Certified Nurse Midwife Practice Test

Certified Nurse Midwife Practice Test

The American Midwifery Certification Board (AMCB) administers the National Certification Exam in Midwifery.

The AMCB is the main certifying body for Certified Nurse-Midwives (CNMs).

Are you considering taking the national exam in midwifery?

Check your knowledge with these 40 review questions for the CNM test so you get familiar with the official exam content and question format.

Certified Midwife Practice Test

Congratulations - you have completed Certified Midwife Practice Test.You scored %%SCORE%% out of %%TOTAL%%.Your performance has been rated as %%RATING%%
Your answers are highlighted below.
Question 1
Flat, pink to red patches can be spotted at the back of the neck of a female newborn. Please indicate which of the following statements is correct:
A
The patches will fade with time
B
The patches will remain
C
The patches result from a midwife mistake during labor
D
A and C
Question 1 Explanation: 
These are nevus flammeus, also known as port-wine stains, a type of vascular skin tumors, which will not fade with time.
Question 2
A week after delivery, a midwife has to assess whether the infant, whose birth weight was 7.5 lbs, is getting enough milk. What could indicate that this is the case?
A
The infant’s current weight is 6.8 lbs
B
The infant is wetting 6-8 diapers daily
C
A and B
D
None of the above; these are signs that the infant is not getting enough milk
Question 2 Explanation: 
Both A and B indicate signs of good infant development. It is normal to lose up to 10% of the birth weight during the first week after delivery.
Question 3
The fetal heart rate monitor traces decelerations about 35 seconds after the onset of a contraction in a patient, who is receiving IV oxytocin. Which of the following statements indicates a priority course of action for the midwife?
A
Immediately place the patient in a side-lying position
B
Increase the dose of IV oxytocin
C
Stop administering oxytocin
D
None of the above
Question 3 Explanation: 
The midwife must first stop the administration of IV oxytocin because the patient is experiencing uteroplacental insufficiency, a serious complication. Placing the patient in a side-lying position should come after the priority action of stopping IV oxytocin.
Question 4
Clear fluid leaks from the vagina of a patient at 38 weeks of pregnancy, but there are no contractions. Please indicate which of the following would not be an appropriate course of action in a patient with suspected PROM.
A
Sterile speculum vaginal examination
B
Digital vaginal examination
C
Ampicillin administration
D
None of the above
Question 4 Explanation: 
Digital vaginal examination must not be performed due to a risk of infection. For the same reason, an IV Ampicillin administration is in order.
Question 5
Plase indicate what would be an appropriate course of action for a patient, who is in the second stage of labor and has been pushing for the past 45 minutes.
A
Encourage the patient to push with each contraction
B
Encourage the patient to rest between contractions
C
Encourage the patient to drink water between contractions
D
A and B
Question 5 Explanation: 
When a patient is in the second stage of labor, it is important to give the instruction to push with every contraction and rest between contractions to replenish the energy. Water chips should be given instead of fluids if there is a need for hydration.
Question 6
The patient's frequency of contractions is 3 minutes and contractions last uniformly for about 40 seconds. A fetal heart rate 106 beats per minute is recorded. Please indicate what would be an appropriate course of action for the midwife.
A
Guide the patient to Fowler's position
B
Instruct the patient to push with every contraction and to regain energy between contractions
C
Immediate oxygen administration via a face mask
D
None of the above
Question 6 Explanation: 
A fetal heart of rate of 106 beats per minute is below the normal range of 120-160. It may suggest the fetus is experiencing distress. The priority action for the midwife in this case would be to give the patient oxygen via a face mask and place the patient in a side-lying position.
Question 7
The midwifes identifies variable decelerations on the fetal heart rate monitor of a G2P1 client in labor. Please indicate which of the following could be the cause:
A
No underlying condition could be the cause
B
Placental dysfunction
C
Umbilical Cord Compression
D
None of the above
Question 7 Explanation: 
The midwife can conclude that the underlying cause in this case is umbilical cord compression. The sign for uteroplacental insufficiency is late decelerations.
Question 8
