Nursing Elites

1. At 34-40 weeks of pregnancy, the breast changes include:

• A. Nipples become prominent and mobile.
• B. Colostrum can be expressed.
• C. Breasts become tender.
• D. Montgomery's tubercles are prominent.

Correct answer: D

Rationale: During the 34-40 weeks of pregnancy, Montgomery's tubercles become prominent. These are sebaceous glands on the areola, not the nipples. Choice A is incorrect as it describes the changes in nipples, not Montgomery's tubercles. Choice B is incorrect as colostrum production usually starts around the 16th week. Choice C is incorrect as breast tenderness is more common in early pregnancy due to hormonal changes.

2. What is one role of the hormone estrogen?

• A. Stimulates the development of the milk-producing tissue.
• B. Stimulates the production of lactoferrin.
• C. Stimulates the development of the nipple and duct system in the breast.
• D. Stimulates the secretion of relaxin.

Correct answer: A

Rationale: The correct answer is A: Estrogen stimulates the development of the milk-producing tissue in the breast. This hormone is essential in preparing the breast for milk production. Choice B is incorrect because lactoferrin production is not a primary role of estrogen. Choice C is incorrect as estrogen primarily influences the development of the breast tissue rather than specifically the nipple and duct system. Choice D is incorrect because relaxin secretion is not a function typically associated with estrogen.

3. Basal body temperature rise of _____ is seen in the luteal phase due to the thermogenic effects of a metabolite of progesterone in a normal cycle:

• A. 0.1-0.5
• B. 0.2-0.5
• C. 1.0-2.0
• D. 1.5-2.0

Correct answer: B

Rationale: A basal body temperature rise of 0.2-0.5 degrees Celsius is typically seen in the luteal phase of the menstrual cycle due to the thermogenic effects of a metabolite of progesterone. This temperature rise helps to indicate ovulation has occurred. Choices A, C, and D are incorrect as they do not reflect the usual range of temperature increase observed during the luteal phase. A rise of 0.1-0.5 degrees Celsius is too narrow (eliminating choice A), while ranges of 1.0-2.0 and 1.5-2.0 degrees Celsius are too high and not consistent with the expected basal body temperature changes during the menstrual cycle.

4. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy test?

• A. Threatened
• B. Imminent
• C. Missed
• D. Incomplete

Correct answer: C

Rationale: Dark brown vaginal discharge and a negative pregnancy test are characteristic of a missed abortion. In a missed abortion, the fetus has died, but the products of conception are retained in the uterus. This can lead to symptoms like dark brown vaginal discharge as the body tries to expel the nonviable pregnancy. A threatened abortion is characterized by vaginal bleeding without dilation of the cervix, and the pregnancy remains viable. Imminent abortion involves cervical dilation and effacement with no passage of tissue. In an incomplete abortion, only part of the products of conception are expelled, leading to persistent bleeding and cramping.

5. What is the most common site for an ectopic pregnancy?

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

Correct answer: C

Rationale: The correct answer is C, Interstitial. An ectopic pregnancy most commonly occurs in the interstitial portion of the fallopian tube. This is because the interstitial part is narrow and not suitable for the growing embryo, leading to implantation outside the uterus. Choices A, B, and D are incorrect because although ectopic pregnancies can occur in various locations, the interstitial portion of the fallopian tube is the most frequent site for such pregnancies.

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