A 37-year-old female is currently 18 weeks pregnant. She has two sets of twins born at 37 and 38 weeks and a 9-year-old son born at 34 weeks gestation. She has no history of miscarriage or abortion. What is her GTPAL?

G4 T2 P1 A0 L5

G4 T2 P2 A1 L5

G4 T1 P4 A1 L4

G4 T1 P1 A0 L4

Answer and Explanation

The Correct Answer is A

A.   Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
B.   Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
C.   Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.
D.   Gravidity (G): The total number of pregnancies, including the current one. She has had 3 prior pregnancies and is currently pregnant, making her G4. Term (T): Number of term births (37 weeks or later). She has had two sets of twins delivered at 37 and 38 weeks, so T2. Preterm (P): Number of preterm births (between 20 and 36 weeks 6 days). She has one son born at 34 weeks, so P1. Abortions (A): Number of pregnancies ending in miscarriage or abortion before 20 weeks. She has no history of miscarriage or abortion, so A0. Living (L): Number of living children. She has two sets of twins (4 children) and her 9-year-old son (1 child), making a total of L5.

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Correct Answer is D

Explanation

A. Decreased response with sexual activity – Incorrect; decreased libido is common postpartum and not an urgent concern.

B. A scant non-odorous white vaginal discharge – Incorrect; lochia alba (whitish discharge) is normal at 4 weeks postpartum.

C. Uterine cramping during breastfeeding – Incorrect; cramping (due to oxytocin release) is expected postpartum.

D. A moderate serosanguineous malodorous discharge – Correct; foul-smelling lochia can indicate endometritis (a postpartum infection).

A. Massaging the client's back B. Administering prescribed analgesic medication C. Turning the client onto her left side D. Encouraging the client to rest between contractions

Correct Answer is A

Explanation

A. Massaging the client's back – Correct; gate control theory states that non-painful stimuli (e.g., massage, heat, cold) can block pain signals from reaching the brain.

B. Administering prescribed analgesic medication – Incorrect; this is pharmacologic pain relief, not part of gate control theory.

C. Turning the client onto her left side – Incorrect; this improves circulation but does not block pain signals.

D. Encouraging the client to rest between contractions – Incorrect; rest is important but does not directly affect pain perception.

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A 37-year-old female is currently 18 weeks pregnant. She has two sets of twins born at 37 and 38 weeks and a 9-year-old son born at 34 weeks gestation. She has no history of miscarriage or abortion. What is her GTPAL?

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