RNC-OB CERTIFICATION COMPREHENSIVE
STUDY GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ A contraindication of external version of a fetus isa. hydramnios
(polyhydramnios)b. previous Cesarean with low transverse incisionc.
engagement of presenting part.
Answer: CVersion should only be carried out if vaginal birth is expected.
Other contraindications include a malformed uterus, cephalopelvic
disproportion, previous Cesarean with vertical incision (increased risk of
rupture), placenta previa, multiple gestations (version may be done with
second twin after first is delivered), oligohydramnios, ruptured membranes,
nuchal cord, and uteroplacental insufficiency. In rare instances, placental
abruption may occur with version.
◍ s/s of pulmonary edema.
Answer: ‐ usually occurs at night, sudden onset, breathless, hypoxia,
restlessness, pink frothy sputum, tachycardia- you get flat at night so all the
fluid pools up
◍ A neonate born at 36 or more weeks gestation with moderate
hypoxemic-ischemic encephalopathy should be treated with hypothermia for
how long?a. 24 hoursb. 48 hoursc. 72 hours.
Answer: C....with induced temperatures of 33.5C/92.3F to 34.5C/94.1F for
72 hours, with the treatment initiated within 6 hours and the neonate slowly
warmed over a 4 hour period at the conclusion of the therapy. Studies show
that neonates treated with hypothermia had lower rates of neurological
impairment and lower rates of mortality than those who received alternative
treatments.
◍ If meconium-stained amniotic fluid is observed during delivery of an infant,
, the initial response should be toa. suction the infant before his/her first
breathb. evaluate the infant's respiratory statusc. suction the infant after
he/she begins breathing.
Answer: A..., before the shoulders and body are delivered if possible, to
prevent aspiration of meconium and meconium aspiration syndrome (MAS).
The severity of symptoms depends on the amount of meconium aspirated.
Thick meconium poses more or a risk than think meconium. If the neonate
aspirated meconium, the child may exhibit respiratory depression on
delivery, requiring resuscitation.
◍ For an elective Caesarean, the most important preoperative measure is to a.
determine the method of anesthesia. b. position the patient correctly. c.
confirm fetal maturity..
Answer: C...is at least 39 weeks. Confirmation may be done by (1) finding
documentation of fetal heart sounds for 30 weeks by Doppler ultrasound/20
weeks by auscultation, (2) noting a 36 wk internal since positive pregnancy
test by lab, (3) supporting gestation of at least 39 weeks by ultrasound
completed between 6-11 wks, and (4) noting clinical history and later
ultrasound that supports at least 39 weeks gestation
◍ AFP =.
Answer: AFP= PROTEIN SECRETED BY liver OF FETUS AND IS IN
VARIOUS LEVELS IF PROBLEMS EXIST***
◍ Following precipitous labor and birth, the mother is most as risk for a.
hypertension. b. hemorrhage. c. retained placenta..
Answer: B...which is defined as at least 500 mL of blood loss after vaginal
delivery or more than 1000 mL of blood loss after Cesarean. The hematocrit
may show greater than 10% change from admission values. With
hemorrhage, the patient is at increased risk for hypovolemic shock.
Immediate treatment includes providing increased intravenous fluids,
elevated feet and legs, and exploring the cause of bleeding, such as vaginal
lacerations or retained placental fragments.
◍ Folic acid/folate deficiency in the mother places the fetus at risk for a.
, hypoxic encephalopathyb. IUGRc. neural tube defects.
Answer: C...., cleft lip, and cleft palate and is more common with multiple
gestations than singleton. With folate deficiency, red blood cells enlarge
(macrocytic) instead of divide so the number of circulating blood cells
decreases. Pregnant women should take 0.4 mg daily and those at high risk
1-4 mg daily along with an iron supplement. Women with a previous infant
born with neural tube defect should take 4 mg daily for the month preceding
pregnancy and for the first trimester.
◍ Med management for DMII.
Answer: - Oral glyburide (diabeta): starts at 1.25-2.5 mg/day may increase -
metformin (glucophage): 500-1000 mg q day or BID, max dosage is 2500
mg/day, take with food as it causes GI upset, but food also helps increase
absorption
◍ A woman develops varicella in the third trimester. This increases the risk
for.
Answer: congenital varicella syndrome
◍ what causes the ductus to start closing at delivery.
Answer: When the cord is clamped, O2 levelsfall, pressure becomes greater
on left side than right and this causes the ductus to start closing!
◍ A woman is being induced at 38 weeks gestation because of abnormal
antenatal screening. What component is most concerning?.
Answer: Contraction pattern
◍ total previa.
