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RNC-NIC EXAM WITH COMPLETE SOLUTIONS LATEST UPDATE
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RNC-NIC EXAM WITH COMPLETE SOLUTIONSLATEST UPDATE
What are the risks for infants of mothers who receive no or little prenatal care? -
ANSWER LBW
preterm birth
Maternal iron deficiency anemia
Higher neonatal death
Explain the fetal response to mothers with diabetes - ANSWER Because glucose crosses
the placenta, the baby's BG is increased as mom's is. Insulin does not cross the
placenta and the fetal pancreas does not begin to produce until 20 weeks. So before
production of insulin, the increased BG results in restricted growth. When the insulin is
on, it produces rapidly to respond to the high BG and these high levels are associated
with rapid fetal growth—> hepatosplenomegaly, cardiomegaly, increased head size
What is commonly seen in IDM immediately after birth? Why? - ANSWER Hypoglycemia
The sudden withdrawal from maternal glucose + continued production of insulin
What conditions does an IDM present with? - ANSWER Birth trauma r/t cephalopelvic
disproportion
Hypoglycemia
RDS because inc insulin inhibits surfactant production
Polycythemia & hyperviscosity bc inc insulin & BG inc metabolic rate and oxygen
consumption
Iron deficiency bc polycythemia leaches iron
Hyperbilirubinemia from inc rbc destruction
CV & congenital malformations
,Electrolyte disturbances (low Ca and Mg)
What is pre-eclampsia? - ANSWER Inc BP, proteinuria, edema that occurs around 20
week's gestation
What's the initial tx for pre-eclampsia?-ANSWER Mag sulfate to prevent maternal sz
If severe—premature delivery
What complications occur to fetus with a mother suffering from pre-eclampsia?
Why?-ANSWER IUGR—longstanding HTN causes uteroplacental vascular insufficiency
which impairs transfer of nutrients and oxygen which causes IUGR and inc mortality
Amniotic Fluid What is the purpose of amniotic fluid, and how is it produced? When? -
ANSWER To cushion fetus and allow normal development of lungs
Produced mainly by fetus' excretion of urine and fluids excreted by respiratory tract &
oral/nasal cavity
Around 20 week's
Oligohydramnios What is oligohydramnios? What conditions are associated with it? -
ANSWER Decreased AF
UT anomalies like obstructive uropathy, renal agenesis, polycystic kidneys
Pulmonary hypoplasia
Pressure deformities
Compression of umbilical cord & hypoxia
Mecon staining (remember hypoxia causes release of mecon in utero)
Post-term gestation
Leaking AF, prolonged or premature ROM
Polyhydramnios & assoc with? - ANSWER Increased AF
,TEF, EA, duodenal atresia
Anencephaly
CNS abnormalities that impair swallow
Twin-twin transfusion
Macrosomia
Fetal/neonatal hydrops & assoc CV rhythms
Trisomy 21, 18, 13
Skeletal malformations
Inc risk for prolapsed cord/placental abruption
Biochemical marker useful in predicting preterm birth - ANSWER Fibronectins
What is the best indicator of fetal oxygenation status during labor as observed on
electric fetal monitoring? - ANSWER Variability
What five parts make up the biophysical profile? - ANSWER Fetal tone, breathing,
movement; no stress test, amniotic fluid volume
When is glucose screening during pregnancy indicated if one is at low risk for
developing GD? - ANSWER 24-28 weeks
In sitting upright position, during deliveries, women have cord blood values that have
lower - ANSWER PCO2
An intrauterine pressure catheter, that is placed for the monitoring of uterine pressure,
amino infusion, and fluid sampling, is useful in the treatment of - ANSWER Variable
decelerations by correcting cord compression
What is the normal neonatal blood volume? - ANSWER 85-100 mL/kg
, Risks for FMH include - ANSWER Maternal trauma
Placenta abruption
Placental tumors
Third semester amnios
Fetal hydrops
Twins
What test is used to determine if FMH has taken place? - ANSWER Kleihauer-Betke test
examines maternal blood for fetal hemoglobin; determines the amount of hemorrhage
that has taken place
What increases the chances of having multiple births? - ANSWER Delayed childbearing
What are risks of multiple gestations? - ANSWER Premature birth
LBW
Morbidities such as CP
What are the effects of smoking during pregnancy? - ANSWER Carbon monoxide,
nicotine, and hydrogen cyanide cross placenta—CO displaces oxygen from hemoglobin
so fetus has decreased O2 delivery
SGA
Congenital birth defects
Placenta previa/abruption
What are the risks when mom continues smoking post partum? - ANSWER SIDS
increased infant resp infections
Asthma
Behavioral problems
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