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: About 1 of every 5 women will experience abuse in her lifetime is a statistic that shows the prevalence of domestic violence, but it does not address the question of what the nurse should emphasize to the group of women.

Choice B Reason: When women go back to the situation after the abuser has calmed down, things will be beter is a false statement that reﬂects the cycle of abuse, where the abuser may apologize and promise to change after a violent episode, but then repeat the same behavior later. This does not help the women understand their situation or seek help.

Choice C Reason: The victimized woman can easily leave the situation is a false statement that ignores the many barriers and challenges that women face when trying to escape from domestic violence, such as fear, isolation, financial dependence, lack of support, legal issues, and threats from the abuser. This does not empower the women or provide them with realistic options.

Choice D Reason: The violence will not stop or decrease if the woman becomes pregnant is a true statement that highlights the danger of staying in an abusive relationship during pregnancy. Domestic violence can increase the risk of miscarriage, preterm birth, low birth weight, placental abruption, fetal injury, and maternal death. This may motivate the women to seek safety and protection for themselves and their unborn children.

A. Vitamin K will increase erythropoiesis. B. Vitamin K will enhance bilirubin breakdown. C. Vitamin K will stop Rh sensitization. D. Vitamin K will promote blood clotting ability. Vitamin K will promote blood clotting ability.

Correct Answer is D

Explanation

Choice A Reason: Vitamin K will increase erythropoiesis. This is an incorrect statement that confuses vitamin K with erythropoietin. Erythropoietin is a hormone that stimulates red blood cell production in the bone marrow. Vitamin K does not aﬀect erythropoiesis.

Choice B Reason: Vitamin K will enhance bilirubin breakdown. This is an incorrect statement that confuses vitamin K with phototherapy. Phototherapy is a treatment that exposes the newborn's skin to light, which converts bilirubin into water-soluble forms that can be excreted by the liver and kidneys. Bilirubin is a yellow pigment that results from the breakdown of red blood cells. High levels of bilirubin can cause jaundice and brain damage in newborns. Vitamin K does not aﬀect bilirubin metabolism.

Choice C Reason: Vitamin K will stop Rh sensitization. This is an incorrect statement that confuses vitamin K with Rh immune globulin. Rh immune globulin is an injection given to Rh-negative mothers who deliver Rh-positive babies, to prevent them from developing antibodies against Rh-positive blood cells in future pregnancies. Rh sensitization is a condition where the mother's immune system atacks the baby's blood cells, causing hemolytic disease of the newborn. Vitamin K does not aﬀect Rh sensitization.

Choice D Reason: Vitamin K will promote blood clotting ability. This is a correct statement that explains the rationale for administering vitamin K as prophylaxis to newborns. Vitamin K is essential for the synthesis of clotting factors in the liver. Newborns have low levels of vitamin K at birth due to poor placental transfer and lack of intestinal bacteria that produce vitamin K. Therefore, they are at risk of bleeding disorders such as hemorrhagic disease of the newborn.

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Naxlex Comprehensive Predictor Exams

The nurse at a shelter is counseling a group of women experiencing domestic violence. What is most important for the nurse to emphasize? Select one:

Correct Answer is D

Explanation

The nurse administers vitamin K intramuscularly as prophylaxis to the newborn based on which of the following rationales? Select one:

Correct Answer is D

Explanation

The nurse's initial action when caring for an otherwise stable, full term infant with a slightly decreased temperature is to: Select one:

A client with insulin-dependent type 2 diabetes and an HbA1c of 6.0% is planning to become pregnant soon. What anticipatory teaching should the nurse provide this client? Select one:

Assessment of a pregnant woman reveals a pigmented vertical line between the umbilicus and the pubis. The nurse documents this finding as: Select one:

A woman is being treated for preterm labor with magnesium sulfate. Which finding by the nurse indicates magnesium sulfate toxicity? Select one:

Which of the following would the nurse include in the plan of care for a newborn receiving phototherapy? Select one:

An nurse explains to new parents that their infant has developed Transient Tachypnea of the Newborn (TTN). The nurse understands that risk factors for TTN include which of the following? 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:

The patient is 34 weeks pregnant and during a regular prenatal visit she asks how to do kick counts. The best response by the nurse would be: Select one: