RNC-OB COMPREHENSIVE STUDY GUIDE
2026 FULL QUESTIONS AND SOLUTIONS
GRADED A+
◍ Chlamydia.
Answer: -A bacterial infection that affects the reproductive organs of both
males and females (oral, vaginal, anal routes)- s/s: mucus discharge,
salpingitis, inflamed cervix, risk for pp endometritis, burning with urination
- tx: Azithromax 7 day oral or 1g IM- retest in 2 weeks- must wait 7 days to
have sex and treat partner
◍ why are there increased risks for appendicitis in pregnacy?.
Answer: Increase risk due to constipation, enlarging uterus,
progesterone>>> fecal material lodges in appendix be progesterone makes
everything relax
◍ 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.
◍ A symmetrical deceleration with a gradually decreasing fetal heart rate and
return to baseline over at least 30 seconds in response to uterine contractions
, with the deceleration nadir occurring at the peak of the contraction is a. a
late deceleration b. an early deceleration c. a variable deceleration.
Answer: BLate decelerations: similar parameters but the nadir of the
deceleration occurs after the peak of the uterine contraction.Variable
deceleration: sudden decrease in heart rate lasting less than 30 seconds that
may or may not be associated with uterine contractions with the heart rate
decreasing by at least 15 bpm for at least 15 seconds but less than 2
minutes.Prolonged decelerations: lasts at least 2 minutes but less than 10
minutes
◍ most concerning parameters of BPP scoring.
Answer: Fluid is concerning and lack of tone is MOST concerning
◍ Why does GDM happen.
Answer: The demand for insulin production by maternal pancreas increases
2-3 times more than normal in pregnancy. If the demands can't be met, then
you have Gdm
◍ If the mother is Rh- and the father Rh+, what are the odds that the fetus will
be Rh+? a. 25% b. 50% c. 100%.
Answer: C...because every fetus will receive the Rh+ antigen from the father
who provides half of the genetic makeup. With a first pregnancy, typically
the fetus develops no problems because antibodies have not yet formed
against the Rh+ antigen, but subsequent pregnancies are at high risk for the
development of erythroblastosis fetalis, a hemolytic disease, unless the
mother receives RhoGAM (Rh immune globulin) during the first pregnancy
at 28 weeks gestation and within 3 days after delivery.
◍ risks for HG.
Answer: twins, molar pregnancy
◍ causes of PROM/PPROM.
Answer: Prior PTDPolyhydramniosPost
AmniocentesisMultiplesIncompetent Cervixinfection
◍ what can cause a false positive L/S.
, Answer: diabetic momsContaminated amniotic fluidErythroblastosis
fetalisPlacental/fetal disordersBloody amniocentesis (RBCs in fluid)
◍ In the postpartal period, marked edema and severe bruising on one side of
the episiotomy with severe pain in the perineal area and severe rectal
pressure probably indicatesa. vulval hematomab. episiotomy infectionc. soft
tissue trauma.
Answer: ATypically, the risk of hematoma decreases with an episiotomy,
but if a vessel is leaking, the hematoma may occur as blood pools in the
tissue. Treatment includes incision and drainage and ligation of drainage. In
some cases, a drainage tube may be left in place temporarily.
◍ nursing notes for PUBS.
Answer: - watch for PTL‐‐‐‐ note if blood is from vein or artery for
acid/base analysis- RP US in one hour/bleeding and hematoma formation
◍ how do the organs compensate inhydrops?.
Answer: Organs compensate by making more RBCs which leads to organ
failure in liver, kidneys and eventually heart failure‐ (from anemia)
◍ A vaginal pH of 7.2 probably indicates the presence of a. inconclusive
results. b. vaginal fluid. c. amniotic fluid..
Answer: CNormal vaginal fluid is more acidic with pH ranging from 4.5-5.5
while amniotic fluid is more alkaline with pH ranging from 7.0-7.5.
However, blood has a pH that is similar to that of amniotic fluid and semen
is highly alkaline, so the presence of either of these two substances may
produce a pH that is suggestive of amniotic fluid.
◍ loading dose and maintence dose of mag.
Answer: load 4-6 gm/hr, maintenance 2-4 gm/hr
◍ Glucola Screening Test.
