CARE OF CHILDBEARING FAMILY-NACE
EXAM 2026 QUESTIONS AND ANSWERS.
SECTION 1: ANTEPARTUM CARE (Q1–12)
#1
A 28-year-old primigravida at 9 weeks gestation reports occasional nausea without vomiting.
What is the first-line recommendation per 2026 ACOG guidelines?
A. Ondansetron 4 mg every 8 hours
B. Small, frequent bland meals and vitamin B6 10–25 mg three times daily
C. Promethazine 25 mg at bedtime
D. Metoclopramide 10 mg before meals
Answer: B
Rationale: 2026 ACOG guidelines recommend nonpharmacologic measures and vitamin B6
(pyridoxine) as initial therapy for mild-to-moderate nausea and vomiting of pregnancy due to its
established safety profile and efficacy in reducing symptoms without increasing fetal risk.
#2
For a woman with pre-pregnancy BMI of 27 kg/m², what is the recommended total gestational
weight gain range according to 2026 Institute of Medicine guidelines endorsed by ACOG?
A. 15–25 lb (6.8–11.3 kg)
B. 25–35 lb (11.3–15.9 kg)
C. 28–40 lb (12.7–18.1 kg)
D. 11–20 lb (5–9 kg)
Answer: A
Rationale: 2026 ACOG-endorsed IOM guidelines specify 15–25 lb total weight gain for women
with pre-pregnancy overweight BMI (25.0–29.9 kg/m²) to optimize maternal and neonatal
outcomes including reduced risk of cesarean birth and macrosomia.
#3
,A 34-year-old G2P1 Rh-negative woman at 27 weeks gestation has a negative antibody screen.
When should antenatal Rho(D) immune globulin be administered per current ACOG
recommendations?
A. At 24 weeks
B. Routinely at 28 weeks
C. Only after any episode of bleeding
D. At 32 weeks
Answer: B
Rationale: 2026 ACOG continues to recommend routine administration of 300 mcg Rho(D)
immune globulin at 28 weeks gestation to all unsensitized Rh-negative pregnant women to
prevent isoimmunization.
#4
Which laboratory test is routinely recommended at the initial prenatal visit for all pregnant
women per 2026 AWHONN/ACOG standards?
A. Hemoglobin A1c
B. HIV antibody/antigen combination test
C. Thyroid-stimulating hormone (TSH)
D. Serum ferritin
Answer: B
Rationale: Universal opt-out HIV screening with a fourth-generation antigen/antibody
combination test at the first prenatal visit is mandated by 2026 ACOG guidelines to allow timely
antiretroviral therapy and reduce vertical transmission risk to <1%.
#5
A 31-year-old G3P2 at 15 weeks gestation asks about cell-free DNA (cfDNA) screening. Which
statement is most accurate per 2026 ACOG?
A. It is diagnostic for trisomy 21
B. It is recommended as first-tier screening for all pregnant women
C. It should replace serum analyte screening in high-risk women only
, D. It screens for trisomies 21, 18, 13, and sex chromosome aneuploidies with high sensitivity
Answer: D
Rationale: 2026 ACOG states that cfDNA is a highly sensitive screening test (not diagnostic) for
trisomies 21, 18, 13, and selected sex chromosome conditions; it may be offered to all women
regardless of risk but does not replace the need for confirmatory diagnostic testing when
positive.
#6
Select all that apply: Which conditions warrant early (first-trimester) diabetes screening per
2026 ACOG guidelines?
A. Obesity (BMI ≥30 kg/m²)
B. Previous macrosomic infant (>4000 g)
C. First-degree relative with type 2 diabetes
D. Age ≥35 years
E. Caucasian ethnicity
Answer: A, B, C
Rationale: 2026 ACOG recommends early screening (at first prenatal visit) for undiagnosed type
2 diabetes in women with risk factors including obesity, history of macrosomia, and family
history of diabetes to allow prompt glycemic control and reduce congenital anomaly risk.
#7
What is the recommended frequency of prenatal visits after 28 weeks for an uncomplicated
singleton pregnancy per 2026 ACOG?
A. Every 4 weeks until 36 weeks, then weekly
B. Every 2 weeks until 36 weeks, then weekly
C. Monthly until 32 weeks, then biweekly, then weekly
D. Every 3 weeks until 36 weeks, then weekly
Answer: B
Rationale: 2026 ACOG standard schedule for low-risk pregnancies is every 4 weeks until 28
weeks, every 2 weeks from 28–36 weeks, and weekly thereafter to allow timely detection of
preeclampsia, fetal growth restriction, and other late-pregnancy complications.
