Nursing Elites

1. 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.

2. Which of the following are outcomes of an ectopic pregnancy EXCEPT?

• A. Tubal abortion
• B. Tubal rupture
• C. Intra-tubal bleeding
• D. Secondary abdominal pregnancy

Correct answer: D

Rationale: Ectopic pregnancy occurs when a fertilized egg implants outside the uterus. Common outcomes include tubal abortion (spontaneous termination of ectopic pregnancy within the fallopian tube), tubal rupture (rupture of the fallopian tube leading to internal bleeding), and intra-tubal bleeding. Secondary abdominal pregnancy, on the other hand, is a rare occurrence and not a typical outcome of an ectopic pregnancy. It involves the implantation of a fertilized egg in the peritoneal cavity rather than the uterus.

3. Which one of the following is not associated with poor maternal outcome?

• A. APH
• B. PPH
• C. Cord prolapse
• D. Pre-eclampsia

Correct answer: C

Rationale: Cord prolapse is not typically associated with poor maternal outcomes. Acute placental hemorrhage (APH - choice A) and postpartum hemorrhage (PPH - choice B) can lead to maternal morbidity and mortality due to excessive blood loss. Pre-eclampsia (choice D) is a serious pregnancy complication characterized by high blood pressure and signs of damage to other organ systems, which can result in severe maternal complications if not managed promptly. Cord prolapse, though concerning for fetal well-being, does not inherently pose direct risks to maternal health if managed appropriately, making it the correct answer in this context.

4. How many arteries are there in an umbilical cord?

• A. Three
• B. One
• C. Two
• D. Four

Correct answer: C

Rationale: There are two arteries in an umbilical cord. The umbilical cord contains two arteries and one vein. Artery carries blood away from the fetus, while the vein returns blood to the fetus. Therefore, choices A, B, and D are incorrect as they do not represent the correct number of arteries in an umbilical cord.

5. The structures of the vulva lie ____________ to the vagina.

• A. Posterior
• B. Inferior
• C. Lateral
• D. Superior

Correct answer: B

Rationale: The correct answer is 'Inferior.' The structures of the vulva are positioned below the vagina, making them inferior. Choice A, 'Posterior,' refers to structures located at the back, not below the vagina. Choice C, 'Lateral,' means to the side, which is not the correct orientation in this context. Choice D, 'Superior,' indicates above, which is the opposite of the correct relationship described in the question.

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