RNC-OB REAL EXAM 2025/2026 ACCURATE FALL-SPRING
SESSION ORIGINAL COMPLETE QUESTION AND ANSWER
GRADED A+ 300 QUESTIONS
If vaginal fluid contains blood, the nitrazine test for the presence of amniotic fluid
a. may show a false positive.
b. may show a false negative.
c. is unaffected by blood.
A
because the pH of blood ranges from 7.35-7.45 and the pH of amniotic fluid ranges
from 7.0-7.5, so they may react similarly. A pH in the range of 6.57.5 is considered
positive for amniotic fluid in the absence of other factors (blood, semen, urine) that
may affect results. The test sample should include vaginal secretions from the
posterior vagina but not the mucous plug
To reduce the risk of hemorrhagic disease after birth, a neonate should receive
a. vitamin B9 (folic acid).
b. vitamin C.
c. vitamin K.
C
Neonates are born with low levels of vitamin K, which is necessary to activate clotting
factors. Additionally, while platelet levels are near adult level, the platelets do not
respond effectively to stimuli for several days after birth. Combined, these factors
increase the risk of hemorrhage, but the risk is markedly reduced if the neonate
receives an IM injection of vitamin K.
A patient is in active labor and has contractions every 8 minutes lasting for 45 seconds
and increasing in intensity by 25 mm Hg during contractions. This patient is likely
experiencing
a. hypertonic labor.
b. hypotonic labor.
c. normal labor.
,B
The average amplitude is 40-50 mmHG. Because the contractions are often irregular
and have low amplitude, cervical dilation is usually slowed or may arrest so that labor
becomes prolonged without interventions. Treatment may include ROM and/or oxytocin
to strengthen the contractions
A pregnant patient who presents with sudden onset of severe uterine pain with slow
increase in fundal height but no vaginal bleeding should be assessed for
a. abruptio placentae.
b. bladder retention.
c. fecal impaction.
A
Up to 80% of patients with abruptio placentae exhibit vaginal bleeding, but bleeding
may be contained between the uterine wall and the placenta, resulting in maternal
shock without obvious bleeding. If the fetus is at term, bleeding is severe, or the
mother or fetus is in jeopardy, immediate delivery is indicated.
During the second stage of labor, when does external rotation occur?
a. As the fetus descends from station 2+ to 4+
b. Before delivery of the head
c. After delivery of the head
C
The head is delivered face down but then externally rotates so that the face is toward
the right or left (facing maternal inner thighs) in order to allow passage of the
shoulders and body. If shoulder dystocia occurs, delivery may halt at this time.
McRoberts technique, in which the patient elevates the knees to the chest position,
may reduce the angle and allow expulsion.
Supporting a patient's request that she receive an opioid and an epidural during labor
is an example of the ethical principle of
a. autonomy.
b. beneficence.
c. justice.
,A
...which recognizes that people have the right to make their own decisions about care.
Beneficence is taking action that benefits another, such as providing pain relief
immediately when needed. Justice requires fair and equal treatment of all, making
sure that resources and health care are distributed in a fair manner.
What is a contraindication of oxytocin infusion?
a. Eclampsia
b. Non-reassuring fetal heart rate
c. Dystocia
B
Other contraindications include cephalopelvic disproportion, transverse lie, placenta
previa, vasa previa, previous classic uterine incision or uterine surgery, and invasive
carcinoma of the cervix. Oxytocin is used to stimulate uterine contractions, thus
inducing or augmenting labor, and may be indicated for suspected fetal jeopardy,
dystocia, postterm pregnancy, eclampsia, fetal death, chorioamnionitis, and multiple
maternal medical problems, such as renal disease or uncontrolled diabetes mellitus
If the biophysical profile shows a score of 8 with normal amniotic fluid volume, what is
the required intervention?
a. No intervention needed
b. Induction of labor
c. Repeat test the same day
A
A normal BPP is 10 (score of 2 on 5 different measures). A score of 8 with normal AFI
suggests very little risk to the fetus and no intervention is required. If however, the
amniotic fluid volume were abnormal, this would suggest chronic asphyxia and
increased rate of perinatal mortality within a week, so birth should be induced. A score
of 6 indicated possible asphyxia, 4 probably asphyxia, 2 almost certain asphyxia, and 0
certain asphyxia
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.
, 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
A cordocentesis can be performed after how many weeks' gestation?
a. 16
b. 18
c. 20
B
aka percutaneous umbilical cord blood sampling (PUBS), guided by ultrasound, can be
performed after 18 wks of pregnancy, as risks are higher at earlier gestation. If the
placenta is located on the posterior wall of the uterus, the needle is inserted through
the amniotic fluid to the umbilical cord near attachment to the placenta, but if the
placenta is located on the anterior or lateral walls, the needle must first go through
the placenta. Cordocentesis can be used to identify fetal abnormalities, infections,
anemia, and congenital alloimmune thrombocytopenia.
Velamentous insertion of the umbilical cord is commonly associated with
a. singleton gestations.
b. abruptio placentae.
c. placenta previa.
C
associated with placenta previa, vasa previa, and multiple gestations. With
velamentous insertion, the umbilical cord vessels divide at a distance from the
placenta, protected only by the thin placental membranes, which may become
compressed or injured during pregnancy, labor, and delivery. Because the vessels lack
the protection of Wharton's jelly, they are especially susceptible to tearing, resulting in
fetal hemorrhage. If the vessels precede the fetus at the internal os, this is termed
vasa previa.
