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. 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. 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.

4. According to the Medical Termination of Pregnancy (MTP) Act, 1971, how many weeks of pregnancy is Medical Termination of Pregnancy considered safe up to?

• A. 8 Weeks
• B. 12 Weeks
• C. 18 Weeks
• D. 6 Weeks

Correct answer: B

Rationale: According to the Medical Termination of Pregnancy (MTP) Act, 1971, Medical Termination of Pregnancy is considered safe up to 12 weeks of pregnancy. This timeframe is crucial to ensure the safety and well-being of the individual undergoing the procedure. Choices A, C, and D are incorrect because they do not align with the legal provisions outlined in the MTP Act, 1971.

5. The letter 'T' in the Acronym 'GATHER' denotes:

• A. Ask the client about themselves - particular needs, obstetric and medical history
• B. Tell the client about modern FP methods available, and discuss each in detail
• C. Help the client choose a method and repeat information regarding the chosen method if necessary
• D. Explain how to use the method - what, where, when, and how

Correct answer: B

Rationale: The correct answer is B: 'Tell the client about modern FP methods available, and discuss each in detail.' In the GATHER acronym, 'T' stands for providing information about modern family planning methods to the client and having a detailed discussion. Choices A, C, and D are incorrect because they do not accurately represent the 'T' component in the GATHER approach. Choice A focuses more on gathering information from the client, choice C is about helping the client choose a method, and choice D is about explaining how to use the method, none of which align with the 'T' in GATHER.

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