A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has a 7-year-old daughter who was born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:
3-2-1-0-2
4-1-1-1-3
4-1-1-1-2
4-1-2-0-3
The Correct Answer is C
Choice A Reason: 3-2-1-0-2. This is an incorrect answer that underestimates the number of pregnancies and overestimates the number of preterm births. The client has had four pregnancies, not three. She has had one preterm birth, not two.
Choice B Reason: 4-1-1-1-3. This is an incorrect answer that overestimates the number of living children. The client has two living children, not three.
Choice C Reason 4-1-1-1-2. This is because the GTPAL method is a way of summarizing a woman's obstetric history using five numbers: G (gravida), T (term births), P (preterm births), A (abortions), and L (living children). Gravida is the number of pregnancies, regardless of outcome. Term births are deliveries after 37 weeks' gestation. Preterm births are deliveries between 20 and 37 weeks' gestation. Abortions are pregnancies that end before 20 weeks' gestation, either spontaneously or electively. Living children are the number of children who are alive at the time of assessment.
Choice D Reason: 4-1-2-0-3. This is an incorrect answer that overestimates the number of preterm births and living children, and underestimates the number of abortions. The client has had one preterm birth, not two. She has had one abortion, not zero. She has two living children, not three.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason: Preterm infant. This is an incorrect answer that confuses TTN with another respiratory condition called respiratory distress syndrome (RDS). RDS is a serious condition where the newborn's lungs are immature and lack sufficient surfactant, which is a substance that reduces surface tension and prevents alveolar collapse. RDS can cause respiratory distress, hypoxia, acidosis, and organ failure. It is more common in preterm infants, especially those born before 37 weeks' gestation.
Choice B Reason: Female infant. This is an incorrect answer that has no evidence or rationale to support it. TTN does not have a gender preference or difference in incidence or severity.
Choice C Reason: GBS status of mother. This is an incorrect answer that relates to another respiratory complication called early-onset neonatal sepsis (EONS). EONS is a bacterial infection that occurs within 72 hours after birth, which can affect multiple organs and systems in the newborn. EONS can be caused by group B streptococcus (GBS), which is a common bacterium that colonizes in some women's vagina or rectum. GBS can be transmited to the newborn during delivery and cause pneumonia, meningitis, or septic shock.
Choice D Reason: Cesarean section. This is because cesarean section is a risk factor for TTN, which is a mild respiratory problem that results from delayed clearance of fetal lung fluid after birth. TTN causes rapid breathing, nasal flaring, grunting, and mild cyanosis. It usually resolves within 24 to 48 hours after birth. Cesarean section can increase the risk of TTN because it bypasses the normal process of labor, which helps squeeze out some of the fluid from the fetal lungs.

Correct Answer is B
Explanation
Choice A Reason: Pulmonary edema is a condition where fluid accumulates in the lungs, causing shortness of breath and difficulty breathing. It can occur in preeclampsia due to increased blood pressure and fluid retention, but it is not a definitive sign of eclampsia.
Choice B Reason: Convulsion (seizure) is a sudden, involuntary contraction of muscles that can cause loss of consciousness, shaking, and twitching. It is the main symptom of eclampsia and distinguishes it from preeclampsia.
Choice C Reason: Renal failure is a condition where the kidneys fail to filter waste products from the blood, resulting in high levels of creatinine and urea. It can occur in preeclampsia due to reduced blood flow to the kidneys, but it is not a specific indicator of eclampsia.
Choice D Reason: Retinal edema is a condition where fluid leaks into the retina, causing blurred vision and flashes of light. It can occur in preeclampsia due to increased blood pressure and damage to the blood vessels in the eye, but it is not a characteristic feature of eclampsia.

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