“CNM ACNM Exam Prep 2025: Certified Nurse Midwife
Practice Test, High-Yield Questions, Verified Answers &
Study Guide for ACNM Certification”
“Prepare for the CNM ACNM Exam with this complete 2025 study guide featuring high-yield
practice questions, verified answers, and detailed rationales. Master core midwifery
competencies, reproductive health, intrapartum care, postpartum management, newborn
assessment, and professional issues to pass the Certified Nurse Midwife exam on your first
attempt.”
• CNM ACNM exam
• ACNM certification exam
• Certified Nurse Midwife exam
• CNM exam prep 2025
power - ANSWER-assesses strength of contractile efforts; assesses need for labor
augmentation
synclitism - ANSWER--sagittal suture midway between sacrum & symphysis pubis
-biparietal diameter parallel to planes of pelvis
anterior asynclitism - ANSWER-sagittal suture oriented toward sacrum
posterior asynclitism - ANSWER-sagittal suture oriented towards pubis
asynclitism - ANSWER-- can lead to labor dystocia; often delayed at 8-9 cm
- lax abdominal musculature contributes to this
first stage - ANSWER-onset of regular contractions through full dilation (10 cm)
latent phase - ANSWER-onset of labor until 4-6 cm
contractions q5-20 min lasting 15-40 seconds
,20; 14 - ANSWER-latent phase of labor lasts </= _______ hours in nullipara </=
_______ hours
active phase - ANSWER-4-6 cm to 10 cm
contractions q2-3 min lasting 60 sec
200-250 mVu - ANSWER-this in 10 min avg over a 30 min period is considered
adequate in active phase
adolescent - ANSWER-this group is more likely to
- start PNC late; have poor compliance with PNC schedule
- risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA - ANSWER-this group is more likely to:
- struggle with infertility, have 1st tri SAB, ectopic pregnancy, genetic abnormalities
- HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW - ANSWER-African American race is correlated with (LGA/LBW) babies?
PTB - ANSWER-Low SES is related to poor OB outcome including ___________?
multipara - ANSWER-Are Nulliparas or Multiparas associated w/ increased risks of
abruptio placenta, previa, multifetal pregnancy, and PPH?
Transverse lie - ANSWER-Fetal presentation associated with grand multiparous women
(parity > 5)
quad screen - ANSWER-15-22 weeks
- hCG
- AFP
- estriol
- inhibin A
screens for trisomy 18/21, NTD
penta screen - ANSWER-15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
,- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening - ANSWER-- 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station - ANSWER-relationship of leading edge of fetal presenting part to ischial spines
(in cm)
lactated ringer - ANSWER-Fluid of choice for burns, dehydration
d5lr - ANSWER-Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl - ANSWER-normal saline
anesthesia - ANSWER-epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks - ANSWER-paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation - ANSWER-- facilitates increased mobility
- requires 1 to 1 labor attendance
- associated w/ decreased rate of intervention
60; 30; 15 - ANSWER-intermittent auscultation should be done every _____ seconds
after a contraction every _______ minutes in 1st stage of labor if low risk, and every
______ if high risk
15; 5 - ANSWER-intermittent auscultation should be done every ____ minutes in 2nd
stage if low risk; and every _____ min if high risk
continuous EFM - ANSWER-- indicated for AP or IP risk factors
category I - ANSWER-- tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early
decels/accels present or absent
, 15; 5 - ANSWER-continuous fetal monitoring should be done every _____ min for low-
risk in 1st stage and every ______ min if high risk
Category II - ANSWER-indeterminate of fetal acid-base status; requires continued
monitoring and evaluation
- baseline bradycardic or tachycardic
- minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
- prolonged decels between 2-10 minutes
- recurrent lates w/ mod baseline variability
- variable decels w/ overshoots/shoulders
category III - ANSWER-- associated w/ abnormal fetal acid-base status; prompt
corrective action required
- absent variability in conjunction with any of the following:
- bradycardia
- recurrent variables
- recurrent lates
- sinusoidal pattern
10+ minutes - ANSWER-how long does fetal bradycardia/tachycardia need to persist to
be diagnosed
fetal scalp stimulation - ANSWER-- cannot be reliably performed during decel or
bradycardia; wait for FHR recovery
>7.2 - ANSWER-stimulating the head during a vaginal exam with a FHR accel > 15 for
>15 seconds is indicated of fetal pH of _________
intact membranes - ANSWER-- facilitates rotation of head during pelvic descent
-barrier to introduction of bacteria into uterus
1.2; 1.5 - ANSWER-a nullipara will dilate from 4-10 cm at a speed of _______ cm/hr;
and a multip at a speed of ______ cm/hr
3.7, 2.4, 2.2 - ANSWER-length of active phase in nulliparas, para 1 women, and para
2+ women
<100 F - ANSWER-normal temperature during labor, delivery, and immediate
postpartum
epidural - ANSWER-- can artificially elevate temperature
Practice Test, High-Yield Questions, Verified Answers &
Study Guide for ACNM Certification”
“Prepare for the CNM ACNM Exam with this complete 2025 study guide featuring high-yield
practice questions, verified answers, and detailed rationales. Master core midwifery
competencies, reproductive health, intrapartum care, postpartum management, newborn
assessment, and professional issues to pass the Certified Nurse Midwife exam on your first
attempt.”
