Nursing Elites

1. At 3-4 weeks of pregnancy, the breast changes include:

• A. Darkening of the nipple.
• B. Prickling, tingling sensation.
• C. Breast becomes tender.
• D. Colostrum can be expressed.

Correct answer: C

Rationale: At 3-4 weeks of pregnancy, breast changes commonly involve tenderness due to hormonal fluctuations. Darkening of the nipple (Choice A) typically occurs later in pregnancy. Prickling, tingling sensations (Choice B) are more associated with early pregnancy due to increased blood flow to the breast area. Colostrum production (Choice D) usually begins later in pregnancy, closer to the end of the third trimester.

2. 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.

3. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

• A. Risk for infection
• B. Pain
• C. Knowledge Deficit
• D. Anticipatory Grieving

Correct answer: D

Rationale: Anticipatory grieving is the priority nursing diagnosis for a client with an ectopic pregnancy. An ectopic pregnancy is a life-threatening condition that requires immediate medical intervention, often resulting in emotional distress and potential loss. Anticipatory grieving addresses the emotional needs of the client and their family in anticipation of a possible loss. While pain management and infection prevention are important aspects of care, addressing the emotional well-being and coping mechanisms should take precedence in this situation. Knowledge deficit may also be relevant, but emotional support is crucial in this critical scenario.

4. How can the need to respect clients' rights to informed consent be attained in quality of care?

• A. by providing adequate information and counseling
• B. by forcing all patients scheduled for surgery to sign the consent form
• C. by engaging the Senior medical superintendent of the hospital to sign consent forms for the patients
• D. by simply telling the patient to sign the consent form

Correct answer: A

Rationale: The correct answer is A: 'by providing adequate information and counseling.' Respecting clients' rights to informed consent involves ensuring that patients are adequately informed about the procedures they will undergo. This includes providing them with all necessary information and counseling to make an informed decision. Choice B is incorrect because forcing patients to sign consent forms does not ensure that they are fully informed or that their rights are respected. Choice C is incorrect as involving a senior medical superintendent to sign consent forms does not guarantee that patients are adequately informed. Choice D is incorrect because simply telling the patient to sign the consent form does not fulfill the requirement of providing adequate information for informed consent.

5. 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.

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