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RNC-NIC Review Class Questions and Answers 2024
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RNC-NIC Review Class
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RNC-NIC Review ClassAdolescent Moms are at higher risk for - answer
Adolescent moms are at higher risk for: - answer- Maternal malnutrition
- Pre-eclampsia/eclampsia
- IUGR
Moms >35yo are at higher risk for: - answer- Pregnancy-induced hypertension
- DM
- Obesity
- Baby with chromosomal abnormalities
- Increased c/s rate
- Placenta previa
Gravida vs Para - answer Gravida: How many pregnancies, including current
Para: How many Full term, preterm, aborted, living
Chorionic Villus Sampling (CVS) - answer- Tests for fetal chromosomal abnormalities as
early as 10-13 weeks
- Transabdominal/cervical
- Results within 24 hrs
- Recommended for advanced maternal age
Amniocentesis - answer- Screens for chromosomal abnormalities, performed between
15-20 weeks or later in pregnancy to assess fetal lung maturity
- Recommended for advanced maternal age
Cordocentesis/Percutaneous umbilical blood sampling (PUBS) - answer- Used to
diagnose inherited blood disorders, anemia, or congenital infections or for fetal blood
transfusions
Ultrasound - answer- Most accurate by ~20wks
- Different densities between stages of pregnancy ... done throughout pregnancy to look
for certain things
Doppler Velocimetry - answer- Assesses placental function
- Measures bloodflow changes in maternal and fetal circulation
- S/D over 3 = decreased placental perfusion
Normally-growing fetus doppler results: - answer- High-velocity diastolic flow through
umbilical artery, increases with gestational age
,Growth-Restricted fetus doppler results: - answer- Diminished, absent or reverse end
diastolic flow
Diminished, absent or reverse end diastolic flow - answerIndicates extreme downstream
resistance, placental dysfunction, and fetal compromise
Biophysical Profile (BPP) - answerEvaluates fetal well-being in antepartum period
based on:
- fetal heart rate,
- breathing movements,
- gross body movements,
- muscle tone,
- and amniotic fluid volume.
Utilizes Non-Stress Test (NST) and Amniotic Fluid Index (AFI)
BPP scores - answer8-10 normal (unless oligo present)
6 Deliver if term; may repeat test in 12-24hrs
4 or less abnormal, delivery recommended
Maternal Anemia effects on fetus: - answer- Decreased fetal growth
- Increased mortality d/t inadequate oxygen and nutrient supplies
- Preterm birth
Chronic vs Gestational HTN - answer- Chronic: hx before pregnancy or <20wks,
persistent HTN >6wks post partum, no protenuria
- Gestational: >20 wks, usually resolves postpartum, no proteinuria
Maternal Thrombocytopenia effects on fetus: - answer- Increased risk for bleeding
- Breakdown of RBC can release more bilirubin + jaundice
Preeclampsia vs Eclampsia - answer- Preeclampsia: Hypertension with proteinuria; or
without proteinuria but with other systemic signs
- Eclampsia: Preeclampsia + seizures
HELLP Syndrome - answerHigh blood pressure and:
- Hemolysis
- Elevated Liver Enzymes
- Low Platelets
Cytomegalovirus (CMV)
- Symptoms/ Treatment - answer- *Most Common Intrauterine Infection*
- Can cause SGA infants
,Asymptomatic at birth, 10-15% can have hearing/vision loss later
- Tx: Ganciclovir or Valganciclovir (prevents/lessens severity of hearing loss and may
improve head/brain growth)
Toxoplasmosis - answer- Parasite from cats, raw/undercooked meat
- Transplacental transmission, increased risk later in gestation
- Symptoms in newborns: none to vision problems, seizures, and brain damage
Syphilis
- Transmission,
- Effects on Newborn,
- Treatment - answerTransmitted via secretions
- Affects fetal liver/growth : w/o for JAUNDICE, hepatomegaly
- Tx: Penicillin-G: length of treatment depends on where it's growing
- F/u studies for 12 months
Herpes Simplex Virus (HSV)
- Transmission,
- Effects on Newborn,
- Treatment - answerTransmitted via ascending infection / during passage thru infected
canal
- C/S done if vaginal lesions seen
- Symptoms in newborn: skin lesions, chorioretinitis, encephalitis/brain damage
- Can affect liver, lungs, kidneys, and brain
- Tx: Acyclovir
Hepatitis
- Transmission,
- Effects on Newborn,
- Treatment - answerTransmitted via exposure to maternal blood
- Affects newborn liver --> Increased risk for jaundice
- Tx: Hep B Immune Globulin (HBIG)
- Prevention: Hepatitis B vaccine
HIV/AIDS
- Transmission,
- Effects on Newborn,
- Treatment - answerTransmitted via blood/body fluids in utero or during intrapartum
period
- *Can be spread through breastfeeding*
- Marked decrease in newborn infection if mom treated during pregnancy
- Symptoms: Healthy at birth then can appear within 2-3 months --> Poor weight gain,
*REPEATED FUNGAL MOUTH INFECTIONS(THRUSH)*, enlarged lymph
nodes/liver/spleen, neuro problems, multiple bacterial infections like pneumonia
Gonorrhea
, - Transmission,
- Effects on Newborn,
- Treatment - answerMost common in young population
- Transmission during intrapartum period
- Tx: Ophthalmologic prophylaxis with Silver Nitrate or Erythromycin
Chlamydia
- Transmission,
- Effects on Newborn,
- Treatment - answerMost common bacterial STI
- Infant can develop conjunctivitis and *LATE ONSET PNEUMONIA*, and otitis media
Maternal Renal Disease can cause... - answer- Women with CKD and acute onset are
at risk for fetal loss, IUGR, and PTL
- High maternal BUN acts as osmotic diuretic in fetal kidney and can cause PTL and
fetal loss
Functions of amniotic fluid - answer- Fetal lung development
- Symmetrical growth and musculoskeletal development
- Cushions against injury
- Maintains fetal temperature
- Umbilical cord protection
- Antimicrobial properties
- Nutrition
- Prevents adherence of amnion to embryo
Amniotic Bands - answerCan cause decreased perfusion and lymphatic drainage.
- Lymphedema distal to site --> loss of limbs/tissue.
- Can cause death
True or False: Risk of infection is directly proportional to the duration of ROM -
answerTrue.
Chorioamnionitis - answerInflammation of the placental membranes
- S/S in Mom: fever, tachycardia, sweating, uterine tenderness, and foul-smelling
vaginal discharge
- S/S in Newborn: Sepsis, pneumonia, and/or meningitis
Maternal serum alpha-fetoprotein (MSAFP) - answerDone between 15-22 weeks to test
for neural tube defects
- Elevated Levels - indicative of neural tube defects
- Low Levels: Associated with Trisomy 21
If positive ultrasound and amniocentesis ordered
Triple Screen vs Quad Screen - answerTriple: Looks at MSAFP, hCG, and Estriol
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