A nurse is reviewing the prenatal record of a client at 28 weeks' gestation.
The woman's history reveals: two pregnancies terminated by elective abortion at 8 and 10 weeks; the birth of twin girls at 36 weeks; and a spontaneous abortion of twins at 12 weeks.
According to the Gravida Para TPAL system, which of the following describes the client's present situation?
5-1-0-2-1
5-1-0-1-3-2
4-2-0-2-0-2
3-1-2-0-2-2
The Correct Answer is A
Choice A rationale
This represents 5 pregnancies (2 elective abortions, 1 twin birth, 1 spontaneous twin abortion, and current pregnancy), 1 term birth, 0 preterm births, 2 abortions (excluding current pregnancy), and 1 living child.
Choice B rationale
Incorrect because it lists 1 term birth and 3 abortions, which does not accurately reflect the client's history.
Choice C rationale
Incorrect because it states 4 pregnancies and 2 living children, missing the current pregnancy and miscounting the living children.
Choice D rationale
Incorrect as it accounts for 3 pregnancies, incorrectly summing the term birth and spontaneous abortions without considering the current pregnancy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A possible sign of pregnancy includes symptoms that are suggestive but not definitive, such as amenorrhea (absence of menstruation) or fatigue. These signs can have multiple causes and are not conclusive proof of pregnancy.
Choice B rationale
A positive sign of pregnancy includes objective evidence like fetal movement felt by the examiner, fetal heart sounds detected, or visualization of the fetus on ultrasound. These signs provide direct confirmation of pregnancy.
Choice C rationale
Presumptive signs of pregnancy are subjective experiences reported by the patient, such as nausea, breast tenderness, or quickening (feeling fetal movement). These signs are not confirmatory as they can occur in other conditions.
Choice D rationale
Probable signs of pregnancy include objective findings observed by a healthcare provider, such as uterine enlargement, but they are not definitive as they can also be caused by conditions like fibroids.
Correct Answer is D
Explanation
Choice A rationale
While a history of rheumatic heart disease is significant, it does not directly correlate with the need for priority teaching on Quad screening. This condition requires careful cardiac monitoring and management during pregnancy.
Choice B rationale
A history of preterm labor is important and may require additional monitoring and interventions, but it is not a direct indication for priority teaching on Quad screening, which assesses risk for certain fetal conditions.
Choice C rationale
Exposure to HIV requires careful management and monitoring to reduce the risk of mother-to-child transmission. However, it is not specifically linked to the need for Quad screening, which is focused on detecting chromosomal abnormalities.
Choice D rationale
A history of having a child with spina bifida places this client at higher risk for having another child with neural tube defects or chromosomal abnormalities. Therefore, priority teaching on Quad screening, which includes markers for such conditions, is essential. .
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