RNC NIC Review by Me/Maternal Hx &
Risk Factors UPDATED ACTUAL Exam
Questions and CORRECT Answers
Infants born to Mothers who receive no prenatal care are at increased risk of what? - CORRECT
ANSWER - Prematurity
Low Birth Weight
Maternal iron deficiency anemia
Neonatal mortality
Explain in 5 steps why does an IDM presents with hypoglycemia at birth? - CORRECT
ANSWER - 1. Glucose crosses the placenta whereas insulin doesn't.
2. When Mom has elevated insulin, the fetus also has elevated insulin
3. The fetus produces insulin starting at 20 weeks of Gestation
4. After 20 weeks the fetus produces high level of insulin in response to hyperglycemia.
5. Sudden glucose's withdrawal from glucose at birth paired with high insulin production results
in HYPOglycemia
When does the fetus start producing insulin - CORRECT ANSWER - At 20 weeks of
gestation
Why does IDM are often LGA - CORRECT ANSWER - The combo of elevated maternal
glucose and elevated fetal insulin triggers rapid growth
6 Indications for routine blood glucose monitoring in the neonate - CORRECT
ANSWER - 1. Prematurity
2. IUGR
3. Sepsis
4. Hypothermia
5. Congénital Cardiac Malformation
, 6. Endocrine Disorder
IDM often presents with these 8 issues - CORRECT ANSWER - 1. Birth trauma due to
LGA
2. Hypoglycemia
3. RDS because high insulin level inhibits surfactant production
4. Polycythemia because high insulin and glucose increase metabolic rate & O2 consumption, so
the infant produces more RBCs to compensate
5. Iron deficiency due to Polycythemia
6. Hyperbili because increased RBC destruction after birth
7. Congenital Malformations
8. Electrolyte Imbalances (low ca and mg)
What is Oligohydramnious? - CORRECT ANSWER - Decreased amount of amniotic fluid
How is the amniotic fluid produced - CORRECT ANSWER - After 20 weeks the fluid is
mainly made by the fetus' excreted urine
What is the amniotic fluid necessary for? - CORRECT ANSWER - Cushion and lung
development
What are the 7 conditions associated with Oligohydramnious? - CORRECT ANSWER - 1.
Urinary tract anomalies
2. Pulmonary Hypoplasia
3. Cord Compression (Variable Decels.)
4. Meconium Staining
5. Post term gestation
6. Pressure Deformities (clubbed feet)
7. PROM which can lead to infections
Risk Factors UPDATED ACTUAL Exam
Questions and CORRECT Answers
Infants born to Mothers who receive no prenatal care are at increased risk of what? - CORRECT
ANSWER - Prematurity
Low Birth Weight
Maternal iron deficiency anemia
Neonatal mortality
Explain in 5 steps why does an IDM presents with hypoglycemia at birth? - CORRECT
ANSWER - 1. Glucose crosses the placenta whereas insulin doesn't.
2. When Mom has elevated insulin, the fetus also has elevated insulin
3. The fetus produces insulin starting at 20 weeks of Gestation
4. After 20 weeks the fetus produces high level of insulin in response to hyperglycemia.
5. Sudden glucose's withdrawal from glucose at birth paired with high insulin production results
in HYPOglycemia
When does the fetus start producing insulin - CORRECT ANSWER - At 20 weeks of
gestation
Why does IDM are often LGA - CORRECT ANSWER - The combo of elevated maternal
glucose and elevated fetal insulin triggers rapid growth
6 Indications for routine blood glucose monitoring in the neonate - CORRECT
ANSWER - 1. Prematurity
2. IUGR
3. Sepsis
4. Hypothermia
5. Congénital Cardiac Malformation
, 6. Endocrine Disorder
IDM often presents with these 8 issues - CORRECT ANSWER - 1. Birth trauma due to
LGA
2. Hypoglycemia
3. RDS because high insulin level inhibits surfactant production
4. Polycythemia because high insulin and glucose increase metabolic rate & O2 consumption, so
the infant produces more RBCs to compensate
5. Iron deficiency due to Polycythemia
6. Hyperbili because increased RBC destruction after birth
7. Congenital Malformations
8. Electrolyte Imbalances (low ca and mg)
What is Oligohydramnious? - CORRECT ANSWER - Decreased amount of amniotic fluid
How is the amniotic fluid produced - CORRECT ANSWER - After 20 weeks the fluid is
mainly made by the fetus' excreted urine
What is the amniotic fluid necessary for? - CORRECT ANSWER - Cushion and lung
development
What are the 7 conditions associated with Oligohydramnious? - CORRECT ANSWER - 1.
Urinary tract anomalies
2. Pulmonary Hypoplasia
3. Cord Compression (Variable Decels.)
4. Meconium Staining
5. Post term gestation
6. Pressure Deformities (clubbed feet)
7. PROM which can lead to infections
