RNC-NIC ACTUAL CERTIFICATION
PAPER 2026 QUESTIONS WITH ANSWERS
FULL SOLUTION.
◍ chlamydia. Ans: - **most common bacterial sexually transmitted
infection**
- *treatment: erythromycin*
◍ signs/symptoms of neonatal chlamydia. Ans: - conjunctivitis in first
few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
◍ oligohydramnios. Ans: - AF volume <1 L at 36 weeks, <800 mL at
term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal
pulmonary development
- **may be related to Potter sequence/renal agenesis** because AF is
largely made up of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
,- can also lead to IUGR and positional deformities (baby can't move
well)
◍ Potter sequence (renal agenesis). Ans: - **Renal agenesis ->
oligohydramnios -> severe pulmonary hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t failure
of the ureteric bud to divide
- urine formation does not occur --> low or absent amniotic fluid
volumes
- fetal structures are compressed
- associated defects: abnormal genital dev., leg deformities, GI defects,
arthrohyposis, pulmonary hypoplasia
- *most infants will die within the first several days; often d/t associated
lung hypoplasia*
◍ hydramnios or polyhydramnios. Ans: - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal to
anal atresia) d/t the baby being unable to swallow amniotic fluid, so the
AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may also
obstruct or impair fetal swallowing
◍ PROM. Ans: - premature rupture of membranes, before the onset of
labor
- **risk of infection if directly proportional to the duration of ROM**
,- **after 24 hours of ROM, the risk of infection escalates significantly**
◍ PPROM. Ans: - preterm premature rupture of membranes, PROM
occurring before 37 weeks
- does not necessarily lead to the onset of labor if it occurs too early, but
after 24 hours of ROM, the risk of infection escalates
- **risk of infection if directly proportional to the duration of ROM**
◍ maternal serum alpha fetaprotein (MSAFP). Ans: - aka triple or quad
screen
- test during pregnancy that measures a major fetal protein produced in
the fetal liver at >22 wks that is present in the mother's blood
- maternal blood test that is a clue for some fetal anomalies, generally
between 15-22 wks, optimally at 16-18 wks
- **elevated levels may be indicative of neural tube defects (not
diagnostic, but is a clue)**
- low levels associated with Trisomy 21
◍ Lecithin/Sphingomyelin (L/S) ratio. Ans: - test of amniotic fluid to
assess fetal lung maturity
- may help determine lung maturity to see when to deliver prematurely if
necessary
- **normal: greater or equal to ~2**
, - <2 indicates immature lungs, <1.5 is associated with a high risk of
RDS
◍ fetal heart rate (FHR) decelerations. Ans: - defined as a fetal heart rate
decrease of at least 15 bpm that lasts longer than 2 min. but less than 10
min.
◍ cause of early decelerations. Ans: **head compression**
◍ cause of variable decelerations. Ans: **cord compression**
◍ cause of late decelerations. Ans: **hypoxemia or placental
insufficiency**
◍ fetal tachycardia. Ans: - 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. Ans: - tocolytic
medication that can be used for neuroprotection in preterm labor that can
cause **neuromuscular or respiratory depression in the newborn**
PAPER 2026 QUESTIONS WITH ANSWERS
FULL SOLUTION.
◍ chlamydia. Ans: - **most common bacterial sexually transmitted
infection**
- *treatment: erythromycin*
◍ signs/symptoms of neonatal chlamydia. Ans: - conjunctivitis in first
few weeks
- late-onset: pneumonia at 3-4 months
- otitis media
- gastroenteritis
◍ oligohydramnios. Ans: - AF volume <1 L at 36 weeks, <800 mL at
term
- can lead to pulmonary hypoplasia d/t amniotic fluid's role in fetal
pulmonary development
- **may be related to Potter sequence/renal agenesis** because AF is
largely made up of fetal urine (no urine if the baby has no kidneys)
- **can lead to hypoplastic lungs**
,- can also lead to IUGR and positional deformities (baby can't move
well)
◍ Potter sequence (renal agenesis). Ans: - **Renal agenesis ->
oligohydramnios -> severe pulmonary hypoplasia**
- association of defects beginning w/ bilateral renal agenesis d/t failure
of the ureteric bud to divide
- urine formation does not occur --> low or absent amniotic fluid
volumes
- fetal structures are compressed
- associated defects: abnormal genital dev., leg deformities, GI defects,
arthrohyposis, pulmonary hypoplasia
- *most infants will die within the first several days; often d/t associated
lung hypoplasia*
◍ hydramnios or polyhydramnios. Ans: - AF volume >2L
- **may be due to GI obstructions (e.g. esophageal atresia, duodenal to
anal atresia) d/t the baby being unable to swallow amniotic fluid, so the
AF keeps building up in utero **
- also can be d/t tight nuchal cord or neurologic defects which may also
obstruct or impair fetal swallowing
◍ PROM. Ans: - premature rupture of membranes, before the onset of
labor
- **risk of infection if directly proportional to the duration of ROM**
,- **after 24 hours of ROM, the risk of infection escalates significantly**
◍ PPROM. Ans: - preterm premature rupture of membranes, PROM
occurring before 37 weeks
- does not necessarily lead to the onset of labor if it occurs too early, but
after 24 hours of ROM, the risk of infection escalates
- **risk of infection if directly proportional to the duration of ROM**
◍ maternal serum alpha fetaprotein (MSAFP). Ans: - aka triple or quad
screen
- test during pregnancy that measures a major fetal protein produced in
the fetal liver at >22 wks that is present in the mother's blood
- maternal blood test that is a clue for some fetal anomalies, generally
between 15-22 wks, optimally at 16-18 wks
- **elevated levels may be indicative of neural tube defects (not
diagnostic, but is a clue)**
- low levels associated with Trisomy 21
◍ Lecithin/Sphingomyelin (L/S) ratio. Ans: - test of amniotic fluid to
assess fetal lung maturity
- may help determine lung maturity to see when to deliver prematurely if
necessary
- **normal: greater or equal to ~2**
, - <2 indicates immature lungs, <1.5 is associated with a high risk of
RDS
◍ fetal heart rate (FHR) decelerations. Ans: - defined as a fetal heart rate
decrease of at least 15 bpm that lasts longer than 2 min. but less than 10
min.
◍ cause of early decelerations. Ans: **head compression**
◍ cause of variable decelerations. Ans: **cord compression**
◍ cause of late decelerations. Ans: **hypoxemia or placental
insufficiency**
◍ fetal tachycardia. Ans: - 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. Ans: - tocolytic
medication that can be used for neuroprotection in preterm labor that can
cause **neuromuscular or respiratory depression in the newborn**
