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. _______ is a lytic enzyme released by the sperm.

• A. Hyaluronidase
• B. Trypsin
• C. Helicase
• D. None of the above

Correct answer: A

Rationale: Hyaluronidase is the correct answer. It is a lytic enzyme released by the sperm to help penetrate the egg's protective layer. Trypsin is a digestive enzyme produced in the pancreas, not released by sperm. Helicase is an enzyme involved in DNA replication, not released by sperm. 'None of the above' is incorrect as hyaluronidase fits the description provided in the question.

3. What is one of the roles of the oxytocin hormone?

• A. Stimulates milk ejection.
• B. Stimulates the production of milk.
• C. Stimulates the development of lactoferrin.
• D. Stimulates the secretion of relaxin.

Correct answer: A

Rationale: The correct answer is A: 'Stimulates milk ejection.' Oxytocin is responsible for contracting the muscles around the milk ducts, pushing milk into the nipples for breastfeeding. This process is known as milk ejection or let-down. The other choices are incorrect because oxytocin's primary function is to facilitate milk ejection rather than directly stimulating the production of milk, the development of lactoferrin, or the secretion of relaxin.

4. At what point is a fetus considered viable?

• A. 26 weeks
• B. 28 weeks
• C. 37 weeks
• D. 12 weeks

Correct answer: C

Rationale: A fetus is considered viable after 37 weeks of gestation. At this stage, the fetus has a higher chance of surviving outside the womb with medical support. Choice A (26 weeks), Choice B (28 weeks), and Choice D (12 weeks) are incorrect because a fetus is not typically considered viable at those earlier gestational ages.

5. 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.

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