RNC-OB REAL EXAM 2025
RNC-OB REAL EXAM 2025-2026
ACCURATE FALL-SPRING SESSION
ORIGINAL COMPLETE QUESTIONS
AND ANSWERS WITH DETAILED
RATIONALES GRADED A+
Hypotension with a positive Cullen sign (ecchymosis about umbilicus) and shoulder pain may
indicate
a. ruptured uterus
b. ruptured ectopic pregnancy
c. spontaneous abortion
A+ 1
, RNC-OB REAL EXAM 2025
B
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
B
...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
C
Uterine rupture extends through the wall of the uterus and the visceral peritoneum, resulting
A+ 2
, RNC-OB REAL EXAM 2025
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
some cases, instead of full rupture, dehiscence occurs along the previous incisional line, but
dehiscence usually does not involve extensive bleeding and does not breech the visceral
peritoneum, so the fetus and placenta remain inside the uterus.
If meconium-stained amniotic fluid is observed during delivery of an infant, the initial response
should be to
a. suction the infant before his/her first breath
b. evaluate the infant's respiratory status
c. suction the infant after he/she begins breathing
A
..., before the shoulders and body are delivered if possible, to prevent aspiration of meconium
and meconium aspiration syndrome (MAS). The severity of symptoms depends on the
amount of meconium aspirated. Thick meconium poses more or a risk than think meconium.
If the neonate aspirated meconium, the child may exhibit respiratory depression on delivery,
requiring resuscitation.
In a neonate, Klumpke paralysis is associated with injury to the
a. median and ulnar nerves in the arm
b. lower nerves of the brachial plexus
c. upper roots of the brachial plexus
B
It affects the hand while Erb (Erb-Duchenne) palsy, caused by injury to the upper roots of the
brachial plexus, causes paralysis of the upper arm and forearm so that the arm hangs limply
with the forearm extended and internally rotated. Finger function is usually not impaired.
A+ 3
, RNC-OB REAL EXAM 2025
Injury to the brachial plexus is most common with macrosomia and breech or difficult
deliveries.
Low birth weight is defined as
a. 1500 g or less
b. 2000 g or less
c. 2500 g or less
C
It is sometimes used instead of the term preterm birth because weeks of gestation are not
always easy to identify, and preterm birth considers only duration of gestation and not the
weight of the child. Infants who have low birth weight may be preterm as well, or the low
birth weight may be attributable to other factors, such as IUGR, PIH, or maternal malnutrition
With precipitous labor, the entire process of labor and delivery occurs within
a. 2 hours
b. 3 hours
c. 4 hours
B
...with the primigravida dilating 5 cm or more per hour and the multipara up to 10 cm per
hour. Precipitous labor is most common in women older than 35 years. It is usually associated
with low resistance in soft tissues so that the cervix dilates and effaces rapidly, and with
unusually strong uterine contractions. Because the birth is so rapid, it may be unattended or
occur on the way to the hospital.
A+ 4
RNC-OB REAL EXAM 2025-2026
ACCURATE FALL-SPRING SESSION
ORIGINAL COMPLETE QUESTIONS
AND ANSWERS WITH DETAILED
RATIONALES GRADED A+
Hypotension with a positive Cullen sign (ecchymosis about umbilicus) and shoulder pain may
indicate
a. ruptured uterus
b. ruptured ectopic pregnancy
c. spontaneous abortion
A+ 1
, RNC-OB REAL EXAM 2025
B
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
B
...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
C
Uterine rupture extends through the wall of the uterus and the visceral peritoneum, resulting
A+ 2
, RNC-OB REAL EXAM 2025
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
some cases, instead of full rupture, dehiscence occurs along the previous incisional line, but
dehiscence usually does not involve extensive bleeding and does not breech the visceral
peritoneum, so the fetus and placenta remain inside the uterus.
If meconium-stained amniotic fluid is observed during delivery of an infant, the initial response
should be to
a. suction the infant before his/her first breath
b. evaluate the infant's respiratory status
c. suction the infant after he/she begins breathing
A
..., before the shoulders and body are delivered if possible, to prevent aspiration of meconium
and meconium aspiration syndrome (MAS). The severity of symptoms depends on the
amount of meconium aspirated. Thick meconium poses more or a risk than think meconium.
If the neonate aspirated meconium, the child may exhibit respiratory depression on delivery,
requiring resuscitation.
In a neonate, Klumpke paralysis is associated with injury to the
a. median and ulnar nerves in the arm
b. lower nerves of the brachial plexus
c. upper roots of the brachial plexus
B
It affects the hand while Erb (Erb-Duchenne) palsy, caused by injury to the upper roots of the
brachial plexus, causes paralysis of the upper arm and forearm so that the arm hangs limply
with the forearm extended and internally rotated. Finger function is usually not impaired.
A+ 3
, RNC-OB REAL EXAM 2025
Injury to the brachial plexus is most common with macrosomia and breech or difficult
deliveries.
Low birth weight is defined as
a. 1500 g or less
b. 2000 g or less
c. 2500 g or less
C
It is sometimes used instead of the term preterm birth because weeks of gestation are not
always easy to identify, and preterm birth considers only duration of gestation and not the
weight of the child. Infants who have low birth weight may be preterm as well, or the low
birth weight may be attributable to other factors, such as IUGR, PIH, or maternal malnutrition
With precipitous labor, the entire process of labor and delivery occurs within
a. 2 hours
b. 3 hours
c. 4 hours
B
...with the primigravida dilating 5 cm or more per hour and the multipara up to 10 cm per
hour. Precipitous labor is most common in women older than 35 years. It is usually associated
with low resistance in soft tissues so that the cervix dilates and effaces rapidly, and with
unusually strong uterine contractions. Because the birth is so rapid, it may be unattended or
occur on the way to the hospital.
A+ 4
