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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason: "Our baby's newborn rash is from this syndrome." This is because this statement by a parent indicates that additional teaching is required, as it shows a misunderstanding or confusion about FAS and its manifestations. FAS is a condition that occurs when a woman consumes alcohol during pregnancy, which can affect the development and function of various organs and systems in the fetus and child. FAS can cause physical, behavioral, and cognitive problems such as facial abnormalities, growth retardation, learning difficulties, and atention deficits. FAS does not cause newborn rash, which is a common and benign condition that affects many newborns regardless of maternal alcohol intake. Newborn rash is also known as erythema toxicum neonatorum or baby acne, which is characterized by small red bumps or pustules on the face, chest, or back that usually disappear within a few weeks.
Choice B Reason: "His face looks like it does due to this problem." This is a correct answer that indicates adequate understanding of FAS and its features. Facial abnormalities are one of the characteristic signs of FAS, which include small eye openings, thin upper lip, flat nasal bridge, and smooth philtrum (the groove between the nose and upper lip).
Choice C Reason: "He can show signs of withdrawal from alcohol exposure like jiteriness, sweating, hyper reflexes, poor feeding and not sleeping well." This is a correct answer that indicates adequate understanding of FAS and its complications. Signs of withdrawal are possible effects of FAS, which occur when the fetus or newborn is exposed to alcohol in utero or through breast milk, which can cause neurotoxicity and dependency. Signs of withdrawal can include jiteriness, sweating, hyper reflexes, poor feeding, and not sleeping well, as well as irritability, seizures, or tremors.
Choice D Reason: "He is at risk of having intellectual disabilities, so we will need to get extra services to support him." This is a correct answer that indicates adequate understanding of FAS and its implications. Intellectual disabilities are potential outcomes of FAS, which affect the cognitive development and function of the child. Intellectual disabilities can cause problems with memory, Reasoning, language, and social skills. Extra services and support may be needed to help the child achieve their optimal potential and quality of life.
Correct Answer is A
Explanation
Choice A Reason: Place the infant skin to skin with the mother and re-check temperature in 30 minutes. This is because skin-to-skin contact is an effective and safe method of increasing the infant's temperature and promoting thermoregulation. Skin-to-skin contact also has other benefits such as enhancing bonding, breastfeeding, and maternal-infant attachment.
Choice B Reason: Check the infant's CBC and blood cultures, as this is a sign of probable sepsis. This is an unnecessary action that may cause undue stress and discomfort to the infant and the mother. A slightly decreased temperature in a full-term infant is not a sign of probable sepsis, but rather a common finding that may be due to environmental factors, such as exposure to cold air or wet linens.
Choice C Reason: Return the infant to the nursery for close observation under warming lights. This is an undesirable action that may interfere with the early initiation of breastfeeding and bonding between the mother and the infant. Warming lights are not recommended for routine use in healthy newborns, as they may cause dehydration, hyperthermia, or eye damage.
Choice D Reason: Notify the physician immediately and suggest orders for placement in an incubator. This is an excessive action that may indicate a lack of knowledge or confidence on the part of the nurse. An incubator is not indicated for a stable, full term infant with a slightly decreased temperature, as it may expose the infant to unnecessary interventions, infections, or separation from the mother.
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