Perinatal Nursing Certification (RNC-OB)
Exam Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A laboring patient at 39 weeks gestation is experiencing late
decelerations on the fetal monitor. What is the priority nursing
action?
A. Increase IV oxytocin infusion
B. Place the patient in left lateral position
C. Prepare for immediate cesarean section
D. Perform a sterile vaginal exam
Answer: B. Place the patient in left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency.
The first nursing action is intrauterine resuscitation, including
repositioning the patient to improve placental perfusion.
, 2. Which finding is most concerning in the second stage of labor?
A. Contractions every 2–3 minutes
B. Maternal urge to push
C. Fetal heart rate of 90 bpm
D. Cervical dilation of 10 cm
Answer: C. Fetal heart rate of 90 bpm
Rationale: A fetal heart rate below 110 bpm indicates bradycardia
and possible fetal distress requiring immediate intervention.
3. A patient receiving magnesium sulfate therapy shows which sign
of toxicity?
A. Increased deep tendon reflexes
B. Respiratory rate of 10 breaths/min
C. Blood pressure 150/90 mmHg
D. Urine output 100 mL/hr
Answer: B. Respiratory rate of 10 breaths/min
Rationale: Magnesium sulfate toxicity is characterized by respiratory
depression, loss of reflexes, and decreased urine output.
, 4. The nurse notes early decelerations on the fetal monitor. What is
the likely cause?
A. Umbilical cord compression
B. Uteroplacental insufficiency
C. Fetal head compression
D. Placental abruption
Answer: C. Fetal head compression
Rationale: Early decelerations are benign and caused by fetal head
compression during contractions.
5. Which maternal condition is a contraindication for vaginal
delivery?
A. Gestational diabetes
B. Placenta previa
C. Mild preeclampsia
D. Post-term pregnancy
Answer: B. Placenta previa
Rationale: Placenta previa increases risk of severe hemorrhage during
vaginal delivery.
, 6. A postpartum patient presents with heavy lochia and a boggy
uterus. What is the priority intervention?
A. Administer antibiotics
B. Massage the fundus
C. Place patient in Trendelenburg position
D. Apply ice packs to perineum
Answer: B. Massage the fundus
Rationale: A boggy uterus indicates uterine atony, and fundal
massage promotes contraction and reduces bleeding.
7. Which lab result is most indicative of preeclampsia?
A. Platelets 250,000/mm³
B. Proteinuria 3+
C. Hematocrit 30%
D. Blood glucose 90 mg/dL
Answer: B. Proteinuria 3+
Rationale: Proteinuria is a hallmark diagnostic finding in
preeclampsia.
Exam Questions and Correct Answers
(Verified Answers) Plus Rationales 2026
Q&A | Instant Download Pdf
1. A laboring patient at 39 weeks gestation is experiencing late
decelerations on the fetal monitor. What is the priority nursing
action?
A. Increase IV oxytocin infusion
B. Place the patient in left lateral position
C. Prepare for immediate cesarean section
D. Perform a sterile vaginal exam
Answer: B. Place the patient in left lateral position
Rationale: Late decelerations indicate uteroplacental insufficiency.
The first nursing action is intrauterine resuscitation, including
repositioning the patient to improve placental perfusion.
, 2. Which finding is most concerning in the second stage of labor?
A. Contractions every 2–3 minutes
B. Maternal urge to push
C. Fetal heart rate of 90 bpm
D. Cervical dilation of 10 cm
Answer: C. Fetal heart rate of 90 bpm
Rationale: A fetal heart rate below 110 bpm indicates bradycardia
and possible fetal distress requiring immediate intervention.
3. A patient receiving magnesium sulfate therapy shows which sign
of toxicity?
A. Increased deep tendon reflexes
B. Respiratory rate of 10 breaths/min
C. Blood pressure 150/90 mmHg
D. Urine output 100 mL/hr
Answer: B. Respiratory rate of 10 breaths/min
Rationale: Magnesium sulfate toxicity is characterized by respiratory
depression, loss of reflexes, and decreased urine output.
, 4. The nurse notes early decelerations on the fetal monitor. What is
the likely cause?
A. Umbilical cord compression
B. Uteroplacental insufficiency
C. Fetal head compression
D. Placental abruption
Answer: C. Fetal head compression
Rationale: Early decelerations are benign and caused by fetal head
compression during contractions.
5. Which maternal condition is a contraindication for vaginal
delivery?
A. Gestational diabetes
B. Placenta previa
C. Mild preeclampsia
D. Post-term pregnancy
Answer: B. Placenta previa
Rationale: Placenta previa increases risk of severe hemorrhage during
vaginal delivery.
, 6. A postpartum patient presents with heavy lochia and a boggy
uterus. What is the priority intervention?
A. Administer antibiotics
B. Massage the fundus
C. Place patient in Trendelenburg position
D. Apply ice packs to perineum
Answer: B. Massage the fundus
Rationale: A boggy uterus indicates uterine atony, and fundal
massage promotes contraction and reduces bleeding.
7. Which lab result is most indicative of preeclampsia?
A. Platelets 250,000/mm³
B. Proteinuria 3+
C. Hematocrit 30%
D. Blood glucose 90 mg/dL
Answer: B. Proteinuria 3+
Rationale: Proteinuria is a hallmark diagnostic finding in
preeclampsia.
