RNC-NIC exam Exam Guide Exam
Questions and CORRECT Answers
The biochemical marker useful in this situation for predicting preterm birth is: - CORRECT
ANSWER - fetal fibronectin
A bedside immunoassay called AmniSure is performed. This test identifies a glycoprotein
abundant in amniotic fluid. This glycoprotein is called: - CORRECT ANSWER - placenta
α-microglobulin-1
When electronic fetal monitoring is used, the best indicator of fetal oxygenation status during
labor is: - CORRECT ANSWER - moderate fetal heart rate variability
Early decelerations - CORRECT ANSWER - *safe* Begin prior to peak of the contraction
and end by the end of it. they are caused by head compression. no need for intervention if
variability is within normal range (6-10) and the FHR is within normal range.
Late decelerations - CORRECT ANSWER - They are a sign of decreased blood flow to the
placenta, which can lead to fetal acidemia
Variable decelerations - CORRECT ANSWER - a type of fetal heart rate (FHR) change
that occurs when a baby's heart rate suddenly drops by at least 15 beats per minute (bpm) and
lasts at least 15 seconds
They happen when the baby's umbilical cord is temporarily compressed, which can reduce blood
flow and prevent the baby from getting enough oxygen and nutrients.
The biophysical profile (BPP) is currently the primary method for evaluating fetal well-being
through the assessment of various activities that are controlled by the central nervous system and
are sensitive to oxygenation. The five variables included in the BPP are: - CORRECT
ANSWER - fetal tone, fetal breathing, fetal movement, nonstress test, and amniotic fluid
volume
,An appropriate gestational age for glucose screening in women who are at low risk for
developing gestational diabetes in pregnancy is: - CORRECT ANSWER - 24 to 28 weeks'
gestation
When women give birth sitting upright, which of the following indicators show lower values in
cord blood? - CORRECT ANSWER - PCO2
A patient is experiencing preterm labor at 33 weeks' gestation. She has a history of preterm labor
and is currently showing regular contractions. To ensure that she receives her two doses of
steroids to promote fetal lung maturity, a tocolytic medication is prescribed. This medication, a
calcium channel blocker, has been marketed to treat hypertension, angina, and arrhythmia and
does not commonly have adverse effects on the fetus or neonate. The medication is: - CORRECT
ANSWER - nifedipine (Procardia)
A patient who is at 42 5/7 weeks' gestation has been pushing for 90 minutes and is near delivery.
Her membranes spontaneously ruptured 3 hours ago, and meconium was observed. The
electronic fetal monitor demonstrates minimal fetal heart rate baseline variability. The most
likely potential cause is: - CORRECT ANSWER - etal metabolic acidosis
When performing a biophysical profile (BPP), which of these fetal variables should the nurse
recognize as placing the fetus at high risk and in need of either delivery or repeat BPPs no fewer
than two times per week? - CORRECT ANSWER - An amniotic fluid pocket measuring
1.5 cm in two planes perpendicular to each other
Oligohydramnios, a decreased amount of amniotic fluid, is defined as a single deepest pocket of
<2 cm, or an amniotic fluid index of <5 cm. Abnormalities in amniotic fluid volume often
require further evaluation and can significantly impact perinatal outcome.
Elevated maternal serum α-fetoprotein is associated with: - CORRECT ANSWER - neural
tube defects
,A patient has chosen to receive a combined spinal-epidural for the management of labor pain.
The nurse should instruct the patient that this type of analgesia: - CORRECT ANSWER -
ncreases the risk of hypotension
During resuscitation of a term newborn in the labor and delivery department, a saturation probe
is placed on the infant to assess the need for supplemental oxygen. Which of the following
describes the appropriate site for placement and an acceptable saturation during the first 10
minutes of life? - CORRECT ANSWER - Right hand—3-minute saturation at 74%
The right arm is considered preductal, and saturation should be monitored on the right upper
extremity during delivery room resuscitation because infants may have an increase in pulmonary
vascular resistance with right to left shunting. With right to left shunting, saturations in the lower
extremities may be lower than the upper extremities depending on the insertion of the ductus
arteriosus to the aorta in relation to the subclavian arteries. The right arm is always preductal.
