The nurse is obtaining an obstetrical history on a currently pregnant woman. The client has an 18-month-old daughter who was delivered 2 days after estimated due date and a 3-year-old son who was born at 35 weeks' gestation. Before her son was born, she lost two pregnancies: one at 10 weeks and the other at 22 weeks. Using the GTPAL method, how would the nurse record this history?
G5 T1 P2 A1 L2
G5 T2 P2 A1 L2
G4 T1 P2 A2 L2
G4 T1 P1 A2 L2
The Correct Answer is A
A) G5 T1 P2 A1 L2:
G (Gravida): Gravida refers to the total number of pregnancies, including the current pregnancy. In this case, the woman is currently pregnant and has had 4 previous pregnancies (one miscarriage at 10 weeks, one at 22 weeks, and two live births). Therefore, her Gravida (G) is 5.
T (Term births): Term births are those that occur at or after 37 weeks of gestation. The woman delivered an 18-month-old daughter who was born 2 days after her due date, which is a term birth. Thus, her Term (T) is 1.
P (Preterm births): Preterm births occur between 20 and 36 weeks of gestation. The woman had a son born at 35 weeks, which is classified as a preterm birth. Therefore, the Preterm (P) is 2.
A (Abortions or miscarriages): Abortions refer to pregnancies that ended before 20 weeks of gestation. The woman experienced two miscarriages, one at 10 weeks and one at 22 weeks. Thus, the Abortions (A) is 1.
L (Living children): Living children are those who are currently alive. The woman has a 3-year-old son and an 18-month-old daughter, so the Living (L) is 2.
Thus, the correct GTPAL classification is G5 T1 P2 A1 L2.
B) G5 T2 P2 A1 L2:
This is incorrect because the woman had only one term birth (not two). She delivered her daughter at term, but the son was preterm (born at 35 weeks). Therefore, her Term (T) should be 1, not 2.
C) G4 T1 P2 A2 L2:
This is incorrect because the woman is currently pregnant, so her Gravida (G) is 5, not 4. Additionally, the woman had 1 abortion, not 2.
D) G4 T1 P1 A2 L2:
This is also incorrect because the woman is currently pregnant, so her Gravida (G) is 5, not 4. Furthermore, the woman had 2 preterm births, not 1.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","E","H","I"]
Explanation
Findings that require follow-up:
Uterus boggy at 24 hr postpartum:
A boggy uterus indicates poor uterine contraction, which can lead to postpartum hemorrhage. Effective uterine contraction is crucial to prevent excessive bleeding after delivery, and this finding warrants immediate intervention, such as fundal massage or administering uterotonic medications.
Lochia rubra with foul odor:
Foul-smelling lochia is a sign of potential infection, often indicative of endometritis, which is an infection of the uterine lining. The presence of this odor requires prompt follow-up and possibly antibiotic treatment to prevent further complications.
Elevated temperature (38.3°C/100.9°F) at 24 hr postpartum:
A postpartum fever may indicate infection, such as endometritis or a urinary tract infection (UTI). This fever should be investigated further to determine the cause and appropriate treatment, as untreated infections can lead to serious complications.
Increased heart rate (105/min) at 24 hr postpartum:
Tachycardia in the postpartum period can be a sign of infection or early signs of hemodynamic instability, possibly due to blood loss or infection. Close monitoring is necessary, and the healthcare provider should be notified to evaluate the cause and initiate treatment if necessary.
Correct Answer is C
Explanation
A) Fetal heart monitoring:
Nurses are trained to monitor fetal heart rates, interpret patterns, and identify signs of distress, but this task is typically within the scope of a registered nurse's (RN) practice. It may not involve the critical decision-making or advanced skills associated with the highest level of licensure.
B) Taking specimens to the lab:
Taking specimens to the laboratory is a necessary but routine part of care. While it is important for ensuring proper diagnostic testing, it is a lower-level task and does not demonstrate the highest level of nursing practice. This task is often delegated or performed as part of standard nursing duties.
C) Performing vaginal delivery:
Performing a vaginal delivery is a high-level skill that typically requires advanced education, certification, and licensure beyond that of a registered nurse. This is usually performed by a midwife, obstetrician, or other healthcare providers with advanced training and certification. In many settings, a registered nurse may assist with vaginal deliveries but cannot independently perform them unless they have additional certifications (such as Certified Nurse Midwife).
D) Giving a client a bed bath:
While important for patient care and comfort, giving a client a bed bath is a basic nursing task that does not demonstrate working at the highest level of licensure. It is a fundamental nursing activity often carried out by nurses, nursing assistants, or other support staff. The act of providing a bed bath is part of the foundational skill set and does not require advanced knowledge or decision-making that would demonstrate the highest level of practice.
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