Nursing Elites

1. Discuss the anatomical/physiological changes in pregnancy under the following: Haematological system

• A. Blood volume and plasma volume increase, red blood cells increase, erythropoietin levels decrease, and leukocyte count increases.
• B. Blood volume and plasma volume decrease, and red blood cells decrease.
• C. No changes occur in the haematological system during pregnancy.
• D. Platelet count remains constant, and no change in coagulation factors.

Correct answer: A

Rationale: During pregnancy, the haematological system undergoes changes to support the growing fetus. Blood volume and plasma volume increase to accommodate the needs of the developing baby. Red blood cells increase to support the increased oxygen demand. Contrary to the statement, erythropoietin levels actually increase to stimulate red blood cell production. Additionally, leukocyte count increases to help the mother's immune system cope with the changes during pregnancy. Choice B is incorrect as it describes a decrease in blood components, which is not the case in pregnancy. Choice C is incorrect as there are significant changes in the haematological system during pregnancy. Choice D is incorrect as platelet count can fluctuate during pregnancy, and there are changes in coagulation factors to prevent excessive bleeding.

2. Which of the following is included in a pelvic examination?

• A. Inspection of internal genitalia
• B. Inspection of the cervix and vaginal wall
• C. Palpation of the vagina and vaginal cervix by digital examination
• D. Rectal examination

Correct answer: B

Rationale: The correct answer is B. A pelvic examination involves the inspection of the cervix and vaginal wall. This is typically done to assess the health of the reproductive organs and screen for any abnormalities. Choices A, C, and D are incorrect because while palpation and digital examination may be part of a pelvic exam, the specific focus on the cervix and vaginal wall is a key component that distinguishes it from other types of examinations.

3. Expanded access to family planning through non-public delivery systems is facilitated by all of the following EXCEPT:

• A. By using the private sector and social marketing
• B. Community-based programs
• C. Information, Education, and Communication
• D. Key persons in the community

Correct answer: D

Rationale: Expanded access to family planning through non-public delivery systems involves utilizing various strategies to reach more people. Options A, B, and C are all effective methods for expanding access to family planning services. The involvement of key persons in the community is not a typical approach for non-public delivery systems. Key persons in the community may have influence but may not be directly involved in the delivery of family planning services, making option D the correct answer.

4. Which of the following are layers of endometrium in pregnancy EXCEPT?

• A. Decidua compacta
• B. Decidua spongiosum
• C. Decidua functionalis
• D. Decidua basalis

Correct answer: C

Rationale: During pregnancy, the layers of endometrium include decidua compacta, decidua spongiosum, and decidua basalis. Decidua functionalis is the layer that sheds during menstruation and regenerates each cycle, not a layer of the endometrium during pregnancy. Therefore, choice C is the correct answer. Decidua compacta is the layer closest to the conceptus, decidua spongiosum is the middle layer, and decidua basalis is the layer adjacent to the myometrium.

5. Outlet of the true pelvis anteriorly bounded by:

• A. Ischiopubic arch (T)
• B. Linea terminalis (F)
• C. Coccyx (T)
• D. Promontory of the sacrum (F)

Correct answer: A

Rationale: The correct answer is A: Ischiopubic arch. The outlet of the true pelvis is indeed anteriorly bounded by the ischiopubic arch, which consists of the ischium and the pubic bones. This structure forms the lower boundary of the pelvic outlet. The other choices, B, C, and D, are incorrect. The linea terminalis (pelvic brim) forms the upper boundary of the true pelvis, the coccyx is part of the bony pelvis but does not bound the pelvic outlet anteriorly, and the promontory of the sacrum is located in the posterior part of the pelvis, not the anterior boundary of the pelvic outlet.

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