Nursing Elites

1. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal discharge and a negative pregnancy test?

• A. Threatened
• B. Imminent
• C. Missed
• D. Incomplete

Correct answer: C

Rationale: Dark brown vaginal discharge and a negative pregnancy test are characteristic of a missed abortion. In a missed abortion, the fetus has died, but the products of conception are retained in the uterus. This can lead to symptoms like dark brown vaginal discharge as the body tries to expel the nonviable pregnancy. A threatened abortion is characterized by vaginal bleeding without dilation of the cervix, and the pregnancy remains viable. Imminent abortion involves cervical dilation and effacement with no passage of tissue. In an incomplete abortion, only part of the products of conception are expelled, leading to persistent bleeding and cramping.

2. The upper folds of the labia minora surround the clitoris and unite to form the:

• A. Frenulum
• B. Prepuce
• C. Fourchette
• D. Vestibule

Correct answer: B

Rationale: The correct answer is B: Prepuce. The upper folds of the labia minora surround the clitoris and unite to form the prepuce, which is a hood-like structure protecting the clitoris. The frenulum (choice A) is a small fold of tissue under the tongue or upper lip, not related to the female genitalia. The fourchette (choice C) refers to the area where the labia minora meet at the posterior end of the vulva, not involving the clitoris. The vestibule (choice D) is the space between the labia minora containing the vaginal and urethral openings, not directly formed by the upper folds of the labia minora.

3. At 34-40 weeks of pregnancy, the breast changes include:

• A. Nipples become prominent and mobile.
• B. Colostrum can be expressed.
• C. Breasts become tender.
• D. Montgomery's tubercles are prominent.

Correct answer: D

Rationale: During the 34-40 weeks of pregnancy, Montgomery's tubercles become prominent. These are sebaceous glands on the areola, not the nipples. Choice A is incorrect as it describes the changes in nipples, not Montgomery's tubercles. Choice B is incorrect as colostrum production usually starts around the 16th week. Choice C is incorrect as breast tenderness is more common in early pregnancy due to hormonal changes.

4. Which hormone is primarily responsible for the development of female secondary sexual characteristics?

• A. Progesterone
• B. Testosterone
• C. Estrogen
• D. Oxytocin

Correct answer: C

Rationale: Estrogen is primarily responsible for the development of female secondary sexual characteristics. Progesterone, while important in the menstrual cycle and pregnancy, is not primarily responsible for secondary sexual characteristics. Testosterone is the primary male sex hormone. Oxytocin is involved in labor, lactation, and social bonding, but not in the development of female secondary sexual characteristics.

5. 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.

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