TEST BANK – FALL SEMESTER SEPTEMBER
2026 | NACE CARE OF THE CHILDBEARING
FAMILY | 400+ VERIFIED PRACTICE
QUESTIONS WITH ANSWERS & DETAILED
RATIONALES | COMPREHENSIVE MATERNAL &
NEWBORN NURSING EXAM PREP FOR RN, BSN
& NURSING BRIDGE PROGRAMS
TEST BANK – FALL SEMESTER
NACE: CARE OF THE CHILDBEARING FAMILY
300 Verified Practice Questions | RN, BSN & Nursing Bridge Programs
1. A pregnant client at 10 weeks gestation asks the nurse when she can first hear
the fetal heartbeat using a Doppler device. What is the nurse's best response?
A. 6 weeks gestation B. 8 weeks gestation C. 10–12 weeks gestation D. 16 weeks
gestation E. 20 weeks gestation
RATIONALE: The fetal heartbeat can typically be detected by Doppler ultrasound at
10–12 weeks gestation. Before this time, the fetal heart may not produce a strong
enough signal to be detected externally by Doppler. A fetoscope can detect it later,
around 16–20 weeks.
2. A nurse is reviewing the prenatal chart of a client who is G4P2102. Which
interpretation of this obstetric history is correct?
A. The client has had 4 pregnancies and 2 living children B. The client has been
pregnant 4 times, had 2 term births, 1 preterm birth, 0 abortions, and 2 living children C.
The client has had 4 pregnancies and 2 term deliveries D. The client has had 4
pregnancies with 1 miscarriage and 2 living children E. The client has been pregnant 4
times with 2 premature births and 2 living children
RATIONALE: The GTPAL system stands for Gravida, Term, Preterm,
Abortions/miscarriages, Living children. G4P2102 = 4 pregnancies, 2 term births, 1
preterm birth, 0 abortions, 2 living children.
,3. During the first prenatal visit, the nurse calculates the estimated date of birth
(EDB) using Nägele's rule. The client's LMP began on July 10. What is the EDB?
A. March 17 B. April 17 C. May 10 D. April 10 E. March 10
RATIONALE: Nägele's rule: subtract 3 months from the LMP, add 7 days, and
adjust the year if needed. July 10 – 3 months = April 10 + 7 days = April 17. This is the
estimated date of birth.
4. A client at 12 weeks gestation asks the nurse about the purpose of alpha-
fetoprotein (AFP) screening. What is the most accurate response?
A. It detects chromosomal abnormalities such as Down syndrome B. It evaluates
placental maturity C. It screens for neural tube defects and certain chromosomal
abnormalities D. It measures fetal lung maturity E. It identifies gestational diabetes
RATIONALE: AFP is a protein produced by the fetal liver. Elevated maternal serum
AFP levels may indicate open neural tube defects (spina bifida, anencephaly), while low
levels may suggest Down syndrome (trisomy 21). It is typically drawn between 15–20
weeks.
5. A nurse is educating a prenatal client about physiologic changes during
pregnancy. Which cardiovascular change is expected and normal?
A. Decrease in heart rate B. Increase in hematocrit C. Increase in blood volume by
40–50% D. Decrease in cardiac output E. Decrease in white blood cell count
RATIONALE: Blood volume increases by approximately 40–50% during pregnancy
to meet the demands of the growing fetus, uterus, and placenta. This physiologic
hemodilution causes a decrease in hematocrit and hemoglobin, known as physiologic
anemia of pregnancy.
6. A primigravida at 20 weeks gestation asks what "quickening" means. What is
the nurse's best explanation?
,A. The first fetal heartbeat detected by Doppler B. The first ultrasound confirmation of
fetal movement C. The rapid growth of the uterus D. The first fetal movements felt
by the mother E. The sensation of Braxton Hicks contractions
RATIONALE: Quickening refers to the first perception of fetal movement by the
mother. In primigravidas, it is usually felt between 18–20 weeks. Multigravidas may feel
movement earlier, around 16–18 weeks, because they recognize the sensation.
7. A prenatal client at 8 weeks gestation is concerned about nausea and vomiting.
Which nursing recommendation is most appropriate?
A. Encourage large meals three times daily B. Recommend bedrest until symptoms
resolve C. Advise eating small, frequent meals and dry crackers before rising D.
Instruct the client to avoid all fluids until nausea subsides E. Recommend lying flat after
meals to reduce nausea
RATIONALE: Morning sickness is common in early pregnancy due to rising hCG
levels. Eating small, frequent meals prevents an empty stomach (which worsens
nausea), and eating dry crackers before getting out of bed helps manage symptoms.
Large meals and lying flat worsen nausea.
8. Which finding during the first prenatal visit would require immediate follow-up
by the nurse?
A. Slight breast tenderness B. Urinary frequency C. Fatigue D. Blood pressure 116/74
mmHg E. Blood pressure 148/96 mmHg
RATIONALE: A blood pressure of 148/96 mmHg in a pregnant woman is abnormal
and concerning for hypertensive disorder of pregnancy. Normal blood pressure in
pregnancy is less than 120/80 mmHg. Hypertension before 20 weeks may indicate
chronic hypertension; after 20 weeks it may indicate preeclampsia.
