A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has a 7-year-old daughter who was born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:

3-2-1-0-2

4-1-1-1-3

4-1-1-1-2

4-1-2-0-3

Answer and Explanation

The Correct Answer is C

Choice A Reason: 3-2-1-0-2. This is an incorrect answer that underestimates the number of pregnancies and overestimates the number of preterm births. The client has had four pregnancies, not three. She has had one preterm birth, not two.

Choice B Reason: 4-1-1-1-3. This is an incorrect answer that overestimates the number of living children. The client has two living children, not three.

Choice C Reason 4-1-1-1-2. This is because the GTPAL method is a way of summarizing a woman's obstetric history using five numbers: G (gravida), T (term births), P (preterm births), A (abortions), and L (living children). Gravida is the number of pregnancies, regardless of outcome. Term births are deliveries after 37 weeks' gestation. Preterm births are deliveries between 20 and 37 weeks' gestation. Abortions are pregnancies that end before 20 weeks' gestation, either spontaneously or electively. Living children are the number of children who are alive at the time of assessment.

Choice D Reason: 4-1-2-0-3. This is an incorrect answer that overestimates the number of preterm births and living children, and underestimates the number of abortions. The client has had one preterm birth, not two. She has had one abortion, not zero. She has two living children, not three.

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Correct Answer is D

Explanation

Choice A Reason: Taking the newborn to the nursery for the initial assessment. This is an ineﬀective intervention that disrupts parental atachment by separating the mother and the newborn. It also deprives the newborn of the benefits of skin to skin contact and breastfeeding.

Choice B Reason: Allowing the mother a chance to rest without the baby immediately after delivery. This is an unnecessary intervention that delays parental atachment by postponing the first contact between the mother and the newborn. It also ignores the mother's desire and readiness to hold and feed her baby.

Choice C Reason: Placing the newborn under a radiant warmer to do the initial assessment. This is an outdated intervention that hinders parental atachment by creating a physical barrier between the mother and the newborn. It also exposes the newborn to potential risks such as dehydration, hyperthermia, or eye damage.

Choice D Reason: Placing the newborn on the maternal abdomen and doing the initial assessment. This is because this intervention facilitates skin to skin contact, eye contact, and bonding between the mother and the newborn. It also enhances breastfeeding initiation, thermoregulation, and maternal-infant atachment.

A. Macrosomic newborn. B. Intrauterine growth restriction (IUGR). C. Umbilical cord prolapse. D. Meconium Aspiration Syndrome (MAS).

Correct Answer is C

Explanation

Choice A Reason: Macrosomic newborn. This is a correct answer that describes a possible complication of post-term pregnancy. A macrosomic newborn is a newborn that weighs more than 4000 grams or 8 pounds 13 ounces at birth. It can occur in post-term pregnancies due to prolonged exposure to maternal glucose and insulin. It can increase the risk of birth injuries, shoulder dystocia, cesarean delivery, and hypoglycemia.

Choice B Reason: Intrauterine growth restriction (IUGR). This is a correct answer that indicates a potential problem of post-term pregnancy. IUGR is a condition where the fetal growth is slower than expected for gestational age. It can occur in post-term pregnancies due to placental insufficiency, aging, or calcification, which can impair nutrient and oxygen delivery to the fetus. It can increase the risk of fetal distress, hypoxia, acidosis, and stillbirth.

Choice C Reason: Umbilical cord prolapse. This is an incorrect answer that does not reﬂect a risk of post-term pregnancy, but rather a risk of other factors such as prematurity, low birth weight, breech presentation, multiple gestation, polyhydramnios, or artificial rupture of membranes.

Choice D Reason: Meconium Aspiration Syndrome (MAS). This is a correct answer that denotes a possible complication of post-term pregnancy. MAS occurs when fetal stool (meconium) enters into the lungs before or during birth, causing airway obstruction, inﬂammation, and infection. MAS usually aﬀects term or post-term infants who experience fetal distress or hypoxia in utero. It can cause respiratory distress syndrome (RDS), persistent pulmonary hypertension (PPHN), or chronic lung disease (CLD).

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After the birth of a newborn, the nursing intervention that most eﬀectively promotes parental atachment is: Select one:

Correct Answer is D

Explanation

Post-term fetal risks include all of the following, EXCEPT: Select one:

Correct Answer is C

Explanation

A woman in her 40th week of pregnancy calls the nurse at the clinic and says she's not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor? Select one:

The parents of a newborn who is being treated for bacterial septicemia ask the nurse why their baby didn't seem very ill. The best response of the nurse is: Select one:

In caring for the premature infant, the nurse must continually assess hydration status. Parameters to assess would include all of the following except: Select one:

The Mother-Baby nurse is caring for a two hour old newborn who is 36 4/7 weeks gestation. The nurse assesses that the newborn is experiencing tremors (jiteriness). What nursing action has the highest priority? Select one:

During a physical assessment of a newborn, the nurse observes bluish markings across the newborn's lower back. The nurse interprets this finding as: Select one:

Narcotic analgesia is administered to a laboring client at 10:00 a.m. The infant is delivered at 10:35 A.M. The nurse would anticipate that the narcotic analgesia could: Select one:

The nurse assesses a newborn at 36 weeks' gestation, and the following behaviors are noted: nasal ﬂaring, labored breathing, and excessive mucus. The nurse is most concerned about: Select one: