Advanced RNC-OB (Inpatient Obstetric
Nursing) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Professional Certification Exams
1. A laboring patient at 39 weeks' gestation develops recurrent late decelerations with
minimal variability despite maternal repositioning. The nurse's priority action is to:
A. Encourage pushing efforts during contractions
B. Increase oxytocin infusion
C. Perform a vaginal examination to assess cervical dilation
D. Discontinue oxytocin and administer intrauterine resuscitative measures
Explanation: Recurrent late decelerations with minimal variability suggest uteroplacental
insufficiency and possible fetal hypoxia. The priority is to stop oxytocin and initiate interventions
such as maternal repositioning, oxygen administration if indicated, and IV fluid bolus to
improve fetal oxygenation.
2. A postpartum patient experiences excessive bleeding and a boggy uterus. Which
intervention should the nurse implement first?
A. Obtain a complete blood count
B. Prepare the patient for surgery
C. Perform fundal massage
D. Insert a urinary catheter
Explanation: Uterine atony is the most common cause of postpartum hemorrhage. Immediate
fundal massage stimulates uterine contraction and is the initial intervention to reduce bleeding.
3. A patient with severe preeclampsia receiving magnesium sulfate develops absent deep
tendon reflexes and a respiratory rate of 10 breaths/min. Which medication should the
nurse anticipate administering?
A. Terbutaline
B. Oxytocin
, C. Naloxone
D. Calcium gluconate
Explanation: Magnesium toxicity is characterized by diminished reflexes and respiratory
depression. Calcium gluconate is the antidote and should be readily available whenever
magnesium sulfate is administered.
4. During labor, the fetal monitor demonstrates variable decelerations associated with
contractions. Which etiology is most likely?
A. Maternal hypotension
B. Placental insufficiency
C. Umbilical cord compression
D. Fetal congenital anomaly
Explanation: Variable decelerations are abrupt decreases in fetal heart rate caused primarily by
umbilical cord compression and require assessment for severity and recurrence.
5. A patient at 32 weeks' gestation reports painless vaginal bleeding. Which condition
should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Vasa previa
D. Placenta previa
Explanation: Placenta previa classically presents with painless bright-red bleeding during the
second or third trimester, whereas placental abruption typically causes painful bleeding.
6. A multiparous woman with a history of rapid deliveries presents with contractions every
2 minutes. Which nursing action is most appropriate?
A. Delay cervical assessment until physician arrival
B. Encourage ambulation
C. Prepare for imminent birth
D. Administer tocolytics
Nursing) Multiple Choice Questions (MCQs)
with Answers and Explanations for
Professional Certification Exams
1. A laboring patient at 39 weeks' gestation develops recurrent late decelerations with
minimal variability despite maternal repositioning. The nurse's priority action is to:
A. Encourage pushing efforts during contractions
B. Increase oxytocin infusion
C. Perform a vaginal examination to assess cervical dilation
D. Discontinue oxytocin and administer intrauterine resuscitative measures
Explanation: Recurrent late decelerations with minimal variability suggest uteroplacental
insufficiency and possible fetal hypoxia. The priority is to stop oxytocin and initiate interventions
such as maternal repositioning, oxygen administration if indicated, and IV fluid bolus to
improve fetal oxygenation.
2. A postpartum patient experiences excessive bleeding and a boggy uterus. Which
intervention should the nurse implement first?
A. Obtain a complete blood count
B. Prepare the patient for surgery
C. Perform fundal massage
D. Insert a urinary catheter
Explanation: Uterine atony is the most common cause of postpartum hemorrhage. Immediate
fundal massage stimulates uterine contraction and is the initial intervention to reduce bleeding.
3. A patient with severe preeclampsia receiving magnesium sulfate develops absent deep
tendon reflexes and a respiratory rate of 10 breaths/min. Which medication should the
nurse anticipate administering?
A. Terbutaline
B. Oxytocin
, C. Naloxone
D. Calcium gluconate
Explanation: Magnesium toxicity is characterized by diminished reflexes and respiratory
depression. Calcium gluconate is the antidote and should be readily available whenever
magnesium sulfate is administered.
4. During labor, the fetal monitor demonstrates variable decelerations associated with
contractions. Which etiology is most likely?
A. Maternal hypotension
B. Placental insufficiency
C. Umbilical cord compression
D. Fetal congenital anomaly
Explanation: Variable decelerations are abrupt decreases in fetal heart rate caused primarily by
umbilical cord compression and require assessment for severity and recurrence.
5. A patient at 32 weeks' gestation reports painless vaginal bleeding. Which condition
should the nurse suspect?
A. Placental abruption
B. Uterine rupture
C. Vasa previa
D. Placenta previa
Explanation: Placenta previa classically presents with painless bright-red bleeding during the
second or third trimester, whereas placental abruption typically causes painful bleeding.
6. A multiparous woman with a history of rapid deliveries presents with contractions every
2 minutes. Which nursing action is most appropriate?
A. Delay cervical assessment until physician arrival
B. Encourage ambulation
C. Prepare for imminent birth
D. Administer tocolytics
