Inpatient Obstetric Nursing Practice Exam | Actual
2025/2026 Questions and Verified Answers | Graded A+
Inpatient Obstetric Nursing (RNC-OB®) Certification Practice Exam | Updated for the
2025/2026 testing cycle, this resource features authentic exam-based questions with verified
correct answers. Core content domains include antepartum, intrapartum, postpartum, fetal
assessment and monitoring, complications of pregnancy, maternal and fetal safety, and
professional nursing practice in the obstetric setting.
Overview
This Inpatient Obstetric Nursing exam prep provides real-world, practice exam-style questions
with 100% accurate answers. Verified by clinical experts, each question is designed to strengthen
maternal-newborn knowledge, enhance fetal monitoring interpretation, and support safe,
evidence-based care. Graded A+ for reliability and exam readiness.
Answer Format
All correct answers are displayed in bold green with rationales that explain maternal/fetal
physiology, obstetric complications, and clinical decision-making to build exam confidence and
critical thinking skills.
1. A pregnant patient at 38 weeks gestation presents with regular
contractions and a cervical dilation of 4 cm. What is the priority nursing
intervention?
a) Prepare for immediate cesarean section
b) Assess fetal heart rate and maternal vital signs
c) Administer tocolytics
d) Encourage ambulation
b) Assess fetal heart rate and maternal vital signs
Rationale: In active labor (4 cm dilation), the priority is to monitor fetal well-being and
maternal status to ensure safe progression (ACOG, 2025).
2. What is the normal fetal heart rate range during labor?
a) 80–100 bpm
b) 110–160 bpm
c) 170–200 bpm
d) 200–220 bpm
b) 110–160 bpm
Rationale: The normal fetal heart rate baseline is 110–160 beats per minute, with variability
indicating fetal well-being (AWHONN, 2025).
3. A patient in the second stage of labor reports the urge to push. What is
the nurse’s response?
,a) Instruct the patient to suppress the urge
b) Encourage pushing with contractions
c) Administer pain medication
d) Prepare for forceps delivery
b) Encourage pushing with contractions
Rationale: The urge to push in the second stage indicates full cervical dilation, and guided
pushing facilitates delivery.
4. What is the primary sign of placental abruption?
a) Clear amniotic fluid leakage
b) Vaginal bleeding and abdominal pain
c) Decreased fetal movement
d) Hypertension
b) Vaginal bleeding and abdominal pain
Rationale: Placental abruption presents with painful vaginal bleeding, fetal distress, and uterine
tenderness (ACOG, 2025).
5. During fetal monitoring, a late deceleration is noted. What is the nurse’s
immediate action?
a) Reposition the patient
b) Administer oxygen
c) Increase IV fluids
d) Prepare for delivery
b) Administer oxygen
Rationale: Late decelerations indicate uteroplacental insufficiency; oxygen improves fetal
oxygenation (AWHONN, 2025).
6. What is the recommended postpartum lochia pattern?
a) Lochia rubra for 10 days
b) Lochia serosa for 3–4 weeks
c) Lochia alba indefinitely
d) Lochia rubra for 6 weeks
b) Lochia serosa for 3–4 weeks
Rationale: Postpartum lochia progresses from rubra (1–3 days), serosa (4–10 days), to alba (10
days–4 weeks).
7. A patient at 32 weeks gestation reports decreased fetal movement. What
is the nurse’s first action?
a) Schedule an ultrasound
b) Perform non-stress test
c) Administer betamethasone
d) Encourage bed rest
b) Perform non-stress test
Rationale: Decreased fetal movement requires immediate fetal heart rate monitoring via
non-stress test to assess well-being.
,8. What is the primary intervention for preeclampsia with severe features?
a) Bed rest
b) Magnesium sulfate infusion
c) Oral antihypertensives
d) Fetal monitoring only
b) Magnesium sulfate infusion
Rationale: Magnesium sulfate prevents seizures (eclampsia) in severe preeclampsia (ACOG,
2025).
9. What is the normal variability in fetal heart rate tracing?
a) Absent
b) 6–25 bpm
c) Minimal (<5 bpm)
d) Marked (>25 bpm)
b) 6–25 bpm
Rationale: Moderate variability (6–25 bpm) indicates fetal well-being; absent or minimal
variability is concerning.
10. A postpartum patient reports heavy bleeding and clots. What is the
nurse’s priority?
a) Encourage ambulation
b) Massage the fundus
c) Administer an analgesic
d) Apply a heating pad
b) Massage the fundus
Rationale: Fundal massage expresses the uterus to control postpartum hemorrhage from atony.
