RNC NIC COMPREHENSIVE QUESTIONS
AND SOLUTIONS
◉ Gestational age for glucose screening in low risk women
Answer: 24 to 28 weeks
◉ What is considered low risk for developing gestational
diabetes?
Answer: <25 years, normal weight before pregnancy, not a
member of high risk, ethnic or racial groups, no diabetes in first-
degree relative, no history of abnormal glucose tolerance, no
history of poor obstetric outcome
◉ Five variables included in BPP
Answer: Fetal tone, fetal breathing, fetal movement, non-stress
test, and amniotic fluid volume
-evaluate speed of well-being through use of reflex activities
controlled by the central nervous system
-are sensitive to hypoxia
◉ Patient at high risk for gestational diabetes
,Answer: Greater than 35 years, BMI greater than 30, history of
gestational, diabetes, delivery of a large, gestational, infant, PCOS,
and strong family history of diabetes
-plasma glucose screening at first prenatal visit and at 24-28
weeks
◉ Cause of late decels
Answer: Hypoxemia during uterine contraction
◉ Cause of minimal FHR variability
Answer: Fetal metabolic acidemia
-recurrent or sustained interruption of oxygen transfer from the
environment to the fetus can lead to deterioration of fetal
oxygenation, metabolic acidemia, and blunting of
parasympathetic outflow - this can reduce regulation of FHR
◉ Cause of absent variability in FHR
Answer: Severe hypoxia
◉ Cause of marked variability in FHR
Answer: Meth use and scalp stimulation
◉ Oligohydramnios
Answer: Low amniotic fluid
,-Single deepest pocket of <2cm or amniotic fluid index of <5cm
-abnormalities in amniotic fluid volume after require further
evaluation and can impact perinatal outcome
◉ Shunt responsible for movement of blood flow between right
and left atrium. Which direction does blood flow during fetal
period?
Answer: PFO, right to left (due to high pulmonary resistance)
◉ Vessel responsible for transporting oxygenated blood from
placenta to fetus
Answer: Umbilical vein
◉ What pressure change reflects PPHN in a neonate
Answer: Increase in pulmonary vascular resistance, decrease in
systemic
◉ Where do you put pulse ox after delivery
Answer: Right hand (preductal)
-this is because neonates have an increase in pulmonary vascular
resistance with right to left shunting and saturation in the lower
extremities may be lower
◉ Target preductal sats after birth
Answer: 1 minute: 60 to 65%
, 2 min: 65 to 70%
3 min: 70-75%
4 min: 75-80%
5 min: 80-85%
10 min: 85-95%
◉ Role of indigenous catecholamine release during birth process
for adaptation to occur
Answer: -preterm, baby secretes higher levels of catecholamine,
compared to term, baby
-increase production in pre-term baby is in response to less
responsive organs
-release of catecholamines is responsible for increasing the blood
pressure at birth, the metabolism of Brown, fat and fatty acids to
mobilize, glycogen stores for glucose homeostasis, thermal
regulation, and stimulating the production of surfaced
-production of category means in premiums is increased, but
these babies often have difficulty maintaining their temperature
and require a glucose supplementation
-
Giving steroids to mom before birth causes decrease in
production of catecholamines
◉ Which cord gas is the best indicator of the babies metabolic
condition before delivery
AND SOLUTIONS
◉ Gestational age for glucose screening in low risk women
Answer: 24 to 28 weeks
◉ What is considered low risk for developing gestational
diabetes?
Answer: <25 years, normal weight before pregnancy, not a
member of high risk, ethnic or racial groups, no diabetes in first-
degree relative, no history of abnormal glucose tolerance, no
history of poor obstetric outcome
◉ Five variables included in BPP
Answer: Fetal tone, fetal breathing, fetal movement, non-stress
test, and amniotic fluid volume
-evaluate speed of well-being through use of reflex activities
controlled by the central nervous system
-are sensitive to hypoxia
◉ Patient at high risk for gestational diabetes
,Answer: Greater than 35 years, BMI greater than 30, history of
gestational, diabetes, delivery of a large, gestational, infant, PCOS,
and strong family history of diabetes
-plasma glucose screening at first prenatal visit and at 24-28
weeks
◉ Cause of late decels
Answer: Hypoxemia during uterine contraction
◉ Cause of minimal FHR variability
Answer: Fetal metabolic acidemia
-recurrent or sustained interruption of oxygen transfer from the
environment to the fetus can lead to deterioration of fetal
oxygenation, metabolic acidemia, and blunting of
parasympathetic outflow - this can reduce regulation of FHR
◉ Cause of absent variability in FHR
Answer: Severe hypoxia
◉ Cause of marked variability in FHR
Answer: Meth use and scalp stimulation
◉ Oligohydramnios
Answer: Low amniotic fluid
,-Single deepest pocket of <2cm or amniotic fluid index of <5cm
-abnormalities in amniotic fluid volume after require further
evaluation and can impact perinatal outcome
◉ Shunt responsible for movement of blood flow between right
and left atrium. Which direction does blood flow during fetal
period?
Answer: PFO, right to left (due to high pulmonary resistance)
◉ Vessel responsible for transporting oxygenated blood from
placenta to fetus
Answer: Umbilical vein
◉ What pressure change reflects PPHN in a neonate
Answer: Increase in pulmonary vascular resistance, decrease in
systemic
◉ Where do you put pulse ox after delivery
Answer: Right hand (preductal)
-this is because neonates have an increase in pulmonary vascular
resistance with right to left shunting and saturation in the lower
extremities may be lower
◉ Target preductal sats after birth
Answer: 1 minute: 60 to 65%
, 2 min: 65 to 70%
3 min: 70-75%
4 min: 75-80%
5 min: 80-85%
10 min: 85-95%
◉ Role of indigenous catecholamine release during birth process
for adaptation to occur
Answer: -preterm, baby secretes higher levels of catecholamine,
compared to term, baby
-increase production in pre-term baby is in response to less
responsive organs
-release of catecholamines is responsible for increasing the blood
pressure at birth, the metabolism of Brown, fat and fatty acids to
mobilize, glycogen stores for glucose homeostasis, thermal
regulation, and stimulating the production of surfaced
-production of category means in premiums is increased, but
these babies often have difficulty maintaining their temperature
and require a glucose supplementation
-
Giving steroids to mom before birth causes decrease in
production of catecholamines
◉ Which cord gas is the best indicator of the babies metabolic
condition before delivery
