A woman gives birth to a small infant with a malformed skull.

The infant grows abnormally slowly and shows signs of substantial cognitive and intellectual deficits.

The child also has facial abnormalities including a short nose and thin lip that become more striking as it develops.

The correct answer is choice C.

Choice A rationale:

Generalized vasospasm is not a symptom of abruptio placenta. It is more associated with conditions like preeclampsia.

Choice B rationale:

Abruptio placenta is usually associated with painful dark red vaginal bleeding, not painless bright red bleeding.

Choice C rationale:

“Knife-like” abdominal pain with vaginal bleeding is a classic symptom of abruptio placenta.

Choice D rationale:

Increased fetal movement is not a symptom of abruptio placenta. In fact, fetal movement may decrease due to distress.

The correct answer is choice A.

Choice A rationale:

The GTPAL system stands for Gravida, Term, Preterm, Abortions, and Living children. In this case, the woman has been pregnant 4 times (Gravida 4), has had one term birth (Term 1), one preterm birth (Preterm 1), one abortion/miscarriage (Abortions 1), and one living child (Living 1). Therefore, the correct classification is 4, 1, 1, 1, 1.

Choice B rationale:

This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and does not account for the preterm birth or the number of living children.

Choice C rationale:

This choice overcounts the number of term births and living children.

Choice D rationale:

This choice incorrectly classifies the number of pregnancies (Gravida should be 4, not 3) and overcounts the number of living children.