NACE Care of the Childbearing Family Exam 1 Questions and
Answers with Rationales 2026/2027
TABLE OF CONTENTS
Section I — Preconception & Prenatal Care
Section II — Physiologic Changes of Pregnancy
Section III — Maternal Nutrition, Exercise & Pregnancy Discomforts
Section IV — Prenatal Assessment & Antepartum Testing
Section V — High-Risk Pregnancy & Antepartum Complications
Section VI — Psychosocial, Cultural, Ethical & Family Considerations
Section VII — Preparation for Labor & Intrapartum Care
Section VIII — Labor Complications & Comprehensive Review
SECTION I — PRECONCEPTION & PRENATAL CARE
Question 1
A client planning pregnancy asks why folic acid should be taken before conception. Which
response by the nurse is best?
A. "It prevents gestational diabetes."
B. "It reduces the risk of neural tube defects."
C. "It prevents postpartum hemorrhage."
D. "It eliminates the need for prenatal vitamins."
Answer: B
Rationale: Folic acid taken before conception and during early pregnancy reduces the risk of
fetal neural tube defects such as spina bifida.
,Question 2
Which client should receive priority preconception counseling?
A. A client who exercises regularly
B. A client taking a potentially teratogenic medication
C. A client who eats vegetables daily
D. A client with a normal BMI
Answer: B
Rationale: Potentially teratogenic medications can cause fetal abnormalities. Medication
review should occur before conception whenever possible.
Question 3
Which substance should a client avoid completely during pregnancy?
A. Alcohol
B. Pasteurized milk
C. Whole grains
D. Fresh fruit
Answer: A
Rationale: No safe amount of alcohol during pregnancy has been established. Alcohol exposure
can cause fetal alcohol spectrum disorders.
Question 4
A pregnant client reports smoking cigarettes. What is the nurse's priority teaching?
A. "Smoking only affects the mother's lungs."
B. "Smoking increases the risk of fetal growth restriction."
C. "Smoking prevents preterm birth."
D. "Switching to occasional smoking eliminates fetal risk."
Answer: B
Rationale: Tobacco exposure is associated with fetal growth restriction, placental
complications, preterm birth, and other adverse outcomes.
,Question 5
Which finding is an expected sign of pregnancy?
A. Amenorrhea
B. Severe abdominal pain
C. Heavy vaginal bleeding
D. Persistent high fever
Answer: A
Rationale: Amenorrhea is a common presumptive sign of pregnancy, although other causes of
missed menstruation must also be considered.
Question 6
Which finding is considered a probable rather than presumptive sign of pregnancy?
A. Nausea
B. Breast tenderness
C. Positive pregnancy test
D. Fatigue
Answer: C
Rationale: A positive pregnancy test is a probable sign because it provides objective evidence
but is not by itself absolute proof of a viable pregnancy.
Question 7
Which finding is a positive sign of pregnancy?
A. Amenorrhea
B. Positive urine pregnancy test
C. Fetal heart activity detected by Doppler
D. Breast enlargement
Answer: C
Rationale: Positive signs directly attributable to the fetus include fetal heart activity, fetal
movement palpated by an examiner, and visualization of the fetus.
Question 8
, A client asks when prenatal care should begin. What is the best response?
A. "After the first trimester."
B. "As soon as pregnancy is suspected or confirmed."
C. "At 20 weeks."
D. "Only after fetal movement begins."
Answer: B
Rationale: Early prenatal care allows identification of risk factors, appropriate screening,
nutritional counseling, and timely intervention.
Question 9
Which prenatal finding requires immediate follow-up?
A. Mild urinary frequency
B. Breast tenderness
C. Vaginal bleeding
D. Mild fatigue
Answer: C
Rationale: Vaginal bleeding during pregnancy can indicate miscarriage, ectopic pregnancy,
placenta previa, placental abruption, or another complication.
Question 10
Which vaccine is generally recommended during pregnancy?
A. Live attenuated measles vaccine
B. Live varicella vaccine
C. Inactivated influenza vaccine
D. Live intranasal influenza vaccine
Answer: C
Rationale: Inactivated influenza vaccination is recommended during pregnancy. Live vaccines
such as varicella and MMR are generally avoided during pregnancy.
Question 11
A pregnant client asks why blood type and Rh status are assessed. What is the primary reason?
