Nursing Elites

1. The patient about to undergo gynecological surgery is put on nil by mouth for ____ before surgery to prevent aspiration.

• A. 2-4 hours
• B. 3-5 hours
• C. 4-6 hours
• D. 5-7 hours

Correct answer: C

Rationale: Patients undergoing gynecological surgery are typically advised to be nil by mouth for 4-6 hours before the procedure to reduce the risk of aspiration. This duration allows the stomach to empty its contents, decreasing the likelihood of regurgitation and aspiration of stomach contents during surgery. Choices A, B, and D have shorter durations and may not provide sufficient time for adequate gastric emptying, increasing the risk of aspiration.

2. 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.

3. Practices such as female genital mutilation and unsafe male circumcision are categorized as:

• A. Harmful traditional practices
• B. Encouraged in rural Zambia
• C. Recommended in modern surgery and IRH
• D. Safer sex practices

Correct answer: A

Rationale: Practices like female genital mutilation and unsafe male circumcision are considered harmful traditional practices due to the physical and psychological harm they cause. Choice A is correct as these practices are not safe or recommended. Choice B is incorrect, as harmful traditional practices are not encouraged anywhere. Choice C is incorrect as modern surgery and organizations like IRH aim to eliminate such practices, not recommend them. Choice D is incorrect as these practices are not related to safer sex practices but rather harmful practices that need to be eradicated.

4. What is the purpose of hysteroscopy?

• A. View the uterine cavity
• B. Perform a D&C procedure
• C. Remove the fetus
• D. Visualize the fallopian tubes

Correct answer: A

Rationale: Hysteroscopy is a procedure where a very narrow endoscope is inserted through the cervix to view the uterine cavity. This allows healthcare providers to diagnose and treat various uterine conditions such as polyps, fibroids, and adhesions. Choice B, performing a D&C procedure, involves dilating the cervix and scraping the uterine lining, which is a different procedure. Choice C, removing the fetus, is not the purpose of hysteroscopy and is a procedure done in specific circumstances such as pregnancy termination or miscarriage management. Choice D, visualizing the fallopian tubes, is typically done through a procedure called a hysterosalpingogram, which is different from hysteroscopy.

5. What is the most common symptom in all clinical types of abortion EXCEPT:

• A. Lower abdominal pain
• B. Per vaginal bleeding
• C. Show
• D. Backache

Correct answer: C

Rationale: The correct answer is C. 'Show' is not a common symptom in all types of abortion. Lower abdominal pain, per vaginal bleeding, and backache are common symptoms associated with abortion. Lower abdominal pain may result from uterine contractions, per vaginal bleeding is a typical presentation, and backache can be a symptom due to the process of abortion. 'Show' refers to the mucus plug that blocks the cervix during pregnancy and is not a typical symptom of abortion.

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