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RNC Test Questions with 1000% Complete Solved Solutions
1. b: The insulin requirements for most diabetic breastfeeding mom's is:
a. increased
b.decreased
c. same
2. b: In a normal pregnancy, there is usually a physiologic drop in blood pressure to its lowest point in the
a. first trimester
b.2nd trimester
c. 3rd trimester
3. a: Which statement best describes the relationship between maternal and fetal hemoglobin levels?
a. Fetal hemoglobin is higher than maternal hemoglobin
b.Maternal hemoglobin is higher than fetal hemoglobin
c. Maternal and fetal hemoglobin are the same
4. b: The cardiac output during pregnancy
a. decreases by 23%
b.Increases by 30-50%
c. remains the same
5. a: What class of antihypertensive medication is recommended in pregnancy since it has been shown not to increase the
chance of new onset diabetes by improving sensitivity to insulin glycemic control?
a. Ace inhibitors
b.Beta Blockers
c. Calcium Channel Blockers
6. a: An antihypertensive that Is contraindicated during the second and third trimester of pregnancy is
a. Ace inhibitors (Ex: captopril, enalapril, ramipril)
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b.Calcium channel blockers (Nifedipine)
c. Combined alpha - beta blockers (Labetolol)
7. c: The primary indication for the use of magnesium sulfate in preeclampsia is
a. lowering the blood pressure
b.prevention of HELLP
c. seizure prophylaxis
8. b: A pregnant woman on a continuous infusion of Magnesium Sulfate for preeclampsia exhibits the following:
Respiratory rare: 14 per minute, Deep tendon reflexes: decreased with clonus, absent mental status: awake and alert. The most appropriate nursing action is to
a. decrease the infusion rate
b.discontinue the infusion rate
c. maintain the infusion rate
9. b: Compared to the general population, woman with pregestational diabetes are how likely to deliver a baby with a
major congenital anomaly?
a. 1-2 times more likely
b.3-4 times more likely
c. 5-6 times more likely
10. c: The tocolytic that is contraindicated in the diabetic woman is
a. Magnesium Sulfate
b.Nifedipine (Procardia) Terbutaline
(Beta - mimetics)
11. a: Compared to the first trimester, the insulin requirements for the diabetic mother in the third trimester are
a. greater
b.less
c. the same
12. c: A Type I (pregestational) diabetic woman at 32 weeks gestation is admitted with complaints of abdominal pain,
nausea and vomiting over the last 48 hours. she states she omitted her insulin last evening and this morning since she
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c. placenta previa
18. c: Which one of the cardiac conditions listed below has the highest rate of maternal mortality
a. atrial septal defect
b.mitral stenosis
c. pulmonary hypertension
19. c: The time during labor and birth that is of greatest risk for woman with a cardiac condition is
a. active phase of labor
b.second stage of birth
c. immediately after birth
20. c: The medication that is contraindicated in women with a cardia condition
a. hydralazine (apresoline)
b.oxytocin
c. terbutaline
21. a: Which one of the following infections does not cross the placenta?
a. Neisseria gonorrhea
b.HIV
c. Syphyllis
22. c: Physiologic anemia of pregnancy occurs due to
a. decreased iron stores due to an inadequate diet rich in iron foods
b.inadequate intake of folic acid preconceptionally
c. proportionately greater increase in plasma that red cell volume
23. c: At 32 weeks, an African American prenatal patient has a hemoglobin of gms/dl. She reports no problems and
her assessment at this visit is normal. She most likely would have what type of anemia? a Folic acid deficiency b. Iron deficiency anemia c. physiologic anemia of pregnancy
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24. c: The maternal anemia that results in an increased viscosity of the blood
a. folic acid anemia
b.iron deficiency anemia
c. sickle cell anemia
25. b: A prenatal patient with a negative prenatal RH antibody screen should receive immune globulin (RhoGam) 300
mcg at what stage of her pregnancy
a. 24-26 weeks
b.28-32 weeks
c. 34-36 weeks
26. c: A woman with a history of a pregnancy that was anencephalic should be advised to supplement her diet
with what dosage of folic acid?
