RNC-OBSTERICS EXAM QUESTIONS
CORRECTLY ANSWERED 100% VERIFIED.
At 4 weeks gestation, two beta hCG values taken 48 hours apart show decreasing
values. This suggests
a. normal pregnancy
b. miscarriage/ectopic pregnancy
c. inaccurate calculation of inception
Verified Answer -B
Beta hCG is produced by the trophoblast or placenta and accurately indicates the
presence of pregnancy. For the first 10 days of pregnancy, the levels double every
2 days and then continue to increase until peaking at 60-90 days after conception,
so a stable to falling level indicates that the pregnancy is not progressing.
A neonate's umbilical cord blood values were pH 7.16, pO2 18 mmHg, and pCO2
55 mmHg, with base excess of 11 mEq/L, indicating
a. normal values
b. respiratory acidosis
c. metabolic acidosis
Verified Answer -C
-Respiratory acidosis: pH < 7.25, pO2 varies, pCO2 > 50 mmHg, Base excess < 10
mEq/L
-Metabolic acidosis: pH < 7.25, pO2 < 20 mmHg, pCO2 44-55 mmHg, base excess
> 10 mEq/L
If fetal scalp blood sampling is done because of an unusual fetal heart rate
pattern, a pH of 7.2 indicates
,a. the need for immediate delivery
b. a normal value
c. the need for repeat sampling in 20 minutes
Verified Answer -A
...usually either with forceps delivery if criteria are met or with cesarean. A
normal fetal pH is 7.25 or greater. If the level is 7.21-7.24, repeat fetal scalp blood
sampling may be done every 20 minutes until there is a changes in the FHR
pattern for better or worse, indicating the need for delivery
Repeated variable decelerations of fetal heart rate during labor suggest
a. normal variations
b. umbilical cord occlusion
c. uteroplacental insufficiency
Verified Answer -B
The fetus may roll on the cord or the cord may be around the neck, resulting in
occlusion during uterine contractions Repeated variable decelerations may also
indicate a short cord or occult prolapse of the cord. If the variable decelerations
occur occasionally without pattern, they are usually not of concern, but if they are
repeated and worsen as labor progresses, the fetus is at risk. If the variable
decelerations are in response to rupturing the membranes, changing the mother's
position may alleviate the decelerations.
The latent phase of the first stage of labor for a nullipara usually lasts about
a. 10 hours
b. 8.5 hours
c. 5.3 hours
Verified Answer -B
,...(5.3 hours for a multipara) and the cervix dilates up to 3 cm. The frequency of
contractions varies from every 3 to every 30 minutes with contractions lasting 20-
40 seconds. Contractions usually range from mild to moderate. Most patients can
manage the discomfort during this phase but they may feel increasing anxiety,
especially nulliparas.
During the second stage of labor, the patient feels a strong urge to bear down
because of
a. pressure on the sacral and obturator nerves
b. pressure on the femoral nerves
c. pressure on the perineum, rectum, and anus
Verified Answer -A
...as the fetus descends the birth canal. The second stage usually lasts for about 2
hours for the nullipara and 15 minutes for the multipara with contractions
occurring every 1.5-2 minutes and persisting for 60-90 seconds. As the fetus
descends and the head crowns, the patient feels increasingly intense pain and
pressure on the perineum.
The purpose of a birth plan is to
a. tell the expectant mother what to expect during labor and delivery
b. provide a checklist for the physician and midwife
c. allow the expectant mother and partner to make advance decisions
Verified Answer -C
...about what the patient wants during labor and delivery in terms of labor
(bedrest, ambulation, frequency of vaginal exams), fetal monitoring (continuous,
intermittent), induction (conditions for artificial rupturing of the membranes,
medications), comfort measures/analgesia/anesthesia (natural
childbirth/epidural, opioids), surgical interventions (conditions for cesarean,
episiotomy), delivery (positioning, method), and postpartal period preferences
(rooming in/nursery, cutting cord, breast/bottle feeding)
, A contraindication for external cephalic version (ECV) is
a. non-engaged fetal breech
b. reactive nonstress test (NST)
c. multiple gestation pregnancy is present
Verified Answer -C
...because of the potential for complications. Other contraindications include
engaged fetal breech, inadequate or abnormal amniotic fluid (oligo or poly),
nonreactive NST, abnormal fetal heart rate tracing (indicating fetus already
stressed), ruptured membranes (resulting in inadequate amniotic fluid), fetal
anomalies, suspected intrauterine growth restriction (IUGR), and maternal health
problems, such as pre-E, diabetes requiring insulin, and hypertension.
When using the vocalization technique during contractions to relax muscles, the
patient is encouraged to
a. make low-pitched moans
b. make high-pitched moans
c. describe relaxation verbally
Verified Answer -A
...by dropping her jaw and mimicking "masculine" sounds because this method of
vocalization causes the glottis to open and makes it easier to breathe, relieving
tension. The patient is advised to avoid making any high-pitched moans or cries
as these may increase tension and result in more discomfort. In a variation, some
women may choose to grunt or sing softly
The most important considerations when a patient is using the birthing ball is that
a. the patient have a bar to grasp
b. the patient should not be left unattended
CORRECTLY ANSWERED 100% VERIFIED.
