NORCET 11 OBG Case-Based Questions 2026 With Answers

Why OBG Case-Based Questions Challenge NORCET Aspirants

A fact-recall question asks you what a term means. A case-based question gives you a patient’s details. For example, gestational age, symptoms, sometimes a test result, and asking you to reach a conclusion. Answering it requires the concepts and the judgement to apply them correctly.

This is where aspirants who know OBG well on paper still lose marks. They know what placental abruption is. They don't always connect "32 weeks, abdominal pain, uterine tenderness, and foetal distress" to that “diagnosis” fast enough under exam time pressure. Case questions reward pattern recognition built through practice, not one-time reading. With negative marking in the exam, a rushed guess on a case question costs more than a skipped one.

How These Questions Were Selected

Out of 50 real OBG questions found across five NORCET papers, the ones written as a patient scenario, not a straight definition or one-line fact, were pulled out separately. Each question below is copied from the source paper, with its original answer, plus a plain-language explanation of the clinical reasoning behind it.

Across the 50 OBG questions in the dataset, antenatal and high-risk pregnancy cases made up 11, labour and delivery cases made up another 11, postnatal and newborn care cases made up 10, and reproductive system questions made up 5. The remaining 13 were general OBG facts, not case-based. The questions below focus on the case-based portion.

OBG Case-Based Questions by Chapter

Antenatal and High-Risk Pregnancy Cases

Case 1. A 32-week pregnant mother presents with abdominal pain, uterine tenderness, and fetal distress. What is the diagnosis?

A. Abruptio placenta B. Placenta previa C. Abortion D. Ectopic pregnancy

Answer: A. Abruptio placenta
Pain plus tenderness is the detail that separates this from placenta previa. Previa classically causes painless bleeding. Abruption causes pain, a tender, sometimes rigid uterus, and fetal distress from disrupted blood flow. That combination is the exam's way of testing whether you can tell the two apart, not just define each one.

Case 2. A 32-week pregnant woman is hospitalised with vaginal discharge, and her fetal fibronectin test comes back positive. What does this indicate?

A. Post-term labour B. Prolonged labour C. Preterm labour D. Precipitated labour

Answer: C. Preterm labour
Fetal fibronectin is a protein that should not normally be present in vaginal secretions between 22 and 34 weeks. A positive result at this gestational age flags a real risk of preterm labour, which is exactly why the test is ordered here.

Case 3. A 28-year-old primigravida comes to the ANC OPD. How many additional kcal per day should the nurse recommend?

A. 200 kcal B. 300 kcal C. 500 kcal D. 1000 kcal

Answer: B. 300 kcal
This is the standard antenatal nutrition figure taught across nursing syllabi: an extra 300 kcal a day during pregnancy, on top of normal intake. It's a fixed number, easy to lock in, and it repeats across nursing exams beyond NORCET too.

Case 4. A triple test is performed at 15 to 18 weeks of pregnancy. What does a positive result indicate about the likelihood of Down syndrome?

A. MSAFP and uE3 tend to be high, hCG tends to be low B. MSAFP and uE3 tend to be high, hCG tends to be low C. MSAFP and uE3 tend to be low, hCG tends to be high D. MSAFP and uE3 tend to be higher than hCG

Answer: C. MSAFP and uE3 tend to be low, hCG tends to be high
This is the classic triple-test pattern for Down syndrome: low maternal serum AFP, low unconjugated estriol, and high hCG. The exam tests whether you remember the direction of each marker, not just that the test exists.

Labour and Delivery Cases

Case 5. A CTG trace shows the fetal heart rate gradually decreasing and returning to baseline, but the lowest point of the deceleration occurs after the peak of the uterine contraction. What does this represent?

A. Early deceleration B. Late deceleration C. Variable deceleration D. Acceleration

Answer: B. Late deceleration
The timing detail is the whole question. Early decelerations mirror the contraction exactly. Late decelerations lag behind it, with the lowest point after the contraction peaks, and point to uteroplacental insufficiency. If you only remember one CTG fact for NORCET, make it this timing difference.

Case 6. A pregnant woman presents with cord presentation. What is the priority nursing action?

A. Give the Trendelenburg position B. Give the reverse Trendelenburg position C. Inform the healthcare provider D. Gently push the cord back

Answer: A. Give the Trendelenburg position
Cord presentation puts the umbilical cord at risk of compression once labour progresses. Positioning the woman with hips higher than her head, the Trendelenburg position, uses gravity to take pressure off the cord while the team prepares for emergency delivery. This is an immediate nursing action, not something that waits for the physician to arrive first.

Case 7. A G3P2 woman has had two previous caesarean sections. What is her approximate risk of uterine rupture?

A. 2 to 3% B. 5 to 7% C. 10 to 12% D. 46%

Answer: A. 2 to 3%
This tests a specific number, not a concept. Two prior caesarean sections raise uterine rupture risk above that of a single prior caesarean, but the figure still sits in the low single digits, not the double digits many aspirants guess toward.

Postnatal and Newborn Care Cases

Case 8. A newborn's APGAR score at 1 minute is 7. The nurse notices meconium staining at the corner of the baby's mouth. What is the next best step?

A. Prepare for resuscitation B. Inform the physician C. Suction the mouth and nose D. Perform routine care

Answer: C. Suction the mouth and nose
An APGAR of 7 at one minute means the baby is reasonably vigorous, not in distress. Full resuscitation is reserved for a non-vigorous baby. Here, the correct first step is simple: clear visible secretions from the mouth and nose before doing anything else.

Case 9. A woman who had a lower segment caesarean section has passed only 400 mL of urine in the past 24 hours. What does this indicate?

A. Oliguria B. Polyuria C. Anuria D. Hematuria

Answer: A. Oliguria
Normal urine output sits well above 400 mL a day. Oliguria is generally defined as output below roughly 400 to 500 mL over 24 hours, which is exactly the figure given here. Anuria is a near-total absence of urine, a stricter and lower threshold than this case describes.

Reproductive System Cases

Case 10. In a case of abnormal placental implantation, the placenta is found implanted deeply into the myometrium, without penetrating through it. What is this condition called?

A. Placenta accreta B. Placenta previa C. Placenta increta D. Placenta percreta

Answer: C. Placenta increta
This one is a ladder of depth, and NORCET likes testing exactly where a term sits on it. Accreta attaches to the myometrium without invading it. Increta invades into the myometrium. Percreta goes all the way through it, sometimes into nearby organs. This case sits at the middle step: into, but not through.

How to Approach OBG Case-Based Questions in the Exam

Read the whole case before looking at the options. Underline, even mentally, the two or three details that actually change the diagnosis: pain versus painless, the exact gestational age, a specific lab value. Most OBG cases hinge on one distinguishing detail, not the whole paragraph. Once that detail is identified, the answer usually narrows to two options fast.

An analysis of the AIIMS NORCET question paper found that candidates who had already worked through previous year papers described the real exam's pattern as familiar, and were able to attempt more questions with accuracy, which is the exact advantage case-based practice is meant to build.