RNC-OB Study Guide: All-In-One Guide + 4 Exam Practice Test (700 Questions), Latest for Inpatient Obstetric Nursing (RNC-OB), National Certification Corporation (NCC)

A 32-year-old laboring patient at 6 cm dilation requests aromatherapy to manage her pain. Which essential oil is most appropriate for reducing anxiety and pain perception during labor, according to current evidence-based guidelines?

Scenario: Sarah, a 32-year-old pregnant woman with preexisting Type 1 diabetes (T1DM) at 24 weeks gestation, presents for a routine prenatal visit. Her recent hemoglobin A1c is 7.2%. She reports occasional nocturnal hypoglycemia but denies symptoms of hyperglycemia. Which of the following is the most appropriate intervention to optimize her glycemic control while minimizing fetal risks?

A 28-year-old pregnant patient at 32 weeks gestation presents with regular uterine contractions every 5 minutes, cervical dilation of 2 cm, and effacement of 50%. Her fetal fibronectin (fFN) test is positive. Which of the following findings is most diagnostic of preterm labor according to current NCC guidelines?

Sarah, a 32-year-old G2P1 at 39 weeks gestation, is admitted for induction of labor due to gestational hypertension. Her Bishop score is 3. The obstetrician orders cervical ripening before oxytocin administration. Which pharmacologic agent is most appropriate for cervical ripening in this patient?

Sarah, a 32-year-old G2P1 at 39 weeks gestation, presents to the labor unit with severe abdominal pain, vaginal bleeding, and a rigid, board-like abdomen. Her vital signs show tachycardia (HR 120 bpm) and hypotension (BP 80/50 mmHg). Fetal monitoring reveals bradycardia (80 bpm). Which of the following is the most likely diagnosis?

Scenario: Sarah, a labor and delivery nurse, is caring for a patient, Ms. Johnson, who is in active labor with a history of gestational hypertension. The fetal heart rate (FHR) monitor shows recurrent late decelerations, but Sarah fails to notify the provider promptly, assuming the pattern is transient. The baby is born with significant acidosis and requires NICU admission. Ms. Johnson later files a lawsuit alleging negligence.

Sarah, a 32-year-old G1P0 at 39 weeks gestation, is being evaluated for induction of labor due to gestational hypertension. Her Bishop score is assessed as follows: cervical dilation 2 cm, effacement 50%, station -2, consistency firm, and position posterior. Which component of the Bishop score carries the greatest weight in predicting successful induction of labor?

A pregnant patient at 32 weeks gestation reports prolonged exposure to high levels of indoor air pollution due to mold in her home. Which of the following is the most significant environmental risk associated with this exposure during pregnancy?

A 32-year-old pregnant patient at 38 weeks gestation presents for a non-stress test (NST). The tracing shows a baseline fetal heart rate (FHR) of 140 bpm, moderate variability, and two accelerations in 20 minutes, each lasting 15 seconds and peaking at 15 bpm above baseline. There are no decelerations. How should this NST be interpreted?

A newborn is admitted to the well-baby nursery at 38 weeks gestation. The nurse is preparing to administer prophylactic eye ointment. Which medication is most appropriate for preventing ophthalmia neonatorum in this infant?

Sarah, a 36-week preterm newborn, is placed skin-to-skin (STS) with her mother immediately after birth. The nurse notes that Sarah’s temperature is 36.1°C (97°F) axillary. Which action should the nurse prioritize to promote thermoregulation while maintaining STS contact?

Sarah, a 28-year-old primiparous mother, is breastfeeding her 3-day-old newborn. She reports that her breasts feel full, warm, and slightly tender. The infant is latching well but seems frustrated and is not feeding effectively. On assessment, you note bilateral breast engorgement. What is the most appropriate initial nursing intervention to alleviate Sarah’s symptoms and improve infant feeding?

Scenario: Sarah, a 32-year-old G2P1, delivered a term newborn via spontaneous vaginal delivery. The newborn has poor tone, cyanosis, and a weak cry at birth. The nurse initiates the initial assessment. Which of the following is the priority nursing intervention?

Sarah, a 32-year-old G2P1 at 37 weeks gestation, presents with a persistent breech presentation. The obstetrician plans an external cephalic version (ECV). Which of the following conditions is an absolute contraindication for performing ECV?