Answer: cervical os completely covered
◍ Fetal bradycardia with variable decelerations during uterine contractions
may indicate a. placenta previa. b. abruptio placentae. c. prolapsed cord..
Answer: CIn some cases, the cord may be seen protruding from the vagina,
especially after rupture of the membranes if the presenting part is high, or
felt on digital exam. Immediate action is required to prevent fetal hypoxia.
The patient is placed in modified Sims' or knee chest position and the
, examiner inserts fingers into the vagina to hold the presenting cord off the
cord while awaiting emergent treatment, such as a Cesarean.
◍ TXA prevents breakdown of _________________.
Answer: fibrin
◍ nursing interventions for ICP.
Answer: - Encourage hydration (IVF)- Watch weight
appetite/nausea/jaundice/fatigue - Cold baths/ice water - Antihistamines -
Vitamin K often needed - Steroid treatment for mom - Liver function
testing/ALT/AST (assess right upper quadrant pain) - Fetal growth
scans/BPPs - weekly/NSTs(PTD
◍ nsg things to watch for with polyhydraminos.
Answer: placental abruption or cord prolapse with ROM
◍ A pregnant woman with pre-eclampsia who develops petechiae, hematuria,
and oozing of blood at IV insertions site, likely has a. sepsis. b.
coagulopathy. c. anemia..
Answer: B...such as disseminated intravascular coagulation (DIC). DIC is an
emergent condition that occurs secondary to another disorder, so immediate
assessment should include coagulation studies. The patient should be tilted
toward the left to increase blood flow to the uterus and should receive
oxygen and blood products. Urinary output must be monitored carefully for
signs of renal failure.
◍ s/s of appendicitis.
Answer: ‐ RT Flank Pain, Fever Rebound tenderness, N/V Contractions
sometimes Guarding‐ of the lower Right quadrants (mcBurney's pt)
◍ On the New Ballard Score for assessment of gestational age, a score of zero
(0) indicates how many weeks gestation?a. 20b. 24c. 40.
Answer: B...the gestational age at which a fetus is considered viable. Scores
range from -10 (20 weeks) to 50 (44 weeks) with each increase of 5 points
on a scale indicating 2 additional weeks of gestation, so a score of +5 is
equal to 26 weeks. The New Ballard Score assesses 6 measures of
STUDY GUIDE 2026 FULL QUESTIONS AND
SOLUTIONS GRADED A+
◍ A contraindication of external version of a fetus isa. hydramnios
(polyhydramnios)b. previous Cesarean with low transverse incisionc.
engagement of presenting part.
Answer: CVersion should only be carried out if vaginal birth is expected.
Other contraindications include a malformed uterus, cephalopelvic
disproportion, previous Cesarean with vertical incision (increased risk of
rupture), placenta previa, multiple gestations (version may be done with
second twin after first is delivered), oligohydramnios, ruptured membranes,
nuchal cord, and uteroplacental insufficiency. In rare instances, placental
abruption may occur with version.
◍ s/s of pulmonary edema.
Answer: ‐ usually occurs at night, sudden onset, breathless, hypoxia,
restlessness, pink frothy sputum, tachycardia- you get flat at night so all the
fluid pools up
◍ A neonate born at 36 or more weeks gestation with moderate
hypoxemic-ischemic encephalopathy should be treated with hypothermia for
how long?a. 24 hoursb. 48 hoursc. 72 hours.
Answer: C....with induced temperatures of 33.5C/92.3F to 34.5C/94.1F for
72 hours, with the treatment initiated within 6 hours and the neonate slowly
warmed over a 4 hour period at the conclusion of the therapy. Studies show
that neonates treated with hypothermia had lower rates of neurological
impairment and lower rates of mortality than those who received alternative
treatments.
◍ If meconium-stained amniotic fluid is observed during delivery of an infant,
, the initial response should be toa. suction the infant before his/her first
breathb. evaluate the infant's respiratory statusc. suction the infant after
he/she begins breathing.
Answer: A..., before the shoulders and body are delivered if possible, to
prevent aspiration of meconium and meconium aspiration syndrome (MAS).
The severity of symptoms depends on the amount of meconium aspirated.
Thick meconium poses more or a risk than think meconium. If the neonate
aspirated meconium, the child may exhibit respiratory depression on
delivery, requiring resuscitation.
◍ For an elective Caesarean, the most important preoperative measure is to a.
determine the method of anesthesia. b. position the patient correctly. c.
confirm fetal maturity..