SESSION ORIGINAL COMPLETE QUESTION AND ANSWER
GRADED A+ 300 QUESTIONS
If vaginal fluid contains blood, the nitrazine test for the presence of amniotic fluid
a. may show a false positive.
b. may show a false negative.
c. is unaffected by blood.
A
because the pH of blood ranges from 7.35-7.45 and the pH of amniotic fluid ranges
from 7.0-7.5, so they may react similarly. A pH in the range of 6.57.5 is considered
positive for amniotic fluid in the absence of other factors (blood, semen, urine) that
may affect results. The test sample should include vaginal secretions from the
posterior vagina but not the mucous plug
To reduce the risk of hemorrhagic disease after birth, a neonate should receive
a. vitamin B9 (folic acid).
b. vitamin C.
c. vitamin K.
C
Neonates are born with low levels of vitamin K, which is necessary to activate clotting
factors. Additionally, while platelet levels are near adult level, the platelets do not
respond effectively to stimuli for several days after birth. Combined, these factors
increase the risk of hemorrhage, but the risk is markedly reduced if the neonate
receives an IM injection of vitamin K.
A patient is in active labor and has contractions every 8 minutes lasting for 45 seconds
and increasing in intensity by 25 mm Hg during contractions. This patient is likely
experiencing
a. hypertonic labor.
b. hypotonic labor.
c. normal labor.
,B
The average amplitude is 40-50 mmHG. Because the contractions are often irregular
and have low amplitude, cervical dilation is usually slowed or may arrest so that labor
becomes prolonged without interventions. Treatment may include ROM and/or oxytocin
to strengthen the contractions
A pregnant patient who presents with sudden onset of severe uterine pain with slow
increase in fundal height but no vaginal bleeding should be assessed for
a. abruptio placentae.
b. bladder retention.
c. fecal impaction.
A
Up to 80% of patients with abruptio placentae exhibit vaginal bleeding, but bleeding
may be contained between the uterine wall and the placenta, resulting in maternal
shock without obvious bleeding. If the fetus is at term, bleeding is severe, or the
mother or fetus is in jeopardy, immediate delivery is indicated.
During the second stage of labor, when does external rotation occur?
a. As the fetus descends from station 2+ to 4+
b. Before delivery of the head
c. After delivery of the head
C
The head is delivered face down but then externally rotates so that the face is toward
the right or left (facing maternal inner thighs) in order to allow passage of the
shoulders and body. If shoulder dystocia occurs, delivery may halt at this time.
McRoberts technique, in which the patient elevates the knees to the chest position,
may reduce the angle and allow expulsion.
Supporting a patient's request that she receive an opioid and an epidural during labor
is an example of the ethical principle of
a. autonomy.
b. beneficence.
c. justice.
,A
...which recognizes that people have the right to make their own decisions about care.
Beneficence is taking action that benefits another, such as providing pain relief
immediately when needed. Justice requires fair and equal treatment of all, making
sure that resources and health care are distributed in a fair manner.
What is a contraindication of oxytocin infusion?
a. Eclampsia
b. Non-reassuring fetal heart rate
c. Dystocia
B
Other contraindications include cephalopelvic disproportion, transverse lie, placenta
previa, vasa previa, previous classic uterine incision or uterine surgery, and invasive
carcinoma of the cervix. Oxytocin is used to stimulate uterine contractions, thus
inducing or augmenting labor, and may be indicated for suspected fetal jeopardy,
dystocia, postterm pregnancy, eclampsia, fetal death, chorioamnionitis, and multiple
maternal medical problems, such as renal disease or uncontrolled diabetes mellitus
If the biophysical profile shows a score of 8 with normal amniotic fluid volume, what is
the required intervention?
a. No intervention needed
b. Induction of labor
c. Repeat test the same day
A
A normal BPP is 10 (score of 2 on 5 different measures). A score of 8 with normal AFI
suggests very little risk to the fetus and no intervention is required. If however, the
amniotic fluid volume were abnormal, this would suggest chronic asphyxia and
increased rate of perinatal mortality within a week, so birth should be induced. A score
of 6 indicated possible asphyxia, 4 probably asphyxia, 2 almost certain asphyxia, and 0
certain asphyxia
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.
, 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
A cordocentesis can be performed after how many weeks' gestation?
a. 16
b. 18
c. 20
B
aka percutaneous umbilical cord blood sampling (PUBS), guided by ultrasound, can be
performed after 18 wks of pregnancy, as risks are higher at earlier gestation. If the
placenta is located on the posterior wall of the uterus, the needle is inserted through
the amniotic fluid to the umbilical cord near attachment to the placenta, but if the
placenta is located on the anterior or lateral walls, the needle must first go through
the placenta. Cordocentesis can be used to identify fetal abnormalities, infections,
anemia, and congenital alloimmune thrombocytopenia.
Velamentous insertion of the umbilical cord is commonly associated with
a. singleton gestations.
b. abruptio placentae.
c. placenta previa.
C
associated with placenta previa, vasa previa, and multiple gestations. With
velamentous insertion, the umbilical cord vessels divide at a distance from the
placenta, protected only by the thin placental membranes, which may become
compressed or injured during pregnancy, labor, and delivery. Because the vessels lack
the protection of Wharton's jelly, they are especially susceptible to tearing, resulting in
fetal hemorrhage. If the vessels precede the fetus at the internal os, this is termed
vasa previa.
