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The nurse in an OB clinic is completing an intake assessment of a client at the first prenatal appointment. The client is currently 9 weeks pregnant. She had a miscarriage at 7 weeks and an ectopic pregnancy at 6 weeks that was treated with methotrexate. Her five-year-old son was born vaginally at 39 weeks and her three-year-old daughter was born vaginally at 35 weeks.
What is her GTPAL?

A.

G4T1 P1 A1 L2.

B.

G5T2 P0 A2 L2.

C.

G5T1 P1 A2 L2.

D.

G5T1 P1 A1 L3.

E.

G5T1 P1 A1 L3.

Answer and Explanation

The Correct Answer is C

Choice A rationale

G4T1 P1 A1 L2 implies the client has been pregnant 4 times, with 1 term birth, 1 preterm birth, 1 abortion, and 2 living children. This does not include the correct number of

pregnancies or abortions for this client.

 

Choice B rationale

G5T2 P0 A2 L2 indicates 5 pregnancies, 2 term births, no preterm births, 2 abortions, and 2 living children. This does not correctly account for the preterm birth and abortion history

provided.

 

Choice C rationale

G5T1 P1 A2 L2 is the correct answer, as it denotes 5 pregnancies (including the current one), 1 term birth, 1 preterm birth, 2 abortions, and 2 living children, aligning with the client's

history.

 

Choice D rationale

G5T1 P1 A1 L3 indicates 5 pregnancies, 1 term birth, 1 preterm birth, 1 abortion, and 3 living children. The client has only 2 living children, so this is incorrect.


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Correct Answer is A

Explanation

Choice A rationale

Anaphylactoid syndrome of pregnancy (also known as amniotic fluid embolism) occurs when amniotic fluid, fetal cells, hair, or other debris enter the mother's bloodstream, triggering

a serious reaction. It can cause sudden shortness of breath, cardiovascular collapse, and other severe symptoms immediately after a rupture of membranes and is a rare but critical

obstetrical emergency.

Choice B rationale

Abruptio placentae involves the premature separation of the placenta from the uterine wall, which leads to bleeding and potential fetal and maternal distress. However, it does not

typically present with sudden cardiorespiratory collapse or shortness of breath immediately following membrane rupture.

Choice C rationale

Uterine rupture refers to a tear in the wall of the uterus, usually due to trauma, labor stress, or previous surgical scars. While it is a severe condition, it usually presents with

abdominal pain, vaginal bleeding, and fetal distress rather than sudden respiratory failure.

Choice D rationale

Disseminated intravascular coagulation (DIC) is a condition affecting blood clotting processes, often secondary to other conditions like severe preeclampsia, sepsis, or trauma. It

generally presents with bleeding and clotting issues but not sudden respiratory or cardiovascular collapse.

Correct Answer is B

Explanation

Choice A rationale

The supine position is not recommended for breastfeeding because it can lead to issues with latching and milk flow, making it uncomfortable and potentially unsafe.

Choice B rationale

The cradle position is a common and effective breastfeeding position where the baby's head rests in the crook of the mother's arm, allowing for close contact and support.

Choice C rationale

Upright with chin support is not a standard breastfeeding position and may not provide the necessary support or alignment for effective breastfeeding.

Choice D rationale

Over-the-shoulder is also not a recommended breastfeeding position as it is impractical and does not facilitate proper latching or feeding.

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