Download Maternal Newborn Nursing RNC-MNN Exam Review: Questions & Answers and more Exams Pediatrics in PDF only on Docsity!
Rush University
(Chicago, Illinois)
NCC National Certification Corporation
NCC Registered Nurse Certified in Maternal
Newborn Nursing RNC-MNN Exam
Course Title and Number: NCC Registered Nurse Certified in Maternal Newborn Nursing RNC-MNN Exam Exam Title: Board Exam Exam Date: Exam 2024- 2025 Instructor: [Insert Instructor’s Name] Student Name: [Insert Student’s Name] Student ID: [Insert Student ID]
Examination
180 minutes
Instructions:
**1. Read each question carefully.
- Answer all questions.
- Use the provided answer sheet to mark your responses.
- Ensure all answers are final before submitting the exam.
- Please answer each question below and click Submit when you** **have completed the Exam.
- This test has a time limit, The test will save and submit** **automatically when the time expires
- This is Exam which will assess your knowledge on the course** Learning Resources.
Good Luck!
HMU
📧 Hybridgrades101@gmail.com NCC National Certification Corporation 2024-2025 NCC Registered Nurse Certified in Maternal Newborn Nursing RNC Maternal History and Risk Factor Exam Review Questions and Answers | 100% Pass Guaranteed | Graded A+ | Read All Instructions Carefully and Answer All the Questions Correctly Good Luck: - Alpha Feto-protein - Answer>> done 14-18 weeks elevated=neural tube defect low=Trisomy 21. protein produced by fetal tissue. During development AFP levels in fetal blood and amniotic fluid rise until 12 weeks, then level gradually fall until birth. Some AFP crosses the placenta and appears in maternal blood. HCG - Answer>> elevated in down syndrome hormone produced by the placenta. Levels rise in maternal blood for the first trimester of pregnancy then fall to less than 10% by the end. Unconjugated Estriol - Answer>> elevated in Down Syndrome form of estrogen produced by the fetus through metabolism. This process involves the liver, adrenals and placenta. Some estriol crosses the placenta into the maternal blood. Levels rise around the 8th week and continue to rise until shortly before delivery. Amniocentesis - Answer>> genetic evaluation done between 15-20 weeks for genetic evaluation for neural tube defect, down syndrome, Trisomy 18 and Trisomy 13 with measurement of up to four markers: AFP, estriol, hCG and inhibin A Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com GBS swab - Answer>> 35- weeks, result dependable for 5 weeks. Non-stress test - Answer>> test for fetal well being Indicated for patients at risk for placental insufficiency, postterm preganancy, diabetes, hypertension, previous still births, IUGR, decreased fetal movements, Rh disease. May be started as early as 30-32 weeks test once or twice weekly A reactive test: two fetal heart rate accelerations, defined as 15 beat rise from baseline that lasts 15 seconds with return to baseline after 40 min. A reactive test is reassuring, with risk of fetal death approx. 5 in 1000. A non-reactive test is an indication for further testing. Nuchal Translucency - Answer>> measures the fluid beneath the skin behind baby's neck for genetic screening. It is more reliable screen for multiples. First trimester genetic screen - Answer>> Done at 10- 14 weeks includes ultrasound measurement of fetal nuchal translucency and/or biochemical markers including AFP, hCG, unconjugated estriol, inhibin A, and PAPP-A (pregnancy associated plasma protein) All patients should be offered cystic fibrosis screening and if carrier status is detected then the partner should be tested. Chronic Villus sampling - Answer>> done 9-11 weeks, transabdominal aspiration done if increased risk for NTD, cystic hygroma, or other suspect anomaly Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Indications: prefers to know to make decisions regarding pregnancy in first trimester.
- Severe oligohydraminos. Contraindications: Multiple gestation, uterine bleeding in this pregnancy, active genital Herpes, uterine fibroids. Post amniocentisis or CVS administer Rho-gam to Rh negative mother where father is positive or unknown. Triple Screen - Answer>> The triple screen test is a maternal blood screening test that looks for three specific substances: AFP, hCG, and Estriol. AFP: alpha-fetoprotein is a protein that is produced by the fetus. hCG: human chorionic gonadotropin is a hormone produced within the placenta Estriol: estriol is an estrogen produced by both the fetus and the placenta. It is a non-invasive procedure done through a blood test with little to no known risk to the mother or developing baby. recommended for women who: Have a family history of birth defects Are 35 years or older Used possible harmful medications or drugs during pregnancy Have diabetes and use insulin Had a viral infection during pregnancy Have been exposed to high levels of radiation High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy. Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Modified biophysical profile - Answer>> NST/Amniotic fluid index (AFI) NST is a indicator of present fetal condition Amniotic fluid index (AFI) is a marker of longer-term fetal status Amniotic fluid Index - Answer>> 1. decreased amniotic fluid volume (Oligohydraminos) is associated with uteroplacental insufficiency.
