Nursing Elites

1. In Primary Health care, the concept of accessibility requires that:

• A. Patients should be required to accept one service in order to gain access to another type of service.
• B. A referral network, including transportation, to higher-level facilities should be coupled to PHC services.
• C. Patients' access to services should be contingent on social or cultural backgrounds, age, and marital status.
• D. Patients' access to services should be based on one's educational status.

Correct answer: B

Rationale: In Primary Health care, accessibility entails having a referral network and transportation system in place to link patients to higher-level facilities when needed. Choice A is incorrect because patients should not be required to accept one service to access another. Choice C is incorrect as access to services should not be contingent on social or cultural backgrounds, age, or marital status. Choice D is also incorrect because educational status should not determine patients' access to healthcare services.

2. A client 12 weeks pregnant comes to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cm cervical dilation. The nurse would document these findings as which of the following?

• A. Threatened abortion
• B. Inevitable abortion
• C. Complete abortion
• D. Missed abortion

Correct answer: B

Rationale: The nurse would document these findings as an inevitable abortion. Inevitable abortion is characterized by cervical dilation with or without rupture of membranes and is associated with moderate to heavy vaginal bleeding. 'Threatened abortion' (choice A) refers to vaginal bleeding with a closed cervical os and no tissue passage. 'Complete abortion' (choice C) involves the passage of all products of conception. 'Missed abortion' (choice D) is the retention of a failed intrauterine pregnancy for an extended period without symptoms.

3. The placenta is developed from which part of the trophoblast?

• A. Chorionic Frondosum
• B. Anchoring Villi
• C. Chorionic Laeve
• D. Body Stalk

Correct answer: A

Rationale: The correct answer is A: Chorionic Frondosum. The placenta is developed from the chorionic frondosum part of the trophoblast. This structure gives rise to the fetal part of the placenta. Choices B, C, and D are incorrect. Anchoring Villi are projections from the chorionic plate that attach the placenta to the uterine wall. Chorionic Laeve refers to the smooth chorion that covers the fetal surface of the placenta. The Body Stalk is a structure that connects the early embryo to the trophoblastic pole of the blastocyst.

4. The menstrual disorder in which there is an absence or suppression of the normal menstrual period is called:

• A. Dysmenorrhoea
• B. Polymenorrhoea
• C. Menorrhagia
• D. Amenorrhoea

Correct answer: D

Rationale: Amenorrhoea is the correct term for the absence or suppression of the menstrual period. Dysmenorrhoea refers to painful menstruation, Polymenorrhoea is characterized by frequent, short menstrual cycles, and Menorrhagia is excessive menstrual bleeding. Therefore, 'Amenorrhoea' is the most appropriate term for the described menstrual disorder.

5. What should be included in the differential diagnosis of ectopic pregnancy?

• A. Inevitable abortion
• B. Dysmenorrhea
• C. Twisted ovarian cyst
• D. Fibroids

Correct answer: C

Rationale: In the differential diagnosis of ectopic pregnancy, conditions such as twisted ovarian cysts should be considered. Twisted ovarian cysts can present with similar symptoms to ectopic pregnancy, making it important to include them in the differential diagnosis. Choices A, B, and D are not typically part of the differential diagnosis of ectopic pregnancy. Inevitable abortion refers to an imminent miscarriage, dysmenorrhea is characterized by painful menstruation, and fibroids are benign growths in the uterus, none of which are directly related to ectopic pregnancy.

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