1
RNC-OB Exam – Comprehensive
Obstetric Nursing Exam with Verified
Questions and Answers
1. Late in pregnancy, a patient often develops supine hypotension because of
a. partial occlusion of the vena cava and aorta.
b. decreased peripheral collateral circulation.
c. increased blood flow to the placenta.
ANSWER: A
Because of partial occlusion of the vena cava and aorta from the weight of the
uterus. This impedes venous return from the lower extremities although increased
collateral circulation during pregnancy helps to compensate. Remaining in the
supine position for long periods of time could decrease fetal oxygenation as well.
The lateral recumbent position relieves the pressure on the vena cava and aorta,
allowing the blood pressure to increase and symptoms to decrease.
2. The nurse must educate the new mother that a contraindication to breast
feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infection with HIV/AIDS.
ANSWER: C
3. The initial postpartal intervention indicated for a soft boggy uterus is to
a. apply an ice compress.
,2
b. massage the fundus until firm.
c. apply a warm compress.
ANSWER: B
With the dominant hand while supporting the inferior uterus with the non-
dominant hand to prevent trauma. If the fundus does not contract with massage,
then further evaluation is indicated to determine if placental fragments remain.
After the fundus becomes contracted, the nurse should push firmly downward on
the fundus to expel clots that may have pooled.
4. With the vibroacoustic stimulation test, stimulus with an artificial larynx or
other device is applied to the maternal abdomen for
a. 1 to 3 seconds.
b. 5 to 10 seconds.
c. 1 to 2 minutes.
ANSWER: A
Usually, stimulus is applied for 1-2 seconds and repeated up to 3 times with time
extending to 3 seconds in order to stimulate fetal movement. A positive or reactive
finding is an increased fetal heart rate of 15 bpm or more for at least 15 seconds;
however, a nonreactive result does not always indicate fetal abnormality but
indicates the need for further testing.
5. Absence of the Moro reflex on one side only in a neonate may indicate
a. fractured scapula.
b. cerebral palsy.
c. fractured clavicle.
ANSWER: C
,3
A fractured clavicle or brachial plexus injury. Damage to the central nervous
system, such as may occur with cerebral palsy, often results in bilateral absence of
the reflex. The Moro reflex is elicited by allowing the infant's head and trunk to
fall slightly backward when the infant is raised. A positive Moro reflex includes
immediate extension and abduction of the arms(and sometimes the legs) with
fingers fanning and forming a C-shape with a return of the limbs to the flexed
states
6. In a multiparous woman, what is the lowest Bishop score that predicts labor
induction will be successful?
a. 5
b. 7
c. 9
ANSWER: A
In a multiparous woman, the Bishop score that predicts that labor induction will be
successful is 5 or more while it is a 9 or more for a nulliparous woman. The Bishop
score is a rating system to determine readiness for induction based on scores of 0-3
in four different measures: dilation (cm), effacement (percentage), station (cm),
and cervical consistency (firm, medium, soft), and cervical position (posterior, mid
position, anterior). The fifth measure, cervical position, is scored only 0-2.
7. When cervical laceration occur during delivery, they are most common at
what position?
a. 3 and 9 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock
ANSWER: A
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Cervical lacerations are most often identified with vaginal retractors when bleeding
is persistent after delivery. The lacerations are sutured with absorbable sutures, so
no further treatment is usually indicated. Minor lacerations often occur during
delivery, but they usually require no treatment. Tears are more common after
forceps assisted and vacuum assisted deliveries than normal vaginal births
8. If using fetal pulse oximetry, what is normal oxygen saturation?
a. 30% to 65%
b. 65% to 90%
c. 90% to 100%
ANSWER: A
Because of the fetus's high hemoglobin and hematocrit. A value below 30% may
be associated with hypoxia and metabolic acidosis. For fetal pulse oximetry, which
may be used to determine whether immediate intervention is needed for non-
reassuring fetal heart rate, a special single-use sensor is placed internally along the
fetal cheek, temple, or forehead. However, fetal pulse oximetry has not been found
to reduce overall rates of Caesarean.
9. A decrease of fetal heart rate of at least 15 bpm for at least 10 minutes is
classified as
a. recurrent deceleration.
b. prolonged deceleration.
c. baseline change.
