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

Answer: B

Increase the infusion to 3 g/hour to prevent an eclamptic seizure: The findings indicate magnesium toxicity; increasing the dose could cause respiratory or cardiac arrest.

Stop the infusion and prepare calcium gluconate as ordered: Correct. Absent reflexes and respiratory depression signal toxicity; stop magnesium, support breathing, give calcium gluconate per order and check a serum level.

Recheck reflexes in one hour and continue the current rate: Waiting with ongoing infusion allows toxicity to worsen, especially with low urine output reducing excretion.

Give a 500 mL fluid bolus to increase urine output: Fluid boluses risk pulmonary edema in preeclampsia and do not reverse toxicity.

Magnesium toxicity sequence: loss of reflexes, then respiratory depression, then cardiac arrest. Oliguria raises levels because magnesium is renally cleared; the antidote is calcium gluconate.

Answer: C

Category I, because the baseline rate is within normal limits: Category I requires moderate variability and no late or variable decelerations; a normal baseline is not enough.

Category II, because late decelerations are present: Recurrent late decelerations with minimal or moderate variability are Category II; with absent variability they become Category III.

Category III, because variability is absent with recurrent lates: Correct. Absent variability with recurrent late decelerations is Category III, requiring immediate resuscitation and preparation for expedited birth if it does not resolve.

Unclassifiable, because accelerations were not documented: Accelerations are not required for classification; every tracing is assigned to a category.

Category III = absent variability plus recurrent lates, recurrent variables or bradycardia, or a sinusoidal pattern. It predicts abnormal fetal acid-base status.

Answer: C

A slow, steady rise in maternal blood pressure: Rupture causes hypovolemia and hypotension, not a rising blood pressure.

Contractions that become stronger and more regular: Contractions often decrease or stop after rupture rather than intensifying.

A prolonged deceleration or sudden fetal bradycardia: Correct. A fetal heart rate abnormality, especially prolonged deceleration or bradycardia, is the most common first sign of rupture.

A gradual increase in the fetal baseline variability: Rising variability is not a recognized sign of rupture.

Uterine rupture: FHR abnormality (most common), loss of fetal station, new abdominal pain, vaginal bleeding and maternal hypotension; epidurals may mask the pain.

Answer: B

Keep the oxytocin rate and recheck the tracing in 30 minutes: Continuing oxytocin during tachysystole with an abnormal tracing worsens uteroplacental insufficiency.

Decrease or stop the oxytocin and begin intrauterine resuscitation: Correct. Tachysystole with an indeterminate tracing calls for reducing or stopping oxytocin, lateral positioning and an IV fluid bolus, with a tocolytic if it persists.

Increase the oxytocin to complete labor before the fetus tires: Increasing oxytocin raises contraction frequency and further reduces fetal oxygenation.

Perform amniotomy to strengthen and regulate the contractions: Amniotomy does not correct tachysystole and may increase contraction intensity.

Tachysystole = more than 5 contractions in 10 minutes averaged over 30 minutes; with Category II or III changes, reduce or stop oxytocin and resuscitate.

Answer: A

Feed again and recheck the glucose in one hour: Correct. In the first 4 hours, an initial screen below 25 mg/dL in an asymptomatic at-risk infant calls for feeding and rechecking in 1 hour.

Begin an IV dextrose infusion before the next feeding: IV glucose is used if the recheck stays below 25 mg/dL or the infant is symptomatic.

Take no action, since the level is normal for age: A level of 21 mg/dL is below the screening threshold and requires action.

Wait until 12 hours of age to recheck: Delaying recheck risks prolonged hypoglycemia and neurologic injury.

AAP (birth–4 h, asymptomatic): initial screen <25 mg/dL → feed and recheck in 1 h; if still <25 → IV glucose. Symptomatic infants with low glucose need IV glucose.

Answer: C

Beneficence: Beneficence means acting for the patient's good; it would favor the recommended surgery, not explain respecting refusal.

Justice: Justice concerns fair distribution of care and resources, not an individual's right to refuse.

Autonomy: Correct. A pregnant patient with capacity has the right to make informed decisions, including refusal; the team continues to inform, support and document.

Fidelity: Fidelity concerns keeping promises and commitments; it does not ground the right to refuse treatment.

Autonomy: informed refusal by a capable pregnant patient is respected; court-ordered intervention is ethically discouraged. Document the discussion and continue care.