Certified Perinatal Nurse (RNC-OB)EXAM
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EDITION
,Maternal/Fetal Physiology and Antepartum Care
1. A pregnant patient at 28 weeks' gestation asks why she feels short of breath when walking up stairs. What is the nurse's
best response?
A. "This is a sign of pregnancy-induced cardiac overload and needs immediate evaluation."
B. "The growing uterus elevates your diaphragm, reducing lung expansion."
C. "Your body requires more oxygen because of the increased metabolic rate."
D. "This is caused by the pregnancy hormone relaxing smooth muscles in your airways."
Answer: B
Rationale: Dyspnea in the second and third trimesters is primarily mechanical. The enlarging uterus pushes the diaphragm
upward, decreasing the vertical space for lung expansion. Progesterone (not smooth muscle relaxation of airways)
increases tidal volume and the perception of dyspnea. While cardiac overload is a concern, this is a normal physiological
finding first.
2. A nurse is reviewing the lab results for a patient at 35 weeks' gestation. Which finding should the nurse prioritize
reporting to the provider?
,A. Hemoglobin 11.2 g/dL
B. White blood cell count 14,000/mm³
C. Fasting blood glucose 95 mg/dL
D. Platelet count 98,000/mm³
Answer: D
Rationale: A platelet count below 100,000/mm³ is concerning for gestational thrombocytopenia, HELLP syndrome, or
other disorders and requires immediate investigation. Physiologic anemia of pregnancy is normal with hemoglobin of 11-
12 g/dL. WBC count increases in pregnancy up to 15,000/mm³. Fasting glucose of 95 mg/dL is at the upper limit and
warrants further testing, but low platelets pose a more acute risk for hemorrhage.
3. A patient at 30 weeks' gestation is being evaluated for preterm labor. What fetal fibronectin (fFN) result is the most
reliable predictor that the patient will *not* deliver within the next 2 weeks?
A. Positive result
B. Negative result
C. Indeterminate result
D. Positive result with cervical dilation >3 cm
, Answer: B
Rationale: The high negative predictive value (99%) of fFN testing makes a negative result the most useful. It strongly
indicates the patient is unlikely to deliver within 7-14 days, allowing for avoidance of unnecessary interventions.
4. A patient with Type 1 diabetes is at 8 weeks' gestation. What is the most critical teaching point regarding her glycemic
control during this period?
A. "You will need to increase your insulin doses due to placental hormones."
B. "The risk of diabetic ketoacidosis is reduced during pregnancy."
C. "Strict control is vital now as fetal organogenesis is occurring."
D. "Renal glycosuria is common, so monitoring urine glucose is the best method."
Answer: C
Rationale: The first trimester is when organogenesis occurs. Hyperglycemia during this critical period significantly
increases the risk of major congenital anomalies, particularly cardiac and neural tube defects. Insulin needs may actually
decrease in early pregnancy due to increased insulin sensitivity and nausea/vomiting.
5. A pregnant patient at 16 weeks has a serum alpha-fetoprotein (MSAFP) level that is 2.5 multiples of the median (MoM).
The nurse understands this result is associated with:
LATEST WITH ACTUAL QUESTIONS AND
CORRECT VERIFIED ANSWERS/ALREADY
GRADED A+ 100% GUARANTEED TO PASS
CONCEPTS(ALL WHAT YOU NEED) LATEST
EDITION
,Maternal/Fetal Physiology and Antepartum Care
1. A pregnant patient at 28 weeks' gestation asks why she feels short of breath when walking up stairs. What is the nurse's
best response?
A. "This is a sign of pregnancy-induced cardiac overload and needs immediate evaluation."
B. "The growing uterus elevates your diaphragm, reducing lung expansion."
C. "Your body requires more oxygen because of the increased metabolic rate."
D. "This is caused by the pregnancy hormone relaxing smooth muscles in your airways."
Answer: B
Rationale: Dyspnea in the second and third trimesters is primarily mechanical. The enlarging uterus pushes the diaphragm
upward, decreasing the vertical space for lung expansion. Progesterone (not smooth muscle relaxation of airways)
increases tidal volume and the perception of dyspnea. While cardiac overload is a concern, this is a normal physiological
finding first.
2. A nurse is reviewing the lab results for a patient at 35 weeks' gestation. Which finding should the nurse prioritize
reporting to the provider?
,A. Hemoglobin 11.2 g/dL
B. White blood cell count 14,000/mm³
C. Fasting blood glucose 95 mg/dL
D. Platelet count 98,000/mm³
Answer: D
Rationale: A platelet count below 100,000/mm³ is concerning for gestational thrombocytopenia, HELLP syndrome, or
other disorders and requires immediate investigation. Physiologic anemia of pregnancy is normal with hemoglobin of 11-
12 g/dL. WBC count increases in pregnancy up to 15,000/mm³. Fasting glucose of 95 mg/dL is at the upper limit and
warrants further testing, but low platelets pose a more acute risk for hemorrhage.
3. A patient at 30 weeks' gestation is being evaluated for preterm labor. What fetal fibronectin (fFN) result is the most
reliable predictor that the patient will *not* deliver within the next 2 weeks?
A. Positive result
B. Negative result
C. Indeterminate result
D. Positive result with cervical dilation >3 cm
, Answer: B
Rationale: The high negative predictive value (99%) of fFN testing makes a negative result the most useful. It strongly
indicates the patient is unlikely to deliver within 7-14 days, allowing for avoidance of unnecessary interventions.
4. A patient with Type 1 diabetes is at 8 weeks' gestation. What is the most critical teaching point regarding her glycemic
control during this period?
A. "You will need to increase your insulin doses due to placental hormones."
B. "The risk of diabetic ketoacidosis is reduced during pregnancy."
C. "Strict control is vital now as fetal organogenesis is occurring."
D. "Renal glycosuria is common, so monitoring urine glucose is the best method."
Answer: C
Rationale: The first trimester is when organogenesis occurs. Hyperglycemia during this critical period significantly
increases the risk of major congenital anomalies, particularly cardiac and neural tube defects. Insulin needs may actually
decrease in early pregnancy due to increased insulin sensitivity and nausea/vomiting.
5. A pregnant patient at 16 weeks has a serum alpha-fetoprotein (MSAFP) level that is 2.5 multiples of the median (MoM).
The nurse understands this result is associated with:
