RNC-OB EXAM 2025 UPDATE QUESTIONS AND CORRECT VERIFIED
ANSWERS ALREADY GRADED A+ (BRAND NEW VISION)
If a patient is to receive general anesthesia for emergency cesarean, the patient should first be
administered
a. liquid antacid
b. an opioid
c. a barbiturate - answersA
...often a nonparticulate (clear) antacid, such as sodium citrate, to neutralize stomach acid.
Additionally, some patients may also receive medication, such as an H2-receptor blocker, in
order to decrease production of stomach acid and/or metoclopramide to increase the
emptying rate of gastric contents. Cricoid pressure may be applied prior to incubation to
reduce the risk of vomiting and aspiration.
If utilizing HypnoBirthing during labor and delivery, an important element of "breathing the
baby down" is
a. relaxing
b. verbalizing
c. visualizing - answersC
The patient inhales and then, while exhaling, tips the pelvis up and gently bears down while
visualizing energy flowing toward the fetus and the vagina opening. HypnoBirthing is a
natural childbirth method that utilizes self-hypnosis to reduce stress and anxiety during
childbirth. The patient uses a variety of relaxation and breathing techniques, and the partner
supports the patient with therapeutic touch and prompts.
A patient who survived the acute stages of amniotic fluid embolism (anaphylactoid syndrome of
pregnancy) with disseminated intravascular coagulation (DIC) is at increased risk for
a. left heart failure and neurological impairment
b. right heart failure and liver failure
,c. left heart failure and renal insufficiency - answersA
...because left heart failure often occurs after other symptoms, and almost all patients who
survive have some degree of neurological damage. Amniotic fluid embolism is characterized
by sudden acute hypotension and/or cardiac arrest, hypoxia, and coagulopathy/hemorrhage
(DIC) without other cause occurring during labor, assisted delivery, or cesarean, and up to a
half hour postpartum.
Low amplitude, irregular uterine contractions resulting in less than 1 cm dilation per hour, and
arrest of progress for more than 2 hours often results from
a. hypertonic contractions
b. hypotonic contractions
c. macrosomia - answersB
Treatment includes administration of oxytocin and/or amniotomy (if membranes remain
intact) after assessment to ensure that cephalopelvic disproportion (CPD) or malpresentation
is not present. The cause of hypotonic uterine contractions is not clear, but familial tendencies
exist so genetic factors may play a role. Hypotonic uterine contractions are more common in
patients older than 25 years.
Complications associated with maternal obesity in the labor process include
a. maternal hypotension, uterine rupture and lacerations
b. prolonged second stage of labor, fetal macrosomia and maternal hypertension
c. meconium aspiration and maternal hemorrhage - answersB
The obese mother is at increased risk of developing gestational diabetes and hypertension.
The second stage of labor is often prolonged because the myometrium is overstretched.
Additionally, labor is difficult and associated with macrosomia and shoulder dystocia, which
can cause permanent brachial plexus injury in the newborn. Because of excessive fatty tissue
in the abdomen, monitoring of fetal heart rate and contractions may be difficult. During labor
and delivery, the woman is at increased risk of uterine rupture and lacerations.
The twin pregnancy in which the fetuses are most at risk is
,a. monozygotic, monochorionic/monoamniotic
b. monozygotic, dichorionic/diamniotic
c. dizygotic - answersA
mono/mono twins which includes only 2% of twin monozygotic pregnancies. With this type of
twin pregnancy, which carries a mortality rate of more than 50%, the zygote division occurs
late, 9-13 days after fertilization. In di/di twins (30% of monozygotic twins) the division occurs
at 72 hours after fertilization. With mono/di twins (68% of monozygotic twins), division occurs
4-8 days after fertilization. Dizygotic twins (67% of all twins) develop from two ova and are
fraternal rather than identical.
If a vanishing twin is noted in the first trimester, the pregnancy is considered
a. high risk
b. normal
c. aborted - answersB
The vanishing twin syndrome results from miscarriage of one fetus with the tissue absorbed
by the mother or the other fetus and occurs in up to 30% of twin pregnancies. The patient
may or may not have indications of miscarriage (cramping, bleeding) when one twin dies. If
the vanishing twin occurs in the second or third trimester, the pregnancy is considered high
risk, and the remaining twin is at risk for cerebral palsy.
