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 ["A","B","C","D"]

Explanation

Choice A Reason: This is correct because cloudy malodorous fluid indicates that the amniotic fluid is contaminated with bacteria or other microorganisms that can cause infection in the woman or the fetus. Normally, amniotic fluid is clear and odorless.

Choice B Reason: This is correct because abdominal tenderness suggests that the woman has inflammation or irritation of the uterus or other pelvic organs due to infection. Abdominal tenderness can also be accompanied by cramping, pain, or fever.

Choice C Reason: This is correct because fetal bradycardia, which is a slow fetal heart rate below 110 beats per minute, indicates that the fetus is experiencing distress or hypoxia due to infection. Fetal bradycardia can be detected by electronic fetal monitoring or Doppler device.

Choice D Reason: This is correct because elevated maternal pulse rate, which is a heart rate above 100 beats per minute, indicates that the woman has an increased metabolic demand or systemic inflammation due to infection. Elevated maternal pulse rate can also be caused by dehydration, anxiety, or pain.

Choice E Reason: This is incorrect because decreased C-reactive protein levels do not indicate infection. C-reactive protein (CRP) is a protein that is produced by the liver in response to inflammation or infection. Increased CRP levels can be a sign of infection, but decreased CRP levels can be normal or indicate other conditions such as liver disease or malnutrition.

A. February 18 B. January 18 C. January 8 D. December 28 E. December 18

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.

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Naxlex Comprehensive Predictor Exams

A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings would lead the nurse to suspect that the woman is developing an infection? Select all that apply.

Correct Answer is ["A","B","C","D"]

Explanation

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 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.

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

A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which findings would the nurse most likely assess? Select all that apply.

A nurse is assessing a client who may be pregnant. The nurse reviews the client's history for presumptive signs. Which signs would the nurse most likely note? Select all that apply.

During a prenatal visit, a pregnant woman says, "I know the amniotic fluid is important, but can you tell me more about it?" When describing amniotic fluid to a pregnant woman, which description would the nurse most likely include?

A pregnant woman in the 36th week of gestation reports that her feet are quite swollen at the end of the day. After careful assessment, the nurse determines that this is an expected finding at this stage of pregnancy. Which intervention is appropriate for the nurse to suggest?