Nursing Elites

1. What is a cord inserted to the very edge of the placenta known as?

• A. Battledore insertion
• B. Placenta velamentosa
• C. Placenta accreta
• D. Vasa Praevia

Correct answer: A

Rationale: A cord inserted to the very edge of the placenta is known as battledore insertion. This occurs when the cord is attached to the fetal membranes at the placental margin rather than directly to the placental tissue. Placenta velamentosa refers to the condition where the umbilical cord inserts into the fetal membranes before it reaches the placenta. Placenta accreta is a condition where the placenta attaches too deeply into the uterine wall. Vasa Praevia is a condition where fetal blood vessels run across or near the internal cervical opening.

2. Discuss the anatomical/physiological changes in pregnancy under the following: Uterus

• A. The uterus softens in the anterior midline, becomes flexible at the uterocervical junction, blood vasculature increases in size and number, and hypertrophy of myometrial cells occurs.
• B. The uterus decreases in size during pregnancy and remains rigid.
• C. The uterus size remains unchanged, and no changes occur in the blood vasculature.
• D. Uterus becomes more rigid and hypertrophies.

Correct answer: A

Rationale: During pregnancy, the uterus undergoes various anatomical and physiological changes. The correct answer, Choice A, accurately describes these changes. The uterus softens in the anterior midline, becomes flexible at the uterocervical junction, experiences an increase in blood vasculature size and number, and myometrial cells hypertrophy. This softening and increased vascularity are essential for accommodating the growing fetus and facilitating delivery. Choices B, C, and D are incorrect because they do not reflect the typical changes that occur in the uterus during pregnancy. The uterus does not decrease in size, remain unchanged in size, become more rigid, or hypertrophy without the described softening and vascular changes.

3. The products of conception are retained in which of the following?

• A. Complete abortions
• B. Incomplete abortions
• C. Threatened abortion
• D. Mixed abortion

Correct answer: B

Rationale: In incomplete abortions, the products of conception are retained. In a complete abortion, all the products of conception are expelled from the uterus. Threatened abortion refers to a situation where there is vaginal bleeding but the cervix remains closed, and it does not necessarily involve retention of products of conception. Mixed abortion is not a recognized medical term related to retained products of conception.

4. 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.

5. Which of the following is the most effective method of contraception?

• A. Barrier methods
• B. Hormonal pills
• C. Intrauterine devices (IUDs)
• D. Sterilization

Correct answer: D

Rationale: Sterilization is considered the most effective method of contraception because it permanently prevents pregnancy. Barrier methods, hormonal pills, and IUDs are highly effective as well, but they are reversible methods and may have a higher failure rate compared to sterilization.

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