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. 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.

3. Discuss the anatomical/physiological changes in pregnancy under the following: Kidney/renal system

• A. Kidneys increase in size, pelvis dilates, ureters elongate and dilate, and the glomerular filtration rate increases.
• B. Kidneys decrease in size, and glomerular filtration rate decreases.
• C. There is no change in kidney size or ureter function, but the glomerular filtration rate decreases.
• D. Kidneys shrink, and ureters remain the same.

Correct answer: A

Rationale: During pregnancy, the kidneys increase in size, the pelvis dilates, ureters elongate and dilate, and the glomerular filtration rate increases. This is due to the increased metabolic demands and hormonal changes during pregnancy. Choice B is incorrect as the kidneys do not decrease in size, and the glomerular filtration rate actually increases. Choice C is incorrect as there are changes in kidney size and ureter function during pregnancy. Choice D is incorrect as the kidneys do not shrink during pregnancy.

4. Oligomenorrhea is defined as a cycle longer than:

• A. 28 days
• B. 30 days
• C. 35 days
• D. 40 days

Correct answer: C

Rationale: Oligomenorrhea is defined as a menstrual cycle longer than 35 days. A cycle of 28 days (Choice A) is within the normal range, and not considered oligomenorrhea. Similarly, 30 days (Choice B) and 40 days (Choice D) are also within the normal range. The correct definition of oligomenorrhea specifically refers to cycles longer than 35 days, making Choice C the correct answer.

5. 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.

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