NR 602/NR602 Midterm Childbearing Childrearing Family
Exam Blueprint Actual 2026/2027 with Detailed
Rationales | 100% Verified | Pass Guaranteed
SECTION 1: PRECONCEPTION & ANTEPARTUM CARE (Questions
1–20)
Q1: A 28-year-old woman presents for a preconception visit. She reports taking
isotretinoin for acne. Which recommendation is most appropriate?
A. Continue isotretinoin; it is safe in pregnancy
B. Discontinue isotretinoin and use effective contraception for at least 1 month before
conception
C. Discontinue isotretinoin and use effective contraception for at least 1 month before
conception
D. Switch to topical retinoids; they are safe in pregnancy
Correct Answer: C
Rationale: Correct because isotretinoin is a known teratogen causing severe fetal
malformations, and effective contraception must be used for at least one month before
conception and throughout therapy. Priority is ensuring no fetal exposure to this
category X medication.
Q2: During the first prenatal visit, which laboratory test is most appropriate to screen for
neural tube defects?
A. Maternal serum alpha-fetoprotein (MSAFP) at 8–10 weeks
B. Maternal serum alpha-fetoprotein (MSAFP) at 15–20 weeks
C. Amniocentesis at 12 weeks
D. Chorionic villus sampling at 10–12 weeks
,Correct Answer: B
Rationale: Correct because MSAFP screening is optimally performed between 15 and
20 weeks' gestation to detect open neural tube defects; elevated levels suggest spina
bifida or anencephaly. This matches the standard second-trimester screening protocol.
Q3: A pregnant patient at 10 weeks' gestation asks about recommended folic acid
supplementation. What is the correct daily dose?
A. 200 mcg daily
B. 400 mcg daily
C. 1,000 mcg daily
D. 4,000 mcg daily
Correct Answer: B
Rationale: Correct because all women of childbearing age should consume 400 mcg
(0.4 mg) of folic acid daily to reduce the risk of neural tube defects; higher doses are
reserved for high-risk patients with prior affected pregnancies.
Q4: Using Naegele's rule, what is the estimated date of delivery for a patient whose last
menstrual period began on January 10?
A. October 3
B. October 10
C. October 17
D. November 7
Correct Answer: C
,Rationale: Correct because Naegele's rule calculates EDD by adding 7 days to the first
day of the LMP and subtracting 3 months (January 10 + 7 days = January 17; subtract 3
months = October 17). This is the standard gestational age estimation method.
Q5: A 32-year-old primigravida at 24 weeks' gestation reports persistent headaches,
visual disturbances, and right upper quadrant pain. Her blood pressure is 158/96
mmHg. What is the priority nursing action?
A. Reassure the patient and schedule routine follow-up in 2 weeks
B. Obtain a urine protein level and assess for preeclampsia
C. Administer acetaminophen and recommend rest
D. Begin magnesium sulfate therapy immediately
Correct Answer: B
Rationale: Correct because headache, visual changes, RUQ pain, and elevated BP in the
second half of pregnancy are classic warning signs of preeclampsia; urine protein
assessment is the priority diagnostic step. This matches the preeclampsia screening
protocol requiring immediate evaluation.
Q6: Which maternal physiologic adaptation during pregnancy is correctly matched?
A. Cardiac output decreases by 10% by the third trimester
B. Plasma volume increases by 40–50% by the third trimester
C. Hemoglobin concentration increases significantly
D. Systemic vascular resistance increases throughout pregnancy
Correct Answer: B
Rationale: Correct because plasma volume expands by 40–50% during pregnancy to
perfuse the placenta, representing one of the most significant maternal cardiovascular
adaptations. This hemodilution explains the physiologic anemia of pregnancy.
, Q7: A pregnant patient at 18 weeks' gestation is offered genetic screening. Which test
can be performed at this gestational age?
A. Chorionic villus sampling
B. Nuchal translucency screening
C. Quad screen (multiple marker screening)
D. Cell-free fetal DNA testing is not available at this gestational age
Correct Answer: C
Rationale: Correct because the quad screen (AFP, hCG, estriol, inhibin-A) is performed
between 15 and 22 weeks' gestation to screen for chromosomal abnormalities and
neural tube defects. This matches the second-trimester screening window.
Q8: Which food item should be avoided during pregnancy due to risk of Listeria
monocytogenes infection?
A. Pasteurized milk
B. Hard cheeses
C. Deli meats and hot dogs
D. Cooked chicken breast
Correct Answer: C
Rationale: Correct because deli meats, hot dogs, and unpasteurized soft cheeses are
high-risk foods for Listeria infection, which can cause miscarriage, stillbirth, or severe
neonatal infection. Pregnant women should heat these foods until steaming.
Q9: A patient at 30 weeks' gestation reports decreased fetal movement. Which
assessment is most appropriate?
