RNC-NIC (Neonatal Intensive Care Nursing Certification) (Watson) Exam latest updated

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A patient who is G2P2 at 32-week' gestation arrives at the triage unit complaining of regular uterine contractions. Her pregnancy history includes a preterm delivery at 34 weeks. Prior to examining he... r, the nurse performs electronic fetal monitoring and obtains a complete history. The patient reports no bleeding and no rupture of membranes. She has had no vaginal examinations or sexual activity for more than 24 hours. The biochemical marker useful in this situation for predicting preterm birth is: a. cervical ferritin b. fetal fibronectin c. corticotropin-releasing hormone d. placental alpha-microglobulin-1 - ANSWER b-fetal fibronectin (fFN) is uncommonly present in cervicovaginal secretions in the late second and early third trimesters. fFN is and extracellular glycoprotein that is thought to act as an adhesive between the fetal membrane and uterine wall and can be disrupted by inflammation. A preterm birth within two weeks is probable after a positive test result. Cervical ferritin is not a biomarker but an inflammatory marker whose presence provide support for the theory that infection is a mediator of preterm birth. Maternal plasma concentrations of corticotropin-releasing hormone are elevated in both term and preterm pregnancies. It appears to be a component of the common pathway of labor regardless of gestation. Placenta alpha-microglobulin-1 is a protein found that is a biomarker for rupture of membranes. A patient comes to triage unit at 32 weeks' gestation concerned because she has been "leaking fluid" from her vagina for the past hour. She says she has felt no contractions and reports normal fetal activity. A bedside immunoassay called AmniSure is performed. The test identifies a glycoprotein abundant in amniotic fluid. This glycoprotein is called: a. prolactin b. alpha-fetoprotein c. fetal fibronectin d. placental alpha-microglobulin-1 - ANSWER d-Premature rupture of membranes is one the most common complications of pregnancy resulting in a newborn's admission to the NICU. A bedside immunoassay test, AmniSure ROM, is simple, easy to perform, rapid (5-10 minutes), and minimally invasive. This test identifies a placental glycoprotein that is abundant in amniotic fluid but present in lower concentrations in maternal blood and cervicovaginal secretions. Prolactin is responsible for priming the breast tissue in preparation lactation, Alpha-fetoprotein is assessed to identify neural tube defects (high) and Down Syndrome (low). Fetal fibronectin is an extracellular glycoprotein that is [Show More]

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