Scenario: Sarah, a 32-year-old G2P1 patient at 39 weeks gestation, presents in active labor. During fetal monitoring, recurrent variable decelerations are noted with minimal to moderate variability. On vaginal examination, the nurse palpates a pulsating structure in the vaginal vault. Which of the following is the most appropriate immediate nursing action?

Sarah, a postpartum nurse, is caring for a term newborn delivered via cesarean section under spinal anesthesia. The infant is stable with Apgar scores of 8 and 9 at 1 and 5 minutes, respectively. The mother requests immediate skin-to-skin contact (SSC). Which of the following is the most appropriate action to promote thermoregulation while ensuring safety?

Scenario: Sarah, a 32-year-old G1P1, delivered a term newborn via vacuum-assisted vaginal delivery due to prolonged second-stage labor. Upon assessment, the nurse notes the newborn has limited movement of the right arm, with the forearm held in pronation and slight flexion. There is no swelling or bruising observed. The newborn cries when the arm is touched.

A 32-year-old G2P1 patient at 39 weeks gestation presents for induction of labor due to gestational hypertension. Her Bishop score is 3, and the provider orders cervical ripening. Which method is most appropriate for cervical ripening in this patient?

Scenario: Baby Emma, a 38-week gestational age newborn, is 48 hours old and breastfeeding well. Her total serum bilirubin (TSB) level is 16 mg/dL at 48 hours of life. Her mother has blood type O+, and the baby has blood type A+. The Coombs test is positive. Physical examination reveals no signs of lethargy or poor feeding. Which of the following is the most appropriate next step in Emma’s management?

A 32-year-old G1P0 patient at 39 weeks gestation is admitted for induction of labor due to gestational hypertension. The obstetrician performs an amniotomy. Which of the following is the most critical nursing assessment immediately following amniotomy?

A nurse is caring for a patient who experienced a stillbirth at 32 weeks gestation. The patient expresses feelings of guilt and asks, “What did I do wrong?” Which response by the nurse is most therapeutic and evidence-based?

A 32-year-old pregnant patient at 28 weeks gestation with a history of moderate persistent asthma presents to the labor and delivery unit with acute exacerbation. She reports increased wheezing and shortness of breath over the past 12 hours. Which of the following is the most appropriate initial pharmacological intervention?

A 32-year-old G2P1 patient at 39 weeks gestation is undergoing cervical ripening with misoprostol for induction of labor. Two hours after administration, the fetal heart rate tracing shows recurrent late decelerations with minimal variability. What is the most appropriate immediate nursing action?

A nurse is caring for a patient who experienced a stillbirth at 32 weeks. The patient expresses guilt and repeatedly states, “I should have taken better care of myself.” Which nursing intervention is most appropriate to support this patient’s grief process?

Sarah, a 32-year-old G1P0 patient at 39 weeks gestation, is in active labor with cervical dilation at 6 cm. She reports increasing pain and anxiety, and her breathing has become rapid and shallow. Which of the following breathing techniques should the nurse encourage to promote relaxation and effective pain management at this stage?

A postpartum patient with chronic Hepatitis B (HBV) infection is breastfeeding her newborn. The newborn received Hepatitis B immune globulin (HBIG) and the first dose of the HBV vaccine within 12 hours of birth. Which of the following is the most appropriate nursing intervention to reduce the risk of vertical transmission?

Sarah, a 32-year-old G2P1 at 32 weeks gestation, presents with severe preeclampsia (BP 170/110 mmHg, +3 proteinuria, and headache). The healthcare team decides to administer magnesium sulfate for seizure prophylaxis. Which of the following is the most critical nursing intervention to ensure fetal well-being during magnesium sulfate administration?

A 32-year-old pregnant patient at 28 weeks gestation presents with fever, fatigue, and a maculopapular rash. She reports recent travel to a region with known Zika virus activity. Which diagnostic test is most appropriate to confirm congenital Zika virus infection in the fetus?

Sarah, a labor and delivery nurse, is reviewing research studies to determine the best evidence-based practice for reducing perineal trauma during childbirth. She comes across a systematic review of randomized controlled trials (RCTs) with consistent findings. According to the hierarchy of evidence, what level of evidence does this represent?

Sarah, a 32-year-old pregnant woman at 28 weeks gestation with pregestational type 2 diabetes, presents for a routine prenatal visit. Her recent hemoglobin A1c is 6.8%. She reports good adherence to her diet and insulin regimen but has occasional postprandial hyperglycemia. Which of the following is the most appropriate next step in her management?