RNC-OB Exam Bank/ Inpatient Obstetric Nurse Exam Prep
2022-2023: RNC Study Guide + 350 Test Questions and
Detailed Answer Explanations
1. Late in pregnancy, a patient often develops supine hypotension because of
a. partial occlusion of the vena cava and aorta.
b. decreased peripheral collateral circulation.
c. increased blood flow to the placenta.
✓Answer- A
because of partial occlusion of the vena cava and aorta from the weight of the uterus. This
impedes venous return from the lower extremities although increased collateral circulation
during pregnancy helps to compensate. Remaining in the supine position for long periods of time
could decrease fetal oxygenation as well. The lateral recumbent position relieves the pressure on
the vena cava and aorta, allowing the blood pressure to increase and symptoms to decrease.
The nurse must educate the new mother that a contraindication to breast feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infection with HIV/AIDS.
✓Answer- C
Some maternal contraindications to breastfeeding include:
-Infection with HIV/AIDS
-Use of antiretroviral medications
-Active TB not treated
-Infection with human T-cell lymphotropic virus
-Illicit drug use
-Use of chemotherapeutic agents
-Radiation therapy (may require only interruption during treatment)
-Use of other medications that pass into the breast milk and may harm the child
-Presence of herpes on the breast
-Presence of varicella lesions on the breast (may resume after lesions crust)
The initial postpartal intervention indicated for a soft boggy uterus is to
a. apply an ice compress.
b. massage the fundus until firm.
c. apply a warm compress.
✓Answer- B
...with the dominant hand while supporting the inferior uterus with the non-dominant hand to
prevent trauma. If the fundus does not contract with massage, then further evaluation is indicated
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to determine if placental fragments remain. After the fundus becomes contracted, the nurse
should push firmly downward on the fundus to expel clots that may have pooled.
With the vibroacoustic stimulation test, stimulus with an artificial larynx or other device is
applied to the maternal abdomen for
a. 1 to 3 seconds.
b. 5 to 10 seconds.
c. 1 to 2 minutes.
✓Answer- A
Usually, stimulus is applied for 1-2 seconds and repeated up to 3 times with time extending to 3
seconds in order to stimulate fetal movement. A positive or reactive finding is an increased fetal
heart rate of 15 bpm or more for at least 15 seconds; however, a nonreactive result does not
always indicate fetal abnormality but indicates the need for further testing .
Absence of the Moro reflex on one side only in a neonate may indicate
a. fractured scapula.
b. cerebral palsy.
c. fractured clavicle.
✓Answer- C
a fractured clavicle or brachial plexus injury. Damage to the central nervous system, such as may
occur with cerebral palsy, often results in bilateral absence of the reflex. The Moro reflex is
elicited by allowing the infant's head and trunk to fall slightly backward when the infant is
raised. A positive Moro reflex includes immediate extension and abduction of the arms(and
sometimes the legs) with fingers fanning and forming a C-shape with a return of the limbs to the
flexed states
In a multiparous woman, what is the lowest Bishop score that predicts labor induction will be
successful?
a. 5
b. 7
c. 9
✓Answer- A
In a multiparous woman, the Bishop score that predicts that labor induction will be successful is
5 or more while it is a 9 or more for a nulliparous woman. The Bishop score is a rating system to
determine readiness for induction based on scores of 0-3 in four different measures: dilation
(cm), effacement (percentage), station (cm), and cervical consistency (firm, medium, soft), and
cervical position (posterior, mid position, anterior). The fifth measure, cervical position, is
scored only 0-2.
When cervical laceration occur during delivery, they are most common at what position?
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a. 3 and 9 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock
✓Answer- A
Cervical lacerations are most often identified with vaginal retractors when bleeding is persistent
after delivery. The lacerations are sutured with absorbable sutures, so no further treatment is
usually indicated. Minor lacerations often occur during delivery, but they usually require no
treatment. Tears are more common after forceps assisted and vacuum assisted deliveries than
normal vaginal births
If using fetal pulse oximetry, what is normal oxygen saturation?
a. 30% to 65%
b. 65% to 90%
c. 90% to 100%
✓Answer- A
because of the fetus's high hemoglobin and hematocrit. A value below 30% may be associated
with hypoxia and metabolic acidosis. For fetal pulse oximetry, which may be used to determine
whether immediate intervention is needed for non-reassuring fetal heart rate, a special single-use
sensor is placed internally along the fetal cheek, temple, or forehead. However, fetal pulse
oximetry has not been found to reduce overall rates of Caesarean.
A decrease of fetal heart rate of at least 15 bpm for at least 10 minutes is classified as
a. recurrent deceleration.
b. prolonged deceleration.
c. baseline change.
✓Answer- C
If it persists more than 2 minutes but less than 10 minutes, it is classified as a prolonged
deceleration. Recurrent decelerations are classified as occurring with half or more of uterine
contractions in a 20 minute period. Intermittent decelerations occur with fewer than half of
uterine contractions in a 20 minute period.
With suspected fetal hypoxia, a cord blood gas specimen is obtained during delivery by
a. withdrawing blood from the vein/artery before the cord is clamped or cut and before placental
expulsion.
b. placing one clamp and withdrawing blood above the clamp before cutting the cord.
c. double clamping a 10 to 20 cm segment, cutting it out, and then withdrawing blood from the
segment.
✓Answer- C
The segment can be placed on ice temporarily as cord blood gas can be accurately assessed for
60 minutes. An arterial sample is preferred over venous, but paired sampling is recommended. A
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pH of 7.24 or less is associated with neurological compromise. A base excess of 12 mmol/L or
more is predictive of motor or cognitive impairment.
When eliciting the scarf sign in a neonate, the infant's elbow crosses the midline of the chest,
probably indicating a
a. preterm infant.
b. term infant.
c. postterm infant.
✓Answer- A
At fullterm, the elbow should not cross the midline. For the scarf test, the neonate should be
placed supine. One arm is grasped and the hand pulled toward the opposite shoulder and then the
position of the elbow is assessed in relation to the midline of the chest.
Following birth, which hormone stimulates the alveolar cells of the breast, promoting production
of milk?
a. Estrogen
b. Prolactin
c. Progesterone
✓Answer- B
which increases in response to the neonate's suckling. Suckling also promotes release of
oxytocin, which promotes the letdown reflex by increasing contractibility of the muscles of the
mammary ducts. After milk production is well established, prolactin levels decrease, and most
milk production is then facilitated by oxytocin. During pregnancy, estrogen promotes
proliferation of breast ducts and progesterone the development of lobules and alveoli
Which anesthetic technique provides the best relief of pain during labor and delivery?
a. Epidural
b. Spinal
c. Pudendal block
✓Answer- A
The epidural can provide continuous relief during both labor and delivery and does not pose the
risk of spinal headache and provides less motor blockade. Additionally, there is a deceased risk
of hypotension because of reduced risk of sympathetic blockade. Spinal is now usually reserved
for Cesareans. The pudendal block provides relief primarily during delivery.
A patient with lupus erythematosus places the fetus at risk if she takes which medication during
pregnancy?
a. Prednisone
b. Methotrexate
c. Plaquenil® (hydroxychloroquine) Powered by TCPDF (www.tcpdf.org)
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