a. 0.04 mg
b.0.4 mg
c. 4.0 mg
27. c: A risk factor for prenatal toxoplasmosis is
a. charbroiled meat
b.processed lunch meat
c. sushi
28. a: A 21 year old, 32 week gestation, gravida 4m para 0 with no prenatal care is admitted with complaints of
unremitting abdominal pain and bright red vaginal bleeding. Her abdomen palpates board-like and rigid. This history is suspicious of the use of
a. cocaine
b.heroine
c. marijuana
29. a: A woman at 31 weeks gestation is admitted to labor and delivery in possible labor. On examination, the nurse
notices bruises on the patient's breast and ab- domen. When asked about the bruises she reluctantly admits that her partner threw her against the door when she was trying to leave him due to repeated abusive episodes. The nurse
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c. 3rd trimester biophysical profile
35. a: Failure to elicit a reactive pattern with a nonstress test after 40 minutes of fetal monitoring warrants
a. further evaluation
b.increased testing time
c. retest after giving orange juice
36. b: In a 30 week GA fetus who has never had a NST before, the test is considered reactive when
a. accelerations accompany the marks made by the mother noted in a
20 minute period
b.accelerations peak at 10 bpm above the baseline with a duration of 10 seconds
within 20 minutes
c. at least 2 fetal heart accelerations occur in 20 minutes
37. b: A negative contraction stress test is characterized by
a. accelerations with onset of contractions
b.no late or significant variable decelerations
c. presence of moderate variability in between contractions
38. b: At 32 weeks, a prenatal patient reported decreased fetal movement. A
non-stress test is reported as non reactive. Which of the following is appropriate for this patient?
a. admission to the labor unit for an expedited delivery
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b.Biophysical profile
c. keeping a fetal movement record and return in 24 hours
39. a: A low level of alpha fetoprotein is indicative of
a. Down syndrome
b.maternal fetal hemorrhage
c. neural tube defects
40. c: A woman, who is a gravida 4 para 1212 has had 4 pregnancies with one
a. two term, one preterm, and 2 living children
b.two abortions, one living child and two preterm
c. two preterm, one abortion and two living children
41. b: A potential fetal complication that occurs with cordocentesis (percutaneous umbilical blood sampling) 2% of
the time is
a. cardiac dysrhythmias
b.fetal loss
c. profound persistent bradycardia
42. a: A patient who does not want chromosome testing but would like to know the risk of her delivering a newborn
with a neural tube defect (NTD), should have what test ordered that is specific for NTD?
a. Maternal serum alpha fetal protein (MSAFP)
b.Nuchal translucency
c.Triple Screen
43. c: Quad screening compared to alphafetoprotein testing can better detect
a. metabolic disorders
b.open neural tube defects
c. trisomies
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c. variable deceleration
50. b: Stimulation of the sympathetic nervous system causes the fetal heart rate to
a. decrease
b.increase
c. remain the same
51. c: Which statement describes normal uterine activity?
a. Frequency of 1 1/2 to 2 minutes
b.Intensity of 90 mmHg early in labor
c. Resting tone less than 20-25 mmHg
52. c: using the NICHD definitions, spontaneous occurrence of greater than 5 con- tractions in 10 minutes, averaged
over a 30 minute window is called
a. hyperstimulation
b.hypertonus
c. tachysystole
53. c: The most common side effect of prostaglandin administration is
a. Maternal fever
b.Nausea and vomiting
c.Tachysystole
54. a: When fetal heart tones are heard above the umbilicus abd the fetal head is palpated in the upper part of the
uterus, this is consistent with
a. breech presentation
b.brow presentation
c. occiput posterior position
55. b: Palpate the uterus is best performed by using the
a. back of the hand
b.fingertips
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c. palm
56. c: At a prenatal visit, a woman's uterus is palpated at the xyphoid process. This would be normally found at what
week gestation?
a. 32
b. 34
c. 36
57. a: The first Leopold's maneuver assists in identifying the fetal
a. attitude
b.cephalic prominence
c. presentation
58. b: A fetal scalp blood sample reveals a ph 7.21. Based on the finding, the nurse is prepared to
a. assist repeat testing in 30 minutes
b.recognize the ph is normal
c. transfer the patient to the OR for delivery
59. b: Umbilical blood gas values are used to
a. direct initial steps of neonatal resuscitation
b.establish the state of fetal oxygenation
c. predict adverse neurological outcomes
60. b: An advantage of vibroacoustic testing is that is
a. can be used effectively at any gestational age
b.can decrease nonstress testing time
c. can be used for 3 seconds each time, up to 5 times
61. a: A fetal response to asphyxia is
a. decreased PCO
b.increased lactate level
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b.lightening
c. quickening
65. b: The pelvic type is favorable for a vaginal birth is
a. android
b.gynecoid
c. platypelloid
66. a: One theory of labor initiation is an increase in
a. corticotrophin- releasing-hormone (CRH)
b.progesterone
c. prostacylin
67. a: When differentiating false labor from true labor, a finding that would suggest a woman is in true labor is if after
1-2 hours of walking which of the following occurs?
