FLORIDA BOARD OF NURSING CERTIFIED
NURSE MIDWIFE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1.
A 29-year-old G2P1 at 39 weeks presents to a certified nurse midwife
(CNM) for evaluation of regular contractions occurring every 5 minutes.
Her blood pressure is 118/72 mmHg, pulse 84/min, temperature 37.0°C,
and fetal heart rate is 140/min with moderate variability and
accelerations. Cervical examination reveals 5 cm dilation, 90%
effacement, and −1 station. Which finding most strongly supports that
she is in the active phase of the first stage of labor?
A. Regular contractions occurring every 10 minutes
B. Cervical dilation of approximately 5 cm with progressive change
C. Rupture of membranes without contractions
D. Bloody show without cervical dilation
Answer: B. Cervical dilation of approximately 5 cm with
progressive change
Rationale: Active labor is characterized by regular painful
contractions accompanied by progressive cervical dilation. A patient at
approximately 5 cm with substantial effacement and ongoing cervical
change is consistent with active first-stage labor. Rupture of
membranes or bloody show alone does not establish active labor.
2.
1
,A term pregnant patient presents with spontaneous rupture of
membranes. Her temperature is 37.1°C, fetal heart rate is 145/min, and
the fluid is clear. Which nursing-midwifery intervention is the priority
immediately after confirming rupture of membranes?
A. Perform repeated digital vaginal examinations
B. Assess fetal heart rate and presentation
C. Administer prophylactic antibiotics to every patient
D. Begin oxytocin immediately
Answer: B. Assess fetal heart rate and presentation
Rationale: Following rupture of membranes, fetal assessment is
important because cord prolapse can occur, particularly if the
presenting part is not well engaged. Repeated digital examinations
increase infection risk. Antibiotics and oxytocin are not automatically
indicated solely because membranes have ruptured.
3.
A patient at 34 weeks has blood pressure of 168/112 mmHg on two
measurements 15 minutes apart. She reports severe headache and visual
disturbances. Which intervention has the highest priority?
A. Schedule routine follow-up in 24 hours
B. Administer magnesium sulfate only after delivery
C. Initiate urgent management of severe hypertension and seizure
prevention
D. Encourage oral fluids and bed rest
Answer: C. Initiate urgent management of severe hypertension and
seizure prevention
Rationale: Severe-range blood pressure with neurologic symptoms
represents a potentially life-threatening hypertensive emergency
associated with preeclampsia with severe features. Prompt treatment of
2
,severe hypertension and seizure prophylaxis with magnesium sulfate
are central components of management, while maternal and fetal
stabilization and delivery planning are determined by gestational age
and clinical status.
4.
A patient receiving magnesium sulfate for preeclampsia develops
respirations of 9/min, absent patellar reflexes, and increasing
somnolence. What is the most appropriate immediate action?
A. Increase the magnesium infusion
B. Stop magnesium sulfate and prepare calcium gluconate
C. Administer oxytocin
D. Give additional sedative medication
Answer: B. Stop magnesium sulfate and prepare calcium gluconate
Rationale: Respiratory depression, loss of deep tendon reflexes, and
altered consciousness are classic signs of magnesium toxicity.
Magnesium should be discontinued, respiratory support initiated as
necessary, and calcium gluconate prepared as the antidote.
5.
A 26-year-old G1P0 at 10 weeks presents with vaginal bleeding and
unilateral pelvic pain. Her β-hCG is positive, and transvaginal
ultrasound shows no intrauterine pregnancy but demonstrates an adnexal
mass. Which diagnosis is most concerning?
A. Complete molar pregnancy
B. Ectopic pregnancy
C. Placental abruption
D. Threatened abortion
3
, Answer: B. Ectopic pregnancy
Rationale: A positive pregnancy test combined with unilateral pelvic
pain, vaginal bleeding, and an adnexal mass with no confirmed
intrauterine pregnancy is highly concerning for ectopic pregnancy.
Rupture can cause life-threatening intra-abdominal hemorrhage.
6.
A patient at 30 weeks has painless bright-red vaginal bleeding. Her
uterus is soft and nontender, and fetal heart rate is reassuring. Which
condition is most likely?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Chorioamnionitis
Answer: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-
red vaginal bleeding in the second half of pregnancy. Digital vaginal
examination should be avoided until placenta previa has been
excluded because manipulation may provoke severe hemorrhage.
7.
A woman at 37 weeks presents with sudden severe abdominal pain,
vaginal bleeding, uterine tenderness, and a rigid uterus. Fetal heart rate
shows recurrent late decelerations. Which diagnosis is most likely?
A. Placenta previa
B. Placental abruption
C. Normal bloody show
D. Cervical insufficiency
4
NURSE MIDWIFE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1.