Answer: Screen at 24-28 weeks (earlier if risk factors)Ultimate diagnosis
with 2 abnormal lab results in 3 hour gtt50 gm load oral glucose, 1 hr <140,
if >140, do 3 hr gtt 3 hr gtt = load with 100 gm oral glucose- fasting <95- 1
hr: <180- 2 hr: <155- 3 hr: < 140
, ◍ Methadone/Subutex NAS withdrawal symptoms start.
Answer: 1-3 weeks
◍ Who should not breastfeed:.
Answer: - Mothers receiving chemotherapy/radiation- Infant galactosemia‐
can't break down galactose‐ causing diarrhea/vomiting/weight loss/failure to
thrive- TB moms- Herpes simplex lesions on breast‐ (can only feed on
non‐lesion breast)
◍ meds that decrease effectiveness of OCP:.
Answer: ‐‐ANTIBIOTICS‐ PCN/Tetracycline‐‐ST. Johns Wort (herbal
plant, Tx depression)**‐‐Rifampin (TB TX)‐‐Anticonvulsants‐Dilantin and
Tegretol , phenobarbital
◍ muscle tone scoring in BPP.
Answer: 1 or more flex and extend movement arms, legs, hands
◍ Rule of Thumb US Accuracy:.
Answer: 1st trimester= +/‐ 1 week 2nd trimester= +/‐ 2 weeks3rd trimester=
+/‐3 weeks
◍ Bloody show is an indication of a. extrusion of mucus from endocervical
glands b. placental separation c. maternal bleeding because of alterations in
coagulation.
Answer: A...with blood loss from cervical capillaries, often referred to as a
mucus plug. Bloody show often occurs late in pregnancy after effacement
has begun and may occur prior to the onset of true labor; bloody show is
usually followed by labor within 24-48 hours. Blood-tinged discharge,
usually brownish in color, noted on vaginal exam should not be confused
with bloody show.
◍ funic prolapse.
Answer: ‐Cord is ahead of presenting part
◍ What does IV insulin lead to.
Answer: Hypoglycemia and hypokalemia
2026 FULL QUESTIONS AND SOLUTIONS
GRADED A+
◍ Chlamydia.
Answer: -A bacterial infection that affects the reproductive organs of both
males and females (oral, vaginal, anal routes)- s/s: mucus discharge,
salpingitis, inflamed cervix, risk for pp endometritis, burning with urination
- tx: Azithromax 7 day oral or 1g IM- retest in 2 weeks- must wait 7 days to
have sex and treat partner
◍ why are there increased risks for appendicitis in pregnacy?.
Answer: Increase risk due to constipation, enlarging uterus,
progesterone>>> fecal material lodges in appendix be progesterone makes
everything relax
◍ 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.
◍ A symmetrical deceleration with a gradually decreasing fetal heart rate and
return to baseline over at least 30 seconds in response to uterine contractions
, with the deceleration nadir occurring at the peak of the contraction is a. a
late deceleration b. an early deceleration c. a variable deceleration.
Answer: BLate decelerations: similar parameters but the nadir of the
deceleration occurs after the peak of the uterine contraction.Variable
deceleration: sudden decrease in heart rate lasting less than 30 seconds that
may or may not be associated with uterine contractions with the heart rate
decreasing by at least 15 bpm for at least 15 seconds but less than 2
minutes.Prolonged decelerations: lasts at least 2 minutes but less than 10
minutes
◍ most concerning parameters of BPP scoring.
Answer: Fluid is concerning and lack of tone is MOST concerning
◍ Why does GDM happen.
Answer: The demand for insulin production by maternal pancreas increases
2-3 times more than normal in pregnancy. If the demands can't be met, then
you have Gdm
◍ If the mother is Rh- and the father Rh+, what are the odds that the fetus will
be Rh+? a. 25% b. 50% c. 100%.
Answer: C...because every fetus will receive the Rh+ antigen from the father
who provides half of the genetic makeup. With a first pregnancy, typically
the fetus develops no problems because antibodies have not yet formed
against the Rh+ antigen, but subsequent pregnancies are at high risk for the
development of erythroblastosis fetalis, a hemolytic disease, unless the
mother receives RhoGAM (Rh immune globulin) during the first pregnancy
at 28 weeks gestation and within 3 days after delivery.
