1|Page
NACE CARE OF THE CHILDBEARING FAMILY
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A
GRADED WITH EXPERT FEEDBACK | NEW AND
REVISED
1. A 28-year-old primigravida at 32 weeks gestation reports headaches, visual
spots, and swelling of hands. What is the nurse’s priority?
A. Encourage rest and return in one week
B. Assess blood pressure and proteinuria immediately
C. Schedule routine prenatal visit next month
D. Teach about fetal movement counting
Rationale: Headache, visual changes, and edema are signs of
preeclampsia; immediate BP and urine assessment are urgent to evaluate
severity.
2. A client with gestational diabetes is fasting for a morning appointment.
Which instruction is most appropriate?
A. Skip insulin and fast as usual
B. Only drink water while fasting
C. Continue usual insulin/medication per provider guidance and monitor
glucose
D. Eat a high-carbohydrate snack before coming
Rationale: Clients should follow individualized insulin/medication plans
and monitor glucose; abrupt medication changes can cause
hypo/hyperglycemia.
3. Late decelerations on fetal monitoring most likely indicate:
A. Fetal movement
B. Umbilical cord compression
C. Uteroplacental insufficiency (uteroplacental insufficiency/hypoxia)
D. Early labor contractions
,2|Page
Rationale: Late decelerations occur after contraction peaks and suggest
decreased uteroplacental oxygenation; they require intervention.
4. A woman in active labor with a Category II fetal strip has recurrent
variable decelerations with minimal variability. First nursing action?
A. Notify family to prepare for delivery
B. Document and observe only
C. Reposition mother, administer oxygen, and check maternal vitals
D. Begin oxytocin infusion
Rationale: Variable decelerations often respond to repositioning and
relieving cord compression; oxygen and maternal assessment are
immediate measures.
5. A postpartum patient exhibits boggy uterus and excessive bleeding 20
minutes after delivery. Priority nursing intervention:
A. Start IV antibiotics
B. Massage the fundus and assess bladder distention
C. Encourage breastfeeding immediately
D. Administer pain medication
Rationale: Uterine atony causes postpartum hemorrhage; fundal massage
and checking for bladder distention are first-line interventions.
6. A newborn has a shallow, irregular respirations and central cyanosis at 1
minute. Next step:
A. Swaddle and continue observation
B. Initiate neonatal resuscitation (position airway, stimulate, provide positive-
pressure ventilation if needed)
C. Delay care until APGAR is scored
D. Give inhaled oxygen only
Rationale: Immediate neonatal resuscitation per NRP is needed for
respiratory compromise and central cyanosis.
7. Which maternal condition is a contraindication to vaginal birth after
cesarean (VBAC)?
A. Prior low transverse cesarean only
B. Maternal age >40
C. Classical (vertical) uterine incision from prior cesarean
D. Obesity alone
,3|Page
Rationale: A prior classical uterine incision increases risk of uterine
rupture, contraindicating VBAC.
8. A nurse educates a breastfeeding mother about mastitis prevention. What
to include?
A. Avoid frequent breastfeeding
B. Only pump and discard all milk
C. Ensure proper latch, empty breasts regularly, and maintain hand hygiene
D. Restrict fluids to decrease engorgement
_Rationale: Good latch, frequent emptying, and hygiene help prevent milk
stasis and infection.*
9. A client receives magnesium sulfate for severe preeclampsia. Which
assessment indicates toxicity?
A. Decreased edema
B. Increased urinary output
C. Respiratory depression and absent deep tendon reflexes
D. Improved visual symptoms
_Rationale: Magnesium toxicity presents with respiratory depression,
hypotonia, and loss of DTRs; requires prompt intervention.*
10. When teaching about Rh incompatibility, the nurse explains Rho(D)
immune globulin is given to:
A. Rh-positive mother with Rh-negative fetus
B. All mothers after delivery
C. Rh-negative mother who has been exposed to Rh-positive fetal blood
D. Fathers who are Rh-positive
_Rationale: Rho(D) immune globulin prevents maternal alloimmunization
when Rh-negative mothers are exposed to Rh-positive fetal blood.*
11. A laboring woman requests pain relief. She desires the fastest analgesia
with minimal fetal effect. The nurse suggests:
A. Oral acetaminophen only
B. Inhaled nitrous oxide (if available) or short-acting opioids per policy
C. General anesthesia
D. High-dose benzodiazepines
, 4|Page
_Rationale: Nitrous oxide and short-acting opioids can provide rapid relief
with limited prolonged fetal depression when used appropriately.*
12. A patient with premature rupture of membranes (PROM) at 36 weeks
needs observation. Which sign indicates ascending infection?
