NACE CARE OF CHILDBEARING
FAMILY ACTUAL EXAM 2026/2027 |
Maternal & Newborn Nursing |
Comprehensive Practice Test | Verified
Q&A | Pass Guaranteed - A+ Graded
SECTION 1: ANTEPARTUM CARE & MATERNAL
ADAPTATIONS (30 Questions)
Q1: 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?
A. "Have you experienced any shortness of breath?"
B. "Have you had any episodes of loss of consciousness?"
C. "Have you noticed any spotting?"
D. "Have you noticed any tenderness in your breasts?" [CORRECT]
Correct Answer: D
Rationale: Breast tenderness is one of the earliest signs of pregnancy, occurring as early as
one to two weeks after conception due to hormonal changes (elevated estrogen and
progesterone) preparing the breasts for lactation. Shortness of breath typically occurs later in
pregnancy as the uterus expands, loss of consciousness is not a typical sign of pregnancy,
and while spotting may indicate implantation bleeding, it is not as consistent or early as
breast tenderness.
Q2: On her first visit, a patient had a baseline hemoglobin of 13.0 g/dL and hematocrit of
42.9%. She has been taking ferrous sulfate and eating an iron-rich diet. At 30 weeks gestation,
her hemoglobin is 11.0 g/dL and hematocrit 36.3%. She is concerned about why these values
decreased. Which physiological change should the nurse explain?
,🧠 ANSWER ✔✔ The increase in maternal blood volume is greater than the increase in
maternal red blood cells (hemodilution).
Q3: A patient with no prenatal care is admitted with suspected abruption placentae and
possible drug abuse. Which question would elicit the most information about suspected drug
use?
A. "You don't use drugs, do you?"
B. "What drugs have you used during your pregnancy?" [CORRECT]
C. "Your baby might have problems if you used drugs."
D. "Have you ever tried any recreational substances?"
Correct Answer: B
Rationale: Asking a direct, non-judgmental, open-ended question about specific drug use
during pregnancy is most likely to elicit accurate information. This approach avoids putting
the patient on the defensive while clearly communicating that disclosure will not result in
immediate judgment or punishment.
Q4: A pregnant patient at 33 weeks gestation calls the clinic concerned about irregular,
painless contractions that occur several times per day. She describes them as tightening
sensations that last about 30 seconds and then disappear. The nurse should recognize these
as:
A. Preterm labor contractions requiring immediate evaluation
B. Braxton-Hicks contractions, a normal finding at this gestational age [CORRECT]
C. Signs of placental abruption
D. Indicators of impending miscarriage
Correct Answer: B
Rationale: Braxton-Hicks contractions are irregular, painless uterine contractions that begin
as early as the second trimester but become more noticeable in the third trimester. They are
normal physiological "practice" contractions that help prepare the uterus for labor, unlike the
regular, painful contractions of true preterm labor.
Q5: Which of the following is classified as a positive sign of pregnancy?
,A. Breast tenderness and enlargement
B. Nausea and vomiting
C. Fetal heart tones detected by ultrasound [CORRECT]
D. Amenorrhea
Correct Answer: C
Rationale: Positive signs of pregnancy are those that definitively confirm pregnancy and
include fetal heart tones (detected by Doppler or ultrasound), visualization of the fetus by
ultrasound, and fetal movement felt by an examiner. Breast tenderness, nausea, and
amenorrhea are presumptive or probable signs that could have other causes.
Q6: A pregnant patient's rubella titer returns at 1:8. The nurse understands that this result
indicates:
A. Immunity to rubella
B. The need for further assessment and likely vaccination postpartum [CORRECT]
C. Active rubella infection
D. Previous vaccination only
Correct Answer: B
Rationale: A rubella titer of 1:8 is considered non-immune or borderline, requiring further
assessment. Titers of 1:10 or greater typically indicate immunity. Non-immune pregnant
women should receive MMR vaccination postpartum (not during pregnancy) to prevent
congenital rubella syndrome in future pregnancies.
Q7: Which occupational exposure poses the greatest teratogenic risk to a pregnant nurse?
A. Working in the pediatric ward
B. Working in the oncology unit handling chemotherapy agents [CORRECT]
C. Working in the dietary department
D. Working in medical records
Correct Answer: B
, Rationale: Oncology nurses handling chemotherapy agents face significant teratogenic risks,
as many chemotherapeutic drugs are known teratogens that can cross the placental barrier
and cause fetal malformations, especially during the first trimester. Proper protective
equipment and assignment modifications are essential.
Q8: During pregnancy, plasma volume increases by approximately:
A. 10-20%
B. 30-50% [CORRECT]
C. 60-70%
D. 80-90%
Correct Answer: B
Rationale: Plasma volume increases by 30-50% during pregnancy (peaking at 28-34 weeks),
while red blood cell mass increases by only 20-30%, resulting in the physiological anemia of
pregnancy (hemodilution). This disproportionate increase is necessary to perfuse the
placenta and prepare for potential blood loss at delivery.
Q9: A pregnant patient asks why she needs iron supplementation when her hemoglobin is
already within normal range. The best response is:
A. "Iron is only needed if you become anemic"
B. "Pregnancy increases iron requirements to support fetal growth and maternal blood
volume expansion" [CORRECT]
C. "Iron supplements are optional during pregnancy"
D. "You only need iron during the first trimester"
Correct Answer: B
Rationale: Iron requirements increase significantly during pregnancy (from 15 mg/day to 30
mg/day) to support expanded maternal blood volume, fetal growth, and placental
development. Prophylactic supplementation prevents iron-deficiency anemia, which is
associated with preterm delivery and low birth weight.
Q10: Which cardiovascular change is expected during normal pregnancy?