• CNM ACNM exam
• ACNM certification exam
• Certified Nurse Midwife exam
• CNM exam prep 2025
power - ANSWER-assesses strength of contractile efforts; assesses need for labor
augmentation
synclitism - ANSWER--sagittal suture midway between sacrum & symphysis pubis
-biparietal diameter parallel to planes of pelvis
anterior asynclitism - ANSWER-sagittal suture oriented toward sacrum
posterior asynclitism - ANSWER-sagittal suture oriented towards pubis
asynclitism - ANSWER-- can lead to labor dystocia; often delayed at 8-9 cm
- lax abdominal musculature contributes to this
first stage - ANSWER-onset of regular contractions through full dilation (10 cm)
latent phase - ANSWER-onset of labor until 4-6 cm
contractions q5-20 min lasting 15-40 seconds
,20; 14 - ANSWER-latent phase of labor lasts </= _______ hours in nullipara </=
_______ hours
active phase - ANSWER-4-6 cm to 10 cm
contractions q2-3 min lasting 60 sec
200-250 mVu - ANSWER-this in 10 min avg over a 30 min period is considered
adequate in active phase
adolescent - ANSWER-this group is more likely to
- start PNC late; have poor compliance with PNC schedule
- risks: LBW, PTL/PTB, HTN dx of pregnancy, IUGR, infant mortality
AMA - ANSWER-this group is more likely to:
- struggle with infertility, have 1st tri SAB, ectopic pregnancy, genetic abnormalities
- HTN dx of preg, PTB, GDM, dysfunctional labor --> C/S, placenta previa and abruption
LBW - ANSWER-African American race is correlated with (LGA/LBW) babies?
PTB - ANSWER-Low SES is related to poor OB outcome including ___________?
multipara - ANSWER-Are Nulliparas or Multiparas associated w/ increased risks of
abruptio placenta, previa, multifetal pregnancy, and PPH?
Transverse lie - ANSWER-Fetal presentation associated with grand multiparous women
(parity > 5)
quad screen - ANSWER-15-22 weeks
- hCG
- AFP
- estriol
- inhibin A
screens for trisomy 18/21, NTD
penta screen - ANSWER-15-22 wks
- AFP
- beta hCG
- unconjugated estriol
- inhibin A
,- invasive trophoblast antigen (hHCG)
trisomy 13/18/21/NT
1st trimester screening - ANSWER-- 10 and 13 weeks
- PAPP-A and B-hCG and NT
- determine risk of trisomy 13/18/21
station - ANSWER-relationship of leading edge of fetal presenting part to ischial spines
(in cm)
lactated ringer - ANSWER-Fluid of choice for burns, dehydration
d5lr - ANSWER-Same as LR plus provides about 180 calories per 1000cc's
0.9% NaCl - ANSWER-normal saline
anesthesia - ANSWER-epidural, spinal, intrathecal
- complete neurologic block; can interfere with muscular action
- may increase need for OB intervention
- systemic effects: ***hypotension***, fever
- inadvertent dural puncture can cause a spinal HA
local blocks - ANSWER-paracervical, pudendal, local infiltration
provides pain blockade at site of pain for brief periods of time
intermittent auscultation - ANSWER-- facilitates increased mobility
- requires 1 to 1 labor attendance
- associated w/ decreased rate of intervention
60; 30; 15 - ANSWER-intermittent auscultation should be done every _____ seconds
after a contraction every _______ minutes in 1st stage of labor if low risk, and every
______ if high risk
15; 5 - ANSWER-intermittent auscultation should be done every ____ minutes in 2nd
stage if low risk; and every _____ min if high risk
continuous EFM - ANSWER-- indicated for AP or IP risk factors
category I - ANSWER-- tracing predictive of a well-oxygenated fetus
- normal acid-base balance
- normal baseline, moderate FHR variability, absent late/variable decels, early
decels/accels present or absent
, 15; 5 - ANSWER-continuous fetal monitoring should be done every _____ min for low-
risk in 1st stage and every ______ min if high risk
Category II - ANSWER-indeterminate of fetal acid-base status; requires continued
monitoring and evaluation
- baseline bradycardic or tachycardic
- minimal variability or absent variability with no recurrent decels or marked variability
- no accels despite fetal stimulation
- recurrent variables w/ min/mod baseline variability
- prolonged decels between 2-10 minutes
- recurrent lates w/ mod baseline variability
- variable decels w/ overshoots/shoulders
category III - ANSWER-- associated w/ abnormal fetal acid-base status; prompt
corrective action required
- absent variability in conjunction with any of the following:
- bradycardia
- recurrent variables
- recurrent lates
- sinusoidal pattern
10+ minutes - ANSWER-how long does fetal bradycardia/tachycardia need to persist to
be diagnosed
fetal scalp stimulation - ANSWER-- cannot be reliably performed during decel or
bradycardia; wait for FHR recovery
>7.2 - ANSWER-stimulating the head during a vaginal exam with a FHR accel > 15 for
>15 seconds is indicated of fetal pH of _________
intact membranes - ANSWER-- facilitates rotation of head during pelvic descent
-barrier to introduction of bacteria into uterus
1.2; 1.5 - ANSWER-a nullipara will dilate from 4-10 cm at a speed of _______ cm/hr;
and a multip at a speed of ______ cm/hr
3.7, 2.4, 2.2 - ANSWER-length of active phase in nulliparas, para 1 women, and