, CHAPTER LIST
Chapter 1: Essential Midwifery Practice
Chapter 2: Prenatal Care
Chapter 3: Care of the Pregnant Woman With Prenatal Conditions
Chapter 4: Care of the Woman during Labor and Birth
Chapter 5: Care of the Newborn and the Postpartum Woman
Chapter 6: Well Woman Care Across the Life Span
Chapter 7: Care of the Woman With Reproductive and Sexual Health
Conditions
Chapter 8: Primary Care of Common Health Conditions
Total Questions: 240 (30 questions per chapter)
Chapters: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8
Formats per Chapter; Multiple Choice (12) | True/False (8) | Case-Based Scenario (10 ) A
rationale for the correct answer follows each question.
All content is drawn from the Clinical Practice Guidelines for Midwifery & Women's Health, Sixth
Edition.
, CHAPTER 1: ESSENTIAL MIDWIFERY
PRACTICE
SECTION A: MULTIPLE CHOICE QUESTIONS
Question 1. Which of the following best describes the philosophical
foundation of modern midwifery practice?
A. Interventionist care guided primarily by technology
B. A noninterventionist foundation that works with physiologic
processes and provides interventions only when indicated
C. Provider-directed care with minimal client input
D. Care that prioritizes institutional protocols over individual
client needs
Correct Answer: B
Rationale: According to Chapter 1, modern midwifery and women's
health care build on a noninterventionist foundation to work with
physiologic processes and provide interventions only when
indicated by the individual's preferences and condition.
Question 2. Which ethical principle in midwifery refers to the
human right to personal independence and the capacity to make
decisions for oneself?
A. Justice
B. Beneficence
C. Autonomy
D. Professionalism
Correct Answer: C
Rationale: Autonomy is defined in Chapter 1 as the human right to
personal independence and the capacity to make decisions for
,oneself, act on these decisions, and have others respect one's right
to make decisions.
Question 3. The ethical principle of Nonmalfeasance in midwifery
practice is best described as which of the following?
A. The right to be treated fairly and without discrimination
B. The right to be treated with compassion and empathy
C. The human right to be treated with intent to avoid harm,
following 'First do no harm'
D. Participation in professional activities to ensure autonomy in
midwifery practice
Correct Answer: C
Rationale: Nonmalfeasance is described in Chapter 1 as the human
right to be treated with intent to avoid harm; to follow the classic
'First do no harm' directive attributed to Hippocrates; and to
actively seek and address inherent bias to avoid perpetuating health
disparities.
Question 4. According to Chapter 1, implicit bias is best defined as
which of the following?
A. Conscious and deliberate stereotyping of clients
B. Unconscious evaluations about characteristics irrelevant to
the interaction
C. Openly stated prejudices that affect clinical decisions
D. Cultural sensitivity training outcomes
Correct Answer: B
Rationale: Chapter 1 defines implicit bias as unconscious
evaluations about characteristics irrelevant to the interaction.
,Implicit, or subconscious, bias can influence decision making in
health care, particularly when time for deliberation is short.
Question 5. Which of the following strategies is identified in
Chapter 1 as most effective in reducing implicit bias among
healthcare providers?
A. Cultural sensitivity training alone
B. Relying on the belief that all patients are treated equally
C. Engaging in positive contacts with members of stereotyped
groups
D. Avoiding situations that challenge personal beliefs
Correct Answer: C
Rationale: Chapter 1 states that cultural sensitivity training does
not appear, on its own, to reduce bias, while engaging in positive
contacts with members of stereotyped groups does. Seeking
common identity features and actively engaging egalitarian values
are also helpful.
Question 6. Health disparities are defined in Chapter 1 as which of
the following?
A. Differences in healthcare costs between rural and urban
populations
B. Preventable differences among population groups in disease
burden, health outcomes, or opportunities to be optimally
healthy that disproportionately affect socially marginalized
people
C. Variations in health outcomes caused solely by individual
lifestyle choices
, D. Biological differences between racial groups that lead to
different treatment outcomes
Correct Answer: B
Rationale: According to Chapter 1, health disparities are defined as
preventable differences among population groups in disease
burden, health outcomes, or opportunities to be optimally healthy
that disproportionately affect socially marginalized people and
influence healthcare interactions and outcomes at both an
individual and systemic level (CDC, 2017).
