NACE CARE OF THE CHILDBEARING FAMILY
2026 STUDY GUIDE | PRACTICE EXAM
QUESTIONS & ANSWERS | MATERNAL-
NEWBORN NURSING TEST BANK
NACE CARE OF THE CHILDBEARING FAMILY 2026 STUDY GUIDE
PRACTICE EXAM QUESTIONS & ANSWERS | MATERNAL-NEWBORN NURSING
TEST BANK
DOCUMENT OVERVIEW:
• This comprehensive question practice exam provides realistic, evidence-based
scenarios designed to assess mastery of maternal-newborn nursing across
pregnancy, labor, delivery, postpartum, and neonatal care domains.
• Study this material by reviewing each question carefully, attempting to answer
before reviewing EXPERT RATIONALE, then using detailed explanations to
strengthen understanding of clinical concepts and nursing interventions.
QUESTION 1
A pregnant client at 28 weeks gestation presents to the clinic with complaints
of sudden onset severe headache, vision changes, and epigastric pain. Her
blood pressure is 168/110 mmHg. What is the priority nursing intervention?
A) Assess fundal height and perform Leopold's maneuvers
B) Notify the healthcare provider immediately and prepare for potential emergency
delivery
C) Administer antacids for the epigastric pain
D) Recommend rest and follow-up in one week
E) Encourage the client to increase fluid intake
,✓ CORRECT ANSWER: B) Notify the healthcare provider immediately and
prepare for potential emergency delivery
EXPERT RATIONALE: The client is presenting with classic signs of preeclampsia with
severe features: hypertension (≥160/110), headache, vision changes, and epigastric
pain. These symptoms suggest the development of severe preeclampsia or possible
eclampsia, which are obstetric emergencies. Immediate notification of the
healthcare provider is critical to prevent progression to eclamptic seizures or
maternal complications. At 28 weeks, preterm delivery may be necessary to prevent
maternal death. Assessing fundal height is non-urgent, antacids are inappropriate
without ruling out serious pathology, delayed follow-up is dangerous, and
increased fluid intake is contraindicated in preeclampsia.
QUESTION 2
During the second stage of labor, the nurse observes dark red lochia with
small clots. The client is 4 hours postdelivery. Which assessment finding
would be most concerning?
A) Fundus is firm at the umbilicus
B) Fundus is boggy and two fingerbreadths above the umbilicus
C) Lochia saturates one perineal pad in 1 hour
D) Client reports mild perineal pain
E) Hemoglobin is 10.2 g/dL
✓ CORRECT ANSWER: B) Fundus is boggy and two fingerbreadths above the
umbilicus
EXPERT RATIONALE: A boggy uterus that is higher than expected indicates uterine
atony, the most common cause of postpartum hemorrhage. The fundus should be
firm and at or below the umbilicus by 4 hours postdelivery. A boggy, distended
fundus suggests the uterus is not contracting effectively, leading to continued
bleeding and blood accumulation in the uterine cavity. This requires immediate
,intervention including fundal massage, oxytocin administration, and possible
assessment for retained placental fragments. A firm fundus at the umbilicus is
normal, small clots are expected, one pad per hour is within normal limits, mild
perineal pain is expected, and a hemoglobin of 10.2 is acceptable immediately
postpartum.
QUESTION 3
A client who is breastfeeding her 5-day-old newborn reports breast
engorgement with pain rated 8/10. Her breasts are swollen, firm, and hot to
touch. What is the most appropriate nursing intervention?
