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NCC National Certification
Corporation 2024-2025 NCC Registered Nurse Certified
in Maternal Newborn Nursing RNC Maternal History and
Risk Factor Exam Review Questions and Answers |
100% Pass Guaranteed | Graded A+ |
Read All Instructions Carefully and Answer All the
Questions Correctly Good Luck: -
Alpha Feto-protein - Answer>> done 14-18 weeks
elevated=neural tube defect
low=Trisomy 21.
protein produced by fetal tissue. During development
AFP levels in fetal blood and amniotic fluid rise until 12
weeks, then level gradually fall until birth. Some AFP
crosses the placenta and appears in maternal blood.
HCG - Answer>> elevated in down syndrome
hormone produced by the placenta. Levels rise in
maternal blood for the first trimester of pregnancy then
fall to less than 10% by the end.
Unconjugated Estriol - Answer>> elevated in Down
Syndrome
form of estrogen produced by the fetus through
metabolism.
This process involves the liver, adrenals and placenta.
Some estriol crosses the placenta into the maternal
blood. Levels rise around the 8th week and continue to
rise until shortly before delivery.
Amniocentesis - Answer>> genetic evaluation done
between 15-20 weeks for genetic evaluation for neural
tube defect, down syndrome, Trisomy 18 and Trisomy
13 with measurement of up to four markers: AFP,
estriol, hCG and inhibin A
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Glucose Challenge - Answer>>
done 24-28 weeks to screen for
gestational diabetes
50g glucose load and check dextrose one hour. if
>140/dl perform GTT
Glucose Tolerance Test - Answer>> 100g glucose
load. check dextrose at 1, 2, and 3 hours. If 2 values
elevated test failed.
Fasting: >105
1 hr: >190
2hr: >165
3hr: >145
Rh factor testing - Answer>> at 28 weeks repeated
antibody titer for Rh negative moms
Administer Rh immunoglobulin 300mg, if no anti D
antibody is detected.
HgB and HCT - Answer>> early third trimester repeat
HgB and HCT, if anemic recheck at 36 weeks.
Ultrasound - Answer>> repeat 36-40 weeks if
indicated for serial growth, amniotic fluid volume, and
placenta assessment.
crown-rump measurement during first trimester (6-12
wk) most accurately reflects gestational age plus minus
5 days.
Bi-parietal diameter is most frequently used
measurement of establishing gestational age. most
accurate between 12-20 weeks.
Abdominal circumference can be used to assess
gestational age and intrauterine growth restriction..
Best done before 14 weeks.
GBS swab - Answer>> 35-37 weeks, result
dependable for 5 weeks.
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Non-stress test - Answer>> test
for fetal well being
Indicated for patients at risk for placental insufficiency,
postterm preganancy, diabetes, hypertension, previous
still births, IUGR, decreased fetal movements, Rh
disease.
May be started as early as 30-32 weeks
test once or twice weekly
A reactive test: two fetal heart rate accelerations,
defined as 15 beat rise from baseline that lasts 15
seconds with return to baseline after 40 min.
A reactive test is reassuring, with risk of fetal death
approx. 5 in 1000. A non-reactive test is an indication
for further testing.
Nuchal Translucency - Answer>> measures the fluid
beneath the skin behind baby's neck for genetic
screening. It is more reliable screen for multiples.
First trimester genetic screen - Answer>> Done at 10-
14 weeks includes ultrasound measurement of fetal
nuchal translucency and/or biochemical markers
including AFP, hCG, unconjugated estriol, inhibin A, and
PAPP-A (pregnancy associated plasma protein)
All patients should be offered cystic fibrosis screening
and if carrier status is detected then the partner should
be tested.
Chronic Villus sampling - Answer>> done 9-11 weeks,
transabdominal aspiration
done if increased risk for NTD, cystic hygroma, or other
suspect anomaly
Indications: prefers to know to make decisions
regarding pregnancy in first trimester. 2. Severe
oligohydraminos.
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