Preparing for the RNC-OB (Inpatient Obstetric Nursing) exam? Pathology is one of the areas our deck drills hardest: 340 of its 1050 flashcards focus on pathology, covering topics like NYHA, New York Heart Association. Try the sample questions below — every card is a real question-and-answer pair from the full deck.
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A G2P1 at 24 weeks' gestation reports dyspnea and palpitations only during brisk walking or carrying groceries but feels fine at rest. According to the New York Heart Association (NYHA) functional classification, which category does this patient fall into?
Show answer →NYHA Class II. This class is defined by slight limitation of physical activity. Patients are comfortable at rest, but ordinary physical activity (like climbing stairs or brisk walking) results in fatigue, palpitations, or dyspnea. Exam Tip: Class I has no limitations; Class II has slight limitations with ordinary activity; Class III has marked limitations with less-than-ordinary activity; Class IV has symptoms at rest.
A laboring patient with known mitral stenosis develops a frequent, hacking cough and a respiratory rate of 28. What is the clinical significance of these findings in the context of cardiac decompensation, and what is the priority assessment?
Show answer →A persistent cough is often the earliest sign of cardiac decompensation/pulmonary edema. Priority: Auscultate lung fields for crackles (rales) at the bases. In OB, normal pregnancy dyspnea is common, but a productive cough, moist rales, and sudden tachypnea indicate fluid overload. NCC Strategy: Don't ignore mild respiratory changes in cardiac patients; they precede frank cyanosis.
For a patient classified as NYHA Class III, which labor management strategy is most effective at reducing cardiac workload during the second stage of labor?
Show answer →Use of passive descent (laboring down) and avoidance of the Valsalva maneuver. The patient should be encouraged to use open-glottis pushing or, ideally, an assisted delivery (forceps/vacuum) to shorten the second stage. Rationale: Valsalva increases intrathoracic pressure, decreases venous return, and causes abrupt hemodynamic shifts that a Class III/IV heart cannot tolerate.
A 32-week gestation patient with cardiomyopathy reports she must prop herself up on three pillows to breathe at night and becomes short of breath while brushing her teeth. She is comfortable only when sitting still. How is this classified?
Show answer →NYHA Class III. While she has severe symptoms, the key is that she is comfortable at rest. Class III involves marked limitation of activity; less-than-ordinary activity (like ADLs/brushing teeth) causes symptoms. Class IV patients have symptoms (dyspnea, angina) even while resting. Exam Tip: Orthopnea and PND are significant red flags for Class III/IV decompensation.
Why is the first 24 to 48 hours postpartum considered the most dangerous period for a patient with significant cardiac disease (NYHA Class III or IV)?
Show answer →Rapid autotransfusion of 500-1000 mL of blood from the uteroplacental bed back into the systemic circulation, combined with the release of vena cava compression, causes a massive increase in preload. This fluid shift can overwhelm a compromised heart, leading to sudden pulmonary edema. Monitoring must continue intensely for at least 48 hours post-delivery.
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Try 30 free RNC-OB cards firstThe full RNC-OB deck contains 1050 flashcards, and 340 of them focus on pathology. This page shows 5 free samples.
Our RNC-OB deck dedicates 340 of 1050 cards (32%) to pathology — always cross-check the official NCC exam outline for the current blueprint weighting.
Yes — the samples on this page are free, and the RNC-OB preview page has 30 more free cards. Full access to all 1050 cards is a one-time $7.
RNC-OB practice test
20 mixed questions across every topic, with answers — see where you stand →
RNC-OB study guide
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