FAMILY ACTUAL EXAM 2026/2027 |
Maternal & Newborn Nursing |
Comprehensive Practice Test | Verified
Q&A | Pass Guaranteed - A+ Graded
SECTION 1: ANTEPARTUM CARE & MATERNAL
ADAPTATIONS (30 Questions)
Q1: 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?
A. "Have you experienced any shortness of breath?"
B. "Have you had any episodes of loss of consciousness?"
C. "Have you noticed any spotting?"
D. "Have you noticed any tenderness in your breasts?" [CORRECT]
Correct Answer: D
Rationale: Breast tenderness is one of the earliest signs of pregnancy, occurring as early as
one to two weeks after conception due to hormonal changes (elevated estrogen and
progesterone) preparing the breasts for lactation. Shortness of breath typically occurs later in
pregnancy as the uterus expands, loss of consciousness is not a typical sign of pregnancy,
and while spotting may indicate implantation bleeding, it is not as consistent or early as
breast tenderness.
Q2: On her first visit, a patient had a baseline hemoglobin of 13.0 g/dL and hematocrit of
42.9%. She has been taking ferrous sulfate and eating an iron-rich diet. At 30 weeks gestation,
her hemoglobin is 11.0 g/dL and hematocrit 36.3%. She is concerned about why these values
decreased. Which physiological change should the nurse explain?
,🧠 ANSWER ✔✔ The increase in maternal blood volume is greater than the increase in
maternal red blood cells (hemodilution).
Q3: A patient with no prenatal care is admitted with suspected abruption placentae and
possible drug abuse. Which question would elicit the most information about suspected drug
use?
A. "You don't use drugs, do you?"
B. "What drugs have you used during your pregnancy?" [CORRECT]
C. "Your baby might have problems if you used drugs."
D. "Have you ever tried any recreational substances?"
Correct Answer: B
Rationale: Asking a direct, non-judgmental, open-ended question about specific drug use
during pregnancy is most likely to elicit accurate information. This approach avoids putting
the patient on the defensive while clearly communicating that disclosure will not result in
immediate judgment or punishment.
Q4: A pregnant patient at 33 weeks gestation calls the clinic concerned about irregular,
painless contractions that occur several times per day. She describes them as tightening
sensations that last about 30 seconds and then disappear. The nurse should recognize these
as:
A. Preterm labor contractions requiring immediate evaluation
B. Braxton-Hicks contractions, a normal finding at this gestational age [CORRECT]
C. Signs of placental abruption
D. Indicators of impending miscarriage
Correct Answer: B
Rationale: Braxton-Hicks contractions are irregular, painless uterine contractions that begin
as early as the second trimester but become more noticeable in the third trimester. They are
normal physiological "practice" contractions that help prepare the uterus for labor, unlike the
regular, painful contractions of true preterm labor.
Q5: Which of the following is classified as a positive sign of pregnancy?
,A. Breast tenderness and enlargement
B. Nausea and vomiting
C. Fetal heart tones detected by ultrasound [CORRECT]
D. Amenorrhea
Correct Answer: C
Rationale: Positive signs of pregnancy are those that definitively confirm pregnancy and
include fetal heart tones (detected by Doppler or ultrasound), visualization of the fetus by
ultrasound, and fetal movement felt by an examiner. Breast tenderness, nausea, and
amenorrhea are presumptive or probable signs that could have other causes.
Q6: A pregnant patient's rubella titer returns at 1:8. The nurse understands that this result
indicates:
A. Immunity to rubella
B. The need for further assessment and likely vaccination postpartum [CORRECT]
C. Active rubella infection
D. Previous vaccination only
Correct Answer: B
Rationale: A rubella titer of 1:8 is considered non-immune or borderline, requiring further
assessment. Titers of 1:10 or greater typically indicate immunity. Non-immune pregnant
women should receive MMR vaccination postpartum (not during pregnancy) to prevent
congenital rubella syndrome in future pregnancies.
Q7: Which occupational exposure poses the greatest teratogenic risk to a pregnant nurse?
A. Working in the pediatric ward
B. Working in the oncology unit handling chemotherapy agents [CORRECT]
C. Working in the dietary department
D. Working in medical records
Correct Answer: B
, Rationale: Oncology nurses handling chemotherapy agents face significant teratogenic risks,
as many chemotherapeutic drugs are known teratogens that can cross the placental barrier
and cause fetal malformations, especially during the first trimester. Proper protective
equipment and assignment modifications are essential.
Q8: During pregnancy, plasma volume increases by approximately:
A. 10-20%
B. 30-50% [CORRECT]
C. 60-70%
D. 80-90%
Correct Answer: B
Rationale: Plasma volume increases by 30-50% during pregnancy (peaking at 28-34 weeks),
while red blood cell mass increases by only 20-30%, resulting in the physiological anemia of
pregnancy (hemodilution). This disproportionate increase is necessary to perfuse the
placenta and prepare for potential blood loss at delivery.
Q9: A pregnant patient asks why she needs iron supplementation when her hemoglobin is
already within normal range. The best response is:
A. "Iron is only needed if you become anemic"
B. "Pregnancy increases iron requirements to support fetal growth and maternal blood
volume expansion" [CORRECT]
C. "Iron supplements are optional during pregnancy"
D. "You only need iron during the first trimester"
Correct Answer: B
Rationale: Iron requirements increase significantly during pregnancy (from 15 mg/day to 30
mg/day) to support expanded maternal blood volume, fetal growth, and placental
development. Prophylactic supplementation prevents iron-deficiency anemia, which is
associated with preterm delivery and low birth weight.
Q10: Which cardiovascular change is expected during normal pregnancy?
