RNC OB INPATIENT OBSTETRIC NURSING
CERTIFICATION TEST PAPER QUESTIONS
AND SOLUTIONS VERIFIED ANSWERS
●● Why is obesity a hemorrhage risk?
Answer: More estrogen when obese makes their vascular system fragile
and more likely to bleed
●● Eriksons stage of development for <18 yo deliveries
Answer: ID vs ID confusion
●● Eriksons stage of development for >35 yo deliveries
Answer: Intimacy vs isolation
●● Highest indication for PTD
Answer: Previous PTD
Also if a pt is born preterm they are likely to have their own preterm
delivery
●● What is antiphospholipid antibody syndrome?
Answer: Autoimmune clotting disorder
,- occurs when PLT and endothelial cell membranes change causing
clotting risks
- begins the cycle of: thrombosis > perfusion to the placenta decreases >
severe pre-e, abruption, IUGR, PTD, death
- lupus anticoagulant and anticardiolipin antibodies are the most
common cause
●● Treatment for antiphospholid antibody syndrome
Answer: Lovenox, heparin, low dose asa
●● Lovenox vs Heparin
Answer: - Lovenox is made from heparin, is long acting, and more
predictable. Frequent INRs not as routinely required, used until about 35
wks
- heparin is short acting and can be reversed if needed
●● Heparin antagonist
Answer: protamine sulfate
●● Normal thing that happens to blood during pregnancy
Answer: Becomes hypercoagulable
●● What is a common cause of recurrent miscarriage and early severe
pre-e
,Answer: Antiphospholipid antibody syndrome
●● How many extra calories a day when pregnant
Answer: 300 / day during 2nd trimester or 600/day with twins
●● How much protein do you need in pregnancy
Answer: 75 g daily
●● Good sources of folic acid
Answer: Whole grains, citrus fruits, green vegetables
●● Why do you need folic acid?
Answer: prevent neural tube defects
●● What does maternal lead exposure cause
Answer: Neuro problems and low IQ
●● Weight gain parameters in pregnancy
Answer: Under weight (BMI <18) : 28-40 lbs
Normal weight: 25-35
Overweight: 15-25
Obese: 11-20
, ●● Risks of being obese for labor/delivery
Answer: - macrosomic fetus > shoulder dystocia > c/s birth
- higher wound dehiscence / infection rate
- PTD, GDM, Pre-e
- longer labors and bleeding
●● Why does diabetes cause RDS (respiratory distress syndrome)
Answer: Delayed surfactant from excess glucose
●● Surfactant
Answer: SOAP to open alveoli, w/o surfactant, aveoli STICKY
●● Diabetes and birth defects
Answer: Can cause heart or neural tube defects
- gdm does not usually lead to birth defects, but type 1 and 2 prior to
pregnancy are higher risks
- hgb A1C > 8.5% pre pregnancy = >40% chance of heart defect in baby
●● Type 1 diabetes
Answer: - by age 30 dx
- insufficient insulin secretion
CERTIFICATION TEST PAPER QUESTIONS
AND SOLUTIONS VERIFIED ANSWERS
●● Why is obesity a hemorrhage risk?
Answer: More estrogen when obese makes their vascular system fragile
and more likely to bleed
●● Eriksons stage of development for <18 yo deliveries
Answer: ID vs ID confusion
●● Eriksons stage of development for >35 yo deliveries
Answer: Intimacy vs isolation
●● Highest indication for PTD
Answer: Previous PTD
Also if a pt is born preterm they are likely to have their own preterm
delivery
●● What is antiphospholipid antibody syndrome?
Answer: Autoimmune clotting disorder
,- occurs when PLT and endothelial cell membranes change causing
clotting risks
- begins the cycle of: thrombosis > perfusion to the placenta decreases >
severe pre-e, abruption, IUGR, PTD, death
- lupus anticoagulant and anticardiolipin antibodies are the most
common cause
●● Treatment for antiphospholid antibody syndrome
Answer: Lovenox, heparin, low dose asa
●● Lovenox vs Heparin
Answer: - Lovenox is made from heparin, is long acting, and more
predictable. Frequent INRs not as routinely required, used until about 35
wks
- heparin is short acting and can be reversed if needed
●● Heparin antagonist
Answer: protamine sulfate
●● Normal thing that happens to blood during pregnancy
Answer: Becomes hypercoagulable
●● What is a common cause of recurrent miscarriage and early severe
pre-e
,Answer: Antiphospholipid antibody syndrome
●● How many extra calories a day when pregnant
Answer: 300 / day during 2nd trimester or 600/day with twins
●● How much protein do you need in pregnancy
Answer: 75 g daily
●● Good sources of folic acid
Answer: Whole grains, citrus fruits, green vegetables
●● Why do you need folic acid?
Answer: prevent neural tube defects
●● What does maternal lead exposure cause
Answer: Neuro problems and low IQ
●● Weight gain parameters in pregnancy
Answer: Under weight (BMI <18) : 28-40 lbs
Normal weight: 25-35
Overweight: 15-25
Obese: 11-20
, ●● Risks of being obese for labor/delivery
Answer: - macrosomic fetus > shoulder dystocia > c/s birth
- higher wound dehiscence / infection rate
- PTD, GDM, Pre-e
- longer labors and bleeding
●● Why does diabetes cause RDS (respiratory distress syndrome)
Answer: Delayed surfactant from excess glucose
●● Surfactant
Answer: SOAP to open alveoli, w/o surfactant, aveoli STICKY
●● Diabetes and birth defects
Answer: Can cause heart or neural tube defects
- gdm does not usually lead to birth defects, but type 1 and 2 prior to
pregnancy are higher risks
- hgb A1C > 8.5% pre pregnancy = >40% chance of heart defect in baby
●● Type 1 diabetes
Answer: - by age 30 dx
- insufficient insulin secretion
