The nurse is caring for a client at 8 weeks gestation whose pregnancy history includes: Elective termination of pregnancy at 10 weeks gestation 8 years ago.

Spontaneous abortion at 17 weeks gestation 4 years ago.

Term vaginal delivery at 39 weeks gestation of a two-year-old child.

What is the correct documentation of gravidity and parity for this client?

The scenario requires application of public health education and adolescent communication principles. Knowledge of asymptomatic sexually transmitted infections and barrier methods is essential to address the client resistance while maintaining a therapeutic relationship and promoting preventative health screenings in a non-judgmental manner.

Choice A rationale

Many infections, particularly chlamydia and gonorrhea, are asymptomatic in females. Without screening, these can lead to pelvic inflammatory disease or infertility. Education on silent transmission is the primary evidence-based method to encourage diagnostic compliance in sexually active populations.

Choice B rationale

Monogamy reduces but does not eliminate risk if the partner has an undiagnosed infection. This statement provides a false sense of security and ignores the reality of previous exposure or partner infidelity, violating basic health promotion standards.

Choice C rationale

This response is judgmental and shaming, which destroys the nurse-client relationship. Discussing abstinence after a client is already sexually active is non-therapeutic and fails to address the immediate clinical need for screening and risk reduction.

Choice D rationale

Linking infection risk strictly to race or background is discriminatory and lacks clinical nuance. While health disparities exist, stereotyping the client based on demographics is unprofessional and fails to address the individual biological risk factors of sexual activity.

This obstetric scenario requires the application of maternal-fetal nursing knowledge regarding labor complications. Assessment priorities in the active phase must distinguish between normal labor progression and life-threatening emergencies like placental abruption or uterine rupture, requiring physical evaluation before intervention.

Choice A rationale

Pain medications might mask symptoms of a serious complication like placental abruption. Providing pharmacological relief without first assessing the source of sudden, severe abdominal pain violates the nursing process and delays necessary emergency interventions.

Choice B rationale

Assessing for vaginal bleeding and uterine tone is the priority to evaluate for placental abruption. Severe, constant abdominal pain during labor is an emergency signal. The normal assessment findings would show intermittent contraction-related discomfort.

Choice C rationale

Pulse oximetry measures systemic oxygen saturation but is not the most specific assessment for a fetal or uterine emergency. While vital signs are important, they do not pinpoint the cause of the acute abdominal pain.

Choice D rationale

Preparing for surgery is a premature action before a definitive assessment of the pain is performed. Although a cesarean may eventually be necessary, the nurse must first gather clinical evidence to justify such an intervention.