Page 1 of 26
CCRN-NICU EXAM QUESTIONS WITH COMPLETE SOLUTIONS
2026
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
,Page 2 of 26
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
, Page 3 of 26
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
CCRN-NICU EXAM QUESTIONS WITH COMPLETE SOLUTIONS
2026
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
,Page 2 of 26
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
, Page 3 of 26
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