◍ risks for HG.
Answer: twins, molar pregnancy
◍ causes of PROM/PPROM.
Answer: Prior PTDPolyhydramniosPost
AmniocentesisMultiplesIncompetent Cervixinfection
◍ what can cause a false positive L/S.
, Answer: diabetic momsContaminated amniotic fluidErythroblastosis
fetalisPlacental/fetal disordersBloody amniocentesis (RBCs in fluid)
◍ In the postpartal period, marked edema and severe bruising on one side of
the episiotomy with severe pain in the perineal area and severe rectal
pressure probably indicatesa. vulval hematomab. episiotomy infectionc. soft
tissue trauma.
Answer: ATypically, the risk of hematoma decreases with an episiotomy,
but if a vessel is leaking, the hematoma may occur as blood pools in the
tissue. Treatment includes incision and drainage and ligation of drainage. In
some cases, a drainage tube may be left in place temporarily.
◍ nursing notes for PUBS.
Answer: - watch for PTL‐‐‐‐ note if blood is from vein or artery for
acid/base analysis- RP US in one hour/bleeding and hematoma formation
◍ how do the organs compensate inhydrops?.
Answer: Organs compensate by making more RBCs which leads to organ
failure in liver, kidneys and eventually heart failure‐ (from anemia)
◍ A vaginal pH of 7.2 probably indicates the presence of a. inconclusive
results. b. vaginal fluid. c. amniotic fluid..
Answer: CNormal vaginal fluid is more acidic with pH ranging from 4.5-5.5
while amniotic fluid is more alkaline with pH ranging from 7.0-7.5.
However, blood has a pH that is similar to that of amniotic fluid and semen
is highly alkaline, so the presence of either of these two substances may
produce a pH that is suggestive of amniotic fluid.
◍ loading dose and maintence dose of mag.
Answer: load 4-6 gm/hr, maintenance 2-4 gm/hr
◍ Glucola Screening Test.
Answer: Screen at 24-28 weeks (earlier if risk factors)Ultimate diagnosis
with 2 abnormal lab results in 3 hour gtt50 gm load oral glucose, 1 hr <140,
if >140, do 3 hr gtt 3 hr gtt = load with 100 gm oral glucose- fasting <95- 1
hr: <180- 2 hr: <155- 3 hr: < 140
, ◍ Methadone/Subutex NAS withdrawal symptoms start.
Answer: 1-3 weeks
◍ Who should not breastfeed:.
Answer: - Mothers receiving chemotherapy/radiation- Infant galactosemia‐
can't break down galactose‐ causing diarrhea/vomiting/weight loss/failure to
thrive- TB moms- Herpes simplex lesions on breast‐ (can only feed on
non‐lesion breast)
◍ meds that decrease effectiveness of OCP:.
Answer: ‐‐ANTIBIOTICS‐ PCN/Tetracycline‐‐ST. Johns Wort (herbal
plant, Tx depression)**‐‐Rifampin (TB TX)‐‐Anticonvulsants‐Dilantin and
Tegretol , phenobarbital
◍ muscle tone scoring in BPP.
Answer: 1 or more flex and extend movement arms, legs, hands
◍ Rule of Thumb US Accuracy:.
Answer: 1st trimester= +/‐ 1 week 2nd trimester= +/‐ 2 weeks3rd trimester=
+/‐3 weeks
◍ Bloody show is an indication of a. extrusion of mucus from endocervical
glands b. placental separation c. maternal bleeding because of alterations in
coagulation.
Answer: A...with blood loss from cervical capillaries, often referred to as a
mucus plug. Bloody show often occurs late in pregnancy after effacement
has begun and may occur prior to the onset of true labor; bloody show is
usually followed by labor within 24-48 hours. Blood-tinged discharge,
usually brownish in color, noted on vaginal exam should not be confused
with bloody show.
◍ funic prolapse.
Answer: ‐Cord is ahead of presenting part
◍ What does IV insulin lead to.
Answer: Hypoglycemia and hypokalemia