A. Decreased fetal movements
B. Maternal fever, foul-smelling vaginal discharge, and uterine tenderness
C. Burst of energy before labor
D. Increased urinary frequency
_Rationale: Fever, malodorous discharge, and tenderness suggest
chorioamnionitis and require prompt management.*
13. During postpartum discharge teaching, the nurse emphasizes when to call
provider. Which sign is most urgent?
A. Mild breast tenderness
B. Lochia that changes from red to serosa
C. Heavy bleeding with large clots and lightheadedness
D. Mild constipation
_Rationale: Heavy bleeding and syncope indicate possible hemorrhage and
warrant immediate attention.*
14. A 39-week gestation woman is having induction with oxytocin;
contractions are every 1 minute, lasting 90 seconds, fetal heart rate 110 bpm
with decreased variability. Nursing priority:
A. Increase oxytocin to shorten labor
B. Stop oxytocin infusion and assess for uterine tachysystole and fetal status
C. Encourage mother to ambulate
D. Offer ice chips
_Rationale: Tachysystole can cause fetal compromise; oxytocin should be
stopped to reduce contraction frequency.*
15. A newborn with hypoglycemia risk factors (large for gestational age,
maternal diabetes). Best nursing action at birth:
A. Delay feeding 6 hours
B. Administer dextrose immediately without feeding
C. Initiate early breastfeeding or express breastmilk and monitor glucose
D. Place newborn in radiant warmer only
NACE CARE OF THE CHILDBEARING FAMILY
ACTUAL EXAM PREP 2026 ALL QUESTIONS AND
CORRECT DETAILED ANSWERS ALREADY A
GRADED WITH EXPERT FEEDBACK | NEW AND
REVISED
1. A 28-year-old primigravida at 32 weeks gestation reports headaches, visual
spots, and swelling of hands. What is the nurse’s priority?
A. Encourage rest and return in one week
B. Assess blood pressure and proteinuria immediately
C. Schedule routine prenatal visit next month
D. Teach about fetal movement counting
Rationale: Headache, visual changes, and edema are signs of
preeclampsia; immediate BP and urine assessment are urgent to evaluate
severity.
2. A client with gestational diabetes is fasting for a morning appointment.
Which instruction is most appropriate?
A. Skip insulin and fast as usual
B. Only drink water while fasting
C. Continue usual insulin/medication per provider guidance and monitor
glucose
D. Eat a high-carbohydrate snack before coming
Rationale: Clients should follow individualized insulin/medication plans
and monitor glucose; abrupt medication changes can cause
hypo/hyperglycemia.
3. Late decelerations on fetal monitoring most likely indicate:
A. Fetal movement
B. Umbilical cord compression
C. Uteroplacental insufficiency (uteroplacental insufficiency/hypoxia)
D. Early labor contractions
,2|Page
Rationale: Late decelerations occur after contraction peaks and suggest
decreased uteroplacental oxygenation; they require intervention.
4. A woman in active labor with a Category II fetal strip has recurrent
variable decelerations with minimal variability. First nursing action?
A. Notify family to prepare for delivery
B. Document and observe only
C. Reposition mother, administer oxygen, and check maternal vitals
D. Begin oxytocin infusion
Rationale: Variable decelerations often respond to repositioning and
relieving cord compression; oxygen and maternal assessment are
immediate measures.
5. A postpartum patient exhibits boggy uterus and excessive bleeding 20
minutes after delivery. Priority nursing intervention:
A. Start IV antibiotics
B. Massage the fundus and assess bladder distention
C. Encourage breastfeeding immediately
D. Administer pain medication
Rationale: Uterine atony causes postpartum hemorrhage; fundal massage
and checking for bladder distention are first-line interventions.
6. A newborn has a shallow, irregular respirations and central cyanosis at 1
minute. Next step:
A. Swaddle and continue observation
B. Initiate neonatal resuscitation (position airway, stimulate, provide positive-
pressure ventilation if needed)
C. Delay care until APGAR is scored
D. Give inhaled oxygen only
Rationale: Immediate neonatal resuscitation per NRP is needed for
respiratory compromise and central cyanosis.
7. Which maternal condition is a contraindication to vaginal birth after
cesarean (VBAC)?
A. Prior low transverse cesarean only
B. Maternal age >40
C. Classical (vertical) uterine incision from prior cesarean
D. Obesity alone
,3|Page
Rationale: A prior classical uterine incision increases risk of uterine
rupture, contraindicating VBAC.
8. A nurse educates a breastfeeding mother about mastitis prevention. What
to include?
A. Avoid frequent breastfeeding
B. Only pump and discard all milk
C. Ensure proper latch, empty breasts regularly, and maintain hand hygiene
D. Restrict fluids to decrease engorgement
_Rationale: Good latch, frequent emptying, and hygiene help prevent milk
stasis and infection.*
9. A client receives magnesium sulfate for severe preeclampsia. Which
assessment indicates toxicity?
A. Decreased edema
B. Increased urinary output
C. Respiratory depression and absent deep tendon reflexes
D. Improved visual symptoms
_Rationale: Magnesium toxicity presents with respiratory depression,
hypotonia, and loss of DTRs; requires prompt intervention.*
10. When teaching about Rh incompatibility, the nurse explains Rho(D)
immune globulin is given to:
A. Rh-positive mother with Rh-negative fetus
B. All mothers after delivery
C. Rh-negative mother who has been exposed to Rh-positive fetal blood
D. Fathers who are Rh-positive
_Rationale: Rho(D) immune globulin prevents maternal alloimmunization
when Rh-negative mothers are exposed to Rh-positive fetal blood.*
11. A laboring woman requests pain relief. She desires the fastest analgesia
with minimal fetal effect. The nurse suggests:
A. Oral acetaminophen only
B. Inhaled nitrous oxide (if available) or short-acting opioids per policy
C. General anesthesia
D. High-dose benzodiazepines
, 4|Page
_Rationale: Nitrous oxide and short-acting opioids can provide rapid relief
with limited prolonged fetal depression when used appropriately.*
12. A patient with premature rupture of membranes (PROM) at 36 weeks
needs observation. Which sign indicates ascending infection?
A. Decreased fetal movements
B. Maternal fever, foul-smelling vaginal discharge, and uterine tenderness
C. Burst of energy before labor
D. Increased urinary frequency
_Rationale: Fever, malodorous discharge, and tenderness suggest
chorioamnionitis and require prompt management.*
13. During postpartum discharge teaching, the nurse emphasizes when to call
provider. Which sign is most urgent?
A. Mild breast tenderness
B. Lochia that changes from red to serosa
C. Heavy bleeding with large clots and lightheadedness
D. Mild constipation
_Rationale: Heavy bleeding and syncope indicate possible hemorrhage and
warrant immediate attention.*
14. A 39-week gestation woman is having induction with oxytocin;
contractions are every 1 minute, lasting 90 seconds, fetal heart rate 110 bpm
with decreased variability. Nursing priority:
A. Increase oxytocin to shorten labor
B. Stop oxytocin infusion and assess for uterine tachysystole and fetal status
C. Encourage mother to ambulate
D. Offer ice chips
_Rationale: Tachysystole can cause fetal compromise; oxytocin should be
stopped to reduce contraction frequency.*
15. A newborn with hypoglycemia risk factors (large for gestational age,
maternal diabetes). Best nursing action at birth:
A. Delay feeding 6 hours
B. Administer dextrose immediately without feeding
C. Initiate early breastfeeding or express breastmilk and monitor glucose
D. Place newborn in radiant warmer only
