NCC RNC-NIC ACTUAL EXAM 2026
QUESTIONS WITH ANSWERS GRADED A+
◉ Describe the fetal response to mothers with diabetes. Answer:
Because glucose crosses the placenta, the baby's BG increases as the
mom's does. Insulin does not cross the placenta and the fetal pancreas
does not produce it until 20 weeks. So, before insulin production, the
increased BG leads to restricted growth. Once the insulin is produced, it
produces rapidly to respond to the high BG, and these high levels trigger
rapid fetal growth—> hepatosplenomegaly, cardiomegaly, increased
head size
◉ What is commonly seen in IDM immediately after birth? Why.
Answer: Hypoglycemia
The sudden withdrawal from maternal glucose + continued production
of insulin
◉ What conditions does an IDM present with. Answer: Birth trauma r/t
cephalopelvic disproportion
Hypoglycemia
RDS because inc insulin inhibits surfactant production
Polycythemia & hyperviscosity bc inc insulin & BG inc metabolic rate
and oxygen consumption
,Iron deficiency bc polycythemia leaches iron
Hyperbilirubinemia from inc rbc destruction
CV & congenital malformations
Electrolyte disturbances (low Ca and Mg)
◉ What is pre-eclampsia. Answer: Inc BP, proteinuria, edema that
occurs around 20 week's gestation
◉ What's the initial tx for pre-eclampsia. Answer: Mag sulfate to
prevent maternal sz
If severe—premature delivery
◉ What complications occur to fetus with a mother suffering from pre-
eclampsia? Why. Answer: IUGR— longstanding HTN causes
uteroplacental vascular insufficiency which impairs transfer of nutrients
and oxygen which causes IUGR and inc mortality
◉ What is the purpose of amniotic fluid and how is it produced? When.
Answer: To cushion fetus and allow normal development of lungs
Produced mainly by fetus' excretion of urine and fluids excreted by
respiratory tract & oral/nasal cavity
Around 20 week's
,◉ What is oligohydramnios? What conditions are associated with it.
Answer: Decreased AF
UT anomalies like obstructive uropathy, renal agenesis, polycystic
kidneys
Pulmonary hypoplasia
Pressure deformities
Compression of umbilical cord & hypoxia
Mecon staining (remember hypoxia causes release of mecon in utero)
Post-term gestation
Leaking AF, prolonged or premature ROM
◉ What is polyhydramnios & what is it associated with. Answer:
Increased AF
TEF, EA, duodenal atresia
Anencephaly
CNS abnormalities that impair swallow
Twin-twin transfusion
Macrosomia
Fetal/neonatal hydrops & assoc CV rhythms
Trisomy 21, 18, 13
Skeletal malformations
Inc risk for prolapsed cord/placental abruption
, ◉ What is the biochemical marker useful in predicting preterm birth.
Answer: Fibronectins
◉ What is the best indicator of fetal oxygenation status during labor as
seen on electric fetal monitoring. Answer: Variability
◉ What are the five parts of the biophysical profile. Answer: Fetal tone,
breathing, movement; no stress test, amniotic fluid volume
◉ When should one have a glucose screening during pregnancy if
they're at low risk for developing GD. Answer: 24-28 weeks
◉ When women give birth sitting upright, what shows lower values in
cord blood. Answer: PCO2
◉ An intrauterine pressure catheter, placed for monitoring of uterine
pressure, amino infusion, and fluid sampling, is useful in the treatment
of what. Answer: Variable decelerations by correcting cord compression
◉ What is the normal blood volume for a neonate. Answer: 85-100
mL/kg
QUESTIONS WITH ANSWERS GRADED A+
◉ Describe the fetal response to mothers with diabetes. Answer:
Because glucose crosses the placenta, the baby's BG increases as the
mom's does. Insulin does not cross the placenta and the fetal pancreas
does not produce it until 20 weeks. So, before insulin production, the
increased BG leads to restricted growth. Once the insulin is produced, it
produces rapidly to respond to the high BG, and these high levels trigger
rapid fetal growth—> hepatosplenomegaly, cardiomegaly, increased
head size
◉ What is commonly seen in IDM immediately after birth? Why.
Answer: Hypoglycemia
The sudden withdrawal from maternal glucose + continued production
of insulin
◉ What conditions does an IDM present with. Answer: Birth trauma r/t
cephalopelvic disproportion
Hypoglycemia
RDS because inc insulin inhibits surfactant production
Polycythemia & hyperviscosity bc inc insulin & BG inc metabolic rate
and oxygen consumption
,Iron deficiency bc polycythemia leaches iron
Hyperbilirubinemia from inc rbc destruction
CV & congenital malformations
Electrolyte disturbances (low Ca and Mg)
◉ What is pre-eclampsia. Answer: Inc BP, proteinuria, edema that
occurs around 20 week's gestation
◉ What's the initial tx for pre-eclampsia. Answer: Mag sulfate to
prevent maternal sz
If severe—premature delivery
◉ What complications occur to fetus with a mother suffering from pre-
eclampsia? Why. Answer: IUGR— longstanding HTN causes
uteroplacental vascular insufficiency which impairs transfer of nutrients
and oxygen which causes IUGR and inc mortality
◉ What is the purpose of amniotic fluid and how is it produced? When.
Answer: To cushion fetus and allow normal development of lungs
Produced mainly by fetus' excretion of urine and fluids excreted by
respiratory tract & oral/nasal cavity
Around 20 week's
,◉ What is oligohydramnios? What conditions are associated with it.
Answer: Decreased AF
UT anomalies like obstructive uropathy, renal agenesis, polycystic
kidneys
Pulmonary hypoplasia
Pressure deformities
Compression of umbilical cord & hypoxia
Mecon staining (remember hypoxia causes release of mecon in utero)
Post-term gestation
Leaking AF, prolonged or premature ROM
◉ What is polyhydramnios & what is it associated with. Answer:
Increased AF
TEF, EA, duodenal atresia
Anencephaly
CNS abnormalities that impair swallow
Twin-twin transfusion
Macrosomia
Fetal/neonatal hydrops & assoc CV rhythms
Trisomy 21, 18, 13
Skeletal malformations
Inc risk for prolapsed cord/placental abruption
, ◉ What is the biochemical marker useful in predicting preterm birth.
Answer: Fibronectins
◉ What is the best indicator of fetal oxygenation status during labor as
seen on electric fetal monitoring. Answer: Variability
◉ What are the five parts of the biophysical profile. Answer: Fetal tone,
breathing, movement; no stress test, amniotic fluid volume
◉ When should one have a glucose screening during pregnancy if
they're at low risk for developing GD. Answer: 24-28 weeks
◉ When women give birth sitting upright, what shows lower values in
cord blood. Answer: PCO2
◉ An intrauterine pressure catheter, placed for monitoring of uterine
pressure, amino infusion, and fluid sampling, is useful in the treatment
of what. Answer: Variable decelerations by correcting cord compression
◉ What is the normal blood volume for a neonate. Answer: 85-100
mL/kg
