Nursing Elites

1. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

• A. Risk for infection
• B. Pain
• C. Knowledge Deficit
• D. Anticipatory Grieving

Correct answer: D

Rationale: Anticipatory grieving is the priority nursing diagnosis for a client with an ectopic pregnancy. An ectopic pregnancy is a life-threatening condition that requires immediate medical intervention, often resulting in emotional distress and potential loss. Anticipatory grieving addresses the emotional needs of the client and their family in anticipation of a possible loss. While pain management and infection prevention are important aspects of care, addressing the emotional well-being and coping mechanisms should take precedence in this situation. Knowledge deficit may also be relevant, but emotional support is crucial in this critical scenario.

2. A client 12 weeks pregnant comes to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cm cervical dilation. The nurse would document these findings as which of the following?

• A. Threatened abortion
• B. Inevitable abortion
• C. Complete abortion
• D. Missed abortion

Correct answer: B

Rationale: The nurse would document these findings as an inevitable abortion. Inevitable abortion is characterized by cervical dilation with or without rupture of membranes and is associated with moderate to heavy vaginal bleeding. 'Threatened abortion' (choice A) refers to vaginal bleeding with a closed cervical os and no tissue passage. 'Complete abortion' (choice C) involves the passage of all products of conception. 'Missed abortion' (choice D) is the retention of a failed intrauterine pregnancy for an extended period without symptoms.

3. 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.

4. What lines the uterus?

• A. Endometrium.
• B. Myometrium.
• C. Perimetrium.
• D. Glandular tissue.

Correct answer: A

Rationale: The correct answer is A, Endometrium. The endometrium is the inner lining of the uterus where the fertilized egg implants and develops during pregnancy. Myometrium (Choice B) is the middle layer of the uterus consisting of muscle tissue. Perimetrium (Choice C) is the outer layer of the uterus. Glandular tissue (Choice D) is a broad term referring to tissue containing glands, but it does not specifically line the uterus.

5. Causes of metrorrhagia include:

• A. Cervical carcinoma
• B. Uterine polyp
• C. Cervical endometriosis
• D. Infections like Chlamydia

Correct answer: A

Rationale: Metrorrhagia refers to irregular menstrual bleeding that occurs between periods. Cervical carcinoma, a type of cancer that develops in the cervix, can lead to metrorrhagia. Uterine polyps, which are growths attached to the inner wall of the uterus, can also cause abnormal bleeding. While infections like Chlamydia can cause abnormal vaginal bleeding, they are not common causes of metrorrhagia. Cervical endometriosis, although a possible gynecological condition, is not a typical cause of metrorrhagia. Therefore, the correct answer is cervical carcinoma as it is a known cause of metrorrhagia, making the other options incorrect.

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