According to the American Academy of Pediatrics and the neonatal resuscitation algorithm, the
following chart lists the target preductal saturation after birth:<T type A>1 minute 60-65%2
minutes 65-70%3 minutes 70-75%4 minutes 75-80%5 minutes 80-85%10 minutes 85-90%
Which statement about cord blood gases is correct? - CORRECT ANSWER - The cord
arterial blood is the best indicator of the fetal metabolic condition before delivery
Which hormone activates nonshivering thermogenesis? - CORRECT ANSWER -
Norepinephrine
The process of nonshivering thermogenesis is activated by the hypothalamus. Norepinephrine is
a stress hormone that is activated in response to cold stress. The release of norepinephrine sends
a signal to the nerve endings in the brown fat causing it to be metabolized. Brown fat is located
in the axillary area, mediastinum, kidneys, adrenals, and nape of the neck. The primary enzyme
in the brown fat that regulates nonshivering thermogenesis is thermogenin. The release of fatty
acids is triggered by the norepinephrine. The energy that is produced from this metabolic process
heats the blood as it circulates past the areas where the brown fat is stored
A term infant is now 24 hours old and rooming in with the mother. The infant was delivered by
cesarean section due to maternal arrest of labor. Apgar scores are 7 at 1 minute and 8 at 5
minutes. Membranes ruptured 12 hours before delivery and were meconium stained. Prenatal
group B streptococcus screen at 36 weeks was negative. Maternal temperature before delivery
, was 37.9° C (100.2° F). Beginning shift assessment reveals color slightly pale; decreased
peripheral pulses and perfusion in lower extremities; difficulty getting baby to latch for breast-
feeding; slightly lethargic; and respiratory rate 80 breaths per minute sustained with no grunting,
flaring, or retractions. Based on the assessment, the nurse should carry out which of the
following interventions? - CORRECT ANSWER - Notify the pediatric provider and
transfer the infant to the special care nursery for observation under a radiant warmer, with the
possible diagnosis of coarctation of the aorta
Coarctation of the aorta has the classic finding of decreased perfusion and pulses in the lower
extremities. These infants can develop temperature instability and poor feeding. Congenital heart
disease should be suspected when infants present with an increase in respiratory rate in the
absence of any other respiratory signs of distress and cyanosis. The physician should be notified
immediately and the infant transferred to the nursery for further evaluation and stabilization
Cephalohematoma - CORRECT ANSWER - is a collection of blood between the
periosteum and the skull that does not cross the suture line. It may enlarge during the 24 hours
after birth and may take several months to resolve. These infants are at a higher risk for
developing hyperbilirubinemi
Subgaleal Hemorrhage - CORRECT ANSWER - happens when emissary veins in the
scalp rupture, allowing blood to pool between the skull's periosteum and galea aponeurotica
Caput Succedaneum - CORRECT ANSWER - is caused from pressure on the fetal skull by
the cervix during labor. A common characteristic of a caput succedaneum is pitting edema that
extends across the suture lines. Edema generally resolves within a few days
Craniosynostosis - CORRECT ANSWER - Premature closure of the cranial suture with a
palpable suture line
After the resuscitation of a term infant delivered after a motor vehicle accident, the infant is
noted to be pale with an oxygen saturation of 95%. The blood pressure is 34/22 mm Hg with a
mean of 28 mm Hg. The tone is diminished, and the blood glucose level is 30 mg/dl. The first
action at this time would be to: - CORRECT ANSWER - give 30 ml normal saline
Questions and CORRECT Answers
The biochemical marker useful in this situation for predicting preterm birth is: - CORRECT
ANSWER - fetal fibronectin
A bedside immunoassay called AmniSure is performed. This test identifies a glycoprotein
abundant in amniotic fluid. This glycoprotein is called: - CORRECT ANSWER - placenta
α-microglobulin-1
When electronic fetal monitoring is used, the best indicator of fetal oxygenation status during
labor is: - CORRECT ANSWER - moderate fetal heart rate variability
Early decelerations - CORRECT ANSWER - *safe* Begin prior to peak of the contraction
and end by the end of it. they are caused by head compression. no need for intervention if
variability is within normal range (6-10) and the FHR is within normal range.
Late decelerations - CORRECT ANSWER - They are a sign of decreased blood flow to the
placenta, which can lead to fetal acidemia
Variable decelerations - CORRECT ANSWER - a type of fetal heart rate (FHR) change
that occurs when a baby's heart rate suddenly drops by at least 15 beats per minute (bpm) and
lasts at least 15 seconds
They happen when the baby's umbilical cord is temporarily compressed, which can reduce blood
flow and prevent the baby from getting enough oxygen and nutrients.
The biophysical profile (BPP) is currently the primary method for evaluating fetal well-being
through the assessment of various activities that are controlled by the central nervous system and
are sensitive to oxygenation. The five variables included in the BPP are: - CORRECT
ANSWER - fetal tone, fetal breathing, fetal movement, nonstress test, and amniotic fluid
volume
,An appropriate gestational age for glucose screening in women who are at low risk for
developing gestational diabetes in pregnancy is: - CORRECT ANSWER - 24 to 28 weeks'
gestation
When women give birth sitting upright, which of the following indicators show lower values in
cord blood? - CORRECT ANSWER - PCO2
A patient is experiencing preterm labor at 33 weeks' gestation. She has a history of preterm labor
and is currently showing regular contractions. To ensure that she receives her two doses of
steroids to promote fetal lung maturity, a tocolytic medication is prescribed. This medication, a
calcium channel blocker, has been marketed to treat hypertension, angina, and arrhythmia and
does not commonly have adverse effects on the fetus or neonate. The medication is: - CORRECT
ANSWER - nifedipine (Procardia)
A patient who is at 42 5/7 weeks' gestation has been pushing for 90 minutes and is near delivery.
