NACE CHILDBEARING FAMILY EXAM UPDATED
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
After a client received an epidural anesthesia, a nurse should make which of these
assessments first? · Determine whether the client has bladder distention · Determine
whether the client has sensory impairment in the legs · Determine the frequency of the
client's contractions Determine the clients blood pressure
Answer:
The nurse should determine the client's blood pressure
first. Since epidural anesthesia may cause the blood pressure to drop, it is important to
ensure there is adequate blood flow to the baby. The other options may be subsequent
assessments the nurse would make, but should not be the first assessment.
Question:
The client who is 16 weeks pregnant attends the antepartal clinic. She makes all of these
comments to a nurse. Which of these comments by this client requires FURTHER
discussion by the nurse? · I drink about 2.5 quarts of fluids every day · I've gained about
7 pounds so far. I'll probably gain another 20 pounds by the time I deliver · I had a
problem with hemorrhoids with my other pregnancy, so now I eat a large serving of
bran every evening · I'm being careful to eat mostly salt-free and to use no salt in my
cooking
Answer:
The fourth statement requires further discussion. Sodium requirements increase
during pregnancy. However, the sodium provided by the average diet is likely to be
adequate for expectant mothers. Use of additional salt is rarely warranted.
Question:
A nurse teaches pregnancy exercises to a group of pregnant women. The nurse should
include an explanation that pelvic rock will be helpful at any time in their lives should
the women develop which of these conditions? · Hemorrhoids · Intestinal flatus · Lower
back pain · Leg cramps
Answer:
Pelvic rock helps to relieve lower back pains. Pelvic rocking helps to relieve a sore back
by stretching the lower back muscles. Pelvic rocking also helps stimulate the digestive
system, realigns the uterus, and keeps the stomach muscles toned.
, Question:
A client who is in active labor has a vaginal examination which reveals she is 5cm
dilated and 100% effaced at a -1 station. At the peak of a contraction, the amniotic fluid
ruptures. Which of these actions should a nurse take first? · Records the findings and
notify the provider · Change the linen and make the client comfortable · Check the
perineal area and assess for crowning · Assess the fetal heart rate and check for
regularity
Answer:
After rupture of the membranes, there is a danger of cord prolapse; therefore, the
nurse should assess the fetal heart rate for regularity. Variable decelerations can occur
as a result of cord compression secondary to cord
prolapse. There is also a risk for infection after membrane rupture.
Question:
After teaching a class about relieving leg cramps during pregnancy, a nurse evaluates
the effectiveness of the instructions. Which of these comments, if made by the
participants, would require FURTHER instruction? · When I get a leg cramps in the
middle of the night, my husband presses on my knee and pushes my foot toward my leg
· Sometimes when I'm sitting at my typewriter, I get a horrible leg cramp. First, I stand
and bear weight on my leg in the middle of the night · I take a heating pad to bed with
me so that I can use it if I get a leg cramp in the middle of the night · When I get a leg
cramp while sitting at my desk, I flex my knee and extend my foot
Answer:
The fourth comment would require further education. With leg cramps, the leg should
be straightened and toes should be flexed toward the shin.
Question:
A client who is scheduled for a cesarean delivery has the following written
preoperative orders. Which should the nurse question? · Nothing by mouth after
midnight · Atropine sulfate 0.4mg IM on call · Indwelling urinary catheter to be inserted
in the morning · Cleansing enema this evening
Answer:
The order for a cleansing enema in the evening should be discussed with the physician.
A cleansing enema is not usually done prior to a cesarean section.
Question:
A client who is G1P0 is receiving IV oxytocin injection for labor augmentation. Because
of the effects of Pitocin, a nurse should assess the client for which of these adverse
effects of Pitocin? · Bradypnea and diarrhea · Insomnia and tachycardia · Hypotension
and diuresis · Headache and water intoxication
Answer:
With doses of 20mU/min on above, oxytocin exerts an antidiuretic effect decreases free
water exchange in the kidney, and markedly decreases urine output. Blood pressure
initially may decrease, but after prolonged administration, the blood pressure increases
above the baseline. Oxytocin does not cause bradycardia, diarrhea, insomnia, or
tachycardia.
