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 B

Explanation

Choice A Reason: "If I try to talk to my partner during a contraction, I can't." This is an incorrect answer that indicates a sign of true labor, not false labor. True labor is a condition where there are regular and painful uterine contractions that cause cervical dilation and eﬀacement, and lead to delivery of the baby and placenta. True labor contractions are usually strong and consistent, and they tend to increase or persist with activity or position changes. True labor contractions can be so intense that they interfere with speech or breathing.

Choice B Reason: ) "My contractions slow down when I walk around." This is because this statement by the client would lead the nurse to suspect that the woman is experiencing false labor, which is also known as Braxton Hicks contractions or practice contractions. False labor is a condition where there are irregular and painless uterine contractions that do not cause cervical dilation or eﬀacement. False labor can occur throughout pregnancy, but it becomes more noticeable and frequent in late pregnancy. False labor contractions are usually weak and inconsistent, and they tend to decrease or stop with activity or position changes.

Choice C Reason: "I feel contractions start mostly in my back and they sweep around to the top of my abdomen." This is an incorrect answer that indicates a sign of true labor, not false labor. True labor contractions usually start in the lower back and radiate to the lower abdomen or groin, following a wave-like patern. False labor contractions are more likely to be felt in the upper abdomen or sides, without a clear patern.

Choice D Reason: "My contractions are about 6 minutes apart and regular." This is an incorrect answer that indicates a sign of true labor, not false labor. True labor contractions usually have a regular frequency and duration, and they become closer and longer as labor progresses. False labor contractions are more likely to have an irregular frequency and duration, and they do not change significantly over time.

A. "It's okay to want a small baby when you're a teen." B. "You shouldn't be worrying about your figure." C. "Your baby needs adequate nutrition to develop and to be healthy." D. "You are causing harm to your baby."

Correct Answer is C

Explanation

Choice A Reason: "It's okay to want a small baby when you're a teen." This is an incorrect answer that validates the patient's misconception and reinforces her unhealthy behavior. It also implies that there is something wrong with having a normal-sized baby or being a teen mother.

Choice B Reason: "You shouldn't be worrying about your figure." This is an incorrect answer that dismisses the patient's feelings and concerns and may make her defensive or resistant to change. It also does not address the underlying issues or provide any guidance or support.

Choice C Reason: ""Your baby needs adequate nutrition to develop and to be healthy." This is because this response provides factual information and education to the patient about the importance of nutrition during pregnancy. It also conveys empathy and concern for both the mother and the baby without being judgmental or accusatory.

Choice D Reason: "You are causing harm to your baby." This is an incorrect answer that blames and criticizes the patient and may make her feel guilty or ashamed. It also does not oﬀer any help or solutions for her situation.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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:

Correct Answer is B

Explanation

An adolescent patient at 20 weeks gestation states that it is important not to have a baby that weighs too much. She states this has been her rationale for limiting calories. Her weight has decreased from 110 pounds to 106 pounds. What would be the best nursing response? Select one:

Correct Answer is C

Explanation

Following a normal spontaneous vaginal delivery (NSVD), a 28 year old G3 now P3 mother develops sudden onset shortness of breath, hypoxia and cyanosis. The delivery room nurse quickly recognizes these symptoms as possible: Select one:

A term newborn weighs 4 pounds 5 ounces. The nurse assesses that this newborn is small for gestational age (SGA). The nurse knows that teaching has been eﬀective when the parents state: Select one:

Before applying a cord clamp, the nurse assesses the umbilical cord for vessels. The nurse expects to find: Select one:

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:

Parents have been told their child has fetal alcohol syndrome (FAS). Which statement by a parent indicates that additional teaching is required? Select one:

The nurse, working in labor and delivery, performs a sterile vaginal exam on a laboring woman. During the exam, she feels a loop of pulsating cord in the vagina. The nurse would anticipate: Select one:

A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered? Select one: