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
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
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Fetal hypoxia is typically indicated by abnormal FHR patterns, such as late decelerations, decreased or absent variability, bradycardia, or prolonged decelerations. In this scenario, the FHR shows a normal baseline, moderate variability, and accelerations, all of which suggest adequate oxygenation and fetal well-being.
B. Tachycardia is defined as a baseline FHR greater than 160 beats per minute. Causes of fetal tachycardia can include maternal fever, infection, medications, or fetal hypoxia, but this fetus has a baseline of 135 bpm, which is within the normal range of 110–160 bpm, so tachycardia is not present.
C. Bradycardia is defined as a baseline FHR less than 110 beats per minute. Causes of bradycardia can include prolonged cord compression, maternal hypotension, or congenital heart conditions, but this fetus has a baseline of 135 bpm, ruling out bradycardia.
D. This fetus exhibits a reassuring FHR pattern characterized by a normal baseline indicating adequate cardiac function, moderate variability reflecting an intact autonomic nervous system and good oxygenation, presence of accelerations demonstrating a responsive, well-oxygenated fetus, and absence of decelerations, indicating there is no evidence of uteroplacental compromise or cord compression.
Correct Answer is A
Explanation
A. Stadol (butorphanol) is an opioid agonist-antagonist that can cause respiratory depression in both mother and fetus if administered too rapidly or at the wrong time. Administering through the port farthest from the IV insertion site allows the medication to dilute in the bloodstream before reaching systemic circulation, reducing the risk of adverse effects.
B. Rapid IV fluid administration is not necessary and may cause fluid overload or exacerbate maternal hypotension. Standard IV maintenance rates are sufficient unless otherwise indicated.
C. Opioids should be administered between contractions, not during them, because giving the medication during a contraction can peak in the maternal bloodstream too quickly, increasing fetal exposure and risk of neonatal respiratory depression.
D. Stadol should be administered slowly over 3–5 minutes to prevent maternal adverse effects, including hypotension, respiratory depression, dizziness, and nausea. Rapid administration increases risk to both mother and fetus.
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