Question 7. According to Chapter 1, what is the primary goal of
collaborative relationships in midwifery practice?
A. To ensure midwives maintain sole authority over client care
B. To reduce the number of specialist referrals
C. To ensure access to optimal care for all clients as indicated
by their health conditions and preferences
D. To create financial incentives between interdisciplinary teams
Correct Answer: C
Rationale: Chapter 1 states that the primary goal of collaborative
relationships is ensuring access to the optimal care for all clients as
indicated by their health conditions and preferences for health
professional and practice setting.
Question 8. According to Chapter 1, exemplary midwifery practice
is primarily focused on which of the following?
A. Meeting institutional productivity benchmarks
B. Improving maternal-child health, fostering reproductive
justice, and improving access to primary healthcare services
C. Reducing consultation and referral rates
, D. Standardizing all care interventions regardless of client need
Correct Answer: B
Rationale: Chapter 1 states that exemplary midwifery practice is
person-oriented and focuses on excellence in the processes and
provision of women's health care, with the primary goals of
improving maternal-child health, fostering reproductive justice, and
improving access to primary healthcare services.
Question 9. According to Chapter 1, how does chronic stress
contribute to health disparities?
A. By increasing access to healthcare services in marginalized
communities
B. Through changes in the hypothalamic-pituitary-adrenal axis
that predispose individuals to obesity, hypertension, and other
chronic diseases
C. By reducing inflammatory cytokine expression
D. Through improvements in immune function over time
Correct Answer: B
Rationale: Chapter 1 explains that changes in the functioning of
the hypothalamic-pituitary-adrenal axis have been linked to stress
exposure, and these changes predispose toward the development of
obesity, hypertension, and other chronic diseases. Exposure to
social stressors is also associated with changes in the epigenome.
Question 10. The epigenome, as described in Chapter 1, is best
defined as which of the following?
A. The complete sequence of an individual's DNA
B. The totality of chemical markers and chromatin structures
that affect how and when genes are transcribed
, C. A measure of chromosomal mutations related to stress
D. The genetic blueprint inherited solely from the mother
Correct Answer: B
Rationale: Chapter 1 defines the epigenome as the totality of
chemical markers and chromatin structures that affect how and
when genes are transcribed. Exposure to environmental and social
stressors is associated with changes in the epigenome, and these
changes can be passed to future generations.
Question 11. According to Chapter 1, which of the following intake
form practices best supports culturally sensitive care?
A. Using standardized demographic checkboxes to categorize all
clients
B. Limiting questions to medical history only
C. Using open-ended questions that allow clients to describe
their race, ethnicity, religion, and gender identities in their own
words
D. Assigning gender categories based on clinical observation
Correct Answer: C
Rationale: Chapter 1 states that intake forms with open-ended
questions allow clients to describe their race, ethnicity, religion,
gender identities, and primary relationships in their own words,
which supports cultural sensitivity and inclusivity.
Question 12. According to Chapter 1, which of the following
provider behaviors limits the opportunity to develop a trusting
midwife-client relationship?
A. Using open-ended questions
B. Acknowledging the client's experiences
, C. Asking only yes-no questions and being nonresponsive to
voiced concerns
D. Reflecting back what was heard from the client
Correct Answer: C
Rationale: Chapter 1 identifies that provider behaviors such as
asking 'yes-no' questions, avoiding introductions, limiting eye
contact, and being nonresponsive to voiced questions or concerns
limit the opportunity to develop a trusting relationship and effective
communication.
SECTION B: TRUE / FALSE QUESTIONS
Question 13. True or False: According to Chapter 1, midwifery care
is based on providing individualized, comprehensive care that
promotes optimal mental and physical health while assuring social
needs are addressed?
Correct Answer: True
Rationale: Chapter 1 explicitly states: 'Midwifery care is based on
providing individualized, comprehensive care that promotes optimal
mental and physical health while assuring social needs are
addressed.'
Question 14. True or False: According to Chapter 1, implicit biases
are considered a personal failing unique to clinicians who fail to
engage in self-examination?
Correct Answer: False
Rationale: Chapter 1 clarifies that biases are universally held by
clinicians at the same rate as lay people and are 'not our fault' as
midwives. They are, however, our responsibility to acknowledge and
address.
Chapter 1: Essential Midwifery Practice
Chapter 2: Prenatal Care
Chapter 3: Care of the Pregnant Woman With Prenatal Conditions
Chapter 4: Care of the Woman during Labor and Birth
Chapter 5: Care of the Newborn and the Postpartum Woman
Chapter 6: Well Woman Care Across the Life Span
Chapter 7: Care of the Woman With Reproductive and Sexual Health
Conditions
Chapter 8: Primary Care of Common Health Conditions
Total Questions: 240 (30 questions per chapter)
Chapters: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8
Formats per Chapter; Multiple Choice (12) | True/False (8) | Case-Based Scenario (10 ) A
rationale for the correct answer follows each question.
All content is drawn from the Clinical Practice Guidelines for Midwifery & Women's Health, Sixth
Edition.
, CHAPTER 1: ESSENTIAL MIDWIFERY
PRACTICE
SECTION A: MULTIPLE CHOICE QUESTIONS
Question 1. Which of the following best describes the philosophical
foundation of modern midwifery practice?
A. Interventionist care guided primarily by technology
B. A noninterventionist foundation that works with physiologic
processes and provides interventions only when indicated
C. Provider-directed care with minimal client input
D. Care that prioritizes institutional protocols over individual
client needs
Correct Answer: B
Rationale: According to Chapter 1, modern midwifery and women's
health care build on a noninterventionist foundation to work with
physiologic processes and provide interventions only when
indicated by the individual's preferences and condition.
Question 2. Which ethical principle in midwifery refers to the
human right to personal independence and the capacity to make
decisions for oneself?
A. Justice
B. Beneficence
C. Autonomy
D. Professionalism
Correct Answer: C
Rationale: Autonomy is defined in Chapter 1 as the human right to
personal independence and the capacity to make decisions for
,oneself, act on these decisions, and have others respect one's right
to make decisions.
Question 3. The ethical principle of Nonmalfeasance in midwifery
practice is best described as which of the following?
A. The right to be treated fairly and without discrimination
B. The right to be treated with compassion and empathy
C. The human right to be treated with intent to avoid harm,
following 'First do no harm'
D. Participation in professional activities to ensure autonomy in
midwifery practice
Correct Answer: C
Rationale: Nonmalfeasance is described in Chapter 1 as the human
right to be treated with intent to avoid harm; to follow the classic
'First do no harm' directive attributed to Hippocrates; and to
actively seek and address inherent bias to avoid perpetuating health
disparities.
Question 4. According to Chapter 1, implicit bias is best defined as
which of the following?
A. Conscious and deliberate stereotyping of clients
B. Unconscious evaluations about characteristics irrelevant to
the interaction
C. Openly stated prejudices that affect clinical decisions
D. Cultural sensitivity training outcomes
Correct Answer: B
Rationale: Chapter 1 defines implicit bias as unconscious
evaluations about characteristics irrelevant to the interaction.
,Implicit, or subconscious, bias can influence decision making in
health care, particularly when time for deliberation is short.
Question 5. Which of the following strategies is identified in
Chapter 1 as most effective in reducing implicit bias among
healthcare providers?
A. Cultural sensitivity training alone
B. Relying on the belief that all patients are treated equally
C. Engaging in positive contacts with members of stereotyped
groups
D. Avoiding situations that challenge personal beliefs
Correct Answer: C
Rationale: Chapter 1 states that cultural sensitivity training does
not appear, on its own, to reduce bias, while engaging in positive
contacts with members of stereotyped groups does. Seeking
common identity features and actively engaging egalitarian values
are also helpful.
Question 6. Health disparities are defined in Chapter 1 as which of
the following?
A. Differences in healthcare costs between rural and urban
populations
B. Preventable differences among population groups in disease
burden, health outcomes, or opportunities to be optimally
healthy that disproportionately affect socially marginalized
people
C. Variations in health outcomes caused solely by individual
lifestyle choices
, D. Biological differences between racial groups that lead to
different treatment outcomes
Correct Answer: B
Rationale: According to Chapter 1, health disparities are defined as
preventable differences among population groups in disease
burden, health outcomes, or opportunities to be optimally healthy
that disproportionately affect socially marginalized people and
influence healthcare interactions and outcomes at both an
individual and systemic level (CDC, 2017).
Question 7. According to Chapter 1, what is the primary goal of
collaborative relationships in midwifery practice?
A. To ensure midwives maintain sole authority over client care
B. To reduce the number of specialist referrals
C. To ensure access to optimal care for all clients as indicated
by their health conditions and preferences
D. To create financial incentives between interdisciplinary teams
Correct Answer: C
Rationale: Chapter 1 states that the primary goal of collaborative
relationships is ensuring access to the optimal care for all clients as
indicated by their health conditions and preferences for health
professional and practice setting.
Question 8. According to Chapter 1, exemplary midwifery practice
is primarily focused on which of the following?
A. Meeting institutional productivity benchmarks
B. Improving maternal-child health, fostering reproductive
justice, and improving access to primary healthcare services
C. Reducing consultation and referral rates
, D. Standardizing all care interventions regardless of client need
Correct Answer: B
Rationale: Chapter 1 states that exemplary midwifery practice is
person-oriented and focuses on excellence in the processes and
provision of women's health care, with the primary goals of
improving maternal-child health, fostering reproductive justice, and
improving access to primary healthcare services.
Question 9. According to Chapter 1, how does chronic stress
contribute to health disparities?
A. By increasing access to healthcare services in marginalized
communities
B. Through changes in the hypothalamic-pituitary-adrenal axis
that predispose individuals to obesity, hypertension, and other
chronic diseases
C. By reducing inflammatory cytokine expression
D. Through improvements in immune function over time
Correct Answer: B
Rationale: Chapter 1 explains that changes in the functioning of
the hypothalamic-pituitary-adrenal axis have been linked to stress
exposure, and these changes predispose toward the development of
obesity, hypertension, and other chronic diseases. Exposure to
social stressors is also associated with changes in the epigenome.
Question 10. The epigenome, as described in Chapter 1, is best
defined as which of the following?
A. The complete sequence of an individual's DNA
B. The totality of chemical markers and chromatin structures
that affect how and when genes are transcribed
, C. A measure of chromosomal mutations related to stress
D. The genetic blueprint inherited solely from the mother
Correct Answer: B
Rationale: Chapter 1 defines the epigenome as the totality of
chemical markers and chromatin structures that affect how and
when genes are transcribed. Exposure to environmental and social
stressors is associated with changes in the epigenome, and these
changes can be passed to future generations.
Question 11. According to Chapter 1, which of the following intake
form practices best supports culturally sensitive care?
A. Using standardized demographic checkboxes to categorize all
clients
B. Limiting questions to medical history only
C. Using open-ended questions that allow clients to describe
their race, ethnicity, religion, and gender identities in their own
words
D. Assigning gender categories based on clinical observation
Correct Answer: C
Rationale: Chapter 1 states that intake forms with open-ended
questions allow clients to describe their race, ethnicity, religion,
gender identities, and primary relationships in their own words,
which supports cultural sensitivity and inclusivity.
Question 12. According to Chapter 1, which of the following
provider behaviors limits the opportunity to develop a trusting
midwife-client relationship?
A. Using open-ended questions
B. Acknowledging the client's experiences
, C. Asking only yes-no questions and being nonresponsive to
voiced concerns
D. Reflecting back what was heard from the client
Correct Answer: C
Rationale: Chapter 1 identifies that provider behaviors such as
asking 'yes-no' questions, avoiding introductions, limiting eye
contact, and being nonresponsive to voiced questions or concerns
limit the opportunity to develop a trusting relationship and effective
communication.
SECTION B: TRUE / FALSE QUESTIONS
Question 13. True or False: According to Chapter 1, midwifery care
is based on providing individualized, comprehensive care that
promotes optimal mental and physical health while assuring social
needs are addressed?
Correct Answer: True
Rationale: Chapter 1 explicitly states: 'Midwifery care is based on
providing individualized, comprehensive care that promotes optimal
mental and physical health while assuring social needs are
addressed.'
Question 14. True or False: According to Chapter 1, implicit biases
are considered a personal failing unique to clinicians who fail to
engage in self-examination?
Correct Answer: False
Rationale: Chapter 1 clarifies that biases are universally held by
clinicians at the same rate as lay people and are 'not our fault' as
midwives. They are, however, our responsibility to acknowledge and
address.
