A woman is 6 weeks pregnant.
She has had a previous spontaneous abortion at 14 weeks of gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl.
What is her gravidity and parity using the GTPAL system?
3-1-0-1-0.
2-0-0-1-1.
2-1-0-1-0.
3-0-1-1-0.
The Correct Answer is A
Choice A rationale
Gravidity is the total number of pregnancies, regardless of outcome, which is three: the current pregnancy, the previous spontaneous abortion, and the pregnancy ending in a stillbirth. Parity is broken down by the TPAL system: Term (T) = 0 (stillbirth was at 38 weeks, term is 37 to 42 weeks), Preterm (P) = 1 (pregnancy ending at 38 weeks, though close to term, is often counted here depending on local definition, but the most common classification is T = 1, P = 0, however, given the choices, A is the closest fit for G=3). Abortions (A) = 1 (spontaneous abortion at 14 weeks). Living children (L) = 0 (the second pregnancy was a stillbirth). The standard G3 P1010 would be correct if the 38 week birth was considered Term, making A the closest fit based on given options.
Choice B rationale
This option is incorrect because the woman has been pregnant three times (current, spontaneous abortion, stillbirth), making the Gravidity (G) 3, not 2. Furthermore, the number of pregnancies ending in Term (T), Preterm (P), Abortions (A), and Living children (L) does not match the obstetric history provided in the question, as G must equal T plus P plus A plus the current pregnancy.
Choice C rationale
This option is incorrect because the woman has a Gravidity (G) of 3, encompassing the current pregnancy, the prior spontaneous abortion, and the previous pregnancy ending in stillbirth. Parity (P) is also misrepresented, as the total number of previous pregnancies reaching viability (20 weeks) is two, but the T, P, A, and L components must be calculated separately, and the G count is wrong.
Choice D rationale
This option is incorrect because it inaccurately calculates the components of parity. The total pregnancies (Gravidity) is correctly listed as 3. However, the breakdown of Term (T)=0, Preterm (P)=1, Abortions (A)=1, and Living (L)=0 does not align with the history. T should be 1, P should be 0, A should be 1, and L should be 0, which is G3 T1 P0 A1 L0.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Administering a narcotic analgesic may provide pain relief, but the woman's immediate need is for coping strategies and techniques to manage the present overwhelming sensation of pain and anxiety; teaching breathing first addresses the immediate crisis of her uncontrolled response to contractions.
Choice B rationale
Offering false reassurance that labor will be over soon is unhelpful and undermines trust, as the woman is in the active phase of labor (3 cm dilated), which can last many more hours, and this statement does not provide her with any practical coping mechanisms for her current distress.
Choice C rationale
Assisting the patient with simple breathing and relaxation instructions is the most important initial nursing action because it provides her with immediate, practical coping tools to decrease her pain perception, reduce anxiety, conserve energy, and regain a sense of control over her intense contractions.
Choice D rationale
Notifying the healthcare provider is important for updating them on labor progress and discussing pain management options like an epidural, but it is not the most immediate priority; the nurse must first intervene to help the patient manage her unmanaged pain and distress effectively using non-pharmacological methods.
Correct Answer is ["A","C","D","E"]
Explanation
Choice A rationale
Urinary frequency is a presumptive sign of pregnancy often caused by hormonal changes, particularly increased human chorionic gonadotropin (hCG) and progesterone, and pressure from the enlarging uterus on the bladder, leading to a reduced bladder capacity and increased renal blood flow and filtration rate.
Choice B rationale
A positive urine pregnancy test is a probable sign of pregnancy, as it is highly suggestive but not entirely conclusive. It detects the presence of human chorionic gonadotropin (hCG), which can also be elevated due to certain tumors or conditions other than a viable intrauterine pregnancy.
Choice C rationale
Breast changes, such as fullness, tenderness, and darkening of the areolae, are presumptive signs. These changes are stimulated early in pregnancy by elevated levels of estrogen and progesterone, preparing the mammary glands for lactation and causing vascular engorgement and glandular hyperplasia.
Choice D rationale
Quickening refers to the maternal perception of fetal movement, usually felt between 16 and 20 weeks gestation. Because it is a subjective sensation, it is classified as a presumptive sign; it could potentially be confused with peristalsis or gas in the abdomen.
Choice E rationale
Amenorrhea, the cessation of menstruation, is an early and very common presumptive sign of pregnancy. It is caused by the hormonal milieu, primarily the sustained production of progesterone by the corpus luteum, which prevents the shedding of the endometrial lining.
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