1|Page
RNC-OB EXAM 2026/2027, OBSTETRIC NURSING
EXAM, RNC-OB QUESTIONS AND ANSWERS, 2026
NURSING CERTIFICATION, MATERNAL CARE EXAM,
RNC-OB TEST PREP, VERIFIED OB ANSWERS
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 ......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 ......ANSWER......B
pg. 1
,2|Page
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 ......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 ......ANSWER......C
pg. 2
,3|Page
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 ......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 ......ANSWER......B
pg. 3
, 4|Page
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 ......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 ......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
pg. 4
RNC-OB EXAM 2026/2027, OBSTETRIC NURSING
EXAM, RNC-OB QUESTIONS AND ANSWERS, 2026
NURSING CERTIFICATION, MATERNAL CARE EXAM,
RNC-OB TEST PREP, VERIFIED OB ANSWERS
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 ......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 ......ANSWER......B
pg. 1
,2|Page
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 ......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 ......ANSWER......C
pg. 2
,3|Page
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 ......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 ......ANSWER......B
pg. 3
, 4|Page
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 ......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 ......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
pg. 4
