NR 602 / NR602 Primary Care Childbearing
Childrearing Family Midterm Exam Actual 2026 with
Detailed Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
SECTION 1: Preconception & Prenatal Care (Questions 1–15)
Q1: A 28-year-old woman presents for preconception counseling. Which supplement
should the nurse practitioner recommend she begin taking before conception to
reduce the risk of neural tube defects?
A. Iron 325 mg daily
B. Folic acid 400-800 mcg daily [CORRECT]
C. Vitamin D 2000 IU daily
D. Calcium 1200 mg daily
Correct Answer: B
Rationale: Correct because folic acid supplementation beginning at least one month
before conception and continuing through the first trimester significantly reduces the
incidence of neural tube defects.
Q2: During preconception counseling, which immunization is contraindicated during
pregnancy and should be administered before conception if the client is
non-immune?
,A. Influenza vaccine
B. Tdap vaccine
C. MMR (measles, mumps, rubella) vaccine [CORRECT]
D. Hepatitis B vaccine
Correct Answer: C
Rationale: Correct because the MMR vaccine is a live attenuated vaccine that is
contraindicated during pregnancy due to theoretical risk to the fetus; it should be
administered preconception with a 28-day waiting period before attempting
pregnancy.
Q3: A client with pregestational diabetes is planning pregnancy. Which target
hemoglobin A1C level should be achieved before conception to reduce the risk of
congenital anomalies?
A. Less than 8.0%
B. Less than 6.5% [CORRECT]
C. Less than 10.0%
D. Less than 7.5%
Correct Answer: B
Rationale: Correct because achieving an HbA1C less than 6.5% before conception
significantly reduces the risk of congenital anomalies, macrosomia, and other
diabetes-related pregnancy complications.
,Q4: Which prenatal screening test is recommended for all pregnant clients between
15 and 22 weeks gestation to assess for neural tube defects and chromosomal
abnormalities?
A. Nuchal translucency ultrasound
B. Maternal serum alpha-fetoprotein (MSAFP) and quad screen [CORRECT]
C. Amniocentesis
D. Chorionic villus sampling
Correct Answer: B
Rationale: Correct because the quad screen (MSAFP, hCG, estriol, inhibin-A) is a
routine second-trimester screening test offered to all pregnant clients to assess risk
for neural tube defects and trisomies.
Q5: A pregnant client at 10 weeks gestation asks about prenatal genetic screening
options. Which option is non-invasive and available in the first trimester?
A. Amniocentesis
B. Cell-free DNA testing (NIPT) [CORRECT]
C. Percutaneous umbilical blood sampling
D. Chorionic villus sampling
Correct Answer: B
Rationale: Correct because cell-free DNA testing is a non-invasive prenatal test
(NIPT) that analyzes fetal DNA from maternal blood, available as early as 10 weeks
with high sensitivity for common aneuploidies.
, Q6: During the first prenatal visit, which laboratory test is routinely performed to
screen for neural tube defects risk and gestational trophoblastic disease?
A. Complete blood count
B. Maternal serum alpha-fetoprotein [CORRECT]
C. Group B streptococcus culture
D. Glucose challenge test
Correct Answer: B
Rationale: Correct because maternal serum alpha-fetoprotein is routinely measured
in the second trimester; elevated levels suggest neural tube defects while low levels
may indicate Down syndrome or other chromosomal abnormalities.
Q7: A pregnant client reports nausea and vomiting in the first trimester. Which
dietary recommendation is most appropriate?
A. Consume large meals three times daily
B. Eat small, frequent meals; avoid triggers; and consider ginger or vitamin B6
[CORRECT]
C. Fast until symptoms resolve completely
D. Increase fatty food intake for caloric density
Correct Answer: B
Childrearing Family Midterm Exam Actual 2026 with
Detailed Rationales | 100% Verified | Pass Guaranteed –
A+ Graded
SECTION 1: Preconception & Prenatal Care (Questions 1–15)
Q1: A 28-year-old woman presents for preconception counseling. Which supplement
should the nurse practitioner recommend she begin taking before conception to
reduce the risk of neural tube defects?
A. Iron 325 mg daily
B. Folic acid 400-800 mcg daily [CORRECT]
C. Vitamin D 2000 IU daily
D. Calcium 1200 mg daily
Correct Answer: B
Rationale: Correct because folic acid supplementation beginning at least one month
before conception and continuing through the first trimester significantly reduces the
incidence of neural tube defects.
Q2: During preconception counseling, which immunization is contraindicated during
pregnancy and should be administered before conception if the client is
non-immune?
,A. Influenza vaccine
B. Tdap vaccine
C. MMR (measles, mumps, rubella) vaccine [CORRECT]
D. Hepatitis B vaccine
Correct Answer: C
Rationale: Correct because the MMR vaccine is a live attenuated vaccine that is
contraindicated during pregnancy due to theoretical risk to the fetus; it should be
administered preconception with a 28-day waiting period before attempting
pregnancy.
Q3: A client with pregestational diabetes is planning pregnancy. Which target
hemoglobin A1C level should be achieved before conception to reduce the risk of
congenital anomalies?
A. Less than 8.0%
B. Less than 6.5% [CORRECT]
C. Less than 10.0%
D. Less than 7.5%
Correct Answer: B
Rationale: Correct because achieving an HbA1C less than 6.5% before conception
significantly reduces the risk of congenital anomalies, macrosomia, and other
diabetes-related pregnancy complications.
,Q4: Which prenatal screening test is recommended for all pregnant clients between
15 and 22 weeks gestation to assess for neural tube defects and chromosomal
abnormalities?
A. Nuchal translucency ultrasound
B. Maternal serum alpha-fetoprotein (MSAFP) and quad screen [CORRECT]
C. Amniocentesis
D. Chorionic villus sampling
Correct Answer: B
Rationale: Correct because the quad screen (MSAFP, hCG, estriol, inhibin-A) is a
routine second-trimester screening test offered to all pregnant clients to assess risk
for neural tube defects and trisomies.
Q5: A pregnant client at 10 weeks gestation asks about prenatal genetic screening
options. Which option is non-invasive and available in the first trimester?
A. Amniocentesis
B. Cell-free DNA testing (NIPT) [CORRECT]
C. Percutaneous umbilical blood sampling
D. Chorionic villus sampling
Correct Answer: B
Rationale: Correct because cell-free DNA testing is a non-invasive prenatal test
(NIPT) that analyzes fetal DNA from maternal blood, available as early as 10 weeks
with high sensitivity for common aneuploidies.
, Q6: During the first prenatal visit, which laboratory test is routinely performed to
screen for neural tube defects risk and gestational trophoblastic disease?
A. Complete blood count
B. Maternal serum alpha-fetoprotein [CORRECT]
C. Group B streptococcus culture
D. Glucose challenge test
Correct Answer: B
Rationale: Correct because maternal serum alpha-fetoprotein is routinely measured
in the second trimester; elevated levels suggest neural tube defects while low levels
may indicate Down syndrome or other chromosomal abnormalities.
Q7: A pregnant client reports nausea and vomiting in the first trimester. Which
dietary recommendation is most appropriate?
A. Consume large meals three times daily
B. Eat small, frequent meals; avoid triggers; and consider ginger or vitamin B6
[CORRECT]
C. Fast until symptoms resolve completely
D. Increase fatty food intake for caloric density
Correct Answer: B
