Nursing Elites

1. At 34-40 weeks of pregnancy, the breast changes include:

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

Correct answer: D

Rationale: During the 34-40 weeks of pregnancy, Montgomery's tubercles become prominent. These are sebaceous glands on the areola, not the nipples. Choice A is incorrect as it describes the changes in nipples, not Montgomery's tubercles. Choice B is incorrect as colostrum production usually starts around the 16th week. Choice C is incorrect as breast tenderness is more common in early pregnancy due to hormonal changes.

2. In Reproductive Health services, decision-making about RH matters is mostly done by:

• A. The Woman's parents
• B. The Man's parents
• C. The Husband
• D. The Wife

Correct answer: C

Rationale: In many societies, the husband often plays a significant role in decision-making about reproductive health matters, making choice C the correct answer. While the woman's parents might have some influence in certain cultures, the husband typically has a more direct role in such decisions. Choices A and B are less likely as the focus is on the immediate family unit rather than extended family members. Choice D, the wife, is less common in patriarchal societies where men usually have more authority in decision-making regarding reproductive health matters.

3. When does missed abortion occur?

• A. The fetus dies and is retained in utero with the placenta and membranes.
• B. All products of conception are expelled with minimal bleeding.
• C. The cervix remains closed, and the products of conception remain in the uterus.
• D. The cervix remains closed, but there is heavy bleeding.

Correct answer: C

Rationale: Missed abortion occurs when the cervix is closed, and the products of conception remain in the uterus. Choice A describes a missed abortion, not choice C. Choice B describes a complete abortion. Choice D describes a threatened abortion, where the cervix remains closed but there is heavy bleeding.

4. At what age does the first menstrual period typically occur?

• A. 9 and 15 years
• B. 2 and 10 years
• C. 1 and 5 years
• D. 18 and 20 years

Correct answer: A

Rationale: The first menstrual period, known as menarche, typically occurs between the ages of 9 and 15 years. This marks the onset of puberty in females. Choices B, C, and D are incorrect because the first menstrual period does not occur as early as 2 years old, 1 year old, or as late as 18 to 20 years old.

5. 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.

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