A 32 week pregnant patient with sudden onset of severe lower abdominal pain and tenderness,
vaginal bleeding, tachycardia, hypotension, and fetal bradycardia probably indicates
a. placenta previa
b. uterine rupture
c. abruptio placentae - answersC
...as these are typical symptoms although pain and tenderness are absent in some patients.
About 70% with abruptio placentae present with vaginal bleeding. Pain may be localized or
diffuse. In some cases, blood accumulates between the placenta and the myometrium
(Couvelaire uterus), resulting in ecchymosis, discoloration of the uterus,and loss of
contractility.
, Hypotension with a positive Cullen sign (ecchymosis about umbilicus) and shoulder pain may
indicate
a. ruptured uterus
b. ruptured ectopic pregnancy
c. spontaneous abortion - answersB
The hypotension occurs because of blood loss, and blood in the perineal cavity causes
irritation of the diaphragm and referred pain to the shoulder area as well as the ecchymosis
about the umbilicus. While an unruptured ectopic pregnancy often causes pain, the pain
increases with rupture and may vary in intensity and site, with some patients complaining of
pain in the lower abdomen and some with unilateral or generalized abdominal pain
Preterm labor is defined as onset of labor before
a. 35 weeks
b. 37 weeks
c. 39 weeks - answersB
...with cervical change and uterine contractions during weeks 20-36. Most infant deaths (more
than 75%) associated with preterm labor and birth occur in infants who are fewer than 32
weeks gestation. Risk factors for preterm labor include maternal age younger than 17 or older
than 35 years, non-white race, lower economic status, and lower educational status. Patients
with previous preterm labor or birth or who have undergone second trimester abortions or had
stillbirths are also at increased risk.
The most significant risk factor for uterine rupture is
a. macrosomia
b. multiple gestation
c. previous cesarean - answersC
Uterine rupture extends through the wall of the uterus and the visceral peritoneum, resulting in
extensive bleeding and can include expulsion of the fetus and placenta into the abdominal
cavity. Treatment includes immediate cesarean delivery and usually requires hysterectomy. In
ANSWERS ALREADY GRADED A+ (BRAND NEW VISION)
If a patient is to receive general anesthesia for emergency cesarean, the patient should first be
administered
a. liquid antacid
b. an opioid
c. a barbiturate - answersA
...often a nonparticulate (clear) antacid, such as sodium citrate, to neutralize stomach acid.
Additionally, some patients may also receive medication, such as an H2-receptor blocker, in
order to decrease production of stomach acid and/or metoclopramide to increase the
emptying rate of gastric contents. Cricoid pressure may be applied prior to incubation to
reduce the risk of vomiting and aspiration.
If utilizing HypnoBirthing during labor and delivery, an important element of "breathing the
baby down" is
a. relaxing
b. verbalizing
c. visualizing - answersC
The patient inhales and then, while exhaling, tips the pelvis up and gently bears down while
visualizing energy flowing toward the fetus and the vagina opening. HypnoBirthing is a
natural childbirth method that utilizes self-hypnosis to reduce stress and anxiety during
childbirth. The patient uses a variety of relaxation and breathing techniques, and the partner
supports the patient with therapeutic touch and prompts.
A patient who survived the acute stages of amniotic fluid embolism (anaphylactoid syndrome of
pregnancy) with disseminated intravascular coagulation (DIC) is at increased risk for
a. left heart failure and neurological impairment
b. right heart failure and liver failure
,c. left heart failure and renal insufficiency - answersA
...because left heart failure often occurs after other symptoms, and almost all patients who
survive have some degree of neurological damage. Amniotic fluid embolism is characterized
by sudden acute hypotension and/or cardiac arrest, hypoxia, and coagulopathy/hemorrhage
(DIC) without other cause occurring during labor, assisted delivery, or cesarean, and up to a
half hour postpartum.
