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. 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.

3. 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.

4. Where does the ovum receive the sperm?

• A. Animal pole
• B. Vegetal pole
• C. Zona pellucida
• D. None of the above

Correct answer: C

Rationale: The correct answer is C, 'Zona pellucida.' The ovum receives the sperm at the zona pellucida, which is the glycoprotein layer surrounding the plasma membrane of the oocyte. This layer plays a crucial role in preventing polyspermy. Choices A and B, 'Animal pole' and 'Vegetal pole,' are incorrect as they refer to different regions of the egg and are not where the sperm fertilizes the ovum. Choice D, 'None of the above,' is incorrect as the sperm indeed interacts with the zona pellucida during fertilization.

5. Which of the following is NOT a strategy for family planning?

• A. Integrating family planning services with other Reproductive Health programs
• B. Expanding access to family planning through non-public delivery systems
• C. Targeting family planning services to priority groups
• D. Expanding programs of immunization

Correct answer: D

Rationale: The correct answer is D. Expanded programs of immunization are not considered a strategy for family planning. Immunization programs focus on preventing diseases through vaccines and are distinct from family planning strategies, which aim to help individuals and couples plan their desired family size and spacing of children. Choices A, B, and C are all valid strategies for family planning. Integrating family planning services with other reproductive health programs, expanding access to family planning through non-public delivery systems, and targeting family planning services to priority groups are common approaches to improve the availability and effectiveness of family planning services.

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