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. Which hormone regulates the production of milk after childbirth?

• A. Prolactin
• B. Oxytocin
• C. Estrogen
• D. Progesterone

Correct answer: A

Rationale: The correct answer is Prolactin. Prolactin is the hormone responsible for regulating the production of milk after childbirth. It stimulates the mammary glands in the breasts to produce milk. Oxytocin, on the other hand, is responsible for the ejection of milk from the breasts. Estrogen and progesterone play roles in the menstrual cycle and pregnancy but are not directly involved in milk production. Therefore, choices B, C, and D are incorrect.

3. Complete abortion is characterized by:

• A. Os closed.
• B. Firm contracted uterus.
• C. Heavy bleeding.
• D. Heavy cramping.

Correct answer: A

Rationale: Complete abortion is characterized by a firm contracted uterus with a closed os. This closure of the os indicates that the products of conception have been completely expelled from the uterus. Choices B, C, and D are incorrect because a firm contracted uterus with a closed os is the hallmark sign of a complete abortion, not heavy bleeding, heavy cramping, or any other features.

4. Which of the following Leopold maneuvers assesses the fetal lie?

• A. Fundal grip
• B. Umbilical grip
• C. Pawlick grip
• D. Pelvic grip

Correct answer: A

Rationale: The correct answer is A: Fundal grip. Fundal grip is a specific Leopold maneuver used to assess the fetal lie by palpating the upper abdomen to determine the position of the baby's back and presenting part. This maneuver helps healthcare providers understand the orientation of the fetus within the uterus. Choice B, Umbilical grip, is not a recognized Leopold maneuver and does not assess fetal lie. Choice C, Pawlick grip, and choice D, Pelvic grip, are also not part of the standard Leopold maneuvers used to determine fetal lie.

5. Which one of the following is not associated with poor maternal outcome?

• A. APH
• B. PPH
• C. Cord prolapse
• D. Pre-eclampsia

Correct answer: C

Rationale: Cord prolapse is not typically associated with poor maternal outcomes. Acute placental hemorrhage (APH - choice A) and postpartum hemorrhage (PPH - choice B) can lead to maternal morbidity and mortality due to excessive blood loss. Pre-eclampsia (choice D) is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, which can result in severe maternal complications if not managed promptly. Cord prolapse, though concerning for fetal well-being, does not inherently pose direct risks to maternal health if managed appropriately, making it the correct answer in this context.

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