RNC-OB PRACTICE EXAM AND
STUDYGUIDE 2024-2025 QUESTIONS
AND DETAILED CORRECT ANSWERS |
COMPREHENSIVE STUDY GUIDE
What are the causes of an Amniotic fluid embolism?
Correct Answer Ruptured amniotic membranes, ruptured
uterine/cervical veins, altered pressure gradient from
uterus to vein
s/s of AFE Correct Answer dyspnea, cyanosis, low O2
sats, chest pain, cough, pulmonary edema, bleeding,
decreased cardiac function, altered LOC, headache,
seizures, hypotension, cardiac arrest, coagulopathies
dx tests of AFE Correct Answer ABG, DIC panel, elevated
cardiac enzymes, ECG for ST/T abnormalities
medical treatment for AFE Correct Answer deliver fetus if
possible. O2, norepinephrine, dopamine, dobutamine
(after other vasopressors), cautious IV fluids, recombinant
factor V11a
What to watch out for with a patient with AFE Correct
Answer neurological injury, DIC, MODS, cardiac arrest,
fetal and/or maternal death
diet for a patient with an AFE Correct Answer NPO
,contraindications for a patient with an AFE Correct Answer
vasopressors before IV fluid volume is sufficient. If
maternal resuscitation is not successful, the infant should
be delivered at bedside within 3 to 4 min.
Another name for AFE Correct Answer anaphylactoid
syndrome of pregnancy
AFE is defined as an allergic reaction to what? Correct
Answer any amniotic fluid or debris that erroneously
enters the maternal bloodstream
Mortality rate for patients with DIC Correct Answer 60%
hormones secreted by the placenta Correct Answer
estrogen, progesterone, hCG, hPL
estrogen Correct Answer promotes ligament relaxation in
the symphysis pubis and sacroiliac joints. Causes
enlargement of breasts, uterus and external genitalia
progesterone Correct Answer maintains endometrium
during pregnancy. Reduces myometrial contractions
(reduces preterm labor)
hCG (human chorionic gonadotropin) Correct Answer
increases to week 12, then decreases to stabilize around
week 18. stimulates corpus lute to secrete estrogen and
progesterone until the placenta is large enough to take
over. Suppresses maternal immune response against
,placenta. Test 1-2 weeks post delivery to confirm all
placenta has been delivered if retention is suspected
human placental lactogen (hPL) Correct Answer regulates
maternal protein, fat and glucose levels. Promotes breast
growth in anticipation of lactation. Levels of hormone
increase with increasing placental size
Drug Category A Correct Answer good studies in pregnant
women show no increased risk to the fetus
Drug Category B Correct Answer studies in animals show
no evidence of fetal harm or studies in animals do show
harm, but good studies inn pregnant women do not show
harm
Drug Category C Correct Answer studies in animals show
harm, and no good studies in pregnant women are
available or no animal and no pregnant women studies are
available
Drug Category D Correct Answer Good studies in
pregnant women show evidence of harm but benefit of
med may outweigh risk of harm
Drug Category X Correct Answer Good studies in animals
or pregnant women have shown evidence of fetal
abnormalities. Med is contraindicated
what drug category is Magnesium sulfate? Correct Answer
D
, Action of magnesium sulfate Correct Answer causes
vasodilation to prevent/treat cerebral edema and acts as
central anticonvulsant; used in OB practice
prophylactically to treat seizures from preeclampsia or
eclampsia; no evidence to support use in preterm labor or
for management of HTN
Route of Magnesium Sulfate Correct Answer give 4-6
gram loading dose over 15 to 30 minutes followed by 2-3
gram/hr continuous infusion. Rarely given IM due to
uncontrollable absorption rate
what to watch for with Magnesium Sulfate Correct Answer
dysrhythmias, respiratory paralysis, absent DTRs, PPH
contraindications for Magnesium Sulfate Correct Answer
do not give continuously for more than 5-7 days (may
cause low calcium and alter fetal bone structure); do not
give to its with hx of MU, heart block or coma
what is the antidote for magnesium sulfate? Correct
Answer Calcium gulconate
action of oxytocin Correct Answer stimulates smooth
muscle in the uterus and mammary glands; used to induce
labor, complete a spontaneous abortion, or to decrease
postpartum bleeding
Routes of oxytocin Correct Answer IM, IV; onset for IM is
3-5 minutes
