MIDWIFERY COMPREHENSIVE EXAM 2026
ACTUAL TEST PAPER QUESTIONS SOLUTIONS
VERIFIED COMPLETE STUDY PACKAGE
◉ Approximately what percentage of women are affected by
heartburn in the third trimester of pregnancy?
Answer: 72%
◉ Approximately what percentage of women are affected by
heartburn in the second trimester of pregnancy?
Answer: 39%
◉ Approximately what percentage of women are affected by
heartburn in the first trimester of pregnancy?
Answer: 22%
◉ What medications are safe to use to treat or prevent heartburn?
Answer: First try using antacids containing magnesium, calcium,
aluminum based (Maalox, mylanta, tums...)
If not effective, move onto H2 receptor antagonists (Ranitidine
(Zantac), cimetidine (Tagamet)).
Sodium bicarbonate antacids (Alka-Seltzer) should be avoided.
,◉ What are behavior modifications that can help relieve or prevent
heartburn?
Answer: smaller meals
avoid drinking large amounts of liquid with meals
avoid laying down right after eating
wear nonrestrictive clothing around the waist especially.
◉ What is important to rule out when a pregnant woman complains
of chest pain?
Answer: Myocardial infarction!
Also: pulmonary embolism and asthma attack.
◉ What are differential diagnoses for heartburn?
Answer: hiatal hernia (need endoscopy to confirm)
Peptic ulcer disease (pain 2-5 hours after meal, vomiting, relief with
food and antacids, need endoscopy to confirm)
cholecystitis (fever, nausea, vomiting, anorexia, right upper quadrant
pain)
Pancreatitis (pain lasting for days, radiates to back, nausea,
vomiting, abdominal distention, Turner's and Cullen's sign. test
serum amylase and lipase)
,◉ What might you expect in a normal/problem-free vaginal exam?
Answer: Clear/white discharge, pH 3.8-4.2, negative whiff test,
Lacto-bacilli present on wet mount
◉ Your patient has trichomoniasis. What might you expect in her
exam?
Answer: May c/o of itching, have frothy, gray, green, or malodorous
discharge, "strawberry cervix", pH greater than 4.5, positive whiff
test, protozoa and WBCs on wet mount
◉ Your patient has candidiasis. What might you expect in her exam?
Answer: May c/o itching, discomfort, dysuria. Thick, white, clumping
discharge, with vaginal inflammation/erythema. pH less than 4.5,
negative whiff test, few WBCs on wet mount, yeast present on KOH
wet mount
◉ Your patient has bacterial vaginosis. What might you expect in her
exam?
Answer: May c/o odor, discharge, itching. Discharge, thin,
malodorous, milky white, homogenous, adherent. pH greater than
4.5, positive whiff test, clue cells, no/few WBCs
◉ What is the normal vaginal pH?
Answer: 3.8-4.2
, ◉ What conditions can cause the vaginal pH to rise above 4.5?
Answer: Trichomoniasis, Bacterial Vaginosis
◉ What condition can cause "strawberry cervix"?
Answer: Trichomoniasis, though candidiasis can cause
inflammation/erythema
◉ What conditions can cause a positive whiff test?
Answer: Trichomoniasis, Bacterial vaginosis
◉ What condition presents with clue cells?
Answer: BV
◉ What conditions present with WBCs on wet-mount?
Answer: Trich (many), candidiasis (few), BV (very few, may not be
present)
◉ What is hyperemesis?
Answer: N/V that persists beyond the first trimester of pregnancy.
May result in >5% weight loss, and/or fluid/electrolyte imbalance
ACTUAL TEST PAPER QUESTIONS SOLUTIONS
VERIFIED COMPLETE STUDY PACKAGE
◉ Approximately what percentage of women are affected by
heartburn in the third trimester of pregnancy?
Answer: 72%
◉ Approximately what percentage of women are affected by
heartburn in the second trimester of pregnancy?
Answer: 39%
◉ Approximately what percentage of women are affected by
heartburn in the first trimester of pregnancy?
Answer: 22%
◉ What medications are safe to use to treat or prevent heartburn?
Answer: First try using antacids containing magnesium, calcium,
aluminum based (Maalox, mylanta, tums...)
If not effective, move onto H2 receptor antagonists (Ranitidine
(Zantac), cimetidine (Tagamet)).
Sodium bicarbonate antacids (Alka-Seltzer) should be avoided.
,◉ What are behavior modifications that can help relieve or prevent
heartburn?
Answer: smaller meals
avoid drinking large amounts of liquid with meals
avoid laying down right after eating
wear nonrestrictive clothing around the waist especially.
◉ What is important to rule out when a pregnant woman complains
of chest pain?
Answer: Myocardial infarction!
Also: pulmonary embolism and asthma attack.
◉ What are differential diagnoses for heartburn?
Answer: hiatal hernia (need endoscopy to confirm)
Peptic ulcer disease (pain 2-5 hours after meal, vomiting, relief with
food and antacids, need endoscopy to confirm)
cholecystitis (fever, nausea, vomiting, anorexia, right upper quadrant
pain)
Pancreatitis (pain lasting for days, radiates to back, nausea,
vomiting, abdominal distention, Turner's and Cullen's sign. test
serum amylase and lipase)
,◉ What might you expect in a normal/problem-free vaginal exam?
Answer: Clear/white discharge, pH 3.8-4.2, negative whiff test,
Lacto-bacilli present on wet mount
◉ Your patient has trichomoniasis. What might you expect in her
exam?
Answer: May c/o of itching, have frothy, gray, green, or malodorous
discharge, "strawberry cervix", pH greater than 4.5, positive whiff
test, protozoa and WBCs on wet mount
◉ Your patient has candidiasis. What might you expect in her exam?
Answer: May c/o itching, discomfort, dysuria. Thick, white, clumping
discharge, with vaginal inflammation/erythema. pH less than 4.5,
negative whiff test, few WBCs on wet mount, yeast present on KOH
wet mount
◉ Your patient has bacterial vaginosis. What might you expect in her
exam?
Answer: May c/o odor, discharge, itching. Discharge, thin,
malodorous, milky white, homogenous, adherent. pH greater than
4.5, positive whiff test, clue cells, no/few WBCs
◉ What is the normal vaginal pH?
Answer: 3.8-4.2
, ◉ What conditions can cause the vaginal pH to rise above 4.5?
Answer: Trichomoniasis, Bacterial Vaginosis
◉ What condition can cause "strawberry cervix"?
Answer: Trichomoniasis, though candidiasis can cause
inflammation/erythema
◉ What conditions can cause a positive whiff test?
Answer: Trichomoniasis, Bacterial vaginosis
◉ What condition presents with clue cells?
Answer: BV
◉ What conditions present with WBCs on wet-mount?
Answer: Trich (many), candidiasis (few), BV (very few, may not be
present)
◉ What is hyperemesis?
Answer: N/V that persists beyond the first trimester of pregnancy.
May result in >5% weight loss, and/or fluid/electrolyte imbalance