ACTUAL QUESTIONS AND CORRECT ANSWERS
Question:
After a client received an epidural anesthesia, a nurse should make which of these
assessments first? · Determine whether the client has bladder distention · Determine
whether the client has sensory impairment in the legs · Determine the frequency of the
client's contractions Determine the clients blood pressure
Answer:
The nurse should determine the client's blood pressure
first. Since epidural anesthesia may cause the blood pressure to drop, it is important to
ensure there is adequate blood flow to the baby. The other options may be subsequent
assessments the nurse would make, but should not be the first assessment.
Question:
The client who is 16 weeks pregnant attends the antepartal clinic. She makes all of these
comments to a nurse. Which of these comments by this client requires FURTHER
discussion by the nurse? · I drink about 2.5 quarts of fluids every day · I've gained about
7 pounds so far. I'll probably gain another 20 pounds by the time I deliver · I had a
problem with hemorrhoids with my other pregnancy, so now I eat a large serving of
bran every evening · I'm being careful to eat mostly salt-free and to use no salt in my
cooking
Answer:
The fourth statement requires further discussion. Sodium requirements increase
during pregnancy. However, the sodium provided by the average diet is likely to be
adequate for expectant mothers. Use of additional salt is rarely warranted.
Question:
A nurse teaches pregnancy exercises to a group of pregnant women. The nurse should
include an explanation that pelvic rock will be helpful at any time in their lives should
the women develop which of these conditions? · Hemorrhoids · Intestinal flatus · Lower
back pain · Leg cramps
Answer:
Pelvic rock helps to relieve lower back pains. Pelvic rocking helps to relieve a sore back
by stretching the lower back muscles. Pelvic rocking also helps stimulate the digestive
system, realigns the uterus, and keeps the stomach muscles toned.
, Question:
A client who is in active labor has a vaginal examination which reveals she is 5cm
dilated and 100% effaced at a -1 station. At the peak of a contraction, the amniotic fluid
ruptures. Which of these actions should a nurse take first? · Records the findings and
notify the provider · Change the linen and make the client comfortable · Check the
perineal area and assess for crowning · Assess the fetal heart rate and check for
regularity
Answer:
After rupture of the membranes, there is a danger of cord prolapse; therefore, the
nurse should assess the fetal heart rate for regularity. Variable decelerations can occur
as a result of cord compression secondary to cord
prolapse. There is also a risk for infection after membrane rupture.
Question:
After teaching a class about relieving leg cramps during pregnancy, a nurse evaluates
the effectiveness of the instructions. Which of these comments, if made by the
participants, would require FURTHER instruction? · When I get a leg cramps in the
middle of the night, my husband presses on my knee and pushes my foot toward my leg
· Sometimes when I'm sitting at my typewriter, I get a horrible leg cramp. First, I stand
and bear weight on my leg in the middle of the night · I take a heating pad to bed with
me so that I can use it if I get a leg cramp in the middle of the night · When I get a leg
cramp while sitting at my desk, I flex my knee and extend my foot
Answer:
The fourth comment would require further education. With leg cramps, the leg should
be straightened and toes should be flexed toward the shin.
Question:
A client who is scheduled for a cesarean delivery has the following written
preoperative orders. Which should the nurse question? · Nothing by mouth after
midnight · Atropine sulfate 0.4mg IM on call · Indwelling urinary catheter to be inserted
in the morning · Cleansing enema this evening
Answer:
The order for a cleansing enema in the evening should be discussed with the physician.
A cleansing enema is not usually done prior to a cesarean section.
Question:
A client who is G1P0 is receiving IV oxytocin injection for labor augmentation. Because
of the effects of Pitocin, a nurse should assess the client for which of these adverse
effects of Pitocin? · Bradypnea and diarrhea · Insomnia and tachycardia · Hypotension
and diuresis · Headache and water intoxication
Answer:
With doses of 20mU/min on above, oxytocin exerts an antidiuretic effect decreases free
water exchange in the kidney, and markedly decreases urine output. Blood pressure
initially may decrease, but after prolonged administration, the blood pressure increases
above the baseline. Oxytocin does not cause bradycardia, diarrhea, insomnia, or
tachycardia.