At 4 weeks gestation, two beta hCG values taken 48 hours apart show decreasing
values. This suggests
a. normal pregnancy
b. miscarriage/ectopic pregnancy
c. inaccurate calculation of inception
Verified Answer -B
Beta hCG is produced by the trophoblast or placenta and accurately indicates the
presence of pregnancy. For the first 10 days of pregnancy, the levels double every
2 days and then continue to increase until peaking at 60-90 days after conception,
so a stable to falling level indicates that the pregnancy is not progressing.
A neonate's umbilical cord blood values were pH 7.16, pO2 18 mmHg, and pCO2
55 mmHg, with base excess of 11 mEq/L, indicating
a. normal values
b. respiratory acidosis
c. metabolic acidosis
Verified Answer -C
-Respiratory acidosis: pH < 7.25, pO2 varies, pCO2 > 50 mmHg, Base excess < 10
mEq/L
-Metabolic acidosis: pH < 7.25, pO2 < 20 mmHg, pCO2 44-55 mmHg, base excess
> 10 mEq/L
If fetal scalp blood sampling is done because of an unusual fetal heart rate
pattern, a pH of 7.2 indicates
,a. the need for immediate delivery
b. a normal value
c. the need for repeat sampling in 20 minutes
Verified Answer -A
...usually either with forceps delivery if criteria are met or with cesarean. A
normal fetal pH is 7.25 or greater. If the level is 7.21-7.24, repeat fetal scalp blood
sampling may be done every 20 minutes until there is a changes in the FHR
pattern for better or worse, indicating the need for delivery
Repeated variable decelerations of fetal heart rate during labor suggest
a. normal variations
b. umbilical cord occlusion
c. uteroplacental insufficiency
Verified Answer -B
The fetus may roll on the cord or the cord may be around the neck, resulting in
occlusion during uterine contractions Repeated variable decelerations may also
indicate a short cord or occult prolapse of the cord. If the variable decelerations
occur occasionally without pattern, they are usually not of concern, but if they are
repeated and worsen as labor progresses, the fetus is at risk. If the variable
decelerations are in response to rupturing the membranes, changing the mother's
position may alleviate the decelerations.
The latent phase of the first stage of labor for a nullipara usually lasts about
a. 10 hours
b. 8.5 hours
c. 5.3 hours
Verified Answer -B
,...(5.3 hours for a multipara) and the cervix dilates up to 3 cm. The frequency of
contractions varies from every 3 to every 30 minutes with contractions lasting 20-
40 seconds. Contractions usually range from mild to moderate. Most patients can
manage the discomfort during this phase but they may feel increasing anxiety,
especially nulliparas.
During the second stage of labor, the patient feels a strong urge to bear down
because of
a. pressure on the sacral and obturator nerves
b. pressure on the femoral nerves
c. pressure on the perineum, rectum, and anus
Verified Answer -A
...as the fetus descends the birth canal. The second stage usually lasts for about 2
hours for the nullipara and 15 minutes for the multipara with contractions
occurring every 1.5-2 minutes and persisting for 60-90 seconds. As the fetus
descends and the head crowns, the patient feels increasingly intense pain and
pressure on the perineum.
The purpose of a birth plan is to
a. tell the expectant mother what to expect during labor and delivery
b. provide a checklist for the physician and midwife
c. allow the expectant mother and partner to make advance decisions
Verified Answer -C
...about what the patient wants during labor and delivery in terms of labor
(bedrest, ambulation, frequency of vaginal exams), fetal monitoring (continuous,
intermittent), induction (conditions for artificial rupturing of the membranes,
medications), comfort measures/analgesia/anesthesia (natural
childbirth/epidural, opioids), surgical interventions (conditions for cesarean,
episiotomy), delivery (positioning, method), and postpartal period preferences
(rooming in/nursery, cutting cord, breast/bottle feeding)
, A contraindication for external cephalic version (ECV) is
a. non-engaged fetal breech
b. reactive nonstress test (NST)
c. multiple gestation pregnancy is present
Verified Answer -C
...because of the potential for complications. Other contraindications include
engaged fetal breech, inadequate or abnormal amniotic fluid (oligo or poly),
nonreactive NST, abnormal fetal heart rate tracing (indicating fetus already
stressed), ruptured membranes (resulting in inadequate amniotic fluid), fetal
anomalies, suspected intrauterine growth restriction (IUGR), and maternal health
problems, such as pre-E, diabetes requiring insulin, and hypertension.
When using the vocalization technique during contractions to relax muscles, the
patient is encouraged to
a. make low-pitched moans
b. make high-pitched moans
c. describe relaxation verbally
Verified Answer -A
...by dropping her jaw and mimicking "masculine" sounds because this method of
vocalization causes the glottis to open and makes it easier to breathe, relieving
tension. The patient is advised to avoid making any high-pitched moans or cries
as these may increase tension and result in more discomfort. In a variation, some
women may choose to grunt or sing softly
The most important considerations when a patient is using the birthing ball is that
a. the patient have a bar to grasp
b. the patient should not be left unattended
