NACE Care of the Childbearing Family Exam Questions with Answers & Detailed Rationales

NACE Care of the Childbearing Family Exam Questions with Answers &
Detailed Rationales | Comprehensive Maternal & Newborn Nursing
Test Bank | Exam Prep for RN, BSN, and Nursing Bridge Programs
QUESTION 1:
Which hormone is primarily responsible for maintaining the uterine lining during early
pregnancy?
A. Estrogen
B. Progesterone
C. Oxytocin
D. Prolactin

CORRECT ANSWER: B. Progesterone
RATIONALE: Progesterone, secreted by the corpus luteum and later the placenta, maintains the
endometrial lining for implantation and early fetal development. Estrogen contributes to uterine
growth, oxytocin promotes contractions, and prolactin stimulates milk production.



QUESTION 2:
A nurse teaching a pregnant client about folic acid supplementation explains that it helps
prevent which fetal anomaly?
A. Ventricular septal defect
B. Neural tube defects
C. Cleft palate
D. Gastroschisis

CORRECT ANSWER: B. Neural tube defects
RATIONALE: Folic acid supports neural tube closure during early embryonic development,
preventing conditions like spina bifida and anencephaly.



QUESTION 3:
During labor, the most effective nonpharmacologic method to relieve back labor pain caused by
fetal occiput posterior position is:
A. Effleurage on the abdomen
B. Firm counterpressure on the sacrum
C. Side-lying position with a pillow
D. Application of an abdominal binder

,CORRECT ANSWER: B. Firm counterpressure on the sacrum
RATIONALE: Fetal occiput posterior position increases sacral pressure, relieved by steady
counterpressure to the lower back. Effleurage benefits mild discomfort, while position change
may aid rotation but not immediate relief.



QUESTION 4:
Which maternal sign most reliably indicates placental separation after delivery of the infant?
A. A gush of bright red blood
B. Lengthening of the umbilical cord
C. Uterus becomes globular and rises in the abdomen
D. All of the above

CORRECT ANSWER: D. All of the above
RATIONALE: All listed signs are classic indicators of placental separation: a sudden gush of blood,
apparent cord lengthening, and the uterus rising and firming as the placenta detaches.



QUESTION 5:
Newborns of mothers with diabetes mellitus are at greatest risk for which complication
immediately after birth?
A. Hypocalcemia
B. Hypoglycemia
C. Hyperbilirubinemia
D. Polycythemia

CORRECT ANSWER: B. Hypoglycemia
RATIONALE: Fetal hyperinsulinemia develops in response to maternal hyperglycemia; after birth,
maternal glucose supply ceases abruptly, leading to a rapid glucose drop.



QUESTION 6:
Which finding in a postpartum client requires immediate nursing intervention?
A. Lochia rubra with small clots
B. Uterine fundus firm and midline
C. Perineal edema
D. Saturation of one perineal pad in 15 minutes

,CORRECT ANSWER: D. Saturation of one perineal pad in 15 minutes
RATIONALE: This indicates possible postpartum hemorrhage. Normal lochia should not saturate
a pad that quickly, even in early postpartum hours.



QUESTION 7:
A nurse is instructing a mother on safe sleep practices for her newborn. Which statement
indicates understanding?
A. "I’ll place my baby on his belly to sleep."
B. "I’ll use a loose blanket for warmth."
C. "My baby should sleep on his back in an empty crib."
D. "It’s fine if my baby sleeps with me when I’m tired."

CORRECT ANSWER: C. My baby should sleep on his back in an empty crib.
RATIONALE: Back-sleeping on a firm surface without soft bedding or co-sleeping reduces the risk
of sudden infant death syndrome (SIDS).



QUESTION 8:
The nurse understands that a positive Chadwick’s sign refers to:
A. Bluish discoloration of the cervix and vaginal mucosa
B. Softening of the cervix
C. Softening of the lower uterine segment
D. Enlargement of the uterus

CORRECT ANSWER: A. Bluish discoloration of the cervix and vaginal mucosa
RATIONALE: Increased vascularity during early pregnancy causes the cervix and vagina to
appear bluish—known as Chadwick’s sign. Goodell’s sign is cervical softening, and Hegar’s sign
is uterine segment softening.



QUESTION 9:
A nurse caring for a laboring client notes variable fetal heart rate decelerations. The initial
nursing action should be to:
A. Apply oxygen
B. Increase IV fluids
C. Reposition the client
D. Notify the provider immediately

, CORRECT ANSWER: C. Reposition the client
RATIONALE: Variable decelerations indicate cord compression; changing maternal position
relieves pressure. Oxygen and fluids may follow if decelerations persist.



QUESTION 10:
Which of the following is a priority nursing assessment immediately after rupture of
membranes?
A. Maternal temperature
B. Amniotic fluid color and odor
C. Fetal heart rate
D. Cervical dilation

CORRECT ANSWER: C. Fetal heart rate
RATIONALE: A cord prolapse may occur upon membrane rupture, compromising fetal circulation.
Assessing fetal heart rate identifies distress promptly.



QUESTION 11:
Which newborn finding requires further evaluation?
A. Mongolian spots on the lower back
B. Acrocyanosis
C. Respiratory rate of 80 breaths per minute
D. Overlapping cranial sutures

CORRECT ANSWER: C. Respiratory rate of 80 breaths per minute
RATIONALE: Normal newborn respirations are 30–60 per minute. Persistent tachypnea suggests
respiratory distress or underlying pathology.



QUESTION 12:
The nurse teaches a pregnant client that “quickening” refers to:
A. Fetal heart tones heard on Doppler
B. Fetal movements felt by the mother
C. Uterine contractions
D. Maternal perception of Braxton Hicks contractions