a. Back pain radiating to the abdomen
b.Cervix is soft and closed
c. Contractions lesson some with walking
68. c: The umbilical vein carries
a. carbon dioxide from the fetus back to the placenta
b.deoxygenated blood from the fetus to the placenta
c. oxygenated blood from the placenta to the fetus
69. a: Maternal supine hypotension is caused mainly by compression of the
a. inferior vena cava
b.spiral arteries
c. uterine vessels
70. b: During labor and delivery, cardiac output is at its highest in the
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a. first stage
b.second stage
c. immediate period after delivery
71. b: The Ferguson reflex is the result of
a. cytokine release
b.pressure on the cervix
c. prostaglandin release from the membranes
72. a: Compared to non-pregnant values, the maternal arterial carbon dioxide (pCO2) during pregnancy is
a. decreased
b.increased
c. the same
73. b: Compared to non-pregnant values, the maternal arterial ph during pregnancy is
a. slightly decreased
b.slightly increased
c. the same
74. b: The metabolic states of pregnancy is described as a chronic
a. respiratory acidosis
b.respiratory alkalosis
c. mixed acidosis
75. b: During pregnancy cardiac output increases by what percent?
a. 20-30 %
b.40-50 %
c. 60-70%
76. a: The color of nitrazine paper most indicative of ruptured membranes is
a. blue
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a. 5 minutes
b. 10 minutes
c. 15 minutes
83. b: The phase of labor that distraction techniques are most likely to be effective is
a. active
b.latent
c. transition
84. c: A prolonged second stage in a primigravida with regional anesthesia is defined as a lack of continuous
progress and a second stage duration of greater than a. 1 hour b. 2 hours c. 3 hours
85. a: Internal rotation of the head generally occurs in
a. mid pelvis
b.pelvic entry
c posterior pelvis
86. c: The transition phase of labor is characterized by maternal
a. alertness and seriousness
b.excitement and anticipation
c. panic and fear
87. b: One sign that suggests placental separation is
a. downward movement of the uterus in the abdomen
b.lengthening of the umbilical cord
c. uterus changes shape from a glob to a disk
88. a: A woman in labor is having contractions about every 2-3 minutes. She is 7-8 cm dilated, 100% effaced, and a +
station. These findings are most consistent with what stage of labor?
a. First
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b.Second
c.Third
89. c: The pushing technique that a woman in second stage should be encouraged to use is
a. Alternating between open and closed glottis pushing
b.Closed glottis pushing while holding her breath to the count of 10
c. Open-glottis pushing for 6-8 seconds with 3-4 pushes per contraction
90. c: In the multigravida with no maternal or fetal contraindications, pushing efforts may be delayed up to
a. 30 minutes
b. 1 hour c. 2 hours
91. c: The second stage position that can increase the pelvic diameter as much as 28-30 % is
a. knee-chest
b.semi-fowlers
c. squatting
92. b: The frequency of fetal heart rate assessments for a low risk woman in active labor on Pitocin is every
a. 5 minutes
b. 15 minutes
c. 30 minutes
93. b: After the last dose of misoprostol (cytotec) , oxytocin administration should be delayed for at least
a. 30-60 minutes
b. 4 hours
c. 6-12 hours
94. b: The current recommendation regarding timing of prophylactic antibiotics for a cesarean section is
a. after placenta delivery
b.immediately after cord clamping
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98. b: The half-life of Pitocin is
a. 5-7 minutes
b.10-12 minutes
c. 13-15 minutes
99. c: In order to prevent water intoxication during Pitocin administration, the Pitocin should be mixed in an
intravenous fluid that is
a. hypertonic
b.hypotonic
c. isotonic
100. a: Pitocin dosages during labor should be documented in
a. mU/per minute
b.ml/min
c. cc/hr
101. c: A patient is being induced and is at an oxytocin level of 20 mU/min. she reports nausea and vomiting,
feels her heart beating rapidly, feeling faint and has a headache. She most likely is experiencing
a. an infectious process
b.anxiety from labor
c. water intoxication
102. a: The recommended initial intravaginal dose of misoprostol (cytotec) for cer- vical ripening is
a. 25 mcg
b. 50 mcg
c. 100 mcg
103. a: When cervidyl (Prepdil) is used for induction of labor, at what point can oxytocin be initiated after
insertion of the Cervidyl?
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a. 30 minutes after removal
b.4 hrs after insertion
c. 6 hrs after insertion
104. b: An advantage of prostaglandin E2 over low dose oxytocin is
a. fewer cesarean deliveries
b.labors are shortened
c. less morbidity
105. b: When active labor is achieved during a Pitocin induction or augmentation, the Pitocin dosage can be
a. discontinued
b.incrementally decreased
c. incrementally increased
106. a: The frequency of fetal heart rate assessments for a low risk woman in second stage on Pitocin is every
a. 5 minutes
b. 15 minutes
c. 30 minutes
107. b: When a pattern of coupling and tripling of contractions is occurring the oxytocin dose should be
a. decreased
b.discontinued
c. maintained
108. a: According to the gate control theory relieving pain with massage, heat, and cold acts by
a. blocking the capacity of nerve pathways to transmit pain
b.diverting the pathways to areas of spinal cord decreasing sensation
c. limiting the amount of nerve sensation across the pathway
109. c: Therapeutic touch is based on the theory that