A) Advise the client to stop breastfeeding temporarily and switch to formula
B) Apply warm compresses only, as heat relieves all engorgement symptoms
C) Apply cold compresses between feedings and suggest frequent breastfeeding
every 2-3 hours
D) Manually express milk until the breasts are completely empty before each
feeding
E) Administer ibuprofen and recommend waiting 48 hours before resuming
breastfeeding
✓ CORRECT ANSWER: C) Apply cold compresses between feedings and suggest
frequent breastfeeding every 2-3 hours
EXPERT RATIONALE: Breast engorgement typically peaks at 3-5 days postpartum
and is managed with a combination of cold therapy between feedings and
frequent, effective breastfeeding. Cold compresses reduce inflammation and
swelling, while frequent breastfeeding (every 2-3 hours) prevents milk accumulation
and improves milk removal. Warm compresses are used before feedings to
facilitate milk letdown, not to treat engorgement. Stopping breastfeeding worsens
engorgement and increases infection risk. Manual expression should be minimal to
, avoid further stimulation. NSAIDs are appropriate for pain management but should
accompany, not replace, other interventions.
QUESTION 4
A 32-week pregnant client with gestational diabetes has a fasting blood
glucose of 110 mg/dL. Which action should the nurse take?
A) Inform the client this is normal and requires no intervention
B) Contact the healthcare provider as the fasting glucose exceeds target range
C) Recommend increased simple carbohydrate intake to prevent hypoglycemia
D) Suggest the client increase her insulin dose independently
E) Schedule follow-up testing in 4 weeks
✓ CORRECT ANSWER: B) Contact the healthcare provider as the fasting glucose
exceeds target range
EXPERT RATIONALE: For clients with gestational diabetes, the fasting blood glucose
target is typically 90 mg/dL or less. A fasting glucose of 110 mg/dL exceeds this
target and indicates inadequate glycemic control, which increases risks of fetal
macrosomia, birth trauma, and neonatal hypoglycemia. The healthcare provider
must be notified for possible adjustment of the client's management plan, which
may include changes to diet, exercise, or medication (insulin or metformin).
Assuring the client this is normal delays necessary treatment. Simple carbohydrates
worsen hyperglycemia. Self-adjustment of insulin is unsafe and inappropriate. Four
weeks is too long to wait for intervention.
QUESTION 5
A newborn delivered at 38 weeks gestation has a temperature of 96.8°F (36°C),
respiratory rate of 68 breaths/minute, and heart rate of 165 bpm at 2 hours of
2026 STUDY GUIDE | PRACTICE EXAM
QUESTIONS & ANSWERS | MATERNAL-
NEWBORN NURSING TEST BANK
NACE CARE OF THE CHILDBEARING FAMILY 2026 STUDY GUIDE
PRACTICE EXAM QUESTIONS & ANSWERS | MATERNAL-NEWBORN NURSING
TEST BANK
DOCUMENT OVERVIEW:
• This comprehensive question practice exam provides realistic, evidence-based
scenarios designed to assess mastery of maternal-newborn nursing across
pregnancy, labor, delivery, postpartum, and neonatal care domains.
• Study this material by reviewing each question carefully, attempting to answer
before reviewing EXPERT RATIONALE, then using detailed explanations to
strengthen understanding of clinical concepts and nursing interventions.
QUESTION 1
A pregnant client at 28 weeks gestation presents to the clinic with complaints
of sudden onset severe headache, vision changes, and epigastric pain. Her
blood pressure is 168/110 mmHg. What is the priority nursing intervention?
A) Assess fundal height and perform Leopold's maneuvers
B) Notify the healthcare provider immediately and prepare for potential emergency
delivery
C) Administer antacids for the epigastric pain
D) Recommend rest and follow-up in one week
E) Encourage the client to increase fluid intake
,✓ CORRECT ANSWER: B) Notify the healthcare provider immediately and
prepare for potential emergency delivery
EXPERT RATIONALE: The client is presenting with classic signs of preeclampsia with
severe features: hypertension (≥160/110), headache, vision changes, and epigastric
pain. These symptoms suggest the development of severe preeclampsia or possible
eclampsia, which are obstetric emergencies. Immediate notification of the
healthcare provider is critical to prevent progression to eclamptic seizures or
maternal complications. At 28 weeks, preterm delivery may be necessary to prevent
maternal death. Assessing fundal height is non-urgent, antacids are inappropriate
without ruling out serious pathology, delayed follow-up is dangerous, and
increased fluid intake is contraindicated in preeclampsia.
