause painless, bright red bleeding in the third trimester. Placenta previa can compromise fetal oxygenation and perfusion, and can also trigger preterm labor. Therefore, the nurse should monitor the fetal well- being and readiness for delivery.
The other actions are not appropriate and may cause harm to the client or the fetus.
a. The nurse should not perform a rectal exam, as this can cause trauma or infection to the rectum or the placenta, and increase the risk of bleeding or rupture.
c. The nurse should not complete a vaginal exam, as this can dislodge or damage the placenta, and cause severe
hemorrhage or shock.
d. The nurse should not apply ice to the perineal area, as this can cause vasoconstriction and reduce blood flow to the placenta and the fetus, and worsen their condition.
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