11. What is the primary sign of preterm labor?
a) Increased fetal movement
b) Regular uterine contractions
c) Decreased vaginal discharge
d) Back pain only
b) Regular uterine contractions
Rationale: Regular contractions before 37 weeks indicate preterm labor, requiring tocolysis and
monitoring.
12. During labor, variable decelerations are noted. What is the nurse’s first
action?
a) Administer oxygen
b) Reposition the patient
c) Increase IV fluids
d) Prepare for delivery
b) Reposition the patient
Rationale: Variable decelerations indicate cord compression; repositioning relieves pressure
(AWHONN, 2025).
, 13. What is the recommended dose of oxytocin for labor induction?
a) Start at 1 mU/min, increase by 1 mU/min every 30 minutes
b) Start at 10 mU/min, increase by 5 mU/min every 15 minutes
c) Start at 0.5 mU/min, increase by 0.5 mU/min every 60 minutes
d) Start at 2 mU/min, increase by 2 mU/min every 20 minutes
a) Start at 1 mU/min, increase by 1 mU/min every 30 minutes
Rationale: The standard oxytocin protocol starts low to minimize hyperstimulation risks
(ACOG, 2025).
14. What is the primary intervention for postpartum hemorrhage due to
uterine atony?
a) Administer antibiotics
b) Fundal massage and oxytocin
c) Surgical repair
d) Blood transfusion
b) Fundal massage and oxytocin
Rationale: Uterine atony is treated with fundal massage and oxytocin to promote contraction
and hemostasis.
15. A patient at 28 weeks gestation reports vaginal bleeding. What is the
nurse’s first action?
a) Perform a vaginal exam
b) Assess fetal heart rate
c) Administer tocolytics
d) Encourage ambulation
b) Assess fetal heart rate
Rationale: Vaginal bleeding in the second trimester may indicate placenta previa or abruption,
requiring immediate fetal assessment.
16. What is the normal Bishop score for a patient ready for induction?
a) 0–3
b) 4–6
c) 7–9
d) 10–13
d) 10–13
Rationale: A Bishop score ≥8 indicates a favorable cervix for induction; <6 may require
ripening.
17. What is the primary sign of gestational hypertension?
a) Proteinuria
b) Blood pressure ≥140/90 mmHg
c) Edema
d) Headache
b) Blood pressure ≥140/90 mmHg
Rationale: Gestational hypertension is defined by BP ≥140/90 mmHg after 20 weeks without
proteinuria.
2025/2026 Questions and Verified Answers | Graded A+
Inpatient Obstetric Nursing (RNC-OB®) Certification Practice Exam | Updated for the
2025/2026 testing cycle, this resource features authentic exam-based questions with verified
correct answers. Core content domains include antepartum, intrapartum, postpartum, fetal
assessment and monitoring, complications of pregnancy, maternal and fetal safety, and
professional nursing practice in the obstetric setting.
Overview
This Inpatient Obstetric Nursing exam prep provides real-world, practice exam-style questions
with 100% accurate answers. Verified by clinical experts, each question is designed to strengthen
maternal-newborn knowledge, enhance fetal monitoring interpretation, and support safe,
evidence-based care. Graded A+ for reliability and exam readiness.
Answer Format
All correct answers are displayed in bold green with rationales that explain maternal/fetal
physiology, obstetric complications, and clinical decision-making to build exam confidence and
critical thinking skills.
1. A pregnant patient at 38 weeks gestation presents with regular
contractions and a cervical dilation of 4 cm. What is the priority nursing
intervention?
a) Prepare for immediate cesarean section
b) Assess fetal heart rate and maternal vital signs
c) Administer tocolytics
d) Encourage ambulation
b) Assess fetal heart rate and maternal vital signs
Rationale: In active labor (4 cm dilation), the priority is to monitor fetal well-being and
maternal status to ensure safe progression (ACOG, 2025).
2. What is the normal fetal heart rate range during labor?
a) 80–100 bpm
b) 110–160 bpm
c) 170–200 bpm
d) 200–220 bpm
b) 110–160 bpm
Rationale: The normal fetal heart rate baseline is 110–160 beats per minute, with variability
indicating fetal well-being (AWHONN, 2025).
3. A patient in the second stage of labor reports the urge to push. What is
the nurse’s response?
,a) Instruct the patient to suppress the urge
b) Encourage pushing with contractions
c) Administer pain medication
d) Prepare for forceps delivery
b) Encourage pushing with contractions
Rationale: The urge to push in the second stage indicates full cervical dilation, and guided
pushing facilitates delivery.
4. What is the primary sign of placental abruption?
a) Clear amniotic fluid leakage
b) Vaginal bleeding and abdominal pain
c) Decreased fetal movement
d) Hypertension
b) Vaginal bleeding and abdominal pain
Rationale: Placental abruption presents with painful vaginal bleeding, fetal distress, and uterine
tenderness (ACOG, 2025).
