A pregnant client at 28 weeks gestation comes for her prenatal visit. The nurse obtains her OB history. She delivered her infant at 40.4 weeks, delivered at 37 weeks but the infant died at 2 months old, another infant born at 34 weeks. Using the GTPAL system, the nurse will list the client's OB history in the prenatal chart as?

G4 T3 PO AO L2

G4 T2 P1 AO L2

G4 T2 P1 AO L3

G4 T1 P2 AO L3

Answer and Explanation

The Correct Answer is B

A. G4 T3 P0 A0 L2 is incorrect because the client has only two term deliveries, not three, and she has had one preterm birth.

B. G4 T2 P1 A0 L2 is correct based on the following OB history:

G (Gravida) = 4: She has been pregnant four times, including the current pregnancy.
T (Term) = 2: Two deliveries occurred at term (40.4 weeks and 37 weeks).
P (Preterm) = 1: One infant was born preterm at 34 weeks.
A (Abortions) = 0: There is no history of miscarriage or elective termination before 20 weeks.
L (Living) = 2: Two children are currently living. The infant born at 37 weeks died at 2 months and is not counted as living.

C. G4 T2 P1 A0 L3 is incorrect because only two children are living, not three.

D. G4 T1 P2 A0 L3 is incorrect because the client has two term deliveries, not one, and only one preterm delivery.

Nursing Test Bank

Test Bank #1: RN Pharmacology Exams Test Bank #2: RN Medical-Surgical Exams Test Bank #3: RN Fundamentals Exams Test Bank #4: RN Maternal-Newborn Exams Test Bank #5: RN Anatomy and Physiology Exams Test Bank #6: RN Obstetrics and Pediatrics Exams Test Bank #7: RN Fluid and Electrolytes Exams Test Bank #9: RN Adult Health Test Bank #10: RN Dosage Calculation Test Bank #11: RN Community Health Exams Test Bank #12: RN Psychology Exams Test Bank #13: RN Nursing Care Of Children Test Bank #14: RN Foundations of Nursing Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Exam #1: RN Comprehensive predictor 2023 proctored exam Exam #2: Ati rn vati comprehensive predictor proctored exam Exam #3: Ati Rn Comprehensive Predictor Proctored Exam 2023 Exam #4: Rn Comprehensive Predictor 2023 Proctored Exam - St. Joseph Exam #5: RN Comprehensive Predictor Proctored Exam (National U CA San Diego) Exam #6: Ati rn comprehensive predictor 2023 retake proctored exam Exam #7: RN Hesi Exit Proctored Exam Exam #8: Hesi RN Exit proctored exam Exam #9: Hesi rn exit proctored exam Exam #10: Hesi Rn compass exit B proctored exam

Free Nursing Study Resources

Correct Answer is C

Explanation

A. One cm above the symphysis pubis is typical immediately postpartum (within a few hours) for a fundus that has already begun involuting, but by 26 hours, the uterus is expected to have risen slightly above the umbilicus, so this is too low for this timeframe.

B. Midline at the umbilicus occurs approximately 12 hours postpartum, when the uterus has involuted upward to the level of the umbilicus. At 26 hours, the fundus is expected to have slightly involuted from the umbilicus, but still slightly above it.

C. Midline, 1 cm above the umbilicus is the expected location about 24 hours postpartum. The uterus remains firm and midline but gradually descends approximately 1 cm per day as involution continues. This finding is considered normal for a client 26 hours after delivery.

D. Midline, 2 cm above the umbilicus would be expected closer to immediately postpartum, not 26 hours later. By this time, the fundus has already begun to descend as part of the normal involution process.

A. A client at 8 cm dilation and requesting to push B. A client with vaginal bleeding and no complaints of abdominal pain C. A client in latent labor with cervical dilation of 2 cm D. A client with ruptured membranes and regular contractions

Correct Answer is B

Explanation

A. Vaginal exams are appropriate in this scenario. Assessing cervical dilation, effacement, fetal station, and position is critical at this stage of labor to determine whether the client is ready to begin pushing. Performing the exam helps guide safe labor management and supports maternal and fetal outcomes.

B. Vaginal exams are contraindicated in the presence of unexplained vaginal bleeding during pregnancy, particularly in the third trimester, because the bleeding could indicate placenta previa, vasa previa, or other serious placental issues. Performing a vaginal exam in such cases risks provoking severe hemorrhage, leading to maternal hypovolemic shock and fetal compromise. Before performing any vaginal examination, the cause of bleeding must be evaluated using non-invasive methods such as ultrasound, fetal monitoring, and laboratory studies. Even if the client is asymptomatic for pain, the risk of disrupting placental attachment makes vaginal exams unsafe.

C. Vaginal exams are safe and routine in latent labor. They help monitor cervical progression, effacement, and fetal position. Frequent exams may be limited to reduce infection risk, but there is no absolute contraindication in a low-risk latent labor client.

D. Vaginal exams are generally indicated after rupture of membranes to monitor labor progress. However, precautions must be taken to maintain aseptic technique and reduce the risk of infection (chorioamnionitis). Unless other contraindications exist (such as vaginal bleeding from placenta previa or signs of infection), the exam is considered safe and clinically necessary.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who delivered vaginally 26 hours ago. When palpating the client's abdomen, where should the nurse expect to find the uterine fundus during her assessment?

Correct Answer is C

Explanation

A labor and delivery nurse is orienting a newly hired nurse and is educating her on contraindications for vaginal exams. In which of the following scenarios is a vaginal exam contraindicated?

Correct Answer is B

Explanation

A nurse is caring for a client who has a suspected ectopic pregnancy at 8 weeks of gestation. Which of the following manifestations should the nurse expect to identify as consistent with the diagnosis?

A nurse is caring for a newborn in the delivery room. Which of the following nursing actions is most effective in preventing heat loss via conduction?

A nurse in a prenatal clinic is caring for a client who is suspected of having hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?

A client is admitted to the labor and birth unit at 32 weeks' gestation with gestational hypertension. Which of the following assessment findings may be signs that the client is developing preeclampsia?

A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?

A 36 weeks gestation client at risk for preterm labor presents to the clinic. The nurse understands the indication to perform an amniocentesis at this time is to assess for what?

A breastfeeding woman develops engorged breasts at 3 days postpartum. What action will help this client achieve her goal of reducing the engorgement?