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. 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.

3. Amniocentesis, a prenatal diagnostic test used to determine fetal sex, genetic anomalies, and biochemical abnormalities, is based on:

• A. The karyotyping of the amniotic fluid
• B. Chorionic villus sampling
• C. Umbilical cord blood sampling
• D. Ultrasound

Correct answer: A

Rationale: The correct answer is A. Amniocentesis involves the analysis of the fetal cells present in the amniotic fluid, which is extracted from the amniotic sac surrounding the developing fetus. This fluid contains cells shed by the fetus, which can be cultured and analyzed to obtain a karyotype, providing information about the fetal sex, genetic anomalies, and biochemical abnormalities. Choices B, C, and D are incorrect because chorionic villus sampling involves obtaining a sample of the chorionic villi from the placenta, not the amniotic fluid; umbilical cord blood sampling is typically used for other purposes like assessing the baby's blood for infections or genetic disorders; and ultrasound is a diagnostic imaging technique that does not involve the analysis of fetal cells for genetic information.

4. Discuss the anatomical/physiological changes in pregnancy under the following: Haematological system

• A. Blood volume and plasma volume increase, red blood cells increase, erythropoietin levels decrease, and leukocyte count increases.
• B. Blood volume and plasma volume decrease, and red blood cells decrease.
• C. No changes occur in the haematological system during pregnancy.
• D. Platelet count remains constant, and no change in coagulation factors.

Correct answer: A

Rationale: During pregnancy, the haematological system undergoes changes to support the growing fetus. Blood volume and plasma volume increase to accommodate the needs of the developing baby. Red blood cells increase to support the increased oxygen demand. Contrary to the statement, erythropoietin levels actually increase to stimulate red blood cell production. Additionally, leukocyte count increases to help the mother's immune system cope with the changes during pregnancy. Choice B is incorrect as it describes a decrease in blood components, which is not the case in pregnancy. Choice C is incorrect as there are significant changes in the haematological system during pregnancy. Choice D is incorrect as platelet count can fluctuate during pregnancy, and there are changes in coagulation factors to prevent excessive bleeding.

5. 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.

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