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. Which of the following is a function of the placenta?

• A. The placenta secretes insulin.
• B. The placenta facilitates the exchange of gases and nutrients between mother and fetus.
• C. The placenta provides immunological protection to the fetus.
• D. The placenta stores fat-soluble vitamins for the fetus.

Correct answer: B

Rationale: The correct answer is B. The placenta serves as a crucial organ during pregnancy, facilitating the exchange of gases (oxygen and carbon dioxide) and nutrients (such as glucose and amino acids) between the mother and the developing fetus. This exchange is vital for the fetus's growth and development. Choices A, C, and D are incorrect. The placenta does not secrete insulin; insulin is produced by the pancreas. While the placenta provides some immune support to the fetus, its main role is not immunological protection. Additionally, storing fat-soluble vitamins is not a primary function of the placenta.

3. 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.

4. The products of conception are retained in which of the following?

• A. Complete abortions
• B. Incomplete abortions
• C. Threatened abortion
• D. Mixed abortion

Correct answer: B

Rationale: In incomplete abortions, the products of conception are retained. In a complete abortion, all the products of conception are expelled from the uterus. Threatened abortion refers to a situation where there is vaginal bleeding but the cervix remains closed, and it does not necessarily involve retention of products of conception. Mixed abortion is not a recognized medical term related to retained products of conception.

5. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

• A. Risk for infection
• B. Pain
• C. Knowledge Deficit
• D. Anticipatory Grieving

Correct answer: D

Rationale: Anticipatory grieving is the priority nursing diagnosis for a client with an ectopic pregnancy. An ectopic pregnancy is a life-threatening condition that requires immediate medical intervention, often resulting in emotional distress and potential loss. Anticipatory grieving addresses the emotional needs of the client and their family in anticipation of a possible loss. While pain management and infection prevention are important aspects of care, addressing the emotional well-being and coping mechanisms should take precedence in this situation. Knowledge deficit may also be relevant, but emotional support is crucial in this critical scenario.

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