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The nurse is determining the G/TPAL of a patient at her first prenatal visit. The patient informs the nurse she delivered a set of twins at 32 weeks of gestation who are now 5 years old, delivered her first child 8 years ago 1 week early, and miscarried at 2 months' gestation 3 years ago. What is this patient's Gravida [G] and Parity [P] using the G/TPAL nomenclature?
- A. G3 P1113
- B. G3 P2113
- C. G4 P1113
- D. G4 P2113
Correct Answer: D
Rationale: The correct answer is D: G4 P2113. To determine the Gravida (G) and Parity (P) of the patient:
- Gravida (G): The patient has been pregnant a total of 4 times (twins at 32 weeks, first child 1 week early, miscarriage at 2 months, and current pregnancy). Therefore, G is 4.
- Parity (P): P is divided into four categories: term births (T), preterm births (P), abortions (A), and living children (L). The patient delivered twins at 32 weeks (P2), her first child 1 week early (T1), and had a miscarriage at 2 months (A1). Therefore, the Parity is P2A1L3, represented as 2113. Other choices are incorrect because they do not accurately reflect the patient's obstetric history.
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A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?
- A. A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
- B. Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
- C. The IUD will need to be removed to avoid complications such as miscarriage or infection.
- D. The IUD will need to remain in place to avoid injuring the fetus.
Correct Answer: C
Rationale: Rationale:
C is correct because when a patient with an IUD in place has a positive pregnancy test, the IUD should be removed to avoid complications such as ectopic pregnancy, miscarriage, or infection. Leaving the IUD in place can increase the risk of adverse outcomes for both the mother and the fetus. Removing the IUD allows for safer management of the pregnancy and reduces potential harm.
Summary:
A: Incorrect. Fetal damage is not inevitable, and a therapeutic abortion is not the immediate action required in this situation.
B: Incorrect. Hormonal analyses are not the priority when a positive pregnancy test with an IUD in place is detected.
D: Incorrect. Leaving the IUD in place can lead to complications and is not the recommended course of action.
What does a birth plan help the parents accomplish?
- A. Avoidance of an episiotomy
- B. Determining the outcome of the birth
- C. Assuming complete control of the situation
- D. Taking an active part in planning the birth experience
Correct Answer: D
Rationale: The correct answer is D because a birth plan allows parents to actively participate in planning their birth experience by outlining their preferences and wishes. It helps them communicate their desires to healthcare providers and ensures their preferences are considered during labor and delivery. Choice A is incorrect as avoiding an episiotomy is a specific medical procedure, not the primary purpose of a birth plan. Choice B is incorrect as determining the outcome of birth is not within the control of parents. Choice C is incorrect as assuming complete control of the situation may not be realistic or safe during childbirth.
The nurse is discussing the purpose of the physical examination with a patient at the first prenatal visit. What information does the nurse include in the discussion?
- A. The physical exam helps to confirm the patient's current health.
- B. The physical exam determines nutritional risk factors.
- C. The physical exam confirms the diagnosis of STIs.
- D. The physical exam includes urinalysis.
Correct Answer: A
Rationale: The correct answer is A because the physical exam at the first prenatal visit aims to confirm the patient's current health status, assess baseline health indicators, and identify any potential risks or issues that may affect the pregnancy. This information is crucial for developing a personalized care plan for the patient and ensuring a healthy pregnancy outcome.
Choice B is incorrect because determining nutritional risk factors typically involves assessing dietary habits, weight, and specific nutrient deficiencies, which are not solely addressed through a physical exam.
Choice C is incorrect as confirming the diagnosis of STIs would require specific testing and not solely rely on a physical examination.
Choice D is incorrect because while urinalysis may be part of the physical exam, its primary purpose is not solely to include urinalysis but to comprehensively evaluate the patient's overall health.
The nurse is completing the family assessment on a patient at 10 weeks of gestation. What data are included in the family assessment? Select all that apply.
- A. annual income
- B. total number of cousins
- C. number of people living in the household
- D. person in the household who makes the major decisions for the family
Correct Answer: A
Rationale: The correct answer is A: annual income. This data is crucial for assessing the family's financial resources and potential impact on the patient's health and well-being during pregnancy. Annual income can help identify possible financial stressors that may affect access to healthcare, nutrition, and overall prenatal care.
B: Total number of cousins is not typically part of a family assessment during pregnancy and does not directly impact the patient's prenatal care.
C: Number of people living in the household is important for understanding the household dynamics, but it may not be directly related to the patient's prenatal care needs.
D: Identifying the person in the household who makes major decisions is important for understanding family dynamics, but it may not directly impact the patient's prenatal care.
The nurse is measuring the fundal height of a patient who is at 34 weeks of gestation. What fundal height measurement is expected for a patient who is at 34 weeks of gestation?
- A. 31 cm
- B. 33 cm
- C. 37 cm
- D. 38 cm
Correct Answer: C
Rationale: The correct answer is C (37 cm) because at 34 weeks of gestation, the fundal height measurement should be approximately equal to the number of weeks of gestation in centimeters. This is known as the "fundal height equals gestational age" rule. Therefore, at 34 weeks, the expected fundal height measurement should be around 34 cm. Option C (37 cm) is the closest to this expected measurement. Options A, B, and D are incorrect as they do not align with the fundal height expected at 34 weeks of gestation. Option A (31 cm) is too low, Option B (33 cm) is also lower than expected, and Option D (38 cm) is too high for 34 weeks of gestation.