Think you are ready for the RNC-OB (Inpatient Obstetric Nursing) exam? Our deck rates 525 of its 1050 flashcards as hard — testing concepts like CO, CVP, PCWP, Central Venous Pressure. Try the free samples below; if they feel comfortable, you are in good shape.
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When does maternal cardiac output (CO) reach its absolute peak during the entire pregnancy, labor, and postpartum period?
Show answer →The absolute peak occurs in the immediate postpartum period (first 10-15 minutes). CO increases by 60-80% above pre-labor values due to autotransfusion of approximately 500 mL of blood from the involuting uterus and the relief of inferior vena cava compression. Clinical Pearl: This is the highest-risk period for patients with underlying cardiac disease (e.g., CHF or valve stenosis) to experience decompensation or pulmonary edema.
A patient at 22 weeks gestation presents with a BP of 98/58 mmHg (Baseline 118/76). What physiological mechanism explains this nadir in blood pressure?
Show answer →Systemic Vascular Resistance (SVR) decreases by 20-30% during pregnancy, reaching its lowest point (nadir) at 20-24 weeks. This is driven by high levels of progesterone (smooth muscle relaxant), increased nitric oxide, and prostaglandins. NCC Tip: Diastolic BP typically drops more than systolic (10-15 mmHg vs 5-10 mmHg). BP should return to pre-pregnancy baseline levels by term. Failure to return to baseline or an increase may indicate gestational hypertension.
How does cardiac output change during the second stage of labor (pushing) compared to the pre-labor baseline?
Show answer →Cardiac output increases by approximately 50% during the second stage. Each uterine contraction squeezes 300-500 mL of blood into the maternal systemic circulation. Additionally, the pain and anxiety of pushing (Valsalva maneuvers) further increase CO. Exam Tip: CO increases cumulatively: 15% in early labor, 30% in active labor, and 50% in the second stage. Monitoring for fluid overload is critical in the second stage for cardiac patients.
Despite a 50% increase in total blood volume, why do Central Venous Pressure (CVP) and Pulmonary Capillary Wedge Pressure (PCWP) remain stable in normal pregnancy?
Show answer →CVP and PCWP remain stable because the massive increase in blood volume is offset by a significant decrease in Systemic Vascular Resistance (SVR) and Pulmonary Vascular Resistance (PVR). The vascular bed relaxes and expands to accommodate the extra volume. Clinical Reasoning: If a pregnant patient shows an elevated CVP or PCWP, it is a sign of cardiac dysfunction or fluid overload, as the healthy pregnant heart should maintain normal filling pressures.
In terms of percentages, how does the increase in Cardiac Output (CO) compare to the increase in maternal Oxygen Consumption (VO2) at term?
Show answer →Cardiac Output increases (30-50%) more than Oxygen Consumption (20-30%). This physiologic reserve results in an increase in the mixed venous oxygen saturation. Rationale: This surplus acts as a safety mechanism, ensuring that even when uterine blood flow is temporarily reduced (such as during a contraction), there is sufficient oxygen delivery to the fetus.
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1,050 RNC-OB question-and-answer cards across 8 topics, written for this exam. Refund policy.
525 of the 1050 flashcards in the RNC-OB deck carry a "hard" difficulty rating. 5 free samples are on this page.
Difficulty ratings describe our deck, not the official exam. Practicing above test level builds a margin of safety — check the official NCC materials for representative difficulty.
Assessment
120 cards
Basics
50 cards
Diagnostics
70 cards
Management
190 cards
Pathology
340 cards
Pharmacology
110 cards
Physiology
100 cards
Procedures
70 cards
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