QUESTION 2
During the second stage of labor, the nurse observes dark red lochia with
small clots. The client is 4 hours postdelivery. Which assessment finding
would be most concerning?
A) Fundus is firm at the umbilicus
B) Fundus is boggy and two fingerbreadths above the umbilicus
C) Lochia saturates one perineal pad in 1 hour
D) Client reports mild perineal pain
E) Hemoglobin is 10.2 g/dL
✓ CORRECT ANSWER: B) Fundus is boggy and two fingerbreadths above the
umbilicus
EXPERT RATIONALE: A boggy uterus that is higher than expected indicates uterine
atony, the most common cause of postpartum hemorrhage. The fundus should be
firm and at or below the umbilicus by 4 hours postdelivery. A boggy, distended
fundus suggests the uterus is not contracting effectively, leading to continued
bleeding and blood accumulation in the uterine cavity. This requires immediate
,intervention including fundal massage, oxytocin administration, and possible
assessment for retained placental fragments. A firm fundus at the umbilicus is
normal, small clots are expected, one pad per hour is within normal limits, mild
perineal pain is expected, and a hemoglobin of 10.2 is acceptable immediately
postpartum.
QUESTION 3
A client who is breastfeeding her 5-day-old newborn reports breast
engorgement with pain rated 8/10. Her breasts are swollen, firm, and hot to
touch. What is the most appropriate nursing intervention?
A) Advise the client to stop breastfeeding temporarily and switch to formula
B) Apply warm compresses only, as heat relieves all engorgement symptoms
C) Apply cold compresses between feedings and suggest frequent breastfeeding
every 2-3 hours
D) Manually express milk until the breasts are completely empty before each
feeding
E) Administer ibuprofen and recommend waiting 48 hours before resuming
breastfeeding
✓ CORRECT ANSWER: C) Apply cold compresses between feedings and suggest
frequent breastfeeding every 2-3 hours
EXPERT RATIONALE: Breast engorgement typically peaks at 3-5 days postpartum
and is managed with a combination of cold therapy between feedings and
frequent, effective breastfeeding. Cold compresses reduce inflammation and
swelling, while frequent breastfeeding (every 2-3 hours) prevents milk accumulation
and improves milk removal. Warm compresses are used before feedings to
facilitate milk letdown, not to treat engorgement. Stopping breastfeeding worsens
engorgement and increases infection risk. Manual expression should be minimal to
, avoid further stimulation. NSAIDs are appropriate for pain management but should
accompany, not replace, other interventions.
QUESTION 4
A 32-week pregnant client with gestational diabetes has a fasting blood
glucose of 110 mg/dL. Which action should the nurse take?
A) Inform the client this is normal and requires no intervention
B) Contact the healthcare provider as the fasting glucose exceeds target range
C) Recommend increased simple carbohydrate intake to prevent hypoglycemia
D) Suggest the client increase her insulin dose independently
E) Schedule follow-up testing in 4 weeks
✓ CORRECT ANSWER: B) Contact the healthcare provider as the fasting glucose
exceeds target range
EXPERT RATIONALE: For clients with gestational diabetes, the fasting blood glucose
target is typically 90 mg/dL or less. A fasting glucose of 110 mg/dL exceeds this
target and indicates inadequate glycemic control, which increases risks of fetal
macrosomia, birth trauma, and neonatal hypoglycemia. The healthcare provider
must be notified for possible adjustment of the client's management plan, which
may include changes to diet, exercise, or medication (insulin or metformin).
Assuring the client this is normal delays necessary treatment. Simple carbohydrates
worsen hyperglycemia. Self-adjustment of insulin is unsafe and inappropriate. Four
weeks is too long to wait for intervention.
QUESTION 5
A newborn delivered at 38 weeks gestation has a temperature of 96.8°F (36°C),
respiratory rate of 68 breaths/minute, and heart rate of 165 bpm at 2 hours of
