RNC-MNN Exam
Updated 2026 Complete 400 Questions with
Correct Detailed Answers
1. Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She reports she
is "bleeding a lot" and her perineal pad, changed 45 minutes ago, is fully
saturated. Palpation reveals a boggy uterus. Your first intervention is:
a. start IV fluids
b. place a catheter
c. massage her uterus until firm
d. call the MD - ANSWER-c. massage her uterus until firm
2. Mei experienced premature rupture of membranes during her pregnancy and her
internal fetal monitors placed during labor. She later delivered by cesarean. 12
hours after delivery, her HR is 104 and her lochia smells foul. You suspect:
a. endometriosis
b. mastitis
c. uterine cancer
d. endometritis - ANSWER-d. endometritis
3. You are preparing to discharge Maria after delivering a healthy boy. You believe
Maria understands the discharge teaching instructions when she states:
a. it is acceptable to have bleeding nipples after breastfeeding for the first
few days
b. I should not worry if I have a large mass under my breasts
c. I will call my nurse-midwife if I saturate a pad in one hour
d. suicidal thoughts are okay because the baby blues are normal -
ANSWER-c. I will call my nurse-midwife if I saturate a pad in one hour
4. An infant born to a mother who abused drugs during pregnancy exhibited
withdrawal signs in the nursery that included fever and poor state control. After
stabilization and discharge, the caretaker called to report a return of withdrawal
symptoms. This pattern is consistent with maternal abuse of:
a. alcohol
b. cocaine
c. methadone - ANSWER-b. cocaine
5. Leukocytosis that occurs in normal postpartum adaptation can be differentiated
from an infectious process by the presence of:
, a. a 30% increase in WBC count in a 6 hour period
b. a concomitant increase in the sedimentation rate
c. any elevation in temperature - ANSWER-b. a concomitant increase in the
sedimentation rate
6. Tachypnea, tachycardia, and poor feeding in a 12 hour old neonate, born to a
mother with diabetes mellitus, would be more consistent with the onset of:
a. congestive heart failure
b. hypoglycemia
c. respiratory distress syndrome - ANSWER-b. hypoglycemia
7. A postpartum woman has a BP of 150/92 at 6 hours. Later, the BP is 148/90.
This finding most likely:
a. diminished venous return
b. reflects postpartum peak in cardiac output
c. requires evaluation for postpartum preeclampsia - ANSWER-c. requires
evaluation for postpartum preeclampsia
8. The let down reflex in the breastfeeding woman is responsible for
a. movement of the milk from ducts to the nipple
b. regulation of milk release to ensure milk is available at any given time
c. release of the milk to the alveoli - ANSWER-a. movement of the milk from
ducts to the nipple
9. A woman plans not to breastfeed and asks about how to suppress lactation. She
should be advised that:
a. mechanical suppression occurs with the use of a supportive bra
b. medications can be prescribes to stop lactation
c. physiologically, lactation will not proceed without breastfeeding and no
intervention is needed - ANSWER-a. mechanical suppression occurs with
the use of a supportive bra
10. Spinal blockade occurring with epidural anesthesia results in
a. hypotension
b. tachycardia
c. vertigo - ANSWER-a. hypotension
11. Synthesis of vitamin K in the neonate is dependent upon the presence of
a. amino acids derived from human or formula proteins
b. appropriate bacteria in the GI tract
, c. passively acquired maternal antibodies - ANSWER-b. appropriate bacteria
in the GI tract
12. A woman with a history of breast augmentation asks if she will be able to
breastfeed her baby. The factor that will most influence her ability to breastfeed is
a. time interval since the surgery
b. type of implant
c. type of incision - ANSWER-c. type of incision
13. Assessment for the presence of congenital viral infection would be indicated in
which of the following:
a. 38 weeks, LGA infant with RDS
b. late preterm with elevated indirect bilirubin
c. term, SGA with widespread petechiae - ANSWER-c. term, SGA with
widespread petechiae
14. A woman has been treated with fractionated heparin during pregnancy for
thromboembolism. She wants to breastfeed. In the postpartum period, it would
be expected that she would
a. be changed to a low molecular weight heparin formulation
b. be switched to warfarin
c. continue with heparin therapy - ANSWER-c. continue with heparin therapy
15. An anatomic breast variation that has been linked with insufficient lactation
relates to