Answer: C...is at least 39 weeks. Confirmation may be done by (1) finding
documentation of fetal heart sounds for 30 weeks by Doppler ultrasound/20
weeks by auscultation, (2) noting a 36 wk internal since positive pregnancy
test by lab, (3) supporting gestation of at least 39 weeks by ultrasound
completed between 6-11 wks, and (4) noting clinical history and later
ultrasound that supports at least 39 weeks gestation
◍ AFP =.
Answer: AFP= PROTEIN SECRETED BY liver OF FETUS AND IS IN
VARIOUS LEVELS IF PROBLEMS EXIST***
◍ Following precipitous labor and birth, the mother is most as risk for a.
hypertension. b. hemorrhage. c. retained placenta..
Answer: B...which is defined as at least 500 mL of blood loss after vaginal
delivery or more than 1000 mL of blood loss after Cesarean. The hematocrit
may show greater than 10% change from admission values. With
hemorrhage, the patient is at increased risk for hypovolemic shock.
Immediate treatment includes providing increased intravenous fluids,
elevated feet and legs, and exploring the cause of bleeding, such as vaginal
lacerations or retained placental fragments.
◍ Folic acid/folate deficiency in the mother places the fetus at risk for a.
, hypoxic encephalopathyb. IUGRc. neural tube defects.
Answer: C...., cleft lip, and cleft palate and is more common with multiple
gestations than singleton. With folate deficiency, red blood cells enlarge
(macrocytic) instead of divide so the number of circulating blood cells
decreases. Pregnant women should take 0.4 mg daily and those at high risk
1-4 mg daily along with an iron supplement. Women with a previous infant
born with neural tube defect should take 4 mg daily for the month preceding
pregnancy and for the first trimester.
◍ Med management for DMII.
Answer: - Oral glyburide (diabeta): starts at 1.25-2.5 mg/day may increase -
metformin (glucophage): 500-1000 mg q day or BID, max dosage is 2500
mg/day, take with food as it causes GI upset, but food also helps increase
absorption
◍ A woman develops varicella in the third trimester. This increases the risk
for.
Answer: congenital varicella syndrome
◍ what causes the ductus to start closing at delivery.
Answer: When the cord is clamped, O2 levelsfall, pressure becomes greater
on left side than right and this causes the ductus to start closing!
◍ A woman is being induced at 38 weeks gestation because of abnormal
antenatal screening. What component is most concerning?.
Answer: Contraction pattern
◍ total previa.
Answer: cervical os completely covered
◍ Fetal bradycardia with variable decelerations during uterine contractions
may indicate a. placenta previa. b. abruptio placentae. c. prolapsed cord..
Answer: CIn some cases, the cord may be seen protruding from the vagina,
especially after rupture of the membranes if the presenting part is high, or
felt on digital exam. Immediate action is required to prevent fetal hypoxia.
The patient is placed in modified Sims' or knee chest position and the
, examiner inserts fingers into the vagina to hold the presenting cord off the
cord while awaiting emergent treatment, such as a Cesarean.
◍ TXA prevents breakdown of _________________.
Answer: fibrin
◍ nursing interventions for ICP.
Answer: - Encourage hydration (IVF)- Watch weight
appetite/nausea/jaundice/fatigue - Cold baths/ice water - Antihistamines -
Vitamin K often needed - Steroid treatment for mom - Liver function
testing/ALT/AST (assess right upper quadrant pain) - Fetal growth
scans/BPPs - weekly/NSTs(PTD
◍ nsg things to watch for with polyhydraminos.
Answer: placental abruption or cord prolapse with ROM
◍ A pregnant woman with pre-eclampsia who develops petechiae, hematuria,
and oozing of blood at IV insertions site, likely has a. sepsis. b.
coagulopathy. c. anemia..
Answer: B...such as disseminated intravascular coagulation (DIC). DIC is an
emergent condition that occurs secondary to another disorder, so immediate
assessment should include coagulation studies. The patient should be tilted
toward the left to increase blood flow to the uterus and should receive
oxygen and blood products. Urinary output must be monitored carefully for
signs of renal failure.
◍ s/s of appendicitis.
Answer: ‐ RT Flank Pain, Fever Rebound tenderness, N/V Contractions
sometimes Guarding‐ of the lower Right quadrants (mcBurney's pt)
◍ On the New Ballard Score for assessment of gestational age, a score of zero
(0) indicates how many weeks gestation?a. 20b. 24c. 40.
Answer: B...the gestational age at which a fetus is considered viable. Scores
range from -10 (20 weeks) to 50 (44 weeks) with each increase of 5 points
on a scale indicating 2 additional weeks of gestation, so a score of +5 is
equal to 26 weeks. The New Ballard Score assesses 6 measures of