Answers with Rationales 2026/2027
TABLE OF CONTENTS
Section I — Preconception & Prenatal Care
Section II — Physiologic Changes of Pregnancy
Section III — Maternal Nutrition, Exercise & Pregnancy Discomforts
Section IV — Prenatal Assessment & Antepartum Testing
Section V — High-Risk Pregnancy & Antepartum Complications
Section VI — Psychosocial, Cultural, Ethical & Family Considerations
Section VII — Preparation for Labor & Intrapartum Care
Section VIII — Labor Complications & Comprehensive Review
SECTION I — PRECONCEPTION & PRENATAL CARE
Question 1
A client planning pregnancy asks why folic acid should be taken before conception. Which
response by the nurse is best?
A. "It prevents gestational diabetes."
B. "It reduces the risk of neural tube defects."
C. "It prevents postpartum hemorrhage."
D. "It eliminates the need for prenatal vitamins."
Answer: B
Rationale: Folic acid taken before conception and during early pregnancy reduces the risk of
fetal neural tube defects such as spina bifida.
,Question 2
Which client should receive priority preconception counseling?
A. A client who exercises regularly
B. A client taking a potentially teratogenic medication
C. A client who eats vegetables daily
D. A client with a normal BMI
Answer: B
Rationale: Potentially teratogenic medications can cause fetal abnormalities. Medication
review should occur before conception whenever possible.
Question 3
Which substance should a client avoid completely during pregnancy?
A. Alcohol
B. Pasteurized milk
C. Whole grains
D. Fresh fruit
Answer: A
Rationale: No safe amount of alcohol during pregnancy has been established. Alcohol exposure
can cause fetal alcohol spectrum disorders.
Question 4
A pregnant client reports smoking cigarettes. What is the nurse's priority teaching?
A. "Smoking only affects the mother's lungs."
B. "Smoking increases the risk of fetal growth restriction."
C. "Smoking prevents preterm birth."
D. "Switching to occasional smoking eliminates fetal risk."
Answer: B
Rationale: Tobacco exposure is associated with fetal growth restriction, placental
complications, preterm birth, and other adverse outcomes.
,Question 5
Which finding is an expected sign of pregnancy?
A. Amenorrhea
B. Severe abdominal pain
C. Heavy vaginal bleeding
D. Persistent high fever
Answer: A
Rationale: Amenorrhea is a common presumptive sign of pregnancy, although other causes of
missed menstruation must also be considered.
Question 6
Which finding is considered a probable rather than presumptive sign of pregnancy?
A. Nausea
B. Breast tenderness
C. Positive pregnancy test
D. Fatigue
Answer: C
Rationale: A positive pregnancy test is a probable sign because it provides objective evidence
but is not by itself absolute proof of a viable pregnancy.
Question 7
Which finding is a positive sign of pregnancy?
A. Amenorrhea
B. Positive urine pregnancy test
C. Fetal heart activity detected by Doppler
D. Breast enlargement
Answer: C
Rationale: Positive signs directly attributable to the fetus include fetal heart activity, fetal
movement palpated by an examiner, and visualization of the fetus.
Question 8
, A client asks when prenatal care should begin. What is the best response?
A. "After the first trimester."
B. "As soon as pregnancy is suspected or confirmed."
C. "At 20 weeks."
D. "Only after fetal movement begins."
Answer: B
Rationale: Early prenatal care allows identification of risk factors, appropriate screening,
nutritional counseling, and timely intervention.
Question 9
Which prenatal finding requires immediate follow-up?
A. Mild urinary frequency
B. Breast tenderness
C. Vaginal bleeding
D. Mild fatigue
Answer: C
Rationale: Vaginal bleeding during pregnancy can indicate miscarriage, ectopic pregnancy,
placenta previa, placental abruption, or another complication.
Question 10
Which vaccine is generally recommended during pregnancy?
A. Live attenuated measles vaccine
B. Live varicella vaccine
C. Inactivated influenza vaccine
D. Live intranasal influenza vaccine
Answer: C
Rationale: Inactivated influenza vaccination is recommended during pregnancy. Live vaccines
such as varicella and MMR are generally avoided during pregnancy.
Question 11
A pregnant client asks why blood type and Rh status are assessed. What is the primary reason?
