Nursing Elites

1. Discuss the anatomical/physiological changes in pregnancy under the following: Cardiovascular system

• A. The heart is displaced upward and to the left by the enlarging uterus, cardiac capacity increases, and blood pressure declines slightly.
• B. The heart is displaced downward and to the right, and blood pressure increases.
• C. The cardiovascular system remains unchanged during pregnancy.
• D. Cardiovascular changes include increased peripheral resistance and reduced cardiac output.

Correct answer: A

Rationale: During pregnancy, the cardiovascular system undergoes changes such as the heart being displaced upward and to the left by the enlarging uterus, increased cardiac capacity, and a slight decline in blood pressure. Choice B is incorrect as the heart is displaced upwards, not downwards, and blood pressure typically decreases slightly. Choice C is incorrect as the cardiovascular system does undergo changes during pregnancy. Choice D is incorrect as cardiovascular changes in pregnancy involve increased cardiac output rather than reduced output.

2. _______ is a lytic enzyme released by the sperm.

• A. Hyaluronidase
• B. Trypsin
• C. Helicase
• D. None of the above

Correct answer: A

Rationale: Hyaluronidase is the correct answer. It is a lytic enzyme released by the sperm to help penetrate the egg's protective layer. Trypsin is a digestive enzyme produced in the pancreas, not released by sperm. Helicase is an enzyme involved in DNA replication, not released by sperm. 'None of the above' is incorrect as hyaluronidase fits the description provided in the question.

3. Discuss the anatomical/physiological changes in pregnancy under the following: Uterus

• A. The uterus softens in the anterior midline, becomes flexible at the uterocervical junction, blood vasculature increases in size and number, and hypertrophy of myometrial cells occurs.
• B. The uterus decreases in size during pregnancy and remains rigid.
• C. The uterus size remains unchanged, and no changes occur in the blood vasculature.
• D. Uterus becomes more rigid and hypertrophies.

Correct answer: A

Rationale: During pregnancy, the uterus undergoes various anatomical and physiological changes. The correct answer, Choice A, accurately describes these changes. The uterus softens in the anterior midline, becomes flexible at the uterocervical junction, experiences an increase in blood vasculature size and number, and myometrial cells hypertrophy. This softening and increased vascularity are essential for accommodating the growing fetus and facilitating delivery. Choices B, C, and D are incorrect because they do not reflect the typical changes that occur in the uterus during pregnancy. The uterus does not decrease in size, remain unchanged in size, become more rigid, or hypertrophy without the described softening and vascular changes.

4. What prompted Zambia to implement family planning services?

• A. The nation started to experience the effects of rapid population growth on the economy and individual welfare.
• B. Donors provided free family planning pills.
• C. Mothers were delivering twice a year.
• D. There were too many abortions.

Correct answer: A

Rationale: The correct answer is A. Rapid population growth's impact on the economy and individual welfare prompted Zambia to implement family planning services. This is because a rapidly growing population can strain resources, lead to unemployment, poverty, and inadequate access to healthcare. Choice B is incorrect because the provision of free family planning pills by donors may have been a subsequent intervention rather than the initial reason for implementing family planning services. Choice C is irrelevant as the frequency of deliveries by mothers does not directly relate to the implementation of family planning services. Choice D is also incorrect as high abortion rates may be a consequence of inadequate family planning services rather than the reason for their implementation.

5. Mrs. Banda is a patient at the ward with complaints of light menstrual periods, which occur at intervals greater than 35 days. Your diagnosis will be:

• A. Oligomenorrhea
• B. Menorrhagia
• C. Metrorrhagia
• D. Polymenorrhea

Correct answer: A

Rationale: The correct diagnosis for Mrs. Banda's condition is Oligomenorrhea. Oligomenorrhea is characterized by light menstrual periods occurring at intervals longer than 35 days. Choice B, Menorrhagia, refers to abnormally heavy menstrual bleeding. Choice C, Metrorrhagia, is bleeding at irregular intervals, and Choice D, Polymenorrhea, involves menstrual cycles occurring at intervals shorter than 21 days.

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