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. 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. Outlet of the true pelvis anteriorly bounded by:

• A. Ischiopubic arch (T)
• B. Linea terminalis (F)
• C. Coccyx (T)
• D. Promontory of the sacrum (F)

Correct answer: A

Rationale: The correct answer is A: Ischiopubic arch. The outlet of the true pelvis is indeed anteriorly bounded by the ischiopubic arch, which consists of the ischium and the pubic bones. This structure forms the lower boundary of the pelvic outlet. The other choices, B, C, and D, are incorrect. The linea terminalis (pelvic brim) forms the upper boundary of the true pelvis, the coccyx is part of the bony pelvis but does not bound the pelvic outlet anteriorly, and the promontory of the sacrum is located in the posterior part of the pelvis, not the anterior boundary of the pelvic outlet.

4. 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.

5. What action does the copper used in Copper T have?

• A. Blastocidal
• B. Bacteriostatic
• C. Bacteriocidal
• D. Spermicidal

Correct answer: D

Rationale: The correct answer is D, Spermicidal. The copper in Copper T exerts its action by affecting sperm viability and motility, thus preventing fertilization. Choices A, B, and C are incorrect because Copper T primarily works by preventing sperm from reaching and fertilizing the egg, rather than acting on blastocysts, bacteria, or bacteriocins.

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