- Polyhydraminos may be associated with chromosomal disoders, maternal diabetes, and anatomic anomalies such as tracheoesophageal fistula. Measurement of amniotic fluid: single vertical pocket measurement of 2cm considered adequate. The four quad measure is the AFI, and it varies with gestational age. AFI <5 at term is used as cutoff for oligohydraminos. Lecithin/sphingomyelin (L/S) ratio - Answer>> ration equal or greater the 2.0 indicates fetal lung maturity and occurs when fetal lung surfactant is present in amniotic fluid (at approx. 35 weeks) Positive predictive value is 95% Phosphatidylglycerol (PG) - Answer>> a minor compnent of surfactant, is present in amniotic fluid at approx 35 weeks and increases rapidly at 37 weeks. PG is reported as present or absent. it is a more reliable test in mothers with DIABETES than L/S ratio. Fetal lung maturity assay - Answer>> measures surfactant/albumin ratio in amniotic fluid. It is less expensive and easier to perform and has fewer false negative results than L/s ratio or PG measurement. Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Lamellar body counts - Answer>> storage form of surfactant. test inexpensive and may be performed in 15 minutes with <1ml of amniotic fluid 97-98 positive predictive value. Contraction Stress Test - Answer>> Evaluates reserve function of placenta. Indications are the same for Non- stress test. Done by evaluating 3 contractions in a 10 minute period. A positive CST result is defined as late decelerations of FHR that are present with majority of contractions in a 10 minute window. Delivery should be considered if positive result. Findings considered suspicious/unsatisfactory require retesting in the next 24 hours. Inhibin A - Answer>> prduced by the placenta. Levels in maternal blood decrease slightly between 14 to 17 weeks and then rise again. Chronic HTN - Answer>> blood pressure >140/ -mild chronic HTN >140/90- slightly increases risk of IUGR and placenta abruption -Severe chronic HTN >160/110- superimposed with preeclampsia can lead to fatal placental abruption and neonatal death after planned preterm delivery to protect mother's life. PIH predisposing factors - Answer>> primigravida, younger and older woman, family history of PIH or previous personal history, obesity, diabetes, chronic HTN or renal disease, thrombophilias, multifetal gestation, or large fetus. associated with hydrop fetalis and unexplained IUGR. Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com
- Eclampsia: monitor fetal heart rate for transient bradycardia, rebound tachycardia, decreased variability, and late decels. continuous assessment for abruption. resolves during postpartum PIH assessment of newborn infant - Answer>> 1. IUGR, 2. Preterm gestation 3. hypoxia and acidosis 4. possible adverse drug effects on neonate: Hypermagnesium: respiratory depression,neuromuscular depression (as evidenced by weakness, lethargy, hypotonia, flaccidity, and poor suck) loading dose for mom is 4-6gm with 2-4 gm maintenance. antidote is calcium gluconate Labetalol: hypotension, hypoglycemia, respiratory depression, and transient tachypnea. also used: hydrazaline, aldomet, nifedipine HELLP syndrome - Answer>> Hemolysis, elevated liver enzymes, low platelets <100,000 (DIC) can be associated with visual changes/headache Hemorrhage is a serious concern associated with hypoxemia, low apgars, low umbilical cord pH, mental retardation, abruption DIC management: remove the cause: replace mom with coagulation factors:platelets, crycoprecipitate until maternal/fetal stabilization is established. BP goal is DBP< Premature labor - Answer>> regular contractions with cervical change before 37 weeks PTL Maternal markers - Answer>> African american, age<18 or >40, obese or underweight, poor PNC, smoking, parity 0 or 3 or more, bacturia, bacterial Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com vaginosis, demanding occupation, poor socioeconomics, maternal stress, infection, uterine anomalies, premature cervical dilation
1cm, assisted reproductive technologies, PROM Fetal Factors: IUGR, congenital anomalies,interuterine death, multifetal gestation. Diagnostic markers for PTL - Answer>> fetal fibronectin; performed on vaginal secretions. a negative test result indicates preterm labor will not begin within 2 weeks transvaginal ultrasound subjective data Management of PTL - Answer>> Tocolytics: Beta-adrenergic Terbutaline 0.25 SQ q 20 min for 3 hours (hold for pulse
