If you’re still unsure about your maternity nursing knowledge or how to use the infamous GTPAL, then you don’t want to miss this episode!
In it, I’ll be sharing with you everything you need to know about the GTPAL, from what it is to how to use it to why it matters so much.
After this episode, I’m certain the maternity section in the Next Generation NCLEX will be a breeze.
Then, together, we’ll be answering 9 practice questions!
Are you ready for the challenge?
Then tune in now!
What Is the GTPAL?
GTPAL stands for Gravida, Term births, Preterm births, Abortion, and Living Children.
G is Gravida, which is the number of times the client got pregnant.
T is Term births, which is the number of times a baby has been born 37+ weeks of gestation.
P is Preterm births, which is the number of times a baby has been born between 20 and 37 weeks of gestation.
A is Abortion, which is pregnancy losses before 20 weeks.
L is Living children, which is the number of children that are living.
Here’s a tip for multiples, which are twins, triplets, quadruplets, etc… For example, a twin pregnancy counts as gravida of one, but two living children.
Here is another tip: With gravida, do not forget to count the current pregnancy, miscarriages, and abortion.
The NCLEX could ask you what a pregnant client’s GTPAL is and you need to be prepared to categorize each pregnancy properly.
Let’s apply what you just learned to the following 10 questions.
GTPAL NCLEX Practice Questions
Question #1: A 22-year-old is pregnant for the second time with twins. She had a miscarriage at age 20. What is her GTPAL?
Answer: G=2, T=0, P, 0, A=1, L=0.
Rationale: The patient was pregnant twice, so G equals 2. She has no term or preterm births, so T and P equals 0. She has one miscarriage, so A equals 1. She has no live child, so L equals 0.
Question #2: A 30-year-old patient is currently not pregnant. She had one abortion at 7 weeks gestation. She has no living children. What is her GTPAL?
Answer: G=1, T=0, P=0, A=1, L=0.
Rationale: She was pregnant once, with her abortion, G equals 1. She did not have a pregnancy that resulted in a term or preterm birth, so T and P equals 0. Her abortion equals 1. There are no live children, so L equals 0.
Question #3: A 37-year-old patient is currently pregnant with twins. She had a miscarriage at 8 weeks gestation. Her daughter is nine years old and was born at 34 weeks gestation. What is her GTPAL?
Answer: G=3, T=0, P=1, A=1, L=1.
Rationale: Being pregnant with twins counts as a gravida one. Her miscarriage, live child, and twins add up to gravida 3. None of her pregnancies resulted in a live birth after 37 weeks of gestation, so T equals 0. Her daughter was born at 34 weeks gestation, so P equals 1. She had one miscarriage, so A equals 1. She has one live child, so L equals 1.
Question #4: A 34-year-old woman is currently 25 weeks pregnant. She had a miscarriage at 11 weeks gestation. She currently has a two-year-old who was born at 38 weeks. What is her GTPAL?
Answer: G=3, T=1, P=0, A=1, L=1.
Rationale: She was pregnant three times, so G equals 3. Her live child was born at 38 weeks, so T equals 1. None of her pregnancies led to a birth between 20 weeks and 37 weeks gestation, so P equals 0. Her miscarriage occurred at 11 weeks gestation, so A equals 1. Her two years old is a live child, so L equals 1.
Question #5: A woman reported that she is currently pregnant with triplets. She has no prior pregnancies. What is her GTPAL?
Answer: G=1, T=0, P=0, A=0, L=0.
Rationale: Being pregnant with triplets does NOT make gravida equal to 3. This is where it can get tricky. Triplets count as one, so G equals 1. She has no other pregnancies and no live children, so the rest equals 0.
Question #6: A 21-year-old patient is currently pregnant. She has one child born at 38 weeks, and one miscarriage at 11 weeks. What is her GTPAL?
Answer: G=3, T= 1, P=0, A=1, L=1.
Rationale: The patient has been previously pregnant two times and she is currently pregnant, so G equals 3. One child was born at 38 weeks, so T equals 1. No child was born between 20 and 37 weeks of gestation, so P equals 0. A miscarriage occurred at 11 weeks, so A equals 1. She has one living child out of the two previous pregnancies, so L equals 1.
Question #7: A 32-year-old patient’s obstetric history includes three full-term deliveries, zero preterm birth, and two abortions. She currently has three living children. What is her GTPAL?
Answer: G=5, T=3, P=0, A=2, L=3.
Rationale: The patient was pregnant five times, so G equals 5. She had three full-term deliveries, so T equals 3. She had zero preterm births, so P equals 0. She had two abortions, so A equals 2. She currently has three living children, so L equals 3.
Question #8: A 40-year-old woman is pregnant for the fourth time. She has one child who was born at 39 weeks. She has two children born at 35 weeks each. She has no history of abortions or miscarriages. What is her GTPAL?
Answer: G=4, T=1, P=2, A=0, L=3.
Rationale: The patient is pregnant for the fourth time, so G equals 4. She has one child born at 39 weeks, so T equals 1. She has two children born at 35 weeks, so P equals 2. She has no history of abortions or miscarriages, so A equals 0. She has three live children, so L equals 3.
Question #9: A 30-year-old female client is currently 10 weeks pregnant with no living children. Five years ago, she had 2 miscarriages at 10 and 12 weeks gestation. What is her GTPAL?
Answer: G=3, T=0, P=0, A=2, L=0.
Rationale: She was pregnant three times total, so G equals 3. None of her pregnancies made it to term or preterm, so T and P both equal 0. She had two miscarriages, so A equals 2. None of her pregnancies has currently resulted in a live birth, so L equals 0.