9. A client at 28 weeks gestation is being tested for gestational diabetes. Which
test is most appropriate at this stage?
A. Fasting plasma glucose B. Glycosylated hemoglobin (HbA1c) C. Random blood
glucose D. 1-hour glucose challenge test (GCT) E. Urine ketone test
, RATIONALE: Universal screening for gestational diabetes mellitus (GDM) is
recommended between 24–28 weeks using the 1-hour glucose challenge test (50g oral
glucose, blood drawn 1 hour later). A value ≥140 mg/dL is considered positive and
warrants a 3-hour oral glucose tolerance test (OGTT) for confirmation.
10. A nurse is teaching a client about folic acid supplementation during
pregnancy. Which statement best explains its importance?
A. It prevents gestational hypertension B. It enhances placental blood flow C. It prevents
gestational diabetes D. It reduces the risk of neural tube defects such as spina bifida
E. It promotes uterine growth and development
RATIONALE: Folic acid (vitamin B9) is essential for neural tube closure, which
occurs in the first 28 days after conception — often before a woman knows she is
pregnant. Adequate intake (400–800 mcg/day) before conception and in early
pregnancy significantly reduces the risk of neural tube defects including spina bifida and
anencephaly.
11. A client at 36 weeks gestation reports leaking fluid from her vagina. The nurse
performs a nitrazine test. Which finding indicates rupture of membranes?
A. Yellow color on the nitrazine paper B. Blue-green to dark blue color on the
nitrazine paper C. No color change on the nitrazine paper D. Orange color on the
nitrazine paper E. Red color on the nitrazine paper
RATIONALE: Amniotic fluid is alkaline (pH 7.0–7.5), which turns nitrazine paper
blue-green to dark blue, indicating rupture of membranes. Normal vaginal secretions are
acidic (pH 4.5–5.5) and do not change the color of nitrazine paper. False positives can
occur with blood, semen, or vaginal infections.
12. During a prenatal visit at 32 weeks, the nurse measures fundal height. Which
measurement is considered within normal limits?
A. 20 cm B. 24 cm C. 28 cm D. 32 cm E. 38 cm
RATIONALE: Fundal height in centimeters should approximately equal gestational
age in weeks (±2 cm) from 20–36 weeks. At 32 weeks, a fundal height of 30–34 cm is
2026 | NACE CARE OF THE CHILDBEARING
FAMILY | 400+ VERIFIED PRACTICE
QUESTIONS WITH ANSWERS & DETAILED
RATIONALES | COMPREHENSIVE MATERNAL &
NEWBORN NURSING EXAM PREP FOR RN, BSN
& NURSING BRIDGE PROGRAMS
TEST BANK – FALL SEMESTER
NACE: CARE OF THE CHILDBEARING FAMILY
300 Verified Practice Questions | RN, BSN & Nursing Bridge Programs
1. A pregnant client at 10 weeks gestation asks the nurse when she can first hear
the fetal heartbeat using a Doppler device. What is the nurse's best response?
A. 6 weeks gestation B. 8 weeks gestation C. 10–12 weeks gestation D. 16 weeks
gestation E. 20 weeks gestation
RATIONALE: The fetal heartbeat can typically be detected by Doppler ultrasound at
10–12 weeks gestation. Before this time, the fetal heart may not produce a strong
enough signal to be detected externally by Doppler. A fetoscope can detect it later,
around 16–20 weeks.
2. A nurse is reviewing the prenatal chart of a client who is G4P2102. Which
interpretation of this obstetric history is correct?
A. The client has had 4 pregnancies and 2 living children B. The client has been
pregnant 4 times, had 2 term births, 1 preterm birth, 0 abortions, and 2 living children C.
The client has had 4 pregnancies and 2 term deliveries D. The client has had 4
pregnancies with 1 miscarriage and 2 living children E. The client has been pregnant 4
times with 2 premature births and 2 living children
RATIONALE: The GTPAL system stands for Gravida, Term, Preterm,
Abortions/miscarriages, Living children. G4P2102 = 4 pregnancies, 2 term births, 1
preterm birth, 0 abortions, 2 living children.
,3. During the first prenatal visit, the nurse calculates the estimated date of birth
(EDB) using Nägele's rule. The client's LMP began on July 10. What is the EDB?
A. March 17 B. April 17 C. May 10 D. April 10 E. March 10
RATIONALE: Nägele's rule: subtract 3 months from the LMP, add 7 days, and
adjust the year if needed. July 10 – 3 months = April 10 + 7 days = April 17. This is the
estimated date of birth.
4. A client at 12 weeks gestation asks the nurse about the purpose of alpha-
fetoprotein (AFP) screening. What is the most accurate response?