side effects for fetus: hyperglycemia, tachycardia, MI or hypertrophy and hypoglycemia, hypocalcemia, hypotension. Magnesium 4-6 gm load for 20 min then 2-3gm/hr maintenance fetal side effects: hypotonia, lethargy, respiratory depression, demineralization with prolonged use Prostaglandin inhibitors Indomethacin: given prior to 32 weeks. loading dose 50mg rectal or 50-100 oral, then 25-50 oral every 6- hours ASA, NSAIDS. fetal side effects: PDA closure, IVH, NEC, reversible renal function with Oligo, hyperbili. contraindicated: fetal renal anomalies, oligio, twin to twin transfusion, chorioamnionitis, ductal dependent cardiac defects, PPHN Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com abruption, chorio, preterm premature rupture of membranes, tobacco smoking Clinical presentation of AP - Answer>> Maternal: mild labor pains, board-like and tender abdomen, dark or bright red bleeding, uterine hyperactivity, enlargement of uterus. Fetal Distress: loss of fetal heart tones, tachycardia, late or variable decels, decreased fetal heart rate variability, sinusoidal fetal heart rate pattern. Potential Complications of AP - Answer>> Maternalfeto hemorrhage, anemia. preterm birth, hypoxia and asphixia with intrauterine fetal demise, hypovolemia, long-term neurobehavioral problems, 20- 30% incidence of fetal death; sudden infant death syndrome, IUGR Effect of Maternal anemia on fetus/newborn - Answer>> Maternal anemia during the first half of pregnancy has been linked to increased risk of preterm labor. Maternal eating disorders prior to or during pregnancy lead to SGA/ smaller head circumference with a reduced brain size.risk of preterm birth, low birth weight, and prenatal mortality, birth asphyxia Maternal thrombocytopenia - Answer>> Platelets <150,000. Predisposing factors, maternal drug ingestion (hydralizine, tolbutamide, thiazides), placental infarction, maternal eclampsia/hypertension,immune mediated maternal platelet antibodies (needs to be differentiated from HELLP syndrome). : Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Immune mediated platelet antibodies:idopathic - Answer>> maternal antibodies kill platelets 80% caused by autoimmune form, maternal idopathic thrombocytopenic purpura (ITP) which strikes second or third decade. It is a pre-existing condition where the body produce IgG ANTI-PLATELET ANTIBODIES and destroys platelets to lower platelet count lower than 150,000, IgG can cross the placenta so it can destroy the fetus platelets, mortality is 1-10% and can resolve within first four months. Neonatal Allo-immune thrombocytopenia - Answer>> maternal antibodies destroy foreign fetal platelets (paternally inherited) whereas maternal platelets remain normal. Similar reaction to Rh incompatibility but unlike Rh the Allo-immune response effect upto 50% first pregnancies. The mother develops IgG antibodies that eventually get to fetal circulation. Mortality is 10-15% bleeding tends tobe more severe than idiopatheic, most occurring between 30-35 weeks. Treatment: tranfusion of maternal platelets, exchange transfusion, and IVIG. Platelets usually normalize within 4 weeks. Neonatal factors associated with thrombocytopenia - Answer>> asphixia, low apgar scores, DIC, transfusion, infection, SGA, NEC, Hyperbili,mec aspiration,polycythemia, and pulmonary hypertension. **Formula for estimating rise in platelets:one tenth the volume (in milliliters) of a unit of platelets per kilo of weight will rise the platelets by 50, Maternal CMV transmission - Answer>> Transmitted through bodily fluids. Initial transmission to fetus occurs Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com plasma reagin test which measures anticardiolipin antibody Vertical transmission of treponemas can occur at anytime during pregnancy. Can cause preterm labor, PROM, stillbirth, congenital infection or neonatal death. Current untreated secondary infection has greatest risk to fetus especially if it occurs during the time of organogensis Presentation of neonatal syphilis - Answer>> low birth weight, IUGR, anemia, osteochondritis, there is often bilateral skin peeling on palms and soles. Non-immune hydrops is common presentation of congenital syphilis. Diagnosis of active disease in neonate - Answer>> 1. High VDRL titer 94 times higher than mom)
- Reasctive RPR
- Serum IgM level greater than 20