Low amplitude, irregular uterine contractions resulting in less than 1 cm dilation per hour, and
arrest of progress for more than 2 hours often results from
a. hypertonic contractions
b. hypotonic contractions
c. macrosomia - answersB
Treatment includes administration of oxytocin and/or amniotomy (if membranes remain
intact) after assessment to ensure that cephalopelvic disproportion (CPD) or malpresentation
is not present. The cause of hypotonic uterine contractions is not clear, but familial tendencies
exist so genetic factors may play a role. Hypotonic uterine contractions are more common in
patients older than 25 years.
Complications associated with maternal obesity in the labor process include
a. maternal hypotension, uterine rupture and lacerations
b. prolonged second stage of labor, fetal macrosomia and maternal hypertension
c. meconium aspiration and maternal hemorrhage - answersB
The obese mother is at increased risk of developing gestational diabetes and hypertension.
The second stage of labor is often prolonged because the myometrium is overstretched.
Additionally, labor is difficult and associated with macrosomia and shoulder dystocia, which
can cause permanent brachial plexus injury in the newborn. Because of excessive fatty tissue
in the abdomen, monitoring of fetal heart rate and contractions may be difficult. During labor
and delivery, the woman is at increased risk of uterine rupture and lacerations.
The twin pregnancy in which the fetuses are most at risk is
,a. monozygotic, monochorionic/monoamniotic
b. monozygotic, dichorionic/diamniotic
c. dizygotic - answersA
mono/mono twins which includes only 2% of twin monozygotic pregnancies. With this type of
twin pregnancy, which carries a mortality rate of more than 50%, the zygote division occurs
late, 9-13 days after fertilization. In di/di twins (30% of monozygotic twins) the division occurs
at 72 hours after fertilization. With mono/di twins (68% of monozygotic twins), division occurs
4-8 days after fertilization. Dizygotic twins (67% of all twins) develop from two ova and are
fraternal rather than identical.
If a vanishing twin is noted in the first trimester, the pregnancy is considered
a. high risk
b. normal
c. aborted - answersB
The vanishing twin syndrome results from miscarriage of one fetus with the tissue absorbed
by the mother or the other fetus and occurs in up to 30% of twin pregnancies. The patient
may or may not have indications of miscarriage (cramping, bleeding) when one twin dies. If
the vanishing twin occurs in the second or third trimester, the pregnancy is considered high
risk, and the remaining twin is at risk for cerebral palsy.
A 32 week pregnant patient with sudden onset of severe lower abdominal pain and tenderness,
vaginal bleeding, tachycardia, hypotension, and fetal bradycardia probably indicates
a. placenta previa
b. uterine rupture
c. abruptio placentae - answersC
...as these are typical symptoms although pain and tenderness are absent in some patients.
About 70% with abruptio placentae present with vaginal bleeding. Pain may be localized or
diffuse. In some cases, blood accumulates between the placenta and the myometrium
(Couvelaire uterus), resulting in ecchymosis, discoloration of the uterus,and loss of
contractility.
, Hypotension with a positive Cullen sign (ecchymosis about umbilicus) and shoulder pain may
indicate
a. ruptured uterus
b. ruptured ectopic pregnancy
c. spontaneous abortion - answersB
The hypotension occurs because of blood loss, and blood in the perineal cavity causes
irritation of the diaphragm and referred pain to the shoulder area as well as the ecchymosis
about the umbilicus. While an unruptured ectopic pregnancy often causes pain, the pain
increases with rupture and may vary in intensity and site, with some patients complaining of
pain in the lower abdomen and some with unilateral or generalized abdominal pain
Preterm labor is defined as onset of labor before
a. 35 weeks
b. 37 weeks
c. 39 weeks - answersB
...with cervical change and uterine contractions during weeks 20-36. Most infant deaths (more
than 75%) associated with preterm labor and birth occur in infants who are fewer than 32
weeks gestation. Risk factors for preterm labor include maternal age younger than 17 or older
than 35 years, non-white race, lower economic status, and lower educational status. Patients
with previous preterm labor or birth or who have undergone second trimester abortions or had
stillbirths are also at increased risk.
The most significant risk factor for uterine rupture is
a. macrosomia
b. multiple gestation
c. previous cesarean - answersC
Uterine rupture extends through the wall of the uterus and the visceral peritoneum, resulting in
extensive bleeding and can include expulsion of the fetus and placenta into the abdominal
cavity. Treatment includes immediate cesarean delivery and usually requires hysterectomy. In
