RNC-MNN Practice Questions (2026) — Free Sample Questions with Answers

6 free RNC-MNN questions from our 25-question bank, grouped by content domain. Each answer explains why the right option is right — and why every wrong option is wrong.

Pregnancy, Birth Risk Factors and Complications (1)Maternal Postpartum Assessment, Management, and Education (2)Newborn Assessment and Management (1)Maternal Postpartum Complications (1)Newborn Complications (1)

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Pregnancy, Birth Risk Factors and Complications

Question 1

A term newborn is admitted to the mother-baby unit. The mother received IV magnesium sulfate for preeclampsia with severe features for 18 hours before the birth. Which newborn finding should the nurse anticipate and monitor for most closely?

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Answer: B

Jitteriness and a high-pitched cry: Jitteriness and a high-pitched cry suggest hypoglycemia, hypocalcemia or withdrawal; magnesium produces the opposite (CNS depression).

Hypotonia and respiratory depression: Correct. Magnesium crosses the placenta; neonatal hypermagnesemia can cause hypotonia, lethargy, weak suck and respiratory depression.

Tachycardia and hyperthermia: These are not expected magnesium effects; maternal fever or infection would be more likely causes.

Hyperreflexia and clonus: Magnesium depresses neuromuscular transmission, so reflexes are decreased rather than increased.

Maternal magnesium sulfate = possible newborn CNS and neuromuscular depression: watch tone, respirations, suck and feeding.

Maternal Postpartum Assessment, Management, and Education

Question 2

The nurse is reviewing post-birth warning signs with a patient before discharge. Which symptom should the nurse teach the patient to report by calling 911 rather than calling her health care provider?

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Answer: D

A temperature of 100.4 degrees F (38 degrees C) or higher: Fever is a warning sign, but POST-BIRTH teaching directs the patient to call her health care provider.

A red, swollen, warm area on one calf: Possible DVT is urgent and should be reported to the provider, but it is not one of the call-911 signs.

A headache not relieved by medication: A persistent headache (possible preeclampsia) is a call-the-provider sign in POST-BIRTH teaching.

Chest pain or sudden trouble breathing: Correct. Chest pain and obstructed breathing or shortness of breath may signal pulmonary embolism or cardiac disease and warrant calling 911.

AWHONN POST-BIRTH: call 911 for chest pain, obstructed breathing, seizures, or thoughts of hurting self or baby; call the provider for bleeding, incision problems, leg swelling, fever or headache.

Question 3

Three hours after a vaginal birth, the nurse finds the patient's fundus firm, 2 cm above the umbilicus and deviated to the right, with lochia heavier than at the previous check. What is the most likely cause?

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Answer: A

A distended urinary bladder: Correct. A full bladder displaces the uterus upward and to one side (usually the right) and impairs contraction, increasing bleeding.

Retained placental fragments: Retained fragments cause persistent atony or late bleeding but do not typically displace the fundus laterally.

A normal involution pattern: After birth, the fundus should be midline and at or below the umbilicus, descending about 1 cm per day.

A forming perineal hematoma: A hematoma causes severe perineal or rectal pain and swelling, often with a firm, normally positioned fundus.

Fundus high and deviated (usually right) with increased bleeding = think bladder; help the patient void (or catheterize) and reassess.

Newborn Assessment and Management

Question 4

A term newborn is placed under a radiant warmer, dried, stimulated and positioned with the airway cleared. At 30 seconds the infant is apneic with a heart rate of 80 beats/min. What is the next action?

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Answer: B

Begin chest compressions at a 3:1 ratio: Compressions are indicated only if the heart rate stays below 60 beats/min after at least 30 seconds of effective ventilation.

Start positive-pressure ventilation: Correct. Apnea, gasping or a heart rate below 100 beats/min after initial steps calls for PPV within the first minute, with SpO2 monitoring.

Administer IV epinephrine: Epinephrine is reserved for a heart rate below 60 despite effective ventilation and compressions.

Give free-flow blow-by oxygen: Free-flow oxygen does not help an apneic infant, who needs assisted ventilation.

NRP: ventilation is the single most important step. Apnea or HR < 100 after initial steps means PPV; HR < 60 after effective PPV means compressions.

Maternal Postpartum Complications

Question 5

A postpartum patient with preeclampsia is receiving magnesium sulfate at 2 g/hour. She is drowsy, her respiratory rate is 10 breaths/min, and patellar reflexes are absent. Which action should the nurse take first?

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Answer: A

Stop the infusion and prepare IV calcium gluconate: Correct. Loss of reflexes and respiratory depression indicate magnesium toxicity; stop the infusion, support breathing, notify the provider and give calcium gluconate as ordered.

Increase the infusion to prevent eclamptic seizures: These are signs of excess magnesium; increasing the dose could cause respiratory or cardiac arrest.

Administer naloxone for respiratory depression: Naloxone reverses opioids, not magnesium; the antidote for magnesium is calcium gluconate.

Recheck the reflexes in 1 hour and document: Delay is unsafe; respiratory depression requires immediate intervention.

Magnesium toxicity sequence: loss of DTRs, then respiratory depression, then cardiac arrest. Stop the drip and give calcium gluconate.

Newborn Complications

Question 6

During an 18-hour assessment, the nurse notices yellow skin on a breastfed term newborn's face and upper chest. What is the most appropriate action?

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Answer: B

Document physiologic jaundice and reassess at discharge: Jaundice before 24 hours of age is not physiologic and should not wait for discharge.

Obtain a bilirubin level (TSB or TcB) promptly: Correct. Visible jaundice in the first 24 hours is pathologic until proven otherwise and requires prompt bilirubin measurement.

Supplement each feeding with water to flush bilirubin: Water supplementation does not lower bilirubin and can cause hyponatremia; adequate milk intake is the goal.

Teach the parents to place the infant in indirect sunlight: Sunlight exposure is not a safe or reliable treatment for neonatal hyperbilirubinemia.

Jaundice under 24 hours = measure TSB or TcB right away and look for hemolysis (ABO/Rh incompatibility, G6PD).

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