CCRN-NICU Questions and answers with verified
solutions GRADED A+ with 100% correct answers
2024/2025.
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: -
ANSWER 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 -
ANSWER 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: - ANSWER 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 - ANSWER 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? - ANSWER PCO2
What is the physiologic cause of late decelerations? - ANSWER 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 - ANSWER 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: -
, ANSWER 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? -
ANSWER 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: - ANSWER 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? - ANSWER 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: - ANSWER Subgaleal
hemorrhage- the hemorrhage causes the veins above the skull and periosteum to rupture and
bleeding occurs in the subaponeurotic space, which extends from the orbital ridges to the nape of the
neck laterally to the ears. Potentially, the entire neonatal blood volume can hemorrhage into this
space. Crosses the suture lines. Nurse should monitor serial head circumferences ad HCT levels and
observe for signs of shock
What are the fetal complications of forceps delivery? - ANSWER Transient facial marks, facial
palsies, and fracture of facial bones or the skull
A patient has chosen to receive a combined spinal-epidural for the mgmt of labor pain. The nurse
should instruct the patient that this type of analgesia: - ANSWER Increases the risk of
hypotension- hypotension can be observed in up to 100% of pregnant women after spinal anesthesia
due to the production of a sympathetic vasomotor block
What shunt is responsible for the mvmt of blood between the R and L atrium, and in what direction
does the blood primarily flow during fetal life? - ANSWER Foramen ovale with R to L shunt -
due to the high pulmonary vascular resistance and lower systemic vascular resistance
What is the ductus arteriosus responsible for? - ANSWER Shunting blood from the R to L
between the pulmonary artery and the aorta during fetal life
What vessel(s) is/ are responsible for transporting oxygenated blood from the placenta to the fetus? -
ANSWER Umbilical vein- oxygenated blood from the placenta is delivered to the fetus from the
umbilical vein and carried to the IVC via the ductus venosus. The umbilical arteries transport
deoxygenated blood from the aorta to the placenta.
During resuscitation of a term newborn in the L&D department, a sat probe is placed on the infant to
assess the need for supplemental O2. Which of the following describes the appropriate site for
placement and an acceptable saturation during the first 10 min of life? - ANSWER Right hand-
3 min sat at 74%
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