A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were 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:

3-2-1-0-3

4-1-1-1-3

4-2-1-3-1

3-1-2-2-3

Answer and Explanation

The Correct Answer is B

Choice A Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one preterm birth (the twins), not two.

Choice B Reason: This option is correct because it accurately reflects the client's obstetric history. GTPAL stands for Gravida, Term, Preterm, Abortions, and Living children. Gravida is the number of pregnancies a woman has had, regardless of outcome. Term is the number of pregnancies that ended at or beyond 37 weeks gestation. Preterm is the number of pregnancies that ended between 20 and 36 weeks gestation. Abortions are the number of pregnancies that ended before 20 weeks gestation, either spontaneously or induced. Living children are the number of children who are alive at present.
The client has had four pregnancies (gravida), one term birth (the son), one preterm birth (the twins), one abortion (the miscarriage), and three living children (the twins and the son).

Choice C Reason: This option is incorrect because it overestimates the number of preterm births (preterm) and underestimates the number of living children (living). The client has had one preterm birth (the twins), not two. The client has three living children (the twins and the son), not one.

Choice D Reason: This option is incorrect because it underestimates the number of pregnancies (gravida) and overestimates the number of abortions (abortions) and preterm births (preterm). The client has had four pregnancies (twins count as one pregnancy), not three. The client has had one abortion (the miscarriage), not two. The client has had one preterm birth (the twins), not two.

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Correct Answer is C

Explanation

Choice A Reason: This is incorrect because it adds 10 months and 7 days to the last menstrual period, which is not Nägele's rule.

Choice B Reason: This is incorrect because it adds 9 months and 7 days to the last menstrual period, which is not Nägele's rule.

Choice C Reason: This is correct because it follows Nägele's rule, which is to subtract 3 months and add 7 days to the last menstrual period.

Choice D Reason: This is incorrect because it subtracts 4 months and adds 7 days to the last menstrual period, which is not Nägele's rule.

Choice E Reason: This is incorrect because it subtracts 4 months and adds 17 days to the last menstrual period, which is not Nägele's rule.

A. Be sure that your lupus is stable or in remission for 6 months before getting pregnant. B. It's probably not a good idea for you to get pregnant since you have lupus. C. Your lupus will not have any effect on your pregnancy whatsoever. D. When you get pregnant we'll have to add quite a few medications to your normal treatment plan.

Correct Answer is A

Explanation

Choice A Reason: This is correct because this response provides realistic and supportive advice for a woman who wants to have a baby with lupus. Lupus is an autoimmune disease that causes inflammation and damage to various organs and tissues. Lupus can affect fertility and pregnancy outcomes, such as increasing the risk of miscarriage, preterm delivery, preeclampsia, or neonatal lupus. Therefore, it is important for the woman to have her lupus under control before conceiving and to consult with her doctor about her treatment plan and prenatal care.

Choice B Reason: This is incorrect because this response is discouraging and insensitive for the woman who wants to have a baby with lupus. Lupus does not necessarily prevent a woman from having a healthy pregnancy and a healthy baby, as long as she follows her doctor's recommendations and monitors her condition closely. The nurse should respect the woman's reproductive choices and provide information and support.

Choice C Reason: This is incorrect because this response is inaccurate and misleading for the woman who wants to have a baby with lupus. Lupus can have various effects on pregnancy, such as causing flares or complications that can affect both the mother and the baby. The nurse should educate the woman about the possible risks and benefits of pregnancy with lupus and help her prepare for any challenges.

Choice D Reason: This is incorrect because this response is vague and alarming for the woman who wants to have a baby with lupus. Lupus treatment may or may not change during pregnancy, depending on the type and severity of lupus, the medications used, and the stage of pregnancy. The nurse should explain the rationale and safety of any medication changes and address any concerns or questions that the woman may have.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client's last menstrual period was April 11. Using Nägele's rule, her estimated date of birth (EDB) would be:

Correct Answer is C

Explanation

A woman with a history of systemic lupus erythematosus comes to the clinic for evaluation. The woman tells the nurse that she and her partner would like to have a baby but that they are afraid her lupus will be a problem. Which response would be most appropriate for the nurse to make?

Correct Answer is A

Explanation

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating:

A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?

A provider prescribes quetiapine 50 mg PO divided equally every 12 hours for 3 days. Available is quetiapine 25 mg tablets. How many tablets should the nurse administer per dose on day 3? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which finding?

A nurse is teaching a pregnant client in her first trimester about discomforts that she may experience. The nurse determines that the teaching was successful when the woman identifies which discomforts as common during the first trimester? Select all that apply.