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RNC-OB (INPATIENT OBSTETRIC NURSING
CERTIFICATION) QUESTIONS WITH
VERIFIED SOLUTIONS AND RATIONALES
2026/2027
1. Which of the following findings in a laboring patient at 39 weeks gestation
requires immediate intervention?
A. Fetal heart rate baseline of 140 bpm with moderate variability
B. Contractions every 3 minutes lasting 60 seconds
C. Prolonged deceleration lasting 3 minutes
D. Maternal report of back pain during contractions
Correct Answer: C
Rationale: A prolonged deceleration is a deceleration lasting 2 minutes or longer
but less than 10 minutes. This is a Category II or III tracing requiring intrauterine
resuscitation and immediate evaluation because it may indicate cord
compression, placental insufficiency, or impending fetal acidosis.
2. A patient at 41 weeks gestation is undergoing a biophysical profile (BPP). Which
combination of findings would result in a score of 8/10?
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A. Reactive NST, fetal breathing movements, fetal tone, and amniotic fluid pocket
of 3 cm
B. Non-reactive NST, fetal breathing movements, fetal tone, and amniotic fluid
pocket of 2 cm
C. Reactive NST, absent fetal breathing, fetal tone, and amniotic fluid pocket of 1
cm
D. Non-reactive NST, absent fetal breathing, absent fetal tone, and amniotic fluid
pocket of 4 cm
Correct Answer: A
Rationale: The BPP assesses five components: NST, fetal breathing movements,
fetal tone, fetal movement, and amniotic fluid volume. Each component scores 2
points if normal or 0 if abnormal. A score of 8/10 means one component is
abnormal or equivocal. Option A has a reactive NST (2), fetal breathing (2), fetal
tone (2), and amniotic fluid pocket of 3 cm (2) = 8. Fetal movement is the missing
component.
3. A patient receiving oxytocin for induction has contractions every 2 minutes
lasting 70 seconds with a fetal heart rate baseline of 170 bpm. What is the nurse's
priority action?
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A. Continue oxytocin and increase IV fluids
B. Discontinue oxytocin and administer oxygen
C. Document and reassess in 30 minutes
D. Increase oxytocin to strengthen contractions
Correct Answer: B
Rationale: This patient has tachysystole (more than 5 contractions in 10 minutes)
with fetal tachycardia. The priority is to discontinue oxytocin, administer oxygen,
reposition the patient, and increase IV fluids. Uterine hyperstimulation can cause
fetal hypoxia.
4. Which Bishop score indicates a favorable cervix for induction in a nulliparous
patient?
A. Score of 3
B. Score of 5
C. Score of 7
D. Score of 9
Correct Answer: D
Rationale: A Bishop score of 8 or greater is considered favorable for induction in
nulliparous patients. For multiparous patients, a score of 5 or greater may be
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considered favorable. A higher score indicates a more favorable cervix for
successful induction.
5. A patient at 36 weeks gestation presents with painless, bright red vaginal
bleeding. Which diagnosis should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption typically presents
with painful bleeding and a tense, tender uterus. Vasa previa presents with
bleeding at membrane rupture and fetal distress.
6. A patient with preeclampsia is receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Respiratory rate of 16 breaths per minute
B. Deep tendon reflexes 2+
RNC-OB (INPATIENT OBSTETRIC NURSING
CERTIFICATION) QUESTIONS WITH
VERIFIED SOLUTIONS AND RATIONALES
2026/2027
1. Which of the following findings in a laboring patient at 39 weeks gestation
requires immediate intervention?
A. Fetal heart rate baseline of 140 bpm with moderate variability
B. Contractions every 3 minutes lasting 60 seconds
C. Prolonged deceleration lasting 3 minutes
D. Maternal report of back pain during contractions
Correct Answer: C
Rationale: A prolonged deceleration is a deceleration lasting 2 minutes or longer
but less than 10 minutes. This is a Category II or III tracing requiring intrauterine
resuscitation and immediate evaluation because it may indicate cord
compression, placental insufficiency, or impending fetal acidosis.
2. A patient at 41 weeks gestation is undergoing a biophysical profile (BPP). Which
combination of findings would result in a score of 8/10?
,2|Page
A. Reactive NST, fetal breathing movements, fetal tone, and amniotic fluid pocket
of 3 cm
B. Non-reactive NST, fetal breathing movements, fetal tone, and amniotic fluid
pocket of 2 cm
C. Reactive NST, absent fetal breathing, fetal tone, and amniotic fluid pocket of 1
cm
D. Non-reactive NST, absent fetal breathing, absent fetal tone, and amniotic fluid
pocket of 4 cm
Correct Answer: A
Rationale: The BPP assesses five components: NST, fetal breathing movements,
fetal tone, fetal movement, and amniotic fluid volume. Each component scores 2
points if normal or 0 if abnormal. A score of 8/10 means one component is
abnormal or equivocal. Option A has a reactive NST (2), fetal breathing (2), fetal
tone (2), and amniotic fluid pocket of 3 cm (2) = 8. Fetal movement is the missing
component.
3. A patient receiving oxytocin for induction has contractions every 2 minutes
lasting 70 seconds with a fetal heart rate baseline of 170 bpm. What is the nurse's
priority action?
,3|Page
A. Continue oxytocin and increase IV fluids
B. Discontinue oxytocin and administer oxygen
C. Document and reassess in 30 minutes
D. Increase oxytocin to strengthen contractions
Correct Answer: B
Rationale: This patient has tachysystole (more than 5 contractions in 10 minutes)
with fetal tachycardia. The priority is to discontinue oxytocin, administer oxygen,
reposition the patient, and increase IV fluids. Uterine hyperstimulation can cause
fetal hypoxia.
4. Which Bishop score indicates a favorable cervix for induction in a nulliparous
patient?
A. Score of 3
B. Score of 5
C. Score of 7
D. Score of 9
Correct Answer: D
Rationale: A Bishop score of 8 or greater is considered favorable for induction in
nulliparous patients. For multiparous patients, a score of 5 or greater may be
, 4|Page
considered favorable. A higher score indicates a more favorable cervix for
successful induction.
5. A patient at 36 weeks gestation presents with painless, bright red vaginal
bleeding. Which diagnosis should the nurse suspect?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Correct Answer: B
Rationale: Placenta previa classically presents with painless, bright red vaginal
bleeding in the second or third trimester. Placental abruption typically presents
with painful bleeding and a tense, tender uterus. Vasa previa presents with
bleeding at membrane rupture and fetal distress.
6. A patient with preeclampsia is receiving magnesium sulfate. Which assessment
finding indicates magnesium toxicity requiring immediate intervention?
A. Respiratory rate of 16 breaths per minute
B. Deep tendon reflexes 2+
