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CCRN-NICU Questions with Detailed Verified
Answers
A patient who is G3P2 at 32 weeks' gestation arrives at the triage unit complaining of
regular uterine contractions. Her pregnancy history includes a preterm delivery at 34
weeks. Before examining her, the nurse performs electronic fetal monitoring and
obtains a complete history. The patient reports no bleeding and no rupture of
membranes. She has no vaginal examinations or sexual activity for more than 24 hours.
The biochemical marker useful in this situation for predicting preterm birth is:
Ans: Fetal Fibronectin- Fibronectins are a family of proteins found in extracellular
matrix. Fetal fibronectins are found in fetal membranes and decidua throughout the
pregnancy. As the gestational sac implants and attaches to the interior of the uterus in
the first half of pregnancy, fFns are normally found in cervicovaginal fluid. After 22 wks,
the presence of fFns normally is no longer detected in vaginal secretions until
approximately 2 weeks before the onset of delivery, term or preterm.
When electronic fetal monitoring is used, the best indicator of fetal oxygenation
status during labor is
Ans: Moderate fetal heart rate variability- variability is the most important fetal HR
characteristic. It is the most important indicator of normal fetal pH or acidosis.
Moderate FHR variability reliably predicts the absence of fetal metabolic academia
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:
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Ans: Feral tone, fetal breathing, fetal movement, nonstress test, and amniotic fluid
An appropriate gestational age for glucose screening in women who are at low risk
for developing gestational diabetes is
Ans: 24-28 weeks' gestation. Patients with risk factors (>35 years, body mass index
>30, history of gestational diabetes, delivery of a LGA infant, polycystic ovarian
syndrome, strong family hx) should receive a plasma glucose screening at their first
prenatal visit followed by one at 24-28 weeks
When women give birth sitting upright, which of the following indicators show lower
values in cord blood?
Ans: PCO2
What is the physiologic cause of late decelerations?
Ans: Transient interruption in fetal oxygenation
An intrauterine pressure catheter, placed for the monitoring of uterine pressure,
amnioinfusion, and fluid sampling, is useful in the treatment of
Ans: Variable decelerations- amnioinfusion is used to attempt to resolve variable fetal
heart rate decelerations by correcting umbilical cord compression as a result of
oligohydramnios. Must be careful to not cause polyhydramnios
A patient who is at 42+5 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:
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Ans: Fetal metabolic acidosis- moderate variability reliably predicts the abscence of
fetal metabolic acidemia at the time it is observed. Absent variability --> severe
hypoxia. Marked variability--> methamphetamine use and scalp stimulation
When performing a 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/week?
Ans: An amniotic fluid pocket measuring 1.5cm in two planes perpendicular to each
other. Oligohydramnios is defined as a single deepest pocket of <2cm, or an amniotic
fluid index of <5cm
Elevated maternal serum a-fetoprotein is associated with:
Ans: neural tube defects- MSAFP is a protein made by the fetal liver. High levels may
indicate neural tube defects or ventral abdominal wall defects, esophageal and
duodenal atresia, and some renal or urinary tract anomalies. Low levels occur in some
case of down syndrome
What is triple marker screening?
Ans: Combines the chemical markers of MSAFP, hCG, and unconjugated estriol with
the mother's age. A low value is associated with trisomy 18
After a vacuum-assisted delivery, the nurse should assess the infant for:
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CCRN-NICU Questions with Detailed Verified
Answers
A patient who is G3P2 at 32 weeks' gestation arrives at the triage unit complaining of
regular uterine contractions. Her pregnancy history includes a preterm delivery at 34
weeks. Before examining her, the nurse performs electronic fetal monitoring and
obtains a complete history. The patient reports no bleeding and no rupture of
membranes. She has no vaginal examinations or sexual activity for more than 24 hours.
The biochemical marker useful in this situation for predicting preterm birth is:
Ans: Fetal Fibronectin- Fibronectins are a family of proteins found in extracellular
matrix. Fetal fibronectins are found in fetal membranes and decidua throughout the
pregnancy. As the gestational sac implants and attaches to the interior of the uterus in
the first half of pregnancy, fFns are normally found in cervicovaginal fluid. After 22 wks,
the presence of fFns normally is no longer detected in vaginal secretions until
approximately 2 weeks before the onset of delivery, term or preterm.
When electronic fetal monitoring is used, the best indicator of fetal oxygenation
status during labor is
Ans: Moderate fetal heart rate variability- variability is the most important fetal HR
characteristic. It is the most important indicator of normal fetal pH or acidosis.
Moderate FHR variability reliably predicts the absence of fetal metabolic academia
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:
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,Click here for more: Scholars nexus
Ans: Feral tone, fetal breathing, fetal movement, nonstress test, and amniotic fluid
An appropriate gestational age for glucose screening in women who are at low risk
for developing gestational diabetes is
Ans: 24-28 weeks' gestation. Patients with risk factors (>35 years, body mass index
>30, history of gestational diabetes, delivery of a LGA infant, polycystic ovarian
syndrome, strong family hx) should receive a plasma glucose screening at their first
prenatal visit followed by one at 24-28 weeks
When women give birth sitting upright, which of the following indicators show lower
values in cord blood?
Ans: PCO2
What is the physiologic cause of late decelerations?
Ans: Transient interruption in fetal oxygenation
An intrauterine pressure catheter, placed for the monitoring of uterine pressure,
amnioinfusion, and fluid sampling, is useful in the treatment of
Ans: Variable decelerations- amnioinfusion is used to attempt to resolve variable fetal
heart rate decelerations by correcting umbilical cord compression as a result of
oligohydramnios. Must be careful to not cause polyhydramnios
A patient who is at 42+5 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:
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Click here for more: Scholars nexus
Ans: Fetal metabolic acidosis- moderate variability reliably predicts the abscence of
fetal metabolic acidemia at the time it is observed. Absent variability --> severe
hypoxia. Marked variability--> methamphetamine use and scalp stimulation
When performing a 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/week?
Ans: An amniotic fluid pocket measuring 1.5cm in two planes perpendicular to each
other. Oligohydramnios is defined as a single deepest pocket of <2cm, or an amniotic
fluid index of <5cm
Elevated maternal serum a-fetoprotein is associated with:
Ans: neural tube defects- MSAFP is a protein made by the fetal liver. High levels may
indicate neural tube defects or ventral abdominal wall defects, esophageal and
duodenal atresia, and some renal or urinary tract anomalies. Low levels occur in some
case of down syndrome
What is triple marker screening?
Ans: Combines the chemical markers of MSAFP, hCG, and unconjugated estriol with
the mother's age. A low value is associated with trisomy 18
After a vacuum-assisted delivery, the nurse should assess the infant for:
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