Please identify in which phase of labor is the following patient, who entered the labor and delivery unit 4.5 hours ago. Contractions occur in 5 minute intervals and last 52 seconds on average. The patient's cervical dilatation is 5 cm.
A
Second stage of labor
B
First stage of labor
C
Active phase
D
B and C
Question 8 Explanation: 
In this case, the patient is in the active phase, which is the second phase of the first stage of labor.
Question 9
Please indicate the correct statement about the following finding: The fetus of a patient in labor is in the left occiput anterior position and the presenting part lies at 0 station.
A
The fetal head is engaged
B
The presenting part lies at the level of the ischial spines
C
The fetal head is floating
D
The presenting part lies above the level of the ischial spines
E
A and B
Question 9 Explanation: 
At 0 station, the fetal head is even with the ischial spines and engagement has already occurred.
Question 10
After administering oxytocin to induce labor, the patient should be monitored for the following side effects:
A
Vomiting
B
Fluid overload
C
Headaches
D
All of the above
Question 10 Explanation: 
An an anti-diuretic hormone, oxytocin may cause fluid overload and water intoxication, which manifests with vomiting and headaches.
Question 11
A 34 year old female patient is admitted for an annual check-up. Please indicate which of the following values on a serum electrolyte blood test need to be further assessed.
A
Chloride = 92 mEq/L
B
Sodium = 136 mEq/L
C
Potassium = 4.6 mEq/L
D
All of the above are within the normal range
Question 11 Explanation: 
The normal range for the serum chloride level is 98-107 mEq/L.
Question 12
Please indicate which of the following is the core, underlying goal of applied professional ethics.
A
To encourage identification with the nursing profession
B
To discourage external regulation by maintaining healthy internal regulation
C
To protect patients and care givers alike
D
None of the above
Question 12 Explanation: 
While all of the above are goals of professional ethics, the main role of professional ethics is to maintain healthy internal regulation and thus make external regulation by state bodies and agencies unnecessary.
Question 13
Please indicate which of following is the least appropriate course of action for an intoxicated female patient durign the first 24 hours after she was admitted.
A
Observe for seizure activity
B
Ensure bleeding precautions
C
Provide a calm and quiet environment
D
All of the above actions are necessary
Question 13 Explanation: 
Bleeding precautions are not necessary during the first 24 hours of treatment in patients admitted for alcohol abuse.
Question 14
Please indicate in case of which of the following fundal height measurements the patient requires further evaluation:
A
The fundus is even with the umbilicus in a patient who gave birth 1.2 hours ago via vaginal delivery
B
The fundus is non-palpable in a patient who gave birth 8 days ago via vaginal delivery
C
The fundus is at 2 fingerbreadths below the umbilicus in a patient who gave birth 48 hours ago via vaginal delivery
D
The fundus is at 2 cm below the umbilicus in a patient who gave birth 72 hours ago via vaginal delivery
Question 14 Explanation: 
The uterus lowers at the rate of 1 fingerbreadth per 24 hours on average. Thus, the patient who gave birth 72 hours and has her fundus at 2 cm below the umbilicus should be further examined.
Question 15
Please indicate which of the following statements describes a situation where the midwife should correct a patient conducting breast self-examination.
A
The patient examines every part of her breast using small circular motions, using her right hand on the left breast and vice versa
B
The patient presses every part of her breast with the tips of the first three fingers
C
The patient is in a supine position with one arm raised over her head and a folded towel placed under the same side shoulder
D
All of the above indicate a correct way to perform breast self-examination
Question 15 Explanation: 
If the patient uses the tips of her second, third and fourth fingers to press over her breast, she needs further teaching by the midwife. Instead, the patient should use the pads of her fingers for palpating her breasts.
Question 16
A postpartum patient gave birth 12 hours ago without any complications. When the newborn is brought to the mother for the night, the patient refuses to feed and accept the baby saying she was exhausted and needed a good night sleep. Please indicate what would be the most appropriate course of action for the midwife.Encourage the client to join a parenting skill class. Accept the client’s behavior as an indication that she is in the taking-in phase. Accept the client’s behavior as an indication that she is in the taking-hold phase.
A
Gently encourage the patient to accept the child
B
Start working on a breast feeding teaching plan for the mother
