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RNC-OB EXAM NEWEST QUESTIONS AND DETAILED CORRECT ANSWERS | COMPREHENSIVE STUDY GUIDE
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RNC-OB EXAM NEWEST QUESTIONS AND DETAILED CORRECT ANSWERS | COMPREHENSIVE STUDY GUIDE
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RNC-OB EXAM NEWEST 2024-2025QUESTIONS AND DETAILED CORRECT
ANSWERS | COMPREHENSIVE STUDY
GUIDE
A 32 week pregnant patient with sudden onset of severe
lower abdominal pain and tenderness, vaginal bleeding,
tachycardia, hypotension, and fetal bradycardia probably
indicates
a. placenta previa
b. uterine rupture
c. abruptio placentae Correct Answer C
...as these are typical symptoms although pain and
tenderness are absent in some patients. About 70%
with abruptio placentae present with vaginal bleeding.
Pain may be localized or diffuse. In some cases, blood
accumulates between the placenta and the
myometrium (Couvelaire uterus), resulting in
ecchymosis, discoloration of the uterus,and loss of
contractility.
Hypotension with a positive Cullen sign (ecchymosis about
umbilicus) and shoulder pain may indicate
a. ruptured uterus
b. ruptured ectopic pregnancy
c. spontaneous abortion Correct Answer 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 Correct Answer 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 Correct Answer C
Uterine rupture extends through the wall of the uterus
and the visceral peritoneum, resulting 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 Correct
Answer 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 Correct Answer 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. 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 Correct Answer 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 Correct Answer 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.
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