Her membranes spontaneously ruptured 3 hours ago, and meconium was observed. The
electronic fetal monitor demonstrates minimal fetal heart rate baseline variability. The most
likely potential cause is: - CORRECT ANSWER - etal metabolic acidosis
When performing a biophysical profile (BPP), which of these fetal variables should the nurse
recognize as placing the fetus at high risk and in need of either delivery or repeat BPPs no fewer
than two times per week? - CORRECT ANSWER - An amniotic fluid pocket measuring
1.5 cm in two planes perpendicular to each other
Oligohydramnios, a decreased amount of amniotic fluid, is defined as a single deepest pocket of
<2 cm, or an amniotic fluid index of <5 cm. Abnormalities in amniotic fluid volume often
require further evaluation and can significantly impact perinatal outcome.
Elevated maternal serum α-fetoprotein is associated with: - CORRECT ANSWER - neural
tube defects
,A patient has chosen to receive a combined spinal-epidural for the management of labor pain.
The nurse should instruct the patient that this type of analgesia: - CORRECT ANSWER -
ncreases the risk of hypotension
During resuscitation of a term newborn in the labor and delivery department, a saturation probe
is placed on the infant to assess the need for supplemental oxygen. Which of the following
describes the appropriate site for placement and an acceptable saturation during the first 10
minutes of life? - CORRECT ANSWER - Right hand—3-minute saturation at 74%
The right arm is considered preductal, and saturation should be monitored on the right upper
extremity during delivery room resuscitation because infants may have an increase in pulmonary
vascular resistance with right to left shunting. With right to left shunting, saturations in the lower
extremities may be lower than the upper extremities depending on the insertion of the ductus
arteriosus to the aorta in relation to the subclavian arteries. The right arm is always preductal.
According to the American Academy of Pediatrics and the neonatal resuscitation algorithm, the
following chart lists the target preductal saturation after birth:<T type A>1 minute 60-65%2
minutes 65-70%3 minutes 70-75%4 minutes 75-80%5 minutes 80-85%10 minutes 85-90%
Which statement about cord blood gases is correct? - CORRECT ANSWER - The cord
arterial blood is the best indicator of the fetal metabolic condition before delivery
Which hormone activates nonshivering thermogenesis? - CORRECT ANSWER -
Norepinephrine
The process of nonshivering thermogenesis is activated by the hypothalamus. Norepinephrine is
a stress hormone that is activated in response to cold stress. The release of norepinephrine sends
a signal to the nerve endings in the brown fat causing it to be metabolized. Brown fat is located
in the axillary area, mediastinum, kidneys, adrenals, and nape of the neck. The primary enzyme
in the brown fat that regulates nonshivering thermogenesis is thermogenin. The release of fatty
acids is triggered by the norepinephrine. The energy that is produced from this metabolic process
heats the blood as it circulates past the areas where the brown fat is stored
A term infant is now 24 hours old and rooming in with the mother. The infant was delivered by
cesarean section due to maternal arrest of labor. Apgar scores are 7 at 1 minute and 8 at 5
minutes. Membranes ruptured 12 hours before delivery and were meconium stained. Prenatal
group B streptococcus screen at 36 weeks was negative. Maternal temperature before delivery
, was 37.9° C (100.2° F). Beginning shift assessment reveals color slightly pale; decreased
peripheral pulses and perfusion in lower extremities; difficulty getting baby to latch for breast-
feeding; slightly lethargic; and respiratory rate 80 breaths per minute sustained with no grunting,
flaring, or retractions. Based on the assessment, the nurse should carry out which of the
following interventions? - CORRECT ANSWER - Notify the pediatric provider and
transfer the infant to the special care nursery for observation under a radiant warmer, with the
possible diagnosis of coarctation of the aorta
Coarctation of the aorta has the classic finding of decreased perfusion and pulses in the lower
extremities. These infants can develop temperature instability and poor feeding. Congenital heart
disease should be suspected when infants present with an increase in respiratory rate in the
absence of any other respiratory signs of distress and cyanosis. The physician should be notified
immediately and the infant transferred to the nursery for further evaluation and stabilization
Cephalohematoma - CORRECT ANSWER - is a collection of blood between the
periosteum and the skull that does not cross the suture line. It may enlarge during the 24 hours
after birth and may take several months to resolve. These infants are at a higher risk for
developing hyperbilirubinemi
Subgaleal Hemorrhage - CORRECT ANSWER - happens when emissary veins in the
scalp rupture, allowing blood to pool between the skull's periosteum and galea aponeurotica
Caput Succedaneum - CORRECT ANSWER - is caused from pressure on the fetal skull by
the cervix during labor. A common characteristic of a caput succedaneum is pitting edema that
extends across the suture lines. Edema generally resolves within a few days
Craniosynostosis - CORRECT ANSWER - Premature closure of the cranial suture with a
palpable suture line
After the resuscitation of a term infant delivered after a motor vehicle accident, the infant is
noted to be pale with an oxygen saturation of 95%. The blood pressure is 34/22 mm Hg with a
mean of 28 mm Hg. The tone is diminished, and the blood glucose level is 30 mg/dl. The first
action at this time would be to: - CORRECT ANSWER - give 30 ml normal saline