C
Accept the patient's behavior
D
Advise the patient to learn parenting skills
Question 16 Explanation: 
The midwife should accept the postpartum patient's behavior considering that for the first 24 hours she is in the taking-in stage. It is understandable that during this phase the patient is focused on her own needs.
Question 17
Please indicate which of the following instructions is the best one for a midwife to give to a patient who intends to breastfeed her baby after having a cesarean delivery.
A
Any position is good for breastfeeding as long as it feels comfortable
B
Make use of the football hold position during breastfeeding
C
Breastfeeding is not recommended in case of a cesarean delivery
D
None of the above is an appropriate instruction to be given in this case
Question 17 Explanation: 
A midwife should instruct a mother, who had a cesarean delivery to breastfeed in the football hold position to prevent inducing incisional pain.
Question 18
Please indicate which of the following is the most appropriate course of action for the midwife upon receiving a patient who gave birth an hour ago?
A
Order for the patient's hemoglobin tests
B
Immediately administer oxygen via a face mask
C
Gently palpate the abdomen to determine the height of the fundus
D
None of the above
Question 18 Explanation: 
During the immediate postpartum period, the midwife should immediately palpate to determine the height of the fundus. Order for the patient's hemoglobin tests is not a priority.
Question 19
A patient gave birth without complications one day ago. She is crying and relates feelings of sadness and/or emptiness. This could be an indication that she is experiencing...
A
Postpartum depression
B
Postpartum blues
C
A normal occurrence in postpartum patients
D
A and B
Question 19 Explanation: 
The patient is experiencing postpartum blues, as this occurs during the first days after delivery. It is the case in an estimated 70% of postpartum patients. Postpartum depression occurs several months after giving birth up to a year.
Question 20
A female newborn of a 20-year-old G3P2 patient is being assessed. Please indicate in case of which of the following findings the midwife should notify the physician and order further evaluation.
A
Head circumference of 34 cm
B
Birth length of 52 cm
C
Birth weight of 10 lbs
D
All of the above are normal findings
Question 20 Explanation: 
All of the above values are within the normal range for mature female newborns, except for a birth weight of 10 lbs. The normal range for mature female newborns birth weight is about 7.5 lbs.
Question 21
One system of natural, nonpharmacologic labor techniques rests on the understanding of childbirth as a positive, natural process; stresses the importance of having the father's support during labor; and promotes walking during labor. This method is called...
A
Lamaze method
B
C-section
C
Bradley method
D
Psychosexual method
Question 22
A midwife should especially encourage which of the following groups of women to have their regular Pap smear?
A
Women who are actively attempting to conceive
B
Women who have given birth before
C
Women with a history of HPV
D
Women with a history of genital herpes
Question 22 Explanation: 
A Pap smear, also known as a Pap test, is a procedure that can help with early detection of cervical cancer. Women with a history of HPV should especially be encouraged to have their regular Pap smear, because they are at higher risk of cervical cancer.
Question 23
A patient in the 11th week of pregnancy is experiencing severe nausea and vomits 3 times per day. The midwife decides that the patient is admitted to be monitored for hyperemesis gravidarum. Please indicate which of the following would be an inappropriate course of action in this case:Increase oral intake of fluids. Administer 3,000 mL of Ringer’s lactate. Administer metoclopramide. Monitor
A
The patient's urinary output is to be monitored
B
The patient is instructed to consume an increased amount of fluids
C
IV Ringer’s lactate with B1 is administered
D
A and B
Question 23 Explanation: 
A patient monitored for hyperemesis gravidarum should not consume any fluids for 24 hours. The patient's urinary output is to be monitored. The patient should take IV Ringer’s lactate with B1 to ensure proper hydration during the monitoring period.
Question 24
Please indicate what important psychological development takes place at 18 weeks' gestation.The client is ambivalent about being pregnant. The client begins to imagine how she will feel during the delivery. The client is excited to attend childbirth educational classes. The client engages in nest-building activities.
A
The patient starts thinking about starting good parenting classes
B
The patient becomes anxious about her pregnancy
C
The patient starts thinking about the process of giving birth
D
The patient starts to feel ambivalent about being pregnant
Question 24 Explanation: 
The first trimester of pregnancy is the period, during which the patient is coming to terms with the pregnancy and ambivalent feelings about the pregnancy is a common feeling. During the 18th week of pregnancy, the patient usually starts to focus on and imagine how childbirth would look like.
Question 25
Please indicate which of the following statements describes the benefits of supplementing with folic in the period leading up to, as well as during pregnancy?It prevents the formation of large but ineffective red blood cells. It prevents neural tube defects. It decreases the baby’s risk for cleft lip or palate.
A
Prevents megaloblastic anemia
B
Ensures there will be neural tube defects
C
Lowers the risk of cleft lip, cleft palate and heart defects
D
All of the above
Question 25 Explanation: 
During pregnancy, the blood volume increases and with it, the folic acid requirements. Folic acid deficiency may lead to the formation of large, ineffective red blood cells. Since folic acid is essential in the formation of DNA, folic acid deficiency may lead to the above-mentioned defects.
Question 26
The patient is a sportswoman, who has been subjected to a rigorous training program for the past 4-5 years. During her first pregnancy, she consults the midwife with the question whether she could continue training during pregnancy. Please indicate what would be an appropriate answer in this case.“You should stop exercising when pregnant as it can cause miscarriage or intrauterine growth retardation.” “If you are an athlete, you may proceed with your pre-pregnancy exercise program without limitations.” “You may continue exercising, but make sure to decrease the intensity of exercises. You may return to your pre-pregnancy exercise program two weeks after delivery.” “You should modify the intensity and type of your exercises. Non-weight-bearing exercises are recommended.”
A
Pursuing physical exercise during pregnancy is strongly discouraged
B
Pursuing physical exercise during pregnancy is alright, but her history of rigorous training means she should rest during pregnancy
C
The patient could go on exercising, as long as she adjusts her routine to include only non-impact, non-weight-bearing exercises
D
Physical exercise has no relevance to pregnancy
Question 26 Explanation: 
The midwife should advise the patient that she could continue exercising while pregnant, as long as she modifies her routine and make sure to include only non-weight-bearing, non-impact aerobic exercise with low risk of injury.
Question 27
45 minutes after a contraction stress test (CST), three 40-second-long contractions are observed within 10 minutes, followed by two more in the next 7 minutes. contractions within the next five minutes. During more than 50% of the contractions, the fetal rate is determined to decrease at the end and after the contraction. What would be the appropriate priority course of action for the midwife after the CST in this case?
A
Measure the patient's blood pressure
B
Assist the patient into a side-lying position to her left side
C
Call a physician
D
Administer oxygen
Question 27 Explanation: 
All of the above are appropriate actions in this case, but the priority intervention would be to turn the patient on the left side. Afterwards, oxygen can be administered and the patient can be referred to a physician.
Question 28
A patient with a history of type II diabetes and a BMI of 33 is interested to know whether she can breastfeed after giving birth. What would be a correct answer?
A
Breastfeeding in patients with type II diabetes is encouraged
B
Breastfeeding for women with type II diabetes is discouraged as it carries risks both for the mother and the baby
C
It will be clear only after childbirth since it depends on the mother's glucose levels after delivery
D
None of the above
Question 28 Explanation: 
A mother with type II diabetes is encouraged to breastfeed her baby. This can even reduce the required insulin for her while breastfeeding.
Question 29
A patient tested positive on a home pregnancy test. She got her last period on September 29, 2020. What would be the patient's EDD (estimated date of delivery) according to Nagele’s rule?
A
June 29, 2021
B
July 6, 2021
C
July 13, 2021
D
June 22, 2021
Question 29 Explanation: 
Nagele’s rule is the standard way to estimate a patient's delivery date. To calculate, count one year from the date of the last period, subtract 3 months from this date and, finally, add seven days to get the EDD.
Question 30
A patient at 31 weeks’ gestation is admitted with severe hydramnios. Please indicate which of the following interventions would be appropriate:
A
The patient should consume foods high in fiber
B
Folic acid supplementation
C
Indomethacin is administered
D
A and C
Question 30 Explanation: 
Hydramnios can occur during pregnancy when excess amniotic fluid has accumulated. The condition can cause preterm labor. The patient should consume foods high in fiber to prevent constipation, since the pressure involved in defecating with constipation can cause rupture in the membranes. Indomethacin will help reduce the amniotic fluid volume.
Question 31
A patient in labor received spinal anesthesia. Which of the following is an appropriate action for the midwife?
A
Help the patient remain flat on bed for 8 to 12 hours
B
Administer intravenous fluids
C
A and B
D
Administer oxygen
Question 31 Explanation: 
The midwife should lie flat for up to 12 hours and receive IV fluids.
Question 32
Please identify which of the following are indications for induction of labor:
A
Premature rupture of membranes
B
Prolonged gestation (at more than 42 weeks)
C
Eclampsia and pre-eclampsia
D
All of the above
Question 32 Explanation: 
All of the above options are indications for induction of labor. Others are severe hypertension, PROM at term, Rh sensitization and others.
Question 33
The lab tests of a patient in labor revealed a hemoglobin level of 10 g/dL and a hematocrit concentration of 34%. In the postpartum period, the patient has an increased risk of...
A
Postpartum infection
B
Postpartum psychosis
C
Delayed wound healing
D
A and C
Question 33 Explanation: 
The patient's lab values reveal anemia. Patients with anemia during labor find themselves at an increased risk of postpartum infection and delayed wound healing.
Question 34
Several minutes after a successful vaginal delivery, lengthening of the umbilical cord occurs and the midwife notices a gush of vaginal blood. These are an indication that...
A
the patient is experiencing a haemorrhage
B
the placenta has separated from the uterus
C
the patient has placenta previa
D
None of the above
Question 34 Explanation: 
Lengthening of the umbilical cord, a gush of vaginal blood and change sin the shape of the uterus are all signs of placental separation.
Question 35
A patient with multiple pregnancy is transported to the delivery operating room for cesarean delivery. The patient should be placed in which position in the operating room?
A
Fowler's
B
Supine, with a wedge under the right hip
C
Left side-lying
D
None of the above
Question 35 Explanation: 
The patient should be placed in a supine position, which is customary for abdominal operations. A wedge should be placed under the right hip to prevent decreased blood flow to the uterus.
Question 36
Please indicate the most effective method to prevent pregnancy is...
A
Oral contraception
B
A combination of different contraception methods
C
Abstinence
D
None of the above
Question 36 Explanation: 
The most effective method to prevent pregnancy is abstinence.
Question 37
Please indicate which of the following could be reasons for a couple to consider artificial insemination:
A
Inadequate sperm count
B
Low sperm motility
C
A and B
D
None of the above
Question 37 Explanation: 
When the man has inadequate sperm count or a condition interferes with the woman's sperm motility, artificial insemination can be an option.
Question 38
Please identify which of the following is a risk factor for uterine fibroids.
A
Smoking
B
Obesity
C
Alcohol abuse
D
None of the above
Question 38 Explanation: 
According to research data, a risk factor for uterine fibroids, besides genetic factors, is obesity. Smoking lowers the risk for uterine fibroids.
Question 39
In which of the following cases, the midwife does not need to require the patient's heterosexual partner to be identified and treated?
A
The patient has a bacterial vaginosis diagnosis
B
The patient has a chlamydia diagnosis
C
The patient has a genital herpes diagnosis
D
In all of these cases the patient's partner should be identified and treated
Question 39 Explanation: 
Identification and treatment of the partner in cases when a female patient has bacterial vaginosis is only required when the patient engages in sexual relationships with other women.
Question 40
Please identify which of the following statements indicates that a couple has primary infertility: The couple has been engaging in unprotected sex for ..., without conception occurring and with no previous conception reported.
A
half a year
B
one year
C
two years
D
one to three years
Question 40 Explanation: 
A couple is considered to have primary infertility if the partners have been engaging in unprotected sex for one year without pregnancy occurring and with no previous conception reported.
Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results
There are 40 questions to complete.

Leave a Comment

Find a Program
×