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
c. Excessive uterine enlargement
A hydatidiform mole is a type of gestational trophoblastic disease, where the placenta develops abnormally into a mass of cysts that resemble grape-like clusters. A hydatidiform mole can cause excessive uterine enlargement, as the uterus grows larger than expected for the gestational age. The nurse should measure the fundal height and compare it with the expected value based on the last menstrual period or ultrasound.
The other findings are not associated with a hydatidiform mole and may indicate other conditions.
Whitish vaginal discharge is not a sign of a hydatidiform mole, but it may be normal in pregnancy due to increased cervical mucus production. However, if the discharge is foul-smelling, yellow, green, or bloody, it may indicate an infection or a complication such as preterm labor or placental abruption.
Fetal heart rate irregularities are not a sign of a hydatidiform mole, but they may indicate fetal distress or congenital anomalies. A hydatidiform mole usually does not have a viable fetus, and fetal heart tones are absent or very faint. The nurse should use a Doppler device or a fetal monitor to assess the fetal heart rate and rhythm.
d. Rapidly dropping human chorionic gonadotropin (hCG) levels are not a sign of a hydatidiform mole, but they may indicate a spontaneous abortion or an ectopic pregnancy. A hydatidiform mole usually causes very high hCG levels, as the abnormal placental tissue secretes large amounts of this hormone. The nurse should perform a urine or blood test to measure the hCG levels and monitor them for chan
Correct Answer is C
Explanation
c. "This is expected because of the way iron is broken down during digestion."
The client's stools are black because of the iron supplements, which can cause a harmless change in the color and consistency of the stools. This is due to the oxidation of iron in the gastrointestinal tract, which produces a black pigment called ferrous sulfide. This is not a sign of bleeding or infection and does not require further evaluation or treatment. The nurse should reassure the client that this is a normal side effect of iron supplements and advise her to continue taking them as prescribed.
The other responses are not appropriate and may cause unnecessary anxiety or inconvenience for the client.
The nurse should not ask the client what else she has been eating, as this implies that her diet may be causing her stools to be black. This may confuse or offend the client, who may think that the nurse is questioning her nutritional choices or blaming her for her condition.
The nurse should not tell the client to go to the emergency room, as this suggests that her stools are black because of a serious problem that needs immediate atention. This may frighten or alarm the client, who may think that she or her baby are in danger.
d. The nurse should not tell the client to come to the office, as this indicates that her stools are black because of an abnormal finding that needs further investigation. This may worry or inconvenience the client, who may think that she has a complication or infection that requires testing or treatment.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today