Nursing Elites

1. What is the reasonable available distance from all patients to offer Primary Health Care (PHC) services?

• A. Within a 20 Km radius
• B. Within a 15 Km radius
• C. Within a 12 Km radius
• D. Within a 10 Km radius

Correct answer: A

Rationale: The correct answer is within a 20 Km radius. Primary Health Care services should be accessible within a 20 Km radius to ensure adequate coverage for all patients. This distance allows for a reasonable reach while ensuring that individuals can access essential healthcare services in a timely manner. Choices B, C, and D are incorrect as they offer distances that may limit accessibility and coverage, potentially leaving some patients without timely access to necessary healthcare.

2. At 6-8 weeks of pregnancy, the breast changes include:

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

Correct answer: C

Rationale: At 6-8 weeks of pregnancy, one of the changes in the breast includes the prominence of Montgomery's tubercles. These sebaceous glands around the nipple become more noticeable at this stage. Colostrum production usually occurs later in pregnancy, typically closer to the third trimester. While breast tenderness is a common symptom of early pregnancy, it is not specific to the 6-8 week timeframe. Nipples becoming more prominent and mobile may happen later in pregnancy as the body prepares for breastfeeding, but it is not a typical change seen specifically at 6-8 weeks.

3. 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.

4. Total Fertility Rate is at 6.2 births per woman in Zambia. This implies that:

• A. Zambian women will give birth to 6.2 children on average during their childbearing years.
• B. 6.2% of the time she will be pregnant during her childbearing years.
• C. 6.2% of her deliveries will not be successful.
• D. 6.2% of women will require medical intervention to become pregnant.

Correct answer: A

Rationale: A Total Fertility Rate of 6.2 means that a woman will give birth to an average of 6.2 children during her childbearing years. The correct answer is A as it accurately reflects the concept of Total Fertility Rate. Choice B is incorrect as it misinterprets the concept by equating it to a percentage of time being pregnant. Choice C is incorrect as it does not relate to the Total Fertility Rate but rather to the success rate of deliveries. Choice D is incorrect as it introduces the idea of medical intervention, which is not directly related to the Total Fertility Rate.

5. Discuss the anatomical/physiological changes in pregnancy under the following: Cardiovascular system

• A. The heart is displaced upward and to the left by the enlarging uterus, cardiac capacity increases, and blood pressure declines slightly.
• B. The heart is displaced downward and to the right, and blood pressure increases.
• C. The cardiovascular system remains unchanged during pregnancy.
• D. Cardiovascular changes include increased peripheral resistance and reduced cardiac output.

Correct answer: A

Rationale: During pregnancy, the cardiovascular system undergoes changes such as the heart being displaced upward and to the left by the enlarging uterus, increased cardiac capacity, and a slight decline in blood pressure. Choice B is incorrect as the heart is displaced upwards, not downwards, and blood pressure typically decreases slightly. Choice C is incorrect as the cardiovascular system does undergo changes during pregnancy. Choice D is incorrect as cardiovascular changes in pregnancy involve increased cardiac output rather than reduced output.

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