A. It detects chromosomal abnormalities such as Down syndrome B. It evaluates
placental maturity C. It screens for neural tube defects and certain chromosomal
abnormalities D. It measures fetal lung maturity E. It identifies gestational diabetes
RATIONALE: AFP is a protein produced by the fetal liver. Elevated maternal serum
AFP levels may indicate open neural tube defects (spina bifida, anencephaly), while low
levels may suggest Down syndrome (trisomy 21). It is typically drawn between 15–20
weeks.
5. A nurse is educating a prenatal client about physiologic changes during
pregnancy. Which cardiovascular change is expected and normal?
A. Decrease in heart rate B. Increase in hematocrit C. Increase in blood volume by
40–50% D. Decrease in cardiac output E. Decrease in white blood cell count
RATIONALE: Blood volume increases by approximately 40–50% during pregnancy
to meet the demands of the growing fetus, uterus, and placenta. This physiologic
hemodilution causes a decrease in hematocrit and hemoglobin, known as physiologic
anemia of pregnancy.
6. A primigravida at 20 weeks gestation asks what "quickening" means. What is
the nurse's best explanation?
,A. The first fetal heartbeat detected by Doppler B. The first ultrasound confirmation of
fetal movement C. The rapid growth of the uterus D. The first fetal movements felt
by the mother E. The sensation of Braxton Hicks contractions
RATIONALE: Quickening refers to the first perception of fetal movement by the
mother. In primigravidas, it is usually felt between 18–20 weeks. Multigravidas may feel
movement earlier, around 16–18 weeks, because they recognize the sensation.
7. A prenatal client at 8 weeks gestation is concerned about nausea and vomiting.
Which nursing recommendation is most appropriate?
A. Encourage large meals three times daily B. Recommend bedrest until symptoms
resolve C. Advise eating small, frequent meals and dry crackers before rising D.
Instruct the client to avoid all fluids until nausea subsides E. Recommend lying flat after
meals to reduce nausea
RATIONALE: Morning sickness is common in early pregnancy due to rising hCG
levels. Eating small, frequent meals prevents an empty stomach (which worsens
nausea), and eating dry crackers before getting out of bed helps manage symptoms.
Large meals and lying flat worsen nausea.
8. Which finding during the first prenatal visit would require immediate follow-up
by the nurse?
A. Slight breast tenderness B. Urinary frequency C. Fatigue D. Blood pressure 116/74
mmHg E. Blood pressure 148/96 mmHg
RATIONALE: A blood pressure of 148/96 mmHg in a pregnant woman is abnormal
and concerning for hypertensive disorder of pregnancy. Normal blood pressure in
pregnancy is less than 120/80 mmHg. Hypertension before 20 weeks may indicate
chronic hypertension; after 20 weeks it may indicate preeclampsia.
9. A client at 28 weeks gestation is being tested for gestational diabetes. Which
test is most appropriate at this stage?
A. Fasting plasma glucose B. Glycosylated hemoglobin (HbA1c) C. Random blood
glucose D. 1-hour glucose challenge test (GCT) E. Urine ketone test
, RATIONALE: Universal screening for gestational diabetes mellitus (GDM) is
recommended between 24–28 weeks using the 1-hour glucose challenge test (50g oral
glucose, blood drawn 1 hour later). A value ≥140 mg/dL is considered positive and
warrants a 3-hour oral glucose tolerance test (OGTT) for confirmation.
10. A nurse is teaching a client about folic acid supplementation during
pregnancy. Which statement best explains its importance?
A. It prevents gestational hypertension B. It enhances placental blood flow C. It prevents
gestational diabetes D. It reduces the risk of neural tube defects such as spina bifida
E. It promotes uterine growth and development
RATIONALE: Folic acid (vitamin B9) is essential for neural tube closure, which
occurs in the first 28 days after conception — often before a woman knows she is
pregnant. Adequate intake (400–800 mcg/day) before conception and in early
pregnancy significantly reduces the risk of neural tube defects including spina bifida and
anencephaly.
11. A client at 36 weeks gestation reports leaking fluid from her vagina. The nurse
performs a nitrazine test. Which finding indicates rupture of membranes?
A. Yellow color on the nitrazine paper B. Blue-green to dark blue color on the
nitrazine paper C. No color change on the nitrazine paper D. Orange color on the
nitrazine paper E. Red color on the nitrazine paper
RATIONALE: Amniotic fluid is alkaline (pH 7.0–7.5), which turns nitrazine paper
blue-green to dark blue, indicating rupture of membranes. Normal vaginal secretions are
acidic (pH 4.5–5.5) and do not change the color of nitrazine paper. False positives can
occur with blood, semen, or vaginal infections.
12. During a prenatal visit at 32 weeks, the nurse measures fundal height. Which
measurement is considered within normal limits?
A. 20 cm B. 24 cm C. 28 cm D. 32 cm E. 38 cm
RATIONALE: Fundal height in centimeters should approximately equal gestational
age in weeks (±2 cm) from 20–36 weeks. At 32 weeks, a fundal height of 30–34 cm is
