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 B

Explanation

A. Notify social services – Not the first action; the nurse must assess the situation before reporting.
B. Ask the parents what caused the bruises – Correct; gathering information helps differentiate normal bruising from possible abuse.
C. Ask the toddler what caused the bruises – Not the best initial approach, as toddlers may not provide reliable explanations.
D. Notify the provider – Appropriate but should come after assessing the situation.

A. Maturation of germ cells in ovaries B. Gender differentiation takes place C. Implantation begins D. Differentiation begins

Correct Answer is B

Explanation

A. Maturation of germ cells in ovaries – Incorrect; this occurs later in fetal development and after birth.

B. Gender differentiation takes place – Correct; the embryonic stage (weeks 3-8) is when gender differentiation occurs at around week 7-8.

C. Implantation begins – Incorrect; implantation happens in the blastocyst stage (week 1-2), before the embryonic stage.

D. Differentiation begins – Incorrect; cell differentiation starts earlier, in the blastocyst stage, before full embryonic development.

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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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