CNM ACNM Exam Questions And Accurate Answers
Adolescent-ANSWER this group is most likely to
initiate PNC late; have poor compliance with PNC schedule
risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA-ANSWER this group is most likely to:
experience infertility, 1st tri SAB, ectopic pregnancy, genetic abnormalities
HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW - ANSWER African American race is associated with (LGA/LBW) babies?
PTB - ANSWER Low SES is associated with poor OB outcome including ___________?
multipara - ANSWER Are Nulliparas or Multiparas associated w/ increased risks of
abruptio placenta, previa, multifetal pregnancy, and PPH?
Transverse lie - ANSWER Fetal presentation associated with grand multiparous women
(parity > 5)
quad screen - ANSWER 15-22 weeks
- hCG
- AFP
- estriol
,- inhibin A
screens for trisomy 18/21, NTD
penta screen - ANSWER 15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening - ANSWER - 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station - ANSWER relationship of leading edge of fetal presenting part to ischial spines
(in cm)
lactated ringer - ANSWER Fluid of choice for burns, dehydration
d5lr - ANSWER Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl - ANSWER normal saline
,anesthesia - ANSWER epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks - ANSWER paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation - ANSWER - allows for more mobility
- requires 1:1 staffing in labour
- associated with lower intervention rates
60; 30; 15 - ANSWER intermittent auscultation should be done every _____ seconds after
a contraction every _______ minutes in 1st stage of labor if low risk, and every ______ if
high risk
15; 5 - ANSWER intermittent auscultation should be done every ____ minutes in 2nd
stage if low risk; and every _____ min if high risk
continuous EFM - ANSWER - indicated for AP or IP risk factors
category I - ANSWER - tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early
decels/accels present or absent
15; 5- ANSWER continuous fetal monitoring should be done every _____ min for low-risk
, in 1st stage and every ______ min if high risk
Category II- ANSWER indeterminate of fetal acid-base status; requires continued
monitoring and evaluation
- baseline bradycardic or tachycardic
- minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
-prolonged decels between 2-10 minutes
-recurrent lates w/ mod baseline variability
-variable decels w/ overshoots/shoulders
category III - ANSWER - associated w/ abnormal fetal acid-base status; prompt
corrective action required
-absent variability in conjunction with any of the following:
-bradycardia
-recurrent variables
-recurrent lates
-sinusoidal pattern
10+ minutes - ANSWER how long does fetal bradycardia/tachycardia need to persist to
be diagnosed
fetal scalp stimulation - ANSWER - cannot be reliably performed during decel or
bradycardia; wait for FHR recovery
>7.2 - ANSWER stimulating the head during a vaginal exam with a FHR accel > 15 for >15
seconds is indicated of fetal pH of _________
Adolescent-ANSWER this group is most likely to
initiate PNC late; have poor compliance with PNC schedule
risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA-ANSWER this group is most likely to:
experience infertility, 1st tri SAB, ectopic pregnancy, genetic abnormalities
HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW - ANSWER African American race is associated with (LGA/LBW) babies?
PTB - ANSWER Low SES is associated with poor OB outcome including ___________?
multipara - ANSWER Are Nulliparas or Multiparas associated w/ increased risks of
abruptio placenta, previa, multifetal pregnancy, and PPH?
Transverse lie - ANSWER Fetal presentation associated with grand multiparous women
(parity > 5)
quad screen - ANSWER 15-22 weeks
- hCG
- AFP
- estriol
,- inhibin A
screens for trisomy 18/21, NTD
penta screen - ANSWER 15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening - ANSWER - 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station - ANSWER relationship of leading edge of fetal presenting part to ischial spines
(in cm)
lactated ringer - ANSWER Fluid of choice for burns, dehydration
d5lr - ANSWER Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl - ANSWER normal saline
,anesthesia - ANSWER epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks - ANSWER paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation - ANSWER - allows for more mobility
- requires 1:1 staffing in labour
- associated with lower intervention rates
60; 30; 15 - ANSWER intermittent auscultation should be done every _____ seconds after
a contraction every _______ minutes in 1st stage of labor if low risk, and every ______ if
high risk
15; 5 - ANSWER intermittent auscultation should be done every ____ minutes in 2nd
stage if low risk; and every _____ min if high risk
continuous EFM - ANSWER - indicated for AP or IP risk factors
category I - ANSWER - tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early
decels/accels present or absent
15; 5- ANSWER continuous fetal monitoring should be done every _____ min for low-risk
, in 1st stage and every ______ min if high risk
Category II- ANSWER indeterminate of fetal acid-base status; requires continued
monitoring and evaluation
- baseline bradycardic or tachycardic
- minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
-prolonged decels between 2-10 minutes
-recurrent lates w/ mod baseline variability
-variable decels w/ overshoots/shoulders
category III - ANSWER - associated w/ abnormal fetal acid-base status; prompt
corrective action required
-absent variability in conjunction with any of the following:
-bradycardia
-recurrent variables
-recurrent lates
-sinusoidal pattern
10+ minutes - ANSWER how long does fetal bradycardia/tachycardia need to persist to
be diagnosed
fetal scalp stimulation - ANSWER - cannot be reliably performed during decel or
bradycardia; wait for FHR recovery
>7.2 - ANSWER stimulating the head during a vaginal exam with a FHR accel > 15 for >15
seconds is indicated of fetal pH of _________