EXAM 2026 QUESTIONS AND ANSWERS.
SECTION 1: ANTEPARTUM CARE (Q1–12)
#1
A 28-year-old primigravida at 9 weeks gestation reports occasional nausea without vomiting.
What is the first-line recommendation per 2026 ACOG guidelines?
A. Ondansetron 4 mg every 8 hours
B. Small, frequent bland meals and vitamin B6 10–25 mg three times daily
C. Promethazine 25 mg at bedtime
D. Metoclopramide 10 mg before meals
Answer: B
Rationale: 2026 ACOG guidelines recommend nonpharmacologic measures and vitamin B6
(pyridoxine) as initial therapy for mild-to-moderate nausea and vomiting of pregnancy due to its
established safety profile and efficacy in reducing symptoms without increasing fetal risk.
#2
For a woman with pre-pregnancy BMI of 27 kg/m², what is the recommended total gestational
weight gain range according to 2026 Institute of Medicine guidelines endorsed by ACOG?
A. 15–25 lb (6.8–11.3 kg)
B. 25–35 lb (11.3–15.9 kg)
C. 28–40 lb (12.7–18.1 kg)
D. 11–20 lb (5–9 kg)
Answer: A
Rationale: 2026 ACOG-endorsed IOM guidelines specify 15–25 lb total weight gain for women
with pre-pregnancy overweight BMI (25.0–29.9 kg/m²) to optimize maternal and neonatal
outcomes including reduced risk of cesarean birth and macrosomia.
#3
,A 34-year-old G2P1 Rh-negative woman at 27 weeks gestation has a negative antibody screen.
When should antenatal Rho(D) immune globulin be administered per current ACOG
recommendations?
A. At 24 weeks
B. Routinely at 28 weeks
C. Only after any episode of bleeding
D. At 32 weeks
Answer: B
Rationale: 2026 ACOG continues to recommend routine administration of 300 mcg Rho(D)
immune globulin at 28 weeks gestation to all unsensitized Rh-negative pregnant women to
prevent isoimmunization.
#4
Which laboratory test is routinely recommended at the initial prenatal visit for all pregnant
women per 2026 AWHONN/ACOG standards?
A. Hemoglobin A1c
B. HIV antibody/antigen combination test
C. Thyroid-stimulating hormone (TSH)
D. Serum ferritin
Answer: B
Rationale: Universal opt-out HIV screening with a fourth-generation antigen/antibody
combination test at the first prenatal visit is mandated by 2026 ACOG guidelines to allow timely
antiretroviral therapy and reduce vertical transmission risk to <1%.
#5
A 31-year-old G3P2 at 15 weeks gestation asks about cell-free DNA (cfDNA) screening. Which
statement is most accurate per 2026 ACOG?
A. It is diagnostic for trisomy 21
B. It is recommended as first-tier screening for all pregnant women
C. It should replace serum analyte screening in high-risk women only
, D. It screens for trisomies 21, 18, 13, and sex chromosome aneuploidies with high sensitivity
Answer: D
Rationale: 2026 ACOG states that cfDNA is a highly sensitive screening test (not diagnostic) for
trisomies 21, 18, 13, and selected sex chromosome conditions; it may be offered to all women
regardless of risk but does not replace the need for confirmatory diagnostic testing when
positive.
#6
Select all that apply: Which conditions warrant early (first-trimester) diabetes screening per
2026 ACOG guidelines?
A. Obesity (BMI ≥30 kg/m²)
B. Previous macrosomic infant (>4000 g)
C. First-degree relative with type 2 diabetes
D. Age ≥35 years
E. Caucasian ethnicity
Answer: A, B, C
Rationale: 2026 ACOG recommends early screening (at first prenatal visit) for undiagnosed type
2 diabetes in women with risk factors including obesity, history of macrosomia, and family
history of diabetes to allow prompt glycemic control and reduce congenital anomaly risk.
#7
What is the recommended frequency of prenatal visits after 28 weeks for an uncomplicated
singleton pregnancy per 2026 ACOG?
A. Every 4 weeks until 36 weeks, then weekly
B. Every 2 weeks until 36 weeks, then weekly
C. Monthly until 32 weeks, then biweekly, then weekly
D. Every 3 weeks until 36 weeks, then weekly
Answer: B
Rationale: 2026 ACOG standard schedule for low-risk pregnancies is every 4 weeks until 28
weeks, every 2 weeks from 28–36 weeks, and weekly thereafter to allow timely detection of
preeclampsia, fetal growth restriction, and other late-pregnancy complications.
