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. 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. 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.

4. Which of the following hormone ratios is MOST likely to be increased in a patient with PCOS?

• A. Progesterone/estrogen
• B. LH/FSH
• C. FSH/LH
• D. Glucagon/insulin

Correct answer: B

Rationale: In patients with Polycystic Ovary Syndrome (PCOS), the LH/FSH ratio is most likely to be increased. This hormonal imbalance is a key characteristic of PCOS, where elevated LH levels relative to FSH contribute to the pathophysiology of the condition. Choice A, progesterone/estrogen ratio, is not typically a defining feature of PCOS. Choice C, FSH/LH ratio, is the reverse of what is commonly observed in PCOS. Choice D, glucagon/insulin ratio, is not directly related to the hormonal imbalances seen in PCOS.

5. At 16 weeks of pregnancy, the breast changes include:

• A. Montgomery's tubercles are prominent.
• B. Darkening of the nipple.
• C. Prickling, tingling sensation.
• D. Colostrum can be expressed.

Correct answer: C

Rationale: At 16 weeks of pregnancy, the sensation of prickling and tingling in the breasts is common due to hormonal changes. Montgomery's tubercles becoming prominent is more characteristic of early pregnancy, typically around the first trimester. Darkening of the nipple, known as areola darkening, can occur but is more commonly observed later in pregnancy. The expression of colostrum, the first milk produced by the mammary glands, usually happens closer to the end of pregnancy or after childbirth, not typically at 16 weeks.

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