A woman's obstetric history indicates that she is pregnant for the fourth time, and all of her children from previous pregnancies are living. One child was born at 39 weeks of gestation, twin girls were born at 34 weeks of gestation, and the most recent child was born at 35 weeks of gestation. What is her gravidity and parity using the GTPAL system?

Correct Answer: B

Rationale: The correct answer is B: 4-1-2-0-4. Gravidity refers to the total number of pregnancies a woman has had, including the current one. Parity refers to the number of pregnancies that have reached viability. The GTPAL system breaks down a woman's obstetric history into Gravidity, Term births, Preterm births, Abortions/miscarriages, and Living children. In this case, the woman is pregnant for the fourth time, so her gravidity is 4. She has had one term birth (39 weeks gestation), two preterm births (34 and 35 weeks gestation), no abortions/miscarriages, and all her children from previous pregnancies are living. Let's break down each choice: A: 3-1-1-1-3 - Gravidity of 3 is incorrect as the woman is pregnant for the fourth time. - Parity of 1 is correct as she has had one term birth. - Two preterm births are incorrect. - One abortion/miscarriage is incorrect. - Living children of 3 is incorrect. C: 3-0-3-0-3 - Gravidity of 3 is incorrect. - Parity of 0 is incorrect as she has had one term birth. - Three preterm births are incorrect. - No abortions/miscarriages is incorrect. - Living children of 3 is incorrect. D: 4-2-1-0-3 - Gravidity of 4 is correct. - Parity of 2 is incorrect as she has had one term birth. - One preterm birth is correct. - No abortions/miscarriages is correct. - Living children of 3 is incorrect. Therefore, the correct answer is B: 4-1-2-0-4, as it accurately represents the woman's obstetric history.

Correct Answer: D

Rationale: Placing the neonate skin-to-skin and covering the head with a cap is the highest priority nursing intervention following birth for several reasons. Firstly, skin-to-skin contact immediately after birth promotes bonding between the newborn and the mother, regulates the baby's temperature, stabilizes their heart rate, and helps establish breastfeeding. This practice also allows for the transfer of beneficial bacteria from the mother to the newborn, which can help boost the baby's immune system. Initiating breastfeeding is important, but it is not the highest priority immediately after birth. While breastfeeding is crucial for the newborn's nutrition and overall health, establishing skin-to-skin contact takes precedence as it provides numerous immediate benefits to the newborn's well-being. Performing the initial bath is not a priority immediately following birth. Delaying the newborn's first bath allows for the retention of vernix, a protective substance that helps moisturize the baby's skin and acts as a barrier against infection. It is recommended to delay the first bath for at least 24 hours to ensure the newborn receives these benefits. Giving a Vitamin K injection is important for preventing hemorrhagic disease of the newborn, but it is not the highest priority immediately after birth. While Vitamin K administration is typically done shortly after birth, promoting skin-to-skin contact and bonding between the newborn and mother take precedence in the immediate postnatal period.

Correct Answer: A

Rationale: A fundal assessment is performed to assess the position and height of the uterus in the postpartum period. In a normal postpartum period, the fundus should be located midline and at or slightly below the umbilicus. If the fundus is located on the right abdomen, this may indicate a full bladder pushing the uterus to the side. Option A: Asking the client to empty her bladder is the appropriate action in this situation. A full bladder can displace the uterus and cause it to deviate from its normal position. Once the client empties her bladder, the fundus may return to the midline position. Option B: Straight catheterizing the client immediately is not necessary in this scenario. Unless the client is unable to empty her bladder on her own or experiencing urinary retention, straight catheterization should not be the first intervention. Option C: Calling the client's health provider for direction is not the most immediate action needed in this situation. Emptying the bladder can be done by the nurse without requiring direction from the health provider. Option D: None of the above is incorrect because the appropriate action in this situation is to ask the client to empty her bladder. Ignoring the displaced fundus could lead to inaccurate assessment findings and potentially delay appropriate interventions if needed.

Correct Answer: B

Rationale: The correct answer is B. Wearing a tight-fitting bra can hinder milk production in a formula-feeding postpartum client. Here's why: A: Using warm compresses on her breasts (Choice A) is actually a helpful nursing intervention as it can help stimulate milk production. Warm compresses can help increase blood flow to the breasts, which can lead to increased milk production. B: Wearing a tight-fitting bra (Choice B) can compress the breasts and restrict milk flow. This can lead to engorgement and decrease milk production. It is important for postpartum clients to wear a supportive but not overly tight bra to allow for proper milk production. C: Massaging her breast while in the shower (Choice C) is another beneficial nursing intervention. Breast massage can help with milk letdown and can also help prevent clogged ducts. It is a good practice for postpartum clients to incorporate breast massage into their routine. D: Wearing a loose-fitting bra (Choice D) is also a good choice for a formula-feeding postpartum client. A loose-fitting bra can provide support without constricting the breasts, allowing for proper milk production. It is important for postpartum clients to wear bras that are comfortable and do not impede milk flow. In conclusion, wearing a tight-fitting bra (Choice B) is the nursing intervention that will hinder milk production in a formula-feeding postpartum client. The other choices (using warm compresses, massaging the breasts, and wearing a loose-fitting bra) are all beneficial interventions that can support milk production.

Correct Answer: A

Rationale: Untreated gonorrhea can lead to various complications, one of which is infertility. When left untreated, gonorrhea can cause pelvic inflammatory disease (PID) in women and epididymitis in men, which can result in scarring of the reproductive organs. This scarring can block the fallopian tubes in women or the sperm ducts in men, leading to infertility. Therefore, it is crucial to treat gonorrhea promptly to prevent long-term consequences like infertility. Skin eruptions (choice B) are not a common symptom or complication of untreated gonorrhea. Gonorrhea primarily affects the genital tract and can cause symptoms such as painful urination, discharge, and pelvic pain, rather than skin eruptions. Paralysis (choice C) is not associated with gonorrhea. Gonorrhea is a sexually transmitted infection caused by bacteria, whereas paralysis is a neurological condition that can be caused by various factors such as trauma, infections like polio, or autoimmune disorders. Psychosis (choice D) is also not a known complication of gonorrhea. Psychosis refers to a severe mental disorder characterized by a loss of contact with reality, while gonorrhea primarily affects the reproductive system and does not directly impact mental health. In conclusion, the correct answer is A (infertility) because untreated gonorrhea can lead to pelvic inflammatory disease and scarring of the reproductive organs, resulting in infertility. Skin eruptions, paralysis, and psychosis are not typical complications of gonorrhea.