Michigan Nurse Midwife
AdvancedExam Practice Questions And
Correct Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
Pdf
1. Which hormone primarily stimulates uterine contractions during
labor?
A. Progesterone
B. Estrogen
C. Oxytocin
D. Prolactin
Rationale: Oxytocin, produced by the posterior pituitary, is the key
hormone responsible for initiating and sustaining uterine contractions
during labor.
2. A 28-year-old pregnant woman at 32 weeks gestation presents with
elevated blood pressure and proteinuria. Which condition is most
likely?
A. Gestational diabetes
B. Preeclampsia
C. Hyperemesis gravidarum
D. Placenta previa
Rationale: Preeclampsia is characterized by new-onset hypertension and
proteinuria after 20 weeks of gestation.
, 3. Which of the following is the most appropriate first-line
pharmacologic treatment for postpartum hemorrhage due to uterine
atony?
A. Methylergonovine
B. Oxytocin
C. Carboprost tromethamine
D. Misoprostol
Rationale: Oxytocin is the first-line uterotonic used to manage postpartum
hemorrhage caused by uterine atony due to its rapid onset and
effectiveness.
4. During a routine prenatal visit, a patient reports decreased fetal
movement. Which is the most appropriate initial assessment?
A. Schedule a non-stress test for next week
B. Immediate cesarean section
C. Perform a fetal kick count and possibly a non-stress test
D. Order an amniocentesis
Rationale: Decreased fetal movement warrants prompt evaluation,
typically starting with maternal perception of fetal activity (kick counts)
and possibly a non-stress test to assess fetal well-being.
5. Which immunization is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR (measles, mumps, rubella)
D. Hepatitis B
Rationale: The MMR vaccine is live attenuated and contraindicated during
pregnancy due to potential teratogenic effects.
6. What is the recommended daily intake of folic acid for women
planning pregnancy?
A. 100 mcg
B. 200 mcg
, C. 400 mcg
D. 800 mcg
Rationale: A daily intake of 400 mcg of folic acid is recommended to reduce
the risk of neural tube defects in the developing fetus.
7. Which maternal complication is most strongly associated with multiple
gestations?
A. Hyperemesis gravidarum
B. Preterm labor
C. Placenta accreta
D. Ectopic pregnancy
Rationale: Multiple gestations increase uterine distension, which is
strongly linked to a higher risk of preterm labor.
8. Which fetal heart rate pattern is considered an early sign of fetal
hypoxia?
A. Variable decelerations
B. Late decelerations
C. Tachycardia
D. Sinusoidal pattern
Rationale: Fetal tachycardia can be an early compensatory response to
hypoxia or maternal fever and should prompt further evaluation.
9. In the management of a term breech presentation, which is the safest
delivery method in most cases?
A. Forceps-assisted vaginal delivery
B. Spontaneous vaginal delivery
C. Planned cesarean section
D. Vacuum-assisted delivery
Rationale: Planned cesarean delivery is generally recommended for term
breech presentations to reduce perinatal morbidity and mortality.
AdvancedExam Practice Questions And
Correct Answers (Verified Answers) Plus
Rationale 2026 Q&A| Instant Download
1. Which hormone primarily stimulates uterine contractions during
labor?
A. Progesterone
B. Estrogen
C. Oxytocin
D. Prolactin
Rationale: Oxytocin, produced by the posterior pituitary, is the key
hormone responsible for initiating and sustaining uterine contractions
during labor.
2. A 28-year-old pregnant woman at 32 weeks gestation presents with
elevated blood pressure and proteinuria. Which condition is most
likely?
A. Gestational diabetes
B. Preeclampsia
C. Hyperemesis gravidarum
D. Placenta previa
Rationale: Preeclampsia is characterized by new-onset hypertension and
proteinuria after 20 weeks of gestation.
, 3. Which of the following is the most appropriate first-line
pharmacologic treatment for postpartum hemorrhage due to uterine
atony?
A. Methylergonovine
B. Oxytocin
C. Carboprost tromethamine
D. Misoprostol
Rationale: Oxytocin is the first-line uterotonic used to manage postpartum
hemorrhage caused by uterine atony due to its rapid onset and
effectiveness.
4. During a routine prenatal visit, a patient reports decreased fetal
movement. Which is the most appropriate initial assessment?
A. Schedule a non-stress test for next week
B. Immediate cesarean section
C. Perform a fetal kick count and possibly a non-stress test
D. Order an amniocentesis
Rationale: Decreased fetal movement warrants prompt evaluation,
typically starting with maternal perception of fetal activity (kick counts)
and possibly a non-stress test to assess fetal well-being.
5. Which immunization is contraindicated during pregnancy?
A. Influenza (inactivated)
B. Tdap
C. MMR (measles, mumps, rubella)
D. Hepatitis B
Rationale: The MMR vaccine is live attenuated and contraindicated during
pregnancy due to potential teratogenic effects.
6. What is the recommended daily intake of folic acid for women
planning pregnancy?
A. 100 mcg
B. 200 mcg
, C. 400 mcg
D. 800 mcg
Rationale: A daily intake of 400 mcg of folic acid is recommended to reduce
the risk of neural tube defects in the developing fetus.
7. Which maternal complication is most strongly associated with multiple
gestations?
A. Hyperemesis gravidarum
B. Preterm labor
C. Placenta accreta
D. Ectopic pregnancy
Rationale: Multiple gestations increase uterine distension, which is
strongly linked to a higher risk of preterm labor.
8. Which fetal heart rate pattern is considered an early sign of fetal
hypoxia?
A. Variable decelerations
B. Late decelerations
C. Tachycardia
D. Sinusoidal pattern
Rationale: Fetal tachycardia can be an early compensatory response to
hypoxia or maternal fever and should prompt further evaluation.
9. In the management of a term breech presentation, which is the safest
delivery method in most cases?
A. Forceps-assisted vaginal delivery
B. Spontaneous vaginal delivery
C. Planned cesarean section
D. Vacuum-assisted delivery
Rationale: Planned cesarean delivery is generally recommended for term
breech presentations to reduce perinatal morbidity and mortality.