5. During fetal monitoring, a late deceleration is noted. What is the nurse’s
immediate action?
a) Reposition the patient
b) Administer oxygen
c) Increase IV fluids
d) Prepare for delivery
b) Administer oxygen
Rationale: Late decelerations indicate uteroplacental insufficiency; oxygen improves fetal
oxygenation (AWHONN, 2025).
6. What is the recommended postpartum lochia pattern?
a) Lochia rubra for 10 days
b) Lochia serosa for 3–4 weeks
c) Lochia alba indefinitely
d) Lochia rubra for 6 weeks
b) Lochia serosa for 3–4 weeks
Rationale: Postpartum lochia progresses from rubra (1–3 days), serosa (4–10 days), to alba (10
days–4 weeks).
7. A patient at 32 weeks gestation reports decreased fetal movement. What
is the nurse’s first action?
a) Schedule an ultrasound
b) Perform non-stress test
c) Administer betamethasone
d) Encourage bed rest
b) Perform non-stress test
Rationale: Decreased fetal movement requires immediate fetal heart rate monitoring via
non-stress test to assess well-being.
,8. What is the primary intervention for preeclampsia with severe features?
a) Bed rest
b) Magnesium sulfate infusion
c) Oral antihypertensives
d) Fetal monitoring only
b) Magnesium sulfate infusion
Rationale: Magnesium sulfate prevents seizures (eclampsia) in severe preeclampsia (ACOG,
2025).
9. What is the normal variability in fetal heart rate tracing?
a) Absent
b) 6–25 bpm
c) Minimal (<5 bpm)
d) Marked (>25 bpm)
b) 6–25 bpm
Rationale: Moderate variability (6–25 bpm) indicates fetal well-being; absent or minimal
variability is concerning.
10. A postpartum patient reports heavy bleeding and clots. What is the
nurse’s priority?
a) Encourage ambulation
b) Massage the fundus
c) Administer an analgesic
d) Apply a heating pad
b) Massage the fundus
Rationale: Fundal massage expresses the uterus to control postpartum hemorrhage from atony.
11. What is the primary sign of preterm labor?
a) Increased fetal movement
b) Regular uterine contractions
c) Decreased vaginal discharge
d) Back pain only
b) Regular uterine contractions
Rationale: Regular contractions before 37 weeks indicate preterm labor, requiring tocolysis and
monitoring.
12. During labor, variable decelerations are noted. What is the nurse’s first
action?
a) Administer oxygen
b) Reposition the patient
c) Increase IV fluids
d) Prepare for delivery
b) Reposition the patient
Rationale: Variable decelerations indicate cord compression; repositioning relieves pressure
(AWHONN, 2025).
, 13. What is the recommended dose of oxytocin for labor induction?
a) Start at 1 mU/min, increase by 1 mU/min every 30 minutes
b) Start at 10 mU/min, increase by 5 mU/min every 15 minutes
c) Start at 0.5 mU/min, increase by 0.5 mU/min every 60 minutes
d) Start at 2 mU/min, increase by 2 mU/min every 20 minutes
a) Start at 1 mU/min, increase by 1 mU/min every 30 minutes
Rationale: The standard oxytocin protocol starts low to minimize hyperstimulation risks
(ACOG, 2025).
14. What is the primary intervention for postpartum hemorrhage due to
uterine atony?
a) Administer antibiotics
b) Fundal massage and oxytocin
c) Surgical repair
d) Blood transfusion
b) Fundal massage and oxytocin
Rationale: Uterine atony is treated with fundal massage and oxytocin to promote contraction
and hemostasis.
15. A patient at 28 weeks gestation reports vaginal bleeding. What is the
nurse’s first action?
a) Perform a vaginal exam
b) Assess fetal heart rate
c) Administer tocolytics
d) Encourage ambulation
b) Assess fetal heart rate
Rationale: Vaginal bleeding in the second trimester may indicate placenta previa or abruption,
requiring immediate fetal assessment.
16. What is the normal Bishop score for a patient ready for induction?
a) 0–3
b) 4–6
c) 7–9
d) 10–13
d) 10–13
Rationale: A Bishop score ≥8 indicates a favorable cervix for induction; <6 may require
ripening.
17. What is the primary sign of gestational hypertension?
a) Proteinuria
b) Blood pressure ≥140/90 mmHg
c) Edema
d) Headache
b) Blood pressure ≥140/90 mmHg
Rationale: Gestational hypertension is defined by BP ≥140/90 mmHg after 20 weeks without
proteinuria.
