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. What is the triangular space lying between the vaginal and rectal canals?

• A. Pelvic floor
• B. Perineum
• C. Vestibule
• D. Perineal body

Correct answer: B

Rationale: The correct answer is B: Perineum. The perineum is the triangular space located between the vaginal and rectal canals. It is a region containing various muscles, nerves, and blood vessels that support the pelvic floor. Choice A, Pelvic floor, refers to the structure supporting the organs in the pelvic cavity, not the space between the vaginal and rectal canals. Choice C, Vestibule, is the space within the labia minora containing the openings of the urethra and vagina, not the area between the vaginal and rectal canals. Choice D, Perineal body, is a fibromuscular mass in the perineum area but not the space between the vaginal and rectal canals.

3. The patient about to undergo gynecological surgery is put on nil by mouth for ____ before surgery to prevent aspiration.

• A. 2-4 hours
• B. 3-5 hours
• C. 4-6 hours
• D. 5-7 hours

Correct answer: C

Rationale: Patients undergoing gynecological surgery are typically advised to be nil by mouth for 4-6 hours before the procedure to reduce the risk of aspiration. This duration allows the stomach to empty its contents, decreasing the likelihood of regurgitation and aspiration of stomach contents during surgery. Choices A, B, and D have shorter durations and may not provide sufficient time for adequate gastric emptying, increasing the risk of aspiration.

4. When does missed abortion occur?

• A. The fetus dies and is retained in utero with the placenta and membranes.
• B. All products of conception are expelled with minimal bleeding.
• C. The cervix remains closed, and the products of conception remain in the uterus.
• D. The cervix remains closed, but there is heavy bleeding.

Correct answer: C

Rationale: Missed abortion occurs when the cervix is closed, and the products of conception remain in the uterus. Choice A describes a missed abortion, not choice C. Choice B describes a complete abortion. Choice D describes a threatened abortion, where the cervix remains closed but there is heavy bleeding.

5. 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.

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