A. Reassure the patient that decreased movement is normal at this gestation
Exam Blueprint Actual 2026/2027 with Detailed
Rationales | 100% Verified | Pass Guaranteed
SECTION 1: PRECONCEPTION & ANTEPARTUM CARE (Questions
1–20)
Q1: A 28-year-old woman presents for a preconception visit. She reports taking
isotretinoin for acne. Which recommendation is most appropriate?
A. Continue isotretinoin; it is safe in pregnancy
B. Discontinue isotretinoin and use effective contraception for at least 1 month before
conception
C. Discontinue isotretinoin and use effective contraception for at least 1 month before
conception
D. Switch to topical retinoids; they are safe in pregnancy
Correct Answer: C
Rationale: Correct because isotretinoin is a known teratogen causing severe fetal
malformations, and effective contraception must be used for at least one month before
conception and throughout therapy. Priority is ensuring no fetal exposure to this
category X medication.
Q2: During the first prenatal visit, which laboratory test is most appropriate to screen for
neural tube defects?
A. Maternal serum alpha-fetoprotein (MSAFP) at 8–10 weeks
B. Maternal serum alpha-fetoprotein (MSAFP) at 15–20 weeks
C. Amniocentesis at 12 weeks
D. Chorionic villus sampling at 10–12 weeks
,Correct Answer: B
Rationale: Correct because MSAFP screening is optimally performed between 15 and
20 weeks' gestation to detect open neural tube defects; elevated levels suggest spina
bifida or anencephaly. This matches the standard second-trimester screening protocol.
Q3: A pregnant patient at 10 weeks' gestation asks about recommended folic acid
supplementation. What is the correct daily dose?
A. 200 mcg daily
B. 400 mcg daily
C. 1,000 mcg daily
D. 4,000 mcg daily
Correct Answer: B
Rationale: Correct because all women of childbearing age should consume 400 mcg
(0.4 mg) of folic acid daily to reduce the risk of neural tube defects; higher doses are
reserved for high-risk patients with prior affected pregnancies.
Q4: Using Naegele's rule, what is the estimated date of delivery for a patient whose last
menstrual period began on January 10?
A. October 3
B. October 10
C. October 17
D. November 7
Correct Answer: C
,Rationale: Correct because Naegele's rule calculates EDD by adding 7 days to the first
day of the LMP and subtracting 3 months (January 10 + 7 days = January 17; subtract 3
months = October 17). This is the standard gestational age estimation method.
Q5: A 32-year-old primigravida at 24 weeks' gestation reports persistent headaches,
visual disturbances, and right upper quadrant pain. Her blood pressure is 158/96
mmHg. What is the priority nursing action?
A. Reassure the patient and schedule routine follow-up in 2 weeks
B. Obtain a urine protein level and assess for preeclampsia
C. Administer acetaminophen and recommend rest
D. Begin magnesium sulfate therapy immediately
Correct Answer: B
Rationale: Correct because headache, visual changes, RUQ pain, and elevated BP in the
second half of pregnancy are classic warning signs of preeclampsia; urine protein
assessment is the priority diagnostic step. This matches the preeclampsia screening
protocol requiring immediate evaluation.
Q6: Which maternal physiologic adaptation during pregnancy is correctly matched?
A. Cardiac output decreases by 10% by the third trimester
B. Plasma volume increases by 40–50% by the third trimester
C. Hemoglobin concentration increases significantly
D. Systemic vascular resistance increases throughout pregnancy
Correct Answer: B
Rationale: Correct because plasma volume expands by 40–50% during pregnancy to
perfuse the placenta, representing one of the most significant maternal cardiovascular
adaptations. This hemodilution explains the physiologic anemia of pregnancy.
, Q7: A pregnant patient at 18 weeks' gestation is offered genetic screening. Which test
can be performed at this gestational age?
A. Chorionic villus sampling
B. Nuchal translucency screening
C. Quad screen (multiple marker screening)
D. Cell-free fetal DNA testing is not available at this gestational age
Correct Answer: C
Rationale: Correct because the quad screen (AFP, hCG, estriol, inhibin-A) is performed
between 15 and 22 weeks' gestation to screen for chromosomal abnormalities and
neural tube defects. This matches the second-trimester screening window.
Q8: Which food item should be avoided during pregnancy due to risk of Listeria
monocytogenes infection?
A. Pasteurized milk
B. Hard cheeses
C. Deli meats and hot dogs
D. Cooked chicken breast
Correct Answer: C
Rationale: Correct because deli meats, hot dogs, and unpasteurized soft cheeses are
high-risk foods for Listeria infection, which can cause miscarriage, stillbirth, or severe
neonatal infection. Pregnant women should heat these foods until steaming.
Q9: A patient at 30 weeks' gestation reports decreased fetal movement. Which
assessment is most appropriate?
A. Reassure the patient that decreased movement is normal at this gestation