- Confirmation flourescent treponemal antigen- antibody test treatment: Penicillin. Neonatal therapy should be instituted if maternal treatment is uncertain or if treatment was within last 4 weeks of pregnancy. standard precautions Toxoplasmosis manifestations - Answer>> maculopapular rash, hepatomegaly, splenomegaly, jaundice, thrombocytopenia. CNS involvement: microcephaly or hydrocephalus accompanied by seizures. Toxoplasmosis transmission - Answer>> vertical transmission: uncooked meat or by exposure to infected cat feces during pregnancy. Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Toxoplasmosis diagnosis - Answer>> isolation or histologic demonstration of the organism, detection of toxoplasma antigens in tissues and body fluids, detection of toxoplasma nucleic acid by PCR, and serologic test. Treatment of toxoplasmosis - Answer>> pyrimethamine, trisulfapyrimidines and a folic acid supplement to prevent bone marrow suppression. standard precautions Hepatitis B - Answer>> DNA double shelled; found in bodily secretion including human milk, breastfeeding is not contraindicated if immunoprophalaxis recommendations are followed Treatment of neonate of HBsAg positive mom - Answer>> careful bathing to remove blood and secretions that may be contaminated. Administration of Hep B immunoglobulin (HBIG) 0.5ml IM as soon as 12 hours of birth as well as Hep B vaccine. Isolation procedures: No isolation required. Immediately after birth the infant should be handled with gloves until all maternal blood is removed. HIV - Answer>> RNA virus, suppression of helper T cells B-cell and suppressor t cell dysfunction, with subsequent defects in cell mediated immunity and development of opportunistic infections Maternal antiretroviral treatment HIV - Answer>> Protocol: preceonceptual testing. medication Zidovudine (ZDV) started as early as 14 weeks (medication is a teratogen not to be given in first Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Herpes Simplex Virus (HSV) - Answer>> HSV-1 nongenital type although it can infect the genital area accounts for 25% OF NEONATAL INFECTION hsv-2 GENITAL more often associated with neonatal infection 75% of time Transmission: 90% occur at time of delivery, 75% have been born to women who had no history or clinical findings suggestive of active HSV. infections can also occur in utero or postnatally, Postnatal infections can occur through breast lesions through breast feeding, from oral lesions through direct contact. Presentation HSV of Intrapartum or post natal transmission - Answer>> vescular lesions, thermal instability, lethargy, respiratory distress, vomiting, poor feeding, cyanosis, and if CNS involvement, irritability, bulging fontanelle, seizures, coma Presentation HSV Congenital transmission - Answer>> early vesicular rash, SGA, low birth weight, chorioretinitis, diffuse brain damage, microcephaly, intracranial calcification. Diagnosis of HSV - Answer>> positive culture with specimen obtain from vesicular fluid, blood, or CSF results in diagnosis the polymerase chain reaction (PCR) test has a much higher yield in CSF and should be performed if available. Treatment for neonate HSV - Answer>> 1. systemic infection: Acyclovir, for premature infants 10mg/kg/dose every 12 hours for 14 to 21 days. In term infants 10mg/kg/dose every 8 hours is recommended. Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
HMU
📧 Hybridgrades101@gmail.com Side effects are rare. Phlebitis may occur at the IV site because alkaline pH of 10. Prognosis: Approx half of untreated infants will die Prevention of HSV transmission - Answer>> maternal History Weekly virologic and clinical screening beginning at 32 weeks c-section if lesions present for known exposure, culture specimen from neonate should be obtained within 24-48 hours after birth. treatment should be considered if infant has symptoms, was born prematurely, acquired open wounds during delivery, or other high risk factors. Follow-up with infant closely for minimum 6 weeks even if culture negative. Infants born to mothers with active lesions should be physically isolated from other infants and managed with transmission precautions in addition to standard precautions. Infants born to mother with history but without lesions do not require isolation. Infants with active infection should be isolated and managed with contact precautions. N. Gonorrhoae - Answer>> gram negative. Most frequent STD. Concurrent infection with trachamatis and pallidum are common Opthalmia neonatorum presents first week of life with bilateral copious mucopurulent eye drainage. Lid and conjunctival edema and erythema are common. Diagnosis by gram stain. Evaluation for sepsis and menigitis is also necessary. treatment : third generation cephalosporin, Penicillin. eye irrigation until eye drainage clears. instill Need Writing 📧Help? We've Got You Covered! ✍ 100% NO A I or Plagiarism Guaranteed📧