A 29-year-old G2P1 at 39 weeks presents to a certified nurse midwife
(CNM) for evaluation of regular contractions occurring every 5 minutes.
Her blood pressure is 118/72 mmHg, pulse 84/min, temperature 37.0°C,
and fetal heart rate is 140/min with moderate variability and
accelerations. Cervical examination reveals 5 cm dilation, 90%
effacement, and −1 station. Which finding most strongly supports that
she is in the active phase of the first stage of labor?
A. Regular contractions occurring every 10 minutes
B. Cervical dilation of approximately 5 cm with progressive change
C. Rupture of membranes without contractions
D. Bloody show without cervical dilation
Answer: B. Cervical dilation of approximately 5 cm with
progressive change
Rationale: Active labor is characterized by regular painful
contractions accompanied by progressive cervical dilation. A patient at
approximately 5 cm with substantial effacement and ongoing cervical
change is consistent with active first-stage labor. Rupture of
membranes or bloody show alone does not establish active labor.
2.
1
,A term pregnant patient presents with spontaneous rupture of
membranes. Her temperature is 37.1°C, fetal heart rate is 145/min, and
the fluid is clear. Which nursing-midwifery intervention is the priority
immediately after confirming rupture of membranes?
A. Perform repeated digital vaginal examinations
B. Assess fetal heart rate and presentation
C. Administer prophylactic antibiotics to every patient
D. Begin oxytocin immediately
Answer: B. Assess fetal heart rate and presentation
Rationale: Following rupture of membranes, fetal assessment is
important because cord prolapse can occur, particularly if the
presenting part is not well engaged. Repeated digital examinations
increase infection risk. Antibiotics and oxytocin are not automatically
indicated solely because membranes have ruptured.
3.
A patient at 34 weeks has blood pressure of 168/112 mmHg on two
measurements 15 minutes apart. She reports severe headache and visual
disturbances. Which intervention has the highest priority?
A. Schedule routine follow-up in 24 hours
B. Administer magnesium sulfate only after delivery
C. Initiate urgent management of severe hypertension and seizure
prevention
D. Encourage oral fluids and bed rest
Answer: C. Initiate urgent management of severe hypertension and
seizure prevention
Rationale: Severe-range blood pressure with neurologic symptoms
represents a potentially life-threatening hypertensive emergency
associated with preeclampsia with severe features. Prompt treatment of
2
,severe hypertension and seizure prophylaxis with magnesium sulfate
are central components of management, while maternal and fetal
stabilization and delivery planning are determined by gestational age
and clinical status.
4.
A patient receiving magnesium sulfate for preeclampsia develops
respirations of 9/min, absent patellar reflexes, and increasing
somnolence. What is the most appropriate immediate action?
A. Increase the magnesium infusion
B. Stop magnesium sulfate and prepare calcium gluconate
C. Administer oxytocin
D. Give additional sedative medication
Answer: B. Stop magnesium sulfate and prepare calcium gluconate
Rationale: Respiratory depression, loss of deep tendon reflexes, and
altered consciousness are classic signs of magnesium toxicity.
Magnesium should be discontinued, respiratory support initiated as
necessary, and calcium gluconate prepared as the antidote.
5.
A 26-year-old G1P0 at 10 weeks presents with vaginal bleeding and
unilateral pelvic pain. Her β-hCG is positive, and transvaginal
ultrasound shows no intrauterine pregnancy but demonstrates an adnexal
mass. Which diagnosis is most concerning?
A. Complete molar pregnancy
B. Ectopic pregnancy
C. Placental abruption
D. Threatened abortion
3
, Answer: B. Ectopic pregnancy
Rationale: A positive pregnancy test combined with unilateral pelvic
pain, vaginal bleeding, and an adnexal mass with no confirmed
intrauterine pregnancy is highly concerning for ectopic pregnancy.
Rupture can cause life-threatening intra-abdominal hemorrhage.
6.
A patient at 30 weeks has painless bright-red vaginal bleeding. Her
uterus is soft and nontender, and fetal heart rate is reassuring. Which
condition is most likely?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Chorioamnionitis
Answer: B. Placenta previa
Rationale: Placenta previa classically presents with painless, bright-
red vaginal bleeding in the second half of pregnancy. Digital vaginal
examination should be avoided until placenta previa has been
excluded because manipulation may provoke severe hemorrhage.
7.
A woman at 37 weeks presents with sudden severe abdominal pain,
vaginal bleeding, uterine tenderness, and a rigid uterus. Fetal heart rate
shows recurrent late decelerations. Which diagnosis is most likely?
A. Placenta previa
B. Placental abruption
C. Normal bloody show
D. Cervical insufficiency
4
