Nursing Elites

1. 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.

2. Which one of the following is not associated with poor maternal outcome?

• A. APH
• B. PPH
• C. Cord prolapse
• D. Pre-eclampsia

Correct answer: C

Rationale: Cord prolapse is not typically associated with poor maternal outcomes. Acute placental hemorrhage (APH - choice A) and postpartum hemorrhage (PPH - choice B) can lead to maternal morbidity and mortality due to excessive blood loss. Pre-eclampsia (choice D) is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, which can result in severe maternal complications if not managed promptly. Cord prolapse, though concerning for fetal well-being, does not inherently pose direct risks to maternal health if managed appropriately, making it the correct answer in this context.

3. What does confidentiality in reproductive health services mean?

• A. All information regarding the patient is discussed only between the patient, provider, and supervisors.
• B. Sharing patient information with all healthcare staff.
• C. Sharing patient information with their family members.
• D. Allowing patient information to be discussed in public areas.

Correct answer: A

Rationale: Confidentiality in reproductive health services means that all information regarding the patient should be discussed only among the patient, provider, and supervisors involved in their care. Choice B is incorrect because sharing patient information with all healthcare staff goes against the principle of confidentiality. Choice C is incorrect because sharing patient information with family members should only be done with the patient's explicit consent. Choice D is incorrect as allowing patient information to be discussed in public areas violates patient privacy and confidentiality.

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 what age does the first menstrual period typically occur?

• A. 9 and 15 years
• B. 2 and 10 years
• C. 1 and 5 years
• D. 18 and 20 years

Correct answer: A

Rationale: The first menstrual period, known as menarche, typically occurs between the ages of 9 and 15 years. This marks the onset of puberty in females. Choices B, C, and D are incorrect because the first menstrual period does not occur as early as 2 years old, 1 year old, or as late as 18 to 20 years old.

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