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RNC-OB Exam Questions And 100% Correct Answers
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RNC-OB Exam Questions And 100% Correct Answers1. A patient is often found to develop supine hypotension late in pregnancy 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
It occurs due to partial occlusion of the vena cava and aorta produced by the weight of
the uterus. This impairs venous return from the lower extremities, although increased
collateral circulation during pregnancy partially compensates. Prolonged time spent in
the supine position may also reduce fetal oxygenation. The pressure is taken off the
vena cava and aorta in the lateral recumbent position, allowing blood pressure to rise
and symptoms to subside.
The nurse should instruct the new mother that a contraindication to breast feeding is
a. fetal macrosomia.
b. type II diabetes.
c. infection with HIV/AIDS. - Answer C
Some maternal contraindications to breastfeeding include:
-Infection with HIV/AIDS
-Antiretroviral medications
-Active TB not treated
-Human T-cell lymphotropic virus
-Abuse of illicit drugs
-Chemotherapeutic agents
-Radiation therapy - may require only interruption during treatment
Other medications that excrete into the breast milk and are harmful to the child Herpes
on the breast Varicella lesions on the breast-may reinstitute after lesions crust
,Which of the following is the first postpartal treatment ordered for a soft boggy uterus to
a. administer an ice pack.
b. massage the fundus until firm.
c. administer a warm pack.-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. Following fundal contraction,
the nurse should briskly push downward on the fundus to expel clots that may have
pooled.
Vibroacoustic stimulation test With the vibroacoustic stimulation test, stimulus with an
artificial larynx or other device is applied to the maternal abdomen for Na. 1 to 3
seconds N. 5 to 10 seconds N. 1 to 2 minutes - Answer A
Stimulus is usually applied for 1-2 seconds and can be repeated up to three times with
time extended to 3 seconds in an effort to provoke fetal movement. A positive or
reactive finding is an acceleration of the fetal heart rate of 15 bpm or more for at least
15 seconds; however, a nonreactive result does not necessarily indicate fetal
abnormality but suggests further testing.
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
a fractured clavicle or brachial plexus injury. Damage to the central nervous system, as
may occur with cerebral palsy, often results in bilateral absence of the reflex. The Moro
reflex is obtained by allowing the head and trunk of the infant to fall slightly backward
when the infant is raised. A positive Moro reflex involves immediate extension and
abduction of the arms and sometimes the legs, with fanning of fingers and a C-shape
with return to flexed position.
In a multiparous woman, what is the lowest Bishop score that predicts labour induction
will be successful?
a. 5
,b. 7
c. 9 -Answer A
In a woman who has given birth before, the Bishop score to predict that labour induction
will be successful is 5 or greater, whereas in a nulliparous woman this is 9 or greater.
The Bishop score A scoring system to determine readiness for induction based on
scores of 0-3 in the following four 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.
When cervical laceration occur during delivery, they are most common at what
position?
a. 3 and 9 o'clock
a. Noon and 6 o'clock
b. 12 and 6 o'clock
c. 10 and 4 o'clock - Answer A
Cervical lacerations are most commonly diagnosed with vaginal retractors if bleeding
continues well after delivery. The laceration is usually stitched with resorbable sutures,
so further management is generally unnecessary. Minor laceration may be experienced
during delivery, but they generally require no intervention. It is more common after a
forceps assisted and vacuum assisted deliveries than normal vaginal births.
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. In the case of fetal pulse oximetry,
which can be used to establish whether immediate intervention is required for
non-reassuring fetal heart rate, a special single-use sensor is placed internally along the
fetal cheek, temple, or forehead. Unfortunately, fetal pulse oximetry has not yet been
shown to reduce overall rates of Caesarean.
, A decrease of at least 15 bpm in fetal heart rate 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 decelerations occur with fewer
than half of uterine contractions in a 20 minute period.
With suspected fetal hypoxia, a cord blood gas specimen is obtained during delivery by
a. blood withdrawal from the vein/artery before the cord is clamped or cut and before
placental expulsion.
b. placing one clamp and withdrawing blood above the clamp before cutting the cord.
c. double clamping a 10 to 20 cm segment, cutting it out, and then withdrawing blood
from the segment. - Answer C
The section can be left on ice for a short time since cord blood gas can be measured
accurately for 60 minutes. Ideally arterial sample instead of venous sample but paired
sampling is ideal. Neurological compromise if pH is less than or equal to 7.24. Predictive
of impairment in motor or cognitive function if base excess is 12 mmol/L or more.
When eliciting the scarf sign in a neonate, the infant's elbow crosses the midline of the
chest, probably indicating a
a. preterm infant.
b. term infant.
c. postterm infant. - Answer A
At term, the elbow should not cross the midline. To conduct the scarf test the neonate is
positioned supine. One arm is grasped and the hand pulled toward the opposite
shoulder and then the position of the elbow is evaluated in relationship to the midline of
the chest.
Post delivery, which of the following hormones stimulates the alveolar cells of the
breast, thereby encouraging the secretion of milk?
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