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RNC-IAP® Practice Questions – Original Questions 1-175 with Answers
and Detailed Rationales UPDATED!!!!
1. A 28-year-old woman at 32 weeks gestation is admitted
with preterm labor. She is 3 cm dilated and 80% effaced
with regular contractions every 3 minutes. The provider
orders magnesium sulfate for neuroprotection. The nurse
should monitor for:
A) Hyperreflexia and hypertension
B) Respiratory depression, loss of deep tendon reflexes, and
hypotension
C) Tachycardia and hyperthermia
D) Polyuria and hyperglycemia
Answer: B) Respiratory depression, loss of deep tendon
reflexes, and hypotension
Rationale: Magnesium sulfate is a central nervous system
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depressant and smooth muscle relaxant. It can cause
respiratory depression, loss of deep tendon reflexes,
hypotension, and oliguria. The nurse should monitor
respiratory rate, deep tendon reflexes, urine output, and
serum magnesium levels. Calcium gluconate is the antidote
for magnesium toxicity.
2. A 35-year-old woman at 34 weeks gestation is admitted
with severe preeclampsia. Blood pressure is 170/110 mmHg.
The provider orders labetalol 20 mg IV push. Before
administering the medication, the nurse should:
A) Verify the patient's reflexes
B) Confirm the blood pressure and heart rate, and ensure
the patient is lying down
C) Check urine output for the past 24 hours
D) Obtain a stat ultrasound
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Answer: B) Confirm the blood pressure and heart rate, and
ensure the patient is lying down
Rationale: Before administering IV antihypertensive
medication, the nurse should confirm the current blood
pressure and heart rate. The patient should be lying down
to prevent hypotension-related falls. Labetalol can cause
significant blood pressure reduction, so continuous
monitoring is essential.
3. A 30-year-old woman at 28 weeks gestation is admitted
with preterm premature rupture of membranes (PPROM).
The nurse should assess for which sign of infection?
A) Decreased white blood cell count
B) Maternal fever, fetal tachycardia, and uterine tenderness
C) Increased fetal movement
D) Decreased maternal heart rate
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Answer: B) Maternal fever, fetal tachycardia, and uterine
tenderness
Rationale: Chorioamnionitis is a serious complication of
PPROM. Signs include maternal fever (>100.4°F or 38°C),
maternal tachycardia, fetal tachycardia (>160 bpm), uterine
tenderness, and foul-smelling amniotic fluid. Early
recognition is critical to prevent maternal and fetal
morbidity.
4. A 26-year-old woman at 30 weeks gestation is admitted
with hyperemesis gravidarum. She has lost 10 pounds and
has ketonuria. The priority nursing intervention is:
A) Encourage oral intake of clear liquids
B) Initiate IV fluid resuscitation and correct electrolyte
imbalances
C) Administer antiemetics orally
D) Prepare for immediate delivery
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RNC-IAP® Practice Questions – Original Questions 1-175 with Answers
and Detailed Rationales UPDATED!!!!
1. A 28-year-old woman at 32 weeks gestation is admitted
with preterm labor. She is 3 cm dilated and 80% effaced
with regular contractions every 3 minutes. The provider
orders magnesium sulfate for neuroprotection. The nurse
should monitor for:
A) Hyperreflexia and hypertension
B) Respiratory depression, loss of deep tendon reflexes, and
hypotension
C) Tachycardia and hyperthermia
D) Polyuria and hyperglycemia
Answer: B) Respiratory depression, loss of deep tendon
reflexes, and hypotension
Rationale: Magnesium sulfate is a central nervous system
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depressant and smooth muscle relaxant. It can cause
respiratory depression, loss of deep tendon reflexes,
hypotension, and oliguria. The nurse should monitor
respiratory rate, deep tendon reflexes, urine output, and
serum magnesium levels. Calcium gluconate is the antidote
for magnesium toxicity.
2. A 35-year-old woman at 34 weeks gestation is admitted
with severe preeclampsia. Blood pressure is 170/110 mmHg.
The provider orders labetalol 20 mg IV push. Before
administering the medication, the nurse should:
A) Verify the patient's reflexes
B) Confirm the blood pressure and heart rate, and ensure
the patient is lying down
C) Check urine output for the past 24 hours
D) Obtain a stat ultrasound
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, Page |3
Answer: B) Confirm the blood pressure and heart rate, and
ensure the patient is lying down
Rationale: Before administering IV antihypertensive
medication, the nurse should confirm the current blood
pressure and heart rate. The patient should be lying down
to prevent hypotension-related falls. Labetalol can cause
significant blood pressure reduction, so continuous
monitoring is essential.
3. A 30-year-old woman at 28 weeks gestation is admitted
with preterm premature rupture of membranes (PPROM).
The nurse should assess for which sign of infection?
A) Decreased white blood cell count
B) Maternal fever, fetal tachycardia, and uterine tenderness
C) Increased fetal movement
D) Decreased maternal heart rate
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, Page |4
Answer: B) Maternal fever, fetal tachycardia, and uterine
tenderness
Rationale: Chorioamnionitis is a serious complication of
PPROM. Signs include maternal fever (>100.4°F or 38°C),
maternal tachycardia, fetal tachycardia (>160 bpm), uterine
tenderness, and foul-smelling amniotic fluid. Early
recognition is critical to prevent maternal and fetal
morbidity.
4. A 26-year-old woman at 30 weeks gestation is admitted
with hyperemesis gravidarum. She has lost 10 pounds and
has ketonuria. The priority nursing intervention is:
A) Encourage oral intake of clear liquids
B) Initiate IV fluid resuscitation and correct electrolyte
imbalances
C) Administer antiemetics orally
D) Prepare for immediate delivery
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