Nursing Elites

1. A client 12 weeks pregnant comes to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cm cervical dilation. The nurse would document these findings as which of the following?

• A. Threatened abortion
• B. Inevitable abortion
• C. Complete abortion
• D. Missed abortion

Correct answer: B

Rationale: The nurse would document these findings as an inevitable abortion. Inevitable abortion is characterized by cervical dilation with or without rupture of membranes and is associated with moderate to heavy vaginal bleeding. 'Threatened abortion' (choice A) refers to vaginal bleeding with a closed cervical os and no tissue passage. 'Complete abortion' (choice C) involves the passage of all products of conception. 'Missed abortion' (choice D) is the retention of a failed intrauterine pregnancy for an extended period without symptoms.

2. Discuss the anatomical/physiological changes in pregnancy under the following: Kidney/renal system

• A. Kidneys increase in size, pelvis dilates, ureters elongate and dilate, and the glomerular filtration rate increases.
• B. Kidneys decrease in size, and glomerular filtration rate decreases.
• C. There is no change in kidney size or ureter function, but the glomerular filtration rate decreases.
• D. Kidneys shrink, and ureters remain the same.

Correct answer: A

Rationale: During pregnancy, the kidneys increase in size, the pelvis dilates, ureters elongate and dilate, and the glomerular filtration rate increases. This is due to the increased metabolic demands and hormonal changes during pregnancy. Choice B is incorrect as the kidneys do not decrease in size, and the glomerular filtration rate actually increases. Choice C is incorrect as there are changes in kidney size and ureter function during pregnancy. Choice D is incorrect as the kidneys do not shrink during pregnancy.

3. Where does fertilization normally occur?

• A. Ampulla
• B. Interstitial portion
• C. Isthmus
• D. Infundibulum

Correct answer: A

Rationale: Fertilization typically occurs in the ampulla of the fallopian tube. The ampulla provides the ideal environment for fertilization due to the presence of cilia that help transport the egg and sperm, as well as the nourishing fluid within this region. The interstitial portion, isthmus, and infundibulum of the fallopian tube are not the primary sites for fertilization. The interstitial portion connects the fallopian tube to the uterine cavity, the isthmus is the narrowest part near the uterus, and the infundibulum is the funnel-shaped end near the ovary, where the egg is captured after ovulation.

4. The _________ is a temporary organ that connects a mammalian mother to its foetus.

• A. Placenta
• B. Chorion
• C. Endometrium
• D. None of the above

Correct answer: A

Rationale: The correct answer is A: Placenta. The placenta is a temporary organ that connects a mammalian mother to its foetus. It plays a crucial role in facilitating the exchange of nutrients, oxygen, and waste between the mother and the developing baby. Choice B, Chorion, is incorrect as it is a part of the fetal membrane but not the organ that connects the mother to the fetus. Choice C, Endometrium, is incorrect as it is the lining of the uterus where implantation occurs but is not the organ responsible for connecting the mother to the fetus. Choice D, None of the above, is incorrect as the placenta specifically fits the description provided in the question.

5. Septic abortion is characterized by:

• A. Backache.
• B. Os open.
• C. Heavy bleeding.
• D. Maternal pyrexia.

Correct answer: D

Rationale: Septic abortion is characterized by maternal pyrexia. Maternal pyrexia, or fever, is a hallmark sign of septic abortion due to infection. Backache and heavy bleeding can be present in abortion but are not specific to septic abortion. 'Os open' does not directly characterize septic abortion.

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