CNM ACNM Exam Questions with
Accurate Answers
adolescent correct answer this group is more likely to
- start PNC late; have poor compliance with PNC schedule
- risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA correct answer this group is more likely to:
- struggle with infertility, have 1st tri SAB, ectopic pregnancy, genetic abnormalities
- HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW correct answer African American race is correlated with (LGA/LBW) babies?
PTB correct answer Low SES is related to poor OB outcome including ___________?
multipara correct answer Are Nulliparas or Multiparas associated w/ increased risks of abruptio
placenta, previa, multifetal pregnancy, and PPH?
Transverse lie correct answer Fetal presentation associated with grand multiparous women (parity > 5)
quad screen correct answer 15-22 weeks
- hCG
- AFP
- estriol
,- inhibin A
screens for trisomy 18/21, NTD
penta screen correct answer 15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening correct answer - 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station correct answer relationship of leading edge of fetal presenting part to ischial spines (in cm)
lactated ringer correct answer Fluid of choice for burns, dehydration
d5lr correct answer Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl correct answer normal saline
anesthesia correct answer epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
,- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks correct answer paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation correct answer - facilitates increased mobility
- requires 1 to 1 labor attendance
- associated w/ decreased rate of intervention
60; 30; 15 correct answer intermittent auscultation should be done every _____ seconds after a
contraction every _______ minutes in 1st stage of labor if low risk, and every ______ if high risk
15; 5 correct answer intermittent auscultation should be done every ____ minutes in 2nd stage if low
risk; and every _____ min if high risk
continuous EFM correct answer - indicated for AP or IP risk factors
category I correct answer - tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early decels/accels present or
absent
15; 5 correct answer continuous fetal monitoring should be done every _____ min for low-risk in 1st
stage and every ______ min if high risk
Category II correct answer indeterminate of fetal acid-base status; requires continued monitoring and
evaluation
- baseline bradycardic or tachycardic
, - minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
- prolonged decels between 2-10 minutes
- recurrent lates w/ mod baseline variability
- variable decels w/ overshoots/shoulders
category III correct answer - associated w/ abnormal fetal acid-base status; prompt corrective action
required
- absent variability in conjunction with any of the following:
- bradycardia
- recurrent variables
- recurrent lates
- sinusoidal pattern
10+ minutes correct answer how long does fetal bradycardia/tachycardia need to persist to be
diagnosed
fetal scalp stimulation correct answer - cannot be reliably performed during decel or bradycardia; wait
for FHR recovery
>7.2 correct answer stimulating the head during a vaginal exam with a FHR accel > 15 for >15 seconds is
indicated of fetal pH of _________
intact membranes correct answer - facilitates rotation of head during pelvic descent
-barrier to introduction of bacteria into uterus
power correct answer assesses strength of contractile efforts; assesses need for labor augmentation
Accurate Answers
adolescent correct answer this group is more likely to
- start PNC late; have poor compliance with PNC schedule
- risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA correct answer this group is more likely to:
- struggle with infertility, have 1st tri SAB, ectopic pregnancy, genetic abnormalities
- HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW correct answer African American race is correlated with (LGA/LBW) babies?
PTB correct answer Low SES is related to poor OB outcome including ___________?
multipara correct answer Are Nulliparas or Multiparas associated w/ increased risks of abruptio
placenta, previa, multifetal pregnancy, and PPH?
Transverse lie correct answer Fetal presentation associated with grand multiparous women (parity > 5)
quad screen correct answer 15-22 weeks
- hCG
- AFP
- estriol
,- inhibin A
screens for trisomy 18/21, NTD
penta screen correct answer 15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening correct answer - 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station correct answer relationship of leading edge of fetal presenting part to ischial spines (in cm)
lactated ringer correct answer Fluid of choice for burns, dehydration
d5lr correct answer Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl correct answer normal saline
anesthesia correct answer epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
,- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks correct answer paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation correct answer - facilitates increased mobility
- requires 1 to 1 labor attendance
- associated w/ decreased rate of intervention
60; 30; 15 correct answer intermittent auscultation should be done every _____ seconds after a
contraction every _______ minutes in 1st stage of labor if low risk, and every ______ if high risk
15; 5 correct answer intermittent auscultation should be done every ____ minutes in 2nd stage if low
risk; and every _____ min if high risk
continuous EFM correct answer - indicated for AP or IP risk factors
category I correct answer - tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early decels/accels present or
absent
15; 5 correct answer continuous fetal monitoring should be done every _____ min for low-risk in 1st
stage and every ______ min if high risk
Category II correct answer indeterminate of fetal acid-base status; requires continued monitoring and
evaluation
- baseline bradycardic or tachycardic
, - minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
- prolonged decels between 2-10 minutes
- recurrent lates w/ mod baseline variability
- variable decels w/ overshoots/shoulders
category III correct answer - associated w/ abnormal fetal acid-base status; prompt corrective action
required
- absent variability in conjunction with any of the following:
- bradycardia
- recurrent variables
- recurrent lates
- sinusoidal pattern
10+ minutes correct answer how long does fetal bradycardia/tachycardia need to persist to be
diagnosed
fetal scalp stimulation correct answer - cannot be reliably performed during decel or bradycardia; wait
for FHR recovery
>7.2 correct answer stimulating the head during a vaginal exam with a FHR accel > 15 for >15 seconds is
indicated of fetal pH of _________
intact membranes correct answer - facilitates rotation of head during pelvic descent
-barrier to introduction of bacteria into uterus
power correct answer assesses strength of contractile efforts; assesses need for labor augmentation
