A nurse is reviewing the prenatal record of a client at 28 weeks' gestation.
The woman's history reveals: two pregnancies terminated by elective abortion at 8 and 10 weeks; the birth of twin girls at 36 weeks; and a spontaneous abortion of twins at 12 weeks.
According to the Gravida Para TPAL system, which of the following describes the client's present situation?

5-1-0-2-1

5-1-0-1-3-2

4-2-0-2-0-2

3-1-2-0-2-2

Answer and Explanation

The Correct Answer is A

Choice A rationale

This represents 5 pregnancies (2 elective abortions, 1 twin birth, 1 spontaneous twin abortion, and current pregnancy), 1 term birth, 0 preterm births, 2 abortions (excluding current pregnancy), and 1 living child.

Choice B rationale

Incorrect because it lists 1 term birth and 3 abortions, which does not accurately reflect the client's history.

Choice C rationale

Incorrect because it states 4 pregnancies and 2 living children, missing the current pregnancy and miscounting the living children.

Choice D rationale

Incorrect as it accounts for 3 pregnancies, incorrectly summing the term birth and spontaneous abortions without considering the current pregnancy.

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Choice A rationale

Intrauterine growth restriction (IUGR) is a significant risk for newborns of mothers who smoke. Smoking affects placental blood flow, reducing the supply of oxygen and nutrients to the fetus, leading to poor growth.

Choice B rationale

Smoking is not a direct cause of gestational diabetes. Gestational diabetes is primarily related to hormonal changes in pregnancy that affect insulin regulation.

Choice C rationale

Congenital heart defects are not directly linked to smoking. They are usually caused by genetic and environmental factors during early fetal development, not smoking specifically.

Choice D rationale

Vision loss is not directly associated with maternal smoking. Smoking affects fetal growth and development, but vision loss is not a common outcome.

A. 28-year-old with history of rheumatic heart disease. B. 40-year-old with a history of preterm labor. C. 18-year-old with exposure to HIV. D. 35-year-old with a child with spina bifida.

Correct Answer is D

Explanation

Choice A rationale

While a history of rheumatic heart disease is significant, it does not directly correlate with the need for priority teaching on Quad screening. This condition requires careful cardiac monitoring and management during pregnancy.

Choice B rationale

A history of preterm labor is important and may require additional monitoring and interventions, but it is not a direct indication for priority teaching on Quad screening, which assesses risk for certain fetal conditions.

Choice C rationale

Exposure to HIV requires careful management and monitoring to reduce the risk of mother-to-child transmission. However, it is not specifically linked to the need for Quad screening, which is focused on detecting chromosomal abnormalities.

Choice D rationale

A history of having a child with spina bifida places this client at higher risk for having another child with neural tube defects or chromosomal abnormalities. Therefore, priority teaching on Quad screening, which includes markers for such conditions, is essential. .

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Naxlex Comprehensive Predictor Exams

A nurse is speaking with a client who is 6 weeks' gestation.The client tells the nurse that she smokes one pack per day, but is trying to quit.The nurse should explain that newborns born to women who smoke are at risk for:

Correct Answer is A

Explanation

Each of the following pregnant women is scheduled for a 14-week antepartal visit.In planning care, the nurse would give priority teaching on Quad screening to which client?

Correct Answer is D

Explanation

At her first prenatal visit, a woman and the nurse are discussing fetal development.The client asks, "When will we be able to hear the baby's heartbeat?" The nurse should reply, The fetal heartbeat can be heard with a Doppler at:

A patient has tested positive for a sexually transmitted infection (STI). Which actions are essential in the management of this condition?

A nurse is caring for a client who is coming in for her first prenatal visit and it is estimated to be 9 weeks gestation.An ultrasound is scheduled.The nurse should explain to the client that the ultrasound is being done today to assess for which of the following?

The nurse who is assessing a G2 P1 client palpates the fundal height at the location noted on the picture below (near the umbilicus). The nurse concludes that the fetus is equal to which of the following gestational ages?

A primigravida is 18 weeks gestation and asks the nurse how long it will be until she feels the baby move.The best response by the nurse is:

A nurse is reviewing the electronic medical record of a pregnant client who reports regular use of alcohol. Which of the following findings should the nurse identify as an indication the client may be at risk for polysubstance use disorder? (Select All that Apply)

A pregnant patient enjoys exercising at a local health spa once a week.Which patient comment indicates to the nurse that more health teaching is needed?

A nurse is teaching a client who is 26 weeks pregnant and will be receiving an injection of Rh(D) immunoglobulin.Which of the following should be included in the teaching?