a. inadequate glandular tissue
b. lack of breast tissue elasticity
c. shape and size of nipple - ANSWER-a. inadequate glandular tissue
16. A woman is admitted to the postpartum unit following delivery of her infant on the
route to the hospital. The RN noted bruises on the woman's back and arms. To
assess possible intimate partner violence, the RN should
a. directly ask her if anyone has threatened her or physically harmed her
b. question her on how she obtained the bruises
c. review the patients chart for any indication of domestic violence -
ANSWER-b. question her on how she obtained the bruises
17. The use of phototherapy reduces the risk of
a. bronze baby syndrome
b. exchange transfusion
, c. skin moles - ANSWER-b. exchange transfusion
18. Uterine prolapse associated with childbirth is due to
a. atrophy of the uterine tissue
b. bulging of uterine tissue through the cervix
c. weakening of the pelvic tissue - ANSWER-c. weakening of the pelvic
tissue
19. A new mother verbalizes her concern about the presence of stork bites nevus on
her infant's eyelid. The RN's response will be based on the knowledge that
a. further growth and facial involvement is likely overtime
b. the location of the birth mark carries a risk of eye involvement
c. this type of vascular lesions tend to disappear by the age of one -
ANSWER-c. this type of vascular lesions tend to disappear by the age of
one
20. The recommended antibiotic treatment for postpartum endometritis is
a. a broad spectrum antibiotic
b. based on endometrial culture
c. selected based on provider's preference - ANSWER-a. a broad spectrum
antibiotic
21. It is difficult to determine the extent of blood loss with a vaginal hematoma
because
a. blood is retained in the tissue
b. blood loss is mistaken as part of the normal postpartum course
c. symptoms don't correlate to the amount of blood loss - ANSWER-a. blood
is retained in the tissue
22. A newborn is noted at birth to be hypotonic with characteristics that include small
ears, flat appearance to the face, slanted palpebral tissues, and simian creases
on both palms. Based on the findings, the RN can expect a work up that includes
a. blood work sent for TORCH titers
b. genetic consult from chromosome studies
c. review of the prenatal history of maternal alcohol use - ANSWER-b.
genetic consult from chromosome studies
23. Milk transfer, a key physiologic principle in lactation, is most efficient with
a. adequate prolactin levels
b. good lactation
Updated 2026 Complete 400 Questions with
Correct Detailed Answers
1. Emily is a 28yo mother of 3 who delivered vaginally 4 hours ago. She reports she
is "bleeding a lot" and her perineal pad, changed 45 minutes ago, is fully
saturated. Palpation reveals a boggy uterus. Your first intervention is:
a. start IV fluids
b. place a catheter
c. massage her uterus until firm
d. call the MD - ANSWER-c. massage her uterus until firm
2. Mei experienced premature rupture of membranes during her pregnancy and her
internal fetal monitors placed during labor. She later delivered by cesarean. 12
hours after delivery, her HR is 104 and her lochia smells foul. You suspect:
a. endometriosis
b. mastitis
c. uterine cancer
d. endometritis - ANSWER-d. endometritis
3. You are preparing to discharge Maria after delivering a healthy boy. You believe
Maria understands the discharge teaching instructions when she states:
a. it is acceptable to have bleeding nipples after breastfeeding for the first
few days
b. I should not worry if I have a large mass under my breasts
c. I will call my nurse-midwife if I saturate a pad in one hour
d. suicidal thoughts are okay because the baby blues are normal -
ANSWER-c. I will call my nurse-midwife if I saturate a pad in one hour
4. An infant born to a mother who abused drugs during pregnancy exhibited
withdrawal signs in the nursery that included fever and poor state control. After
stabilization and discharge, the caretaker called to report a return of withdrawal
symptoms. This pattern is consistent with maternal abuse of:
a. alcohol
b. cocaine
c. methadone - ANSWER-b. cocaine
5. Leukocytosis that occurs in normal postpartum adaptation can be differentiated
from an infectious process by the presence of:
, a. a 30% increase in WBC count in a 6 hour period
b. a concomitant increase in the sedimentation rate
c. any elevation in temperature - ANSWER-b. a concomitant increase in the
sedimentation rate
6. Tachypnea, tachycardia, and poor feeding in a 12 hour old neonate, born to a
mother with diabetes mellitus, would be more consistent with the onset of:
a. congestive heart failure
b. hypoglycemia
c. respiratory distress syndrome - ANSWER-b. hypoglycemia
7. A postpartum woman has a BP of 150/92 at 6 hours. Later, the BP is 148/90.
This finding most likely:
a. diminished venous return
b. reflects postpartum peak in cardiac output
c. requires evaluation for postpartum preeclampsia - ANSWER-c. requires
evaluation for postpartum preeclampsia
8. The let down reflex in the breastfeeding woman is responsible for
a. movement of the milk from ducts to the nipple
b. regulation of milk release to ensure milk is available at any given time
c. release of the milk to the alveoli - ANSWER-a. movement of the milk from
ducts to the nipple
9. A woman plans not to breastfeed and asks about how to suppress lactation. She
should be advised that:
a. mechanical suppression occurs with the use of a supportive bra
b. medications can be prescribes to stop lactation
c. physiologically, lactation will not proceed without breastfeeding and no
intervention is needed - ANSWER-a. mechanical suppression occurs with
the use of a supportive bra
10. Spinal blockade occurring with epidural anesthesia results in
a. hypotension
b. tachycardia
c. vertigo - ANSWER-a. hypotension
11. Synthesis of vitamin K in the neonate is dependent upon the presence of
a. amino acids derived from human or formula proteins
b. appropriate bacteria in the GI tract
, c. passively acquired maternal antibodies - ANSWER-b. appropriate bacteria
in the GI tract
12. A woman with a history of breast augmentation asks if she will be able to
breastfeed her baby. The factor that will most influence her ability to breastfeed is
a. time interval since the surgery
b. type of implant
c. type of incision - ANSWER-c. type of incision
13. Assessment for the presence of congenital viral infection would be indicated in
which of the following:
a. 38 weeks, LGA infant with RDS
b. late preterm with elevated indirect bilirubin
c. term, SGA with widespread petechiae - ANSWER-c. term, SGA with
widespread petechiae
14. A woman has been treated with fractionated heparin during pregnancy for
thromboembolism. She wants to breastfeed. In the postpartum period, it would
be expected that she would
a. be changed to a low molecular weight heparin formulation
b. be switched to warfarin
c. continue with heparin therapy - ANSWER-c. continue with heparin therapy
15. An anatomic breast variation that has been linked with insufficient lactation
relates to
a. inadequate glandular tissue
b. lack of breast tissue elasticity
c. shape and size of nipple - ANSWER-a. inadequate glandular tissue
16. A woman is admitted to the postpartum unit following delivery of her infant on the
route to the hospital. The RN noted bruises on the woman's back and arms. To
assess possible intimate partner violence, the RN should
a. directly ask her if anyone has threatened her or physically harmed her
b. question her on how she obtained the bruises
c. review the patients chart for any indication of domestic violence -
ANSWER-b. question her on how she obtained the bruises
17. The use of phototherapy reduces the risk of
a. bronze baby syndrome
b. exchange transfusion
, c. skin moles - ANSWER-b. exchange transfusion
18. Uterine prolapse associated with childbirth is due to
a. atrophy of the uterine tissue
b. bulging of uterine tissue through the cervix
c. weakening of the pelvic tissue - ANSWER-c. weakening of the pelvic
tissue
19. A new mother verbalizes her concern about the presence of stork bites nevus on
her infant's eyelid. The RN's response will be based on the knowledge that
a. further growth and facial involvement is likely overtime
b. the location of the birth mark carries a risk of eye involvement
c. this type of vascular lesions tend to disappear by the age of one -
ANSWER-c. this type of vascular lesions tend to disappear by the age of
one
20. The recommended antibiotic treatment for postpartum endometritis is
a. a broad spectrum antibiotic
b. based on endometrial culture
c. selected based on provider's preference - ANSWER-a. a broad spectrum
antibiotic
21. It is difficult to determine the extent of blood loss with a vaginal hematoma
because
a. blood is retained in the tissue
b. blood loss is mistaken as part of the normal postpartum course
c. symptoms don't correlate to the amount of blood loss - ANSWER-a. blood
is retained in the tissue
22. A newborn is noted at birth to be hypotonic with characteristics that include small
ears, flat appearance to the face, slanted palpebral tissues, and simian creases
on both palms. Based on the findings, the RN can expect a work up that includes
a. blood work sent for TORCH titers
b. genetic consult from chromosome studies
c. review of the prenatal history of maternal alcohol use - ANSWER-b.
genetic consult from chromosome studies
23. Milk transfer, a key physiologic principle in lactation, is most efficient with
a. adequate prolactin levels
b. good lactation
