NLN NACE Care of Childbearing Family Exam Questions and
Answers with Rationales 2026/2027
TABLE OF CONTENTS
1. Preconception and Prenatal Care
2. Normal Pregnancy and Maternal Adaptations
3. Nutrition, Discomforts and Health Promotion
4. Antepartum Assessment and High-Risk Pregnancy
5. Labor and Delivery
6. Labor Complications and Fetal Assessment
7. Postpartum Care and Complications
8. Newborn Care and Complications
9. Psychosocial, Cultural, Family and Comprehensive Review
SECTION 1: PRECONCEPTION AND PRENATAL CARE
Question 1
A client planning pregnancy asks which supplement is most important before
conception to reduce the risk of neural tube defects. Which response is correct?
A. Calcium
B. Folic acid
C. Vitamin C
D. Vitamin K
Answer: B. Folic acid
,Rationale: Adequate folic acid before conception and during early pregnancy
reduces the risk of neural tube defects such as spina bifida.
Question 2
Which assessment finding provides the most reliable evidence that a client is
pregnant?
A. Nausea
B. Breast tenderness
C. Positive pregnancy test
D. Fetal heart activity
Answer: D. Fetal heart activity
Rationale: Fetal heart activity is a positive sign of pregnancy. Symptoms such as
nausea and breast tenderness are presumptive, while a pregnancy test is a
probable sign.
Question 3
A pregnant client asks when the first prenatal visit should occur. Which response
is most appropriate?
A. After fetal movement begins
B. As soon as pregnancy is suspected
C. At approximately 20 weeks
D. During the third trimester
Answer: B. As soon as pregnancy is suspected
Rationale: Early prenatal care permits assessment of maternal health, pregnancy
dating, risk factors, nutrition, medications, and preventive care.
Question 4
Which finding should the nurse identify as a presumptive sign of pregnancy?
,A. Fetal heart rate
B. Ultrasound visualization of fetus
C. Amenorrhea
D. Fetal movement palpated by examiner
Answer: C. Amenorrhea
Rationale: Amenorrhea is a presumptive sign because it can occur for reasons
other than pregnancy.
Question 5
Which information is most important when calculating an estimated date of
delivery using Naegele's rule?
A. Date of conception
B. Date of the last menstrual period
C. Date fetal movement began
D. Date of the first positive pregnancy test
Answer: B. Date of the last menstrual period
Rationale: Naegele's rule traditionally uses the first day of the last menstrual
period to estimate the expected date of delivery.
Question 6
A client asks why blood pressure is checked at every prenatal visit. What is the
best explanation?
A. To determine fetal growth
B. To detect hypertension and possible preeclampsia
C. To identify gestational diabetes
D. To determine fetal position
Answer: B. To detect hypertension and possible preeclampsia
Rationale: Serial blood pressure measurements help identify hypertensive
disorders of pregnancy.
, Question 7
Which finding during pregnancy requires prompt follow-up?
A. Mild urinary frequency
B. Mild fatigue
C. Vaginal bleeding
D. Increased appetite
Answer: C. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy may indicate miscarriage, placenta
previa, placental abruption, or another complication and requires evaluation.
Question 8
Which vaccine is generally recommended during pregnancy to protect the
newborn from pertussis?
A. Tdap
B. MMR
C. Varicella
D. Live attenuated influenza vaccine
Answer: A. Tdap
Rationale: Tdap during pregnancy provides maternal antibodies that help protect
the newborn from pertussis during early life.
Question 9
A pregnant client reports taking a medication prescribed before pregnancy. What
should the nurse do first?
A. Tell the client to stop all medications
B. Determine the medication, dose, and indication
Answers with Rationales 2026/2027
TABLE OF CONTENTS
1. Preconception and Prenatal Care
2. Normal Pregnancy and Maternal Adaptations
3. Nutrition, Discomforts and Health Promotion
4. Antepartum Assessment and High-Risk Pregnancy
5. Labor and Delivery
6. Labor Complications and Fetal Assessment
7. Postpartum Care and Complications
8. Newborn Care and Complications
9. Psychosocial, Cultural, Family and Comprehensive Review
SECTION 1: PRECONCEPTION AND PRENATAL CARE
Question 1
A client planning pregnancy asks which supplement is most important before
conception to reduce the risk of neural tube defects. Which response is correct?
A. Calcium
B. Folic acid
C. Vitamin C
D. Vitamin K
Answer: B. Folic acid
,Rationale: Adequate folic acid before conception and during early pregnancy
reduces the risk of neural tube defects such as spina bifida.
Question 2
Which assessment finding provides the most reliable evidence that a client is
pregnant?
A. Nausea
B. Breast tenderness
C. Positive pregnancy test
D. Fetal heart activity
Answer: D. Fetal heart activity
Rationale: Fetal heart activity is a positive sign of pregnancy. Symptoms such as
nausea and breast tenderness are presumptive, while a pregnancy test is a
probable sign.
Question 3
A pregnant client asks when the first prenatal visit should occur. Which response
is most appropriate?
A. After fetal movement begins
B. As soon as pregnancy is suspected
C. At approximately 20 weeks
D. During the third trimester
Answer: B. As soon as pregnancy is suspected
Rationale: Early prenatal care permits assessment of maternal health, pregnancy
dating, risk factors, nutrition, medications, and preventive care.
Question 4
Which finding should the nurse identify as a presumptive sign of pregnancy?
,A. Fetal heart rate
B. Ultrasound visualization of fetus
C. Amenorrhea
D. Fetal movement palpated by examiner
Answer: C. Amenorrhea
Rationale: Amenorrhea is a presumptive sign because it can occur for reasons
other than pregnancy.
Question 5
Which information is most important when calculating an estimated date of
delivery using Naegele's rule?
A. Date of conception
B. Date of the last menstrual period
C. Date fetal movement began
D. Date of the first positive pregnancy test
Answer: B. Date of the last menstrual period
Rationale: Naegele's rule traditionally uses the first day of the last menstrual
period to estimate the expected date of delivery.
Question 6
A client asks why blood pressure is checked at every prenatal visit. What is the
best explanation?
A. To determine fetal growth
B. To detect hypertension and possible preeclampsia
C. To identify gestational diabetes
D. To determine fetal position
Answer: B. To detect hypertension and possible preeclampsia
Rationale: Serial blood pressure measurements help identify hypertensive
disorders of pregnancy.
, Question 7
Which finding during pregnancy requires prompt follow-up?
A. Mild urinary frequency
B. Mild fatigue
C. Vaginal bleeding
D. Increased appetite
Answer: C. Vaginal bleeding
Rationale: Vaginal bleeding during pregnancy may indicate miscarriage, placenta
previa, placental abruption, or another complication and requires evaluation.
Question 8
Which vaccine is generally recommended during pregnancy to protect the
newborn from pertussis?
A. Tdap
B. MMR
C. Varicella
D. Live attenuated influenza vaccine
Answer: A. Tdap
Rationale: Tdap during pregnancy provides maternal antibodies that help protect
the newborn from pertussis during early life.
Question 9
A pregnant client reports taking a medication prescribed before pregnancy. What
should the nurse do first?
A. Tell the client to stop all medications
B. Determine the medication, dose, and indication
