CCRN - Neonatal (Assessment of Fetal Well-Being)

A pt who is a G3P2 at 33wks arrives at triage w/ regular uterine contractions. Hx includes PT delivery at 34wks. No bleeding, no ROM. What is the biomedical marker for predicting PT birth?

A. cervical ferritin

B. fetal fibronectin - fetal fibronectin (fFN) is a biomarker used to predict preterm birth. It is a protein found in fetal membranes and its presence in cervical fluid can indicate the risk of preterm labor after 22wks.

C. corticotropin-releasing hormone

D. placenta alpha-microglobulin-1

32wks triage concern of leaking fluid. No contractions and NFM. The bedside immunoassay (AmniSure) identifies which glycoprotein?

A. prolactin

B. alpha-fetoprotein

C. fetal fibronectin

D. placenta alpha-microglobulin-1 - PAMG-1 Protein found in amniotic fluid, blood, and cervicovaginal discharge in pregnant women. Found in vaginal secretions after ROM.

BPP is the primary method for evaluating fetal well-being by testing activities controlled by the CNS. What are the 5 variables?

A. fetal tone, fetal breathing, fetal movement, NST, and AFV - reflex activities that are sensitive to hypoxia and fetal environment

B. fetal movement, fetal tone, NST, AFV, and fetal position

C. fetal tone, fetal position, AFV, fetal HR, and fetal activity

D. fetal HR, fetal movement, NST, AFV, and fetal tone

Appropriate age for glucose testing in women with low risk for GDM is?

A. 20-21 weeks

B. 22-23 weeks

C. 24-28 weeks

D. 32-34 weeks

What is the physiologic cause of late decels?

A. Fetal distress

B. Sympathetic response to fetal activity

C. Rapid fetal descent into pelvis

D. Transient hypoxemia during contractions - fetal response to contractions

With BPP, what variable should be recognized as fetal high risk and needs delivery or repeat BPPs at least 2 times a week?

A. reactive NST

B. 3 movements in 30 min

C. 30 sec of fetal breathing in 30 min

D. Amniotic pocket that is 1.5cm in two perpendicular planes - (Oligohydramnios) Decreased AFV is defined as a pocket < 2cm or AFI < 5cm. Can impact perinatal outcome.

Pt is 42wks 5 days and has been pushing for 90 min. SROM 3hrs prior with mec. EMF shows minimal variability. What is the cause?

A. severe hypoxia

B. fetal metabolic acidemia - Decreased O2 to the fetus with pushing can cause acidemia and reduce FHR regulation.

C. recent maternal methamphetamine use

D. fetal scalp stimulation response