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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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A Reason: Assisting with the delivery of the placenta and ensuring that the fundus is contracted afterward. This is an appropriate action for the nurse to perform during the third stage of labor, as it helps complete the process of labor and prevent complications.

Choice B Reason: Palpating the woman's fundus for position and firmness. This is an action that is done after the delivery of the placenta, not during. It is important to monitor the fundal height, location, and consistency to assess uterine involution and bleeding.

Choice C Reason: Encouraging the woman to push with her contractions. This is an action that is done during the second stage of labor, not the third. The second stage of labor is the period from full cervical dilation to the birth of the baby. The nurse's role is to support and coach the woman to push eﬀectively with her contractions.

Choice D Reason: Alleviating perineal discomfort with the application of ice packs. This is an action that is done after the delivery of the placenta, not during. It is a comfort measure that can reduce swelling, pain, and inﬂammation in the perineal area.

A. IgG. B. IgE. C. IgA. D. IgM.

Correct Answer is C

Explanation

Choice A Reason: IgG. This is an incorrect answer that refers to a diﬀerent type of antibody that is not abundant in breast milk. IgG is a type of antibody that provides systemic immunity against various antigens. IgG is found in low concentrations in breast milk, as it does not cross the mammary epithelium easily. IgG can protect the infant from some infections, but it is mainly transferred from the mother to the fetus through the placenta during pregnancy.

Choice B Reason: IgE. This is an incorrect answer that refers to a diﬀerent type of antibody that is not relevant to breast milk. IgE is a type of antibody that mediates allergic reactions and parasitic infections. IgE is found in very low concentrations in breast milk, as it does not have a significant role in mucosal immunity. IgE can trigger mast cells and basophils to release histamine and other inﬂammatory mediators, which can cause symptoms such as itching, swelling, or bronchoconstriction.

Choice C Reason: IgA. This is because IgA is a type of antibody that protects mucosal surfaces from pathogens and toxins. IgA is found in high concentrations in breast milk, especially in colostrum (the first milk produced after delivery). IgA can bind to bacteria and viruses in the infant's gastrointestinal tract and prevent them from ataching to the intestinal wall or crossing into the bloodstream. IgA can also enhance the infant's immune system by stimulating lymphoid tissue development and modulating inﬂammatory responses.

Choice D Reason: IgM. This is an incorrect answer that refers to a diﬀerent type of antibody that is not abundant in breast milk. IgM is a type of antibody that activates complement system and agglutinates antigens. IgM is found in low concentrations in breast milk, as it does not cross the mammary epithelium easily due to its large size. IgM can protect the infant from some infections, but it is mainly produced by the infant's own immune system in response to exposure to antigens.

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Naxlex Comprehensive Predictor Exams

A woman has just entered the third stage of labor. The nurse would focus care on which of the following? Select one:

Correct Answer is A

Explanation

An nurse is counseling a new mother about the immunologic properties of breast milk. The nurse emphasizes that breast milk is the main source of which specific immunoglobulin? Select one:

Correct Answer is C

Explanation

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:

An infant of a Diabetic Mother (IDM) has a blood glucose of 60 upon admission to the well-baby nursery. Which of the following is an appropriate nursing action? Select one:

Which of the following would be essential to implement to prevent late postpartum hemorrhage? Select one:

A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per minute. Which of these actions should the nurse take? Select one:

When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation? Select one:

The nurse is performing a newborn physical assessment and is about to elicit the Moro reﬂex. Which of the following responses should the nurse expect to see? Select one:

When reviewing the causes of late postpartum hemorrhage, which of the following would the nurse identify as the most common cause? Select one:

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: