NACE Care of the Childbearing Family Test Questions
and Answers
1. A nurse is explaining physiological jaundice to a nursing student. Which of the following
should the nurse include when discussing risk factors for neonatal physiological jaundice?
Options:
A. African American ethnicity
B. Meconium-stained amniotic fluid
C. Bottle feeding
D. Gestational age of 35-38 weeks
Answer: D. Gestational age of 35-38 weeks
Rationale: Preterm babies are more likely to develop jaundice due to their immature liver and
increased breakdown of red blood cells. Babies born between 35 and 38 weeks are considered
late preterm and have a higher risk of jaundice than full-term babies. African American ethnicity
is not a risk factor; Asian, European, or Native American ethnicity are more associated.
Meconium-stained amniotic fluid indicates fetal distress but does not affect bilirubin levels.
Bottle feeding is not a risk factor; breastfeeding may be associated due to dehydration.
2. A baby boy is circumcised on the day of discharge. Which observation should the nurse make
prior to the infant's discharge?
Options:
A. Ability to have an erection
B. Ability to urinate without pain
C. Position of the urethral opening
D. Presence of white-yellow exudate around the glans tissue
Answer: B. Ability to urinate without pain
, Rationale: Circumcision may affect urinary function. Ensure the baby can urinate normally and
without pain, with adequate volume for weight and hydration. Erectile ability is not affected or
a priority. Urethral position is assessed at birth. White-yellow exudate is normal for healing.
3. A patient who is 38 weeks pregnant is admitted to the hospital in active labor. On admission,
the patient says, “For the past ten hours, I have been leaking small amounts of urine.” Which
action should the nurse take initially?
Options:
A. Check the patient’s bladder for distention
B. Test the patient’s vaginal secretions with nitrazine paper
C. Check the patient’s urine for glucose content
D. Obtain a specimen of the patient’s vaginal secretions for culture
Answer: B. Test the patient’s vaginal secretions with nitrazine paper
Rationale: Nitrazine paper differentiates amniotic fluid (alkaline, turns blue) from urine (acidic,
turns yellow). Bladder distention or urine glucose does not confirm rupture of membranes.
Culture checks for infection but is not initial.
4. A nurse is caring for a female client who suspects she is pregnant. Which question, if asked by
the nurse, is consistent with signs of early pregnancy?
Options:
A. “Are you experiencing shortness of breath?”
B. “Have you had episodes of loss of consciousness?”
C. “Are you experiencing spotting?”
D. “Have you noticed any tenderness in your breasts?”
Answer: D. “Have you noticed any tenderness in your breasts?”
Rationale: Breast tenderness occurs 1-2 weeks after conception due to hormonal changes.
Shortness of breath happens later from uterine pressure. Loss of consciousness indicates
serious issues like anemia. Spotting may be implantation bleeding but is lighter than a period.
, 5. A nurse is caring for a newborn with a gestational age of 42 weeks. Which finding would the
nurse expect during the assessment of this newborn?
Options:
A. Sole creases that cover only the anterior one-third of the foot
B. Abundance of vernix caseosa on the skin
C. Dryness and flaking of the skin on the hands and feet
D. A large amount of fine, downy hair (lanugo) on the back and shoulders
Answer: C. Dryness and flaking of the skin on the hands and feet
Rationale: Post-mature newborns lose vernix caseosa, leading to peeling skin from amniotic
fluid exposure. Sole creases, vernix, and lanugo are preterm features.
6. A patient who is 37 weeks pregnant and has gestational diabetes is admitted to the labor and
delivery unit for induction. The patient is placed on an external fetal monitor and receives an
epidural anesthesia. Which action should the nurse take to identify a potential side effect of the
epidural?
Options:
A. Assess the patient’s urine for acetone
B. Monitor the patient’s deep tendon reflexes
C. Assess the patient’s pupillary accommodation
D. Monitor the patient’s blood pressure frequently
Answer: D. Monitor the patient’s blood pressure frequently
Rationale: Epidural can cause hypotension, affecting placental flow. Urine acetone relates to
ketoacidosis, reflexes to magnesium, pupillary accommodation to nervous system drugs.
7. A patient is receiving magnesium sulfate. Which side effect should the nurse monitor for with
this patient?
Options:
A. Increased Babinski reflex
and Answers
1. A nurse is explaining physiological jaundice to a nursing student. Which of the following
should the nurse include when discussing risk factors for neonatal physiological jaundice?
Options:
A. African American ethnicity
B. Meconium-stained amniotic fluid
C. Bottle feeding
D. Gestational age of 35-38 weeks
Answer: D. Gestational age of 35-38 weeks
Rationale: Preterm babies are more likely to develop jaundice due to their immature liver and
increased breakdown of red blood cells. Babies born between 35 and 38 weeks are considered
late preterm and have a higher risk of jaundice than full-term babies. African American ethnicity
is not a risk factor; Asian, European, or Native American ethnicity are more associated.
Meconium-stained amniotic fluid indicates fetal distress but does not affect bilirubin levels.
Bottle feeding is not a risk factor; breastfeeding may be associated due to dehydration.
2. A baby boy is circumcised on the day of discharge. Which observation should the nurse make
prior to the infant's discharge?
Options:
A. Ability to have an erection
B. Ability to urinate without pain
C. Position of the urethral opening
D. Presence of white-yellow exudate around the glans tissue
Answer: B. Ability to urinate without pain
, Rationale: Circumcision may affect urinary function. Ensure the baby can urinate normally and
without pain, with adequate volume for weight and hydration. Erectile ability is not affected or
a priority. Urethral position is assessed at birth. White-yellow exudate is normal for healing.
3. A patient who is 38 weeks pregnant is admitted to the hospital in active labor. On admission,
the patient says, “For the past ten hours, I have been leaking small amounts of urine.” Which
action should the nurse take initially?
Options:
A. Check the patient’s bladder for distention
B. Test the patient’s vaginal secretions with nitrazine paper
C. Check the patient’s urine for glucose content
D. Obtain a specimen of the patient’s vaginal secretions for culture
Answer: B. Test the patient’s vaginal secretions with nitrazine paper
Rationale: Nitrazine paper differentiates amniotic fluid (alkaline, turns blue) from urine (acidic,
turns yellow). Bladder distention or urine glucose does not confirm rupture of membranes.
Culture checks for infection but is not initial.
4. A nurse is caring for a female client who suspects she is pregnant. Which question, if asked by
the nurse, is consistent with signs of early pregnancy?
Options:
A. “Are you experiencing shortness of breath?”
B. “Have you had episodes of loss of consciousness?”
C. “Are you experiencing spotting?”
D. “Have you noticed any tenderness in your breasts?”
Answer: D. “Have you noticed any tenderness in your breasts?”
Rationale: Breast tenderness occurs 1-2 weeks after conception due to hormonal changes.
Shortness of breath happens later from uterine pressure. Loss of consciousness indicates
serious issues like anemia. Spotting may be implantation bleeding but is lighter than a period.
, 5. A nurse is caring for a newborn with a gestational age of 42 weeks. Which finding would the
nurse expect during the assessment of this newborn?
Options:
A. Sole creases that cover only the anterior one-third of the foot
B. Abundance of vernix caseosa on the skin
C. Dryness and flaking of the skin on the hands and feet
D. A large amount of fine, downy hair (lanugo) on the back and shoulders
Answer: C. Dryness and flaking of the skin on the hands and feet
Rationale: Post-mature newborns lose vernix caseosa, leading to peeling skin from amniotic
fluid exposure. Sole creases, vernix, and lanugo are preterm features.
6. A patient who is 37 weeks pregnant and has gestational diabetes is admitted to the labor and
delivery unit for induction. The patient is placed on an external fetal monitor and receives an
epidural anesthesia. Which action should the nurse take to identify a potential side effect of the
epidural?
Options:
A. Assess the patient’s urine for acetone
B. Monitor the patient’s deep tendon reflexes
C. Assess the patient’s pupillary accommodation
D. Monitor the patient’s blood pressure frequently
Answer: D. Monitor the patient’s blood pressure frequently
Rationale: Epidural can cause hypotension, affecting placental flow. Urine acetone relates to
ketoacidosis, reflexes to magnesium, pupillary accommodation to nervous system drugs.
7. A patient is receiving magnesium sulfate. Which side effect should the nurse monitor for with
this patient?
Options:
A. Increased Babinski reflex
