A nurse in a prenatal clinic is reviewing the record of a patient at 28 weeks gestation. The woman's history reveals one pregnancy terminated by elective abortion at 12 weeks; the birth of twins at 34 weeks and a spontaneous abortion at 15 weeks. According to the GTPAL system, which of the following describes her present situation?
4-0-1-2-2
4-2-0-2-2
20-02-2
30-2-0-2
The Correct Answer is A
Step 1: Understand GTPAL
G = Gravida (total number of pregnancies, including current)
T = Term births (≥37 weeks)
P = Preterm births (20–36 6/7 weeks)
A = Abortions (spontaneous or elective <20 weeks)
L = Living children
Step 2: Count based on patient history
Gravida (G): Total pregnancies = 1 elective abortion + twins + spontaneous abortion = 3 completed pregnancies + current pregnancy = 4 → G = 4
Term births (T): Birth ≥37 weeks = None → T = 0
Preterm births (P): Birth 20–36 6/7 weeks = twins at 34 weeks → P = 1
Abortions (A): Spontaneous or elective <20 weeks = elective abortion at 12 weeks + spontaneous at 15 weeks → A = 2
Living children (L): Twins survived → L = 2
Step 3: Combine numbers
G = 4, T = 0, P = 1, A = 2, L = 2 → 4-0-1-2-2
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Psychosocial environment is incorrect because while a stimulating and supportive environment can influence growth indirectly, the primary concern for minimal weight gain and fatigue in an infant is related to intake and nutritional status rather than parental interaction or emotional factors alone.
B. Genetics is incorrect because both parents are of average height, suggesting that hereditary factors are unlikely to explain poor weight gain in this infant. Genetic potential affects height and weight trends but would not typically cause sudden minimal weight gain and fatigue.
C. Daycare setting is incorrect because while meal patterns and activity level at daycare could influence intake, the report of decreased appetite and fatigue suggests a direct nutritional or health issue rather than environmental influence alone.
D. Nutrition is correct because insufficient caloric or nutrient intake is the most likely cause of poor weight gain, low energy, and fatigue in a 9-month-old. At this age, infants rely on adequate nutrition from breast milk, formula, or complementary foods to support rapid growth and development.
Correct Answer is D
Explanation
A. Administer a dose of oral antibiotics to treat the infection is incorrect because most cases of croup are viral in origin (commonly parainfluenza virus). Antibiotics are not indicated unless there is a secondary bacterial infection.
B. Place the child in a supine position to facilitate airflow to the lungs is incorrect because lying flat may worsen respiratory distress in a child with croup. Upright positioning is preferred to ease breathing.
C. Encourage the child to lie down to conserve energy is incorrect because supine positioning can increase airway obstruction and worsen stridor. Allowing the child to remain upright and calm is safer.
D. Provide a cool mist humidifier or take the child outside into cool night air is correct because cool, moist air helps reduce laryngeal inflammation and edema, which can relieve stridor and improve breathing. This is a first-line, noninvasive intervention to manage mild to moderate croup symptoms while minimizing respiratory distress.
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