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

Answer and Explanation

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.

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Correct Answer is D

Explanation

Choice A rationale

During pregnancy, the body’s production of red blood cells usually increases to meet the increased demands of the growing fetus. Therefore, a drop in hematocrit is not typically due to insufficient red blood cell production.

Choice B rationale

While iron is essential during pregnancy, a reduction in hematocrit levels at 16 weeks' gestation is primarily due to increased plasma volume, rather than iron deficiency. Nutritional counseling may still be beneficial but isn't the primary explanation for this change.

Choice C rationale

A hematocrit level of 34% at 16 weeks is generally not considered indicative of a severe problem. Instead, it is a physiological response to increased plasma volume, known as dilutional anemia of pregnancy.

Choice D rationale

The primary reason for a lower hematocrit count during pregnancy is the increase in blood plasma volume, leading to dilutional anemia. This is a normal adaptation to pregnancy that ensures adequate blood flow to the fetus.

Correct Answer is ["3.9"]

Explanation

Step 1 is 3900 grams ÷ 1000 = 3.9 kg

Step 2 is 25 mg/kg × 3.9 kg = 97.5 mg

Step 3 is 97.5 mg ÷ (125 mg/5 mL) = 3.9 mL

The newborn will receive 3.9 mL in 24 hours.

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Naxlex Comprehensive Predictor Exams

A pregnant client, at 16 weeks' gestation, has a hematocrit of 34%. Her pre-pregnancy hematocrit was 40%. Which of the following statements by the nurse best explains this change?

Correct Answer is D

Explanation

A newborn who weighs 3900 grams is to receive 25mg/kg of Augmentin (Amoxicillin Clavulanate Potassium) q 24 hours. The supply on hand is 125mg/5mL. How many ml will the newborn receive in 24 hours? (Write in your answer).

Correct Answer is ["3.9"]

Explanation

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