Nursing Elites

1. What structure lies posterior to the vagina?

• A. Pouch of Douglas
• B. Rectum
• C. Perineal body
• D. Structures of the vulva

Correct answer: B

Rationale: The correct answer is B: Rectum. The rectum is located posterior to the vagina in the pelvic cavity. The Pouch of Douglas (choice A) is a peritoneal pouch located between the rectum and the uterus. The perineal body (choice C) is a fibrous structure located between the vagina and the anus. Structures of the vulva (choice D) are external genital structures surrounding the vaginal opening, not posterior to the vagina.

2. During a vaginal examination, which of the following statements is true?

• A. Cervical scrapes cytology can be taken in the same setting.
• B. Preferably done after bimanual examination.
• C. The cervix is best visualized with the Crisco's type of spectrum.
• D. During pregnancy, the cervix feels firm like the tip of the nose.

Correct answer: C

Rationale: The correct answer is C. The cervix is best visualized with the Cusco's type of spectrum. This statement is true and important during a vaginal examination. Choice A is incorrect because cervical cytology scrapes can be taken during the same setting as a vaginal examination, not necessarily prior to it. Choice B is incorrect as it states 'after' bimanual examination, which is not the typical sequence. Choice D is incorrect because during pregnancy, the cervix feels soft rather than firm like the tip of the nose.

3. Amniocentesis, a prenatal diagnostic test used to determine fetal sex, genetic anomalies, and biochemical abnormalities, is based on:

• A. The karyotyping of the amniotic fluid
• B. Chorionic villus sampling
• C. Umbilical cord blood sampling
• D. Ultrasound

Correct answer: A

Rationale: The correct answer is A. Amniocentesis involves the analysis of the fetal cells present in the amniotic fluid, which is extracted from the amniotic sac surrounding the developing fetus. This fluid contains cells shed by the fetus, which can be cultured and analyzed to obtain a karyotype, providing information about the fetal sex, genetic anomalies, and biochemical abnormalities. Choices B, C, and D are incorrect because chorionic villus sampling involves obtaining a sample of the chorionic villi from the placenta, not the amniotic fluid; umbilical cord blood sampling is typically used for other purposes like assessing the baby's blood for infections or genetic disorders; and ultrasound is a diagnostic imaging technique that does not involve the analysis of fetal cells for genetic information.

4. Laparoscopy uses a small instrument known as a laparoscope to:

• A. Take very detailed photographs
• B. Insert a hysteroscope for D&C
• C. Perform an abortion procedure
• D. Perform a hysterectomy

Correct answer: A

Rationale: Laparoscopy uses a small instrument known as a laparoscope to take very detailed photographs of the pelvic organs. This procedure is commonly used for diagnostic purposes, to visualize internal organs, and to perform minimally invasive surgeries. Choice B, inserting a hysteroscope for D&C, is incorrect as hysteroscopy is a different procedure used to examine the inside of the uterus, not the pelvic organs. Choice C, performing an abortion procedure, is incorrect as laparoscopy is not used for abortion. Choice D, performing a hysterectomy, is incorrect as although laparoscopy can be used in some cases for hysterectomy, its primary purpose is not for this procedure.

5. Which structure maintains the uterus in an anteverted and anteflexed position?

• A. Round ligaments
• B. Broad ligaments
• C. Cardinal ligaments
• D. Pubocervical ligaments

Correct answer: A

Rationale: The correct answer is the Round ligaments. The round ligaments are responsible for maintaining the uterus in an anteverted and anteflexed position. These ligaments attach from the sides of the uterus and extend through the inguinal canal to the labia majora. The other choices, Broad ligaments, Cardinal ligaments, and Pubocervical ligaments, have different functions and attachments within the pelvis. Broad ligaments are a double layer of peritoneum that encloses the uterus and supports the uterine tubes. Cardinal ligaments provide support to the cervix and upper vagina. Pubocervical ligaments support the cervix and bladder.

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