RNC-NIC-CCRN Review General
Assessment
Signs and symptoms of anemia in pregnancy include all of the following except:
A. bradycardia.
B. fatigue.
C. dyspnea. - answerA. Signs and symptoms of anemia in pregnancy may include
tachycardia, fatigue, dyspnea, and pallor. Iron supplements are an appropriate
management for this condition which, if untreated, may lead to preterm deliver or low
birthweight infants.
Which of the following is true concerning gestational hypertension?
A. Diagnosed after 20 weeks of pregnancy
B. Proteinuria is present
C. Seizure activity is present - answerA. Gestational hypertension is diagnosed after the
20th week of pregnancy and is defined as to BP of > or = to 140/90 obtained 4-6 hours
apart within the same week. There is no proteinuria with gestational hypertension.
Seizure activity occurs with eclampsia.
Which maternal condition is characterized by hypertension and proteinuria after 20
weeks of pregnancy without seizure activity?
A. Gestational hypertension
B. Preeclampsia
C. Eclampsia - answerB. Preeclampsia is characterized by hypertension and proteinuria
after 20 weeks of pregnancy without seizure activity. Preeclampsia may be diagnosed
without proteinuria if any of the following are present: thrombocytopenia, increased
LFTs, pulmonary edema, or neurological changes.
HELLP syndrome is a severe form of preeclampsia categorized by all of the following
except:
A. Thrombocytopenia
B. Hemolysis
C. Decreased LFTs - answerC. HELLP syndrome is a severe form of preeclampsia
categorized by Hemolysis, Elevated Liver enzymes, and Low Platelets. Signs and
symptoms may include headaches, nausea/vomiting, RUQ pain, and fatigue. Definitive
treatment is delivery of the infant.
Vertical transmission of which infection can occur during delivery?
A. Toxoplasmosis
B. Cytomegalovirus
C. Syphilis - answerC. Vertical transmission (from mother to infant) can occur during
delivery for syphilis, herpes, hepatitis B, HIV, gonorrhea, chlamydia, and GBS.
, Toxoplasmosis and cytomegalovirus infections are teratogenic, meaning they cause
congenital defects to the fetus.
A cesarean delivery is indicated if the mother has active lesions of which infection?
A. Herpes
B. Hepatitis B
C. HIV - answerA. A cesarean delivery is indicated if the mother has an active herpes
infection. HSV-2 is found in the genital tract and is responsible for 75% of neonatal
herpes cases.
Which maternal condition could lead to polyhydramnios?
A. Preeclampsia
B. Gestational diabetes
C. Asthma - answerB. Gestational diabetes can lead to polyhydramnios. Polyuria of the
fetus due to hyperglycemia results in an increase in amniotic fluid. These patients are at
higher risk for cord prolapse. Maternal diabetes can also impair surfactant production,
so these infants are at higher risk for RDS.
Which of the following is a primary risk factor for neonatal sepsis?
A. Chorioamnionitis
B. GBS infection
C. Preeclampsia - answerA. Chorioamnionitis contributes to 20-40% of neonatal sepsis
cases. This infection of the amniotic membranes is usually diagnosed with maternal
fever, leukocytosis, purulent cervical discharge, and fetal tachycardia. Fifty percent of
infants delivered vaginally to a mother with GBS will be colonized, but only 1-2% will
develop an active infection that often leads to sepsis. Both chorioamnionitis and GBS
are treated with intrapartum antibiotics.
A biophysical profile evaluates the wellbeing of the fetus by assessing all of the
following parameters except:
A. fetal heart rate variability.
B. fetal weight.
C. amniotic fluid volume - answerB. A biophysical profile (BPP) evaluates the wellbeing
of the fetus by assessing fetal tone, fetal breathing and gross body movements,
amniotic fluid volume, and FHR reactivity (via nonstress test). Each parameter is
assigned a score of 2 (present) or 0 (absent). A score of 8 or 10 is reassuring. Fetal
weight is not an element of the BPP.
Second trimester ultrasounds are generally done to evaluate which of the following?
A. Fetal anatomy
B. Gestational age
C. Number of fetuses - answerA. Second trimester ultrasounds are generally done to
evaluate fetal anatomy. Gestational age assessments are more accurate if done in the
first trimester. Other indications for a first trimester ultrasound would be to evaluate the
number of fetuses, assess the fetal heartbeat, and assist with genetic screenings (i.e.
amniocentesis).
Assessment
Signs and symptoms of anemia in pregnancy include all of the following except:
A. bradycardia.
B. fatigue.
C. dyspnea. - answerA. Signs and symptoms of anemia in pregnancy may include
tachycardia, fatigue, dyspnea, and pallor. Iron supplements are an appropriate
management for this condition which, if untreated, may lead to preterm deliver or low
birthweight infants.
Which of the following is true concerning gestational hypertension?
A. Diagnosed after 20 weeks of pregnancy
B. Proteinuria is present
C. Seizure activity is present - answerA. Gestational hypertension is diagnosed after the
20th week of pregnancy and is defined as to BP of > or = to 140/90 obtained 4-6 hours
apart within the same week. There is no proteinuria with gestational hypertension.
Seizure activity occurs with eclampsia.
Which maternal condition is characterized by hypertension and proteinuria after 20
weeks of pregnancy without seizure activity?
A. Gestational hypertension
B. Preeclampsia
C. Eclampsia - answerB. Preeclampsia is characterized by hypertension and proteinuria
after 20 weeks of pregnancy without seizure activity. Preeclampsia may be diagnosed
without proteinuria if any of the following are present: thrombocytopenia, increased
LFTs, pulmonary edema, or neurological changes.
HELLP syndrome is a severe form of preeclampsia categorized by all of the following
except:
A. Thrombocytopenia
B. Hemolysis
C. Decreased LFTs - answerC. HELLP syndrome is a severe form of preeclampsia
categorized by Hemolysis, Elevated Liver enzymes, and Low Platelets. Signs and
symptoms may include headaches, nausea/vomiting, RUQ pain, and fatigue. Definitive
treatment is delivery of the infant.
Vertical transmission of which infection can occur during delivery?
A. Toxoplasmosis
B. Cytomegalovirus
C. Syphilis - answerC. Vertical transmission (from mother to infant) can occur during
delivery for syphilis, herpes, hepatitis B, HIV, gonorrhea, chlamydia, and GBS.
, Toxoplasmosis and cytomegalovirus infections are teratogenic, meaning they cause
congenital defects to the fetus.
A cesarean delivery is indicated if the mother has active lesions of which infection?
A. Herpes
B. Hepatitis B
C. HIV - answerA. A cesarean delivery is indicated if the mother has an active herpes
infection. HSV-2 is found in the genital tract and is responsible for 75% of neonatal
herpes cases.
Which maternal condition could lead to polyhydramnios?
A. Preeclampsia
B. Gestational diabetes
C. Asthma - answerB. Gestational diabetes can lead to polyhydramnios. Polyuria of the
fetus due to hyperglycemia results in an increase in amniotic fluid. These patients are at
higher risk for cord prolapse. Maternal diabetes can also impair surfactant production,
so these infants are at higher risk for RDS.
Which of the following is a primary risk factor for neonatal sepsis?
A. Chorioamnionitis
B. GBS infection
C. Preeclampsia - answerA. Chorioamnionitis contributes to 20-40% of neonatal sepsis
cases. This infection of the amniotic membranes is usually diagnosed with maternal
fever, leukocytosis, purulent cervical discharge, and fetal tachycardia. Fifty percent of
infants delivered vaginally to a mother with GBS will be colonized, but only 1-2% will
develop an active infection that often leads to sepsis. Both chorioamnionitis and GBS
are treated with intrapartum antibiotics.
A biophysical profile evaluates the wellbeing of the fetus by assessing all of the
following parameters except:
A. fetal heart rate variability.
B. fetal weight.
C. amniotic fluid volume - answerB. A biophysical profile (BPP) evaluates the wellbeing
of the fetus by assessing fetal tone, fetal breathing and gross body movements,
amniotic fluid volume, and FHR reactivity (via nonstress test). Each parameter is
assigned a score of 2 (present) or 0 (absent). A score of 8 or 10 is reassuring. Fetal
weight is not an element of the BPP.
Second trimester ultrasounds are generally done to evaluate which of the following?
A. Fetal anatomy
B. Gestational age
C. Number of fetuses - answerA. Second trimester ultrasounds are generally done to
evaluate fetal anatomy. Gestational age assessments are more accurate if done in the
first trimester. Other indications for a first trimester ultrasound would be to evaluate the
number of fetuses, assess the fetal heartbeat, and assist with genetic screenings (i.e.
amniocentesis).
