RNC NIC EXAMPREP QUESTIONS AND
DETAILED SOLUTIONS
◉ fetal tachycardia.
Answer: - fetal HR >160 for 10 or more min.
- sustained 170s-180s **think infection**
- also could be caused by acute hypoxemia/hypoxia, maternal fever,
maternal anxiety, maternal hyperthyroidism
◉ effects of maternal magnesium sulfate on newborn.
Answer: - tocolytic medication that can be used for neuroprotection
in preterm labor that can cause **neuromuscular or respiratory
depression in the newborn**
◉ effects of maternal prostaglandin inhibitors in newborn.
Answer: - tocolytic medications such as indomethacin that puts the
fetus at risk of premature ductal closure in utero, pulmonary HTN,
and altered renal function if given to mother
◉ effects of maternal betaminetics in newborn.
Answer: - tocolytic medications such as terbutaline that can cause
**hypoglycemia in the newborn due to hyperinsulinemia** (baby's
pancreas produces too much insulin, thus lowering blood glucose)
,◉ risks of vacuum assisted delivered.
Answer: - can case cephalohematoma, retinal hemorrhage, and
intracranial hemorrhage (rarely); consider **hyperbilirubinemia** --
> may show as bruising and bleeding
◉ transillumination.
Answer: - tool used for newborn physical exam that is a fiberoptic
light source attached to the end of a long, flexible tube
- fluid- or air-filled structures will transmit the light (light up), e.g.
hydroceles, severe hydrocephalus, pneumothorax
-**solid masses will NOT light up/transmit light, e.g. tumors,
testicular torsion**
◉ red reflex.
Answer: - **reflex due to light reflecting off the interior lining of the
eye (fundus)**
- shows as a bright orange-red or pale/gray in darker skinned
newborns
- absent or disrupted reflex could be congenital cataracts, glaucoma,
or retinoblastoma
◉ acrocyanosis.
,Answer: - **blue/pale discoloration of hands and feet, normal in the
first 48 hours of life**
◉ general pallor/cyanosis.
Answer: - blue/pale discoloration outside of the first 48 hours of life
or outside of just the hands/feet that may be due to anemia,
hypoxemia, or shock
◉ how to differentiate between cyanosis and ecchymosis (bruising).
Answer: - **assess the ability of the skin to blanch**
- **ecchymosis (bruising) will NOT blanch**
◉ jaundice/icterus.
Answer: - **yellow discoloration of the skin d/t
hyperbilirubinemia**
- **ALWAYS an abnormal finding in the FIRST 24 HOURS OF LIFE**
◉ general safe temperature range.
Answer: 36 to 37.5 degrees C (96.8 to 99.5 degrees F)
◉ craniotabes.
Answer: - **aka congenital cranial osteoporosis, defined as a
softening of the skull bones**
, - can occur in up to 1/3 of all newborns and can be a normal finding,
especially in preemies
- **soft areas of the skull (especially along the suture line) can pop in
and out like a ping pong ball
- **mostly found along the occipital and parietal bones
◉ caput succedanenum.
Answer: - hemorrhagic edema that **crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually
looks like a bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
◉ preauricular sinuses/pit.
Answer: - **often associated with renal abnormalities and 2-vessel
cord**
- could also be skin tags (more common)
◉ cystic hygroma.
Answer: - fluid-filled sacs that results from a blockage in the
lymphatic system
- **may require immediate intubation or emergent tracheotomy in
the delivery room**
DETAILED SOLUTIONS
◉ fetal tachycardia.
Answer: - fetal HR >160 for 10 or more min.
- sustained 170s-180s **think infection**
- also could be caused by acute hypoxemia/hypoxia, maternal fever,
maternal anxiety, maternal hyperthyroidism
◉ effects of maternal magnesium sulfate on newborn.
Answer: - tocolytic medication that can be used for neuroprotection
in preterm labor that can cause **neuromuscular or respiratory
depression in the newborn**
◉ effects of maternal prostaglandin inhibitors in newborn.
Answer: - tocolytic medications such as indomethacin that puts the
fetus at risk of premature ductal closure in utero, pulmonary HTN,
and altered renal function if given to mother
◉ effects of maternal betaminetics in newborn.
Answer: - tocolytic medications such as terbutaline that can cause
**hypoglycemia in the newborn due to hyperinsulinemia** (baby's
pancreas produces too much insulin, thus lowering blood glucose)
,◉ risks of vacuum assisted delivered.
Answer: - can case cephalohematoma, retinal hemorrhage, and
intracranial hemorrhage (rarely); consider **hyperbilirubinemia** --
> may show as bruising and bleeding
◉ transillumination.
Answer: - tool used for newborn physical exam that is a fiberoptic
light source attached to the end of a long, flexible tube
- fluid- or air-filled structures will transmit the light (light up), e.g.
hydroceles, severe hydrocephalus, pneumothorax
-**solid masses will NOT light up/transmit light, e.g. tumors,
testicular torsion**
◉ red reflex.
Answer: - **reflex due to light reflecting off the interior lining of the
eye (fundus)**
- shows as a bright orange-red or pale/gray in darker skinned
newborns
- absent or disrupted reflex could be congenital cataracts, glaucoma,
or retinoblastoma
◉ acrocyanosis.
,Answer: - **blue/pale discoloration of hands and feet, normal in the
first 48 hours of life**
◉ general pallor/cyanosis.
Answer: - blue/pale discoloration outside of the first 48 hours of life
or outside of just the hands/feet that may be due to anemia,
hypoxemia, or shock
◉ how to differentiate between cyanosis and ecchymosis (bruising).
Answer: - **assess the ability of the skin to blanch**
- **ecchymosis (bruising) will NOT blanch**
◉ jaundice/icterus.
Answer: - **yellow discoloration of the skin d/t
hyperbilirubinemia**
- **ALWAYS an abnormal finding in the FIRST 24 HOURS OF LIFE**
◉ general safe temperature range.
Answer: 36 to 37.5 degrees C (96.8 to 99.5 degrees F)
◉ craniotabes.
Answer: - **aka congenital cranial osteoporosis, defined as a
softening of the skull bones**
, - can occur in up to 1/3 of all newborns and can be a normal finding,
especially in preemies
- **soft areas of the skull (especially along the suture line) can pop in
and out like a ping pong ball
- **mostly found along the occipital and parietal bones
◉ caput succedanenum.
Answer: - hemorrhagic edema that **crosses suture line**
- evident at birth; looks like soft swelling with discoloration (usually
looks like a bruise/red, blue, purple)
- does not grow in size
- may develop hyperbilirubinemia (bleeding/bruising --> jaundice)
◉ preauricular sinuses/pit.
Answer: - **often associated with renal abnormalities and 2-vessel
cord**
- could also be skin tags (more common)
◉ cystic hygroma.
Answer: - fluid-filled sacs that results from a blockage in the
lymphatic system
- **may require immediate intubation or emergent tracheotomy in
the delivery room**