ANSWER: C
If it persists more than 2 minutes but less than 10 minutes, it is classified as a
prolonged deceleration. Recurrent decelerations are classified as occurring with
half or more of uterine contractions in a 20 minute period. Intermittent
RNC-OB Exam – Comprehensive
Obstetric Nursing Exam with Verified
Questions and Answers
1. Late in pregnancy, a patient often develops supine hypotension because of
a. partial occlusion of the vena cava and aorta.
b. decreased peripheral collateral circulation.
c. increased blood flow to the placenta.
ANSWER: A
Because of partial occlusion of the vena cava and aorta from the weight of the
uterus. This impedes venous return from the lower extremities although increased
collateral circulation during pregnancy helps to compensate. Remaining in the
supine position for long periods of time could decrease fetal oxygenation as well.
The lateral recumbent position relieves the pressure on the vena cava and aorta,
allowing the blood pressure to increase and symptoms to decrease.
2. The nurse must educate the new mother that a contraindication to breast
feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infection with HIV/AIDS.
ANSWER: C
3. The initial postpartal intervention indicated for a soft boggy uterus is to
a. apply an ice compress.
,2
b. massage the fundus until firm.
c. apply a warm compress.
ANSWER: B
With the dominant hand while supporting the inferior uterus with the non-
dominant hand to prevent trauma. If the fundus does not contract with massage,
then further evaluation is indicated to determine if placental fragments remain.
After the fundus becomes contracted, the nurse should push firmly downward on
the fundus to expel clots that may have pooled.
4. With the vibroacoustic stimulation test, stimulus with an artificial larynx or
other device is applied to the maternal abdomen for
a. 1 to 3 seconds.
b. 5 to 10 seconds.
c. 1 to 2 minutes.
ANSWER: A
Usually, stimulus is applied for 1-2 seconds and repeated up to 3 times with time
extending to 3 seconds in order to stimulate fetal movement. A positive or reactive
finding is an increased fetal heart rate of 15 bpm or more for at least 15 seconds;
however, a nonreactive result does not always indicate fetal abnormality but
indicates the need for further testing.
5. Absence of the Moro reflex on one side only in a neonate may indicate
a. fractured scapula.
b. cerebral palsy.
c. fractured clavicle.
ANSWER: C
,3
A fractured clavicle or brachial plexus injury. Damage to the central nervous
system, such as may occur with cerebral palsy, often results in bilateral absence of
the reflex. The Moro reflex is elicited by allowing the infant's head and trunk to
fall slightly backward when the infant is raised. A positive Moro reflex includes
immediate extension and abduction of the arms(and sometimes the legs) with
fingers fanning and forming a C-shape with a return of the limbs to the flexed
states
6. In a multiparous woman, what is the lowest Bishop score that predicts labor
induction will be successful?
a. 5
b. 7
c. 9
ANSWER: A
In a multiparous woman, the Bishop score that predicts that labor induction will be
successful is 5 or more while it is a 9 or more for a nulliparous woman. The Bishop
score is a rating system to determine readiness for induction based on scores of 0-3
in four different measures: dilation (cm), effacement (percentage), station (cm),
and cervical consistency (firm, medium, soft), and cervical position (posterior, mid
position, anterior). The fifth measure, cervical position, is scored only 0-2.
7. When cervical laceration occur during delivery, they are most common at
what position?
a. 3 and 9 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock
ANSWER: A
, 4
Cervical lacerations are most often identified with vaginal retractors when bleeding
is persistent after delivery. The lacerations are sutured with absorbable sutures, so
no further treatment is usually indicated. Minor lacerations often occur during
delivery, but they usually require no treatment. Tears are more common after
forceps assisted and vacuum assisted deliveries than normal vaginal births
8. If using fetal pulse oximetry, what is normal oxygen saturation?
a. 30% to 65%
b. 65% to 90%
c. 90% to 100%
ANSWER: A
Because of the fetus's high hemoglobin and hematocrit. A value below 30% may
be associated with hypoxia and metabolic acidosis. For fetal pulse oximetry, which
may be used to determine whether immediate intervention is needed for non-
reassuring fetal heart rate, a special single-use sensor is placed internally along the
fetal cheek, temple, or forehead. However, fetal pulse oximetry has not been found
to reduce overall rates of Caesarean.
9. A decrease of fetal heart rate of at least 15 bpm for at least 10 minutes is
classified as
a. recurrent deceleration.
b. prolonged deceleration.
c. baseline change.
ANSWER: C
If it persists more than 2 minutes but less than 10 minutes, it is classified as a
prolonged deceleration. Recurrent decelerations are classified as occurring with
half or more of uterine contractions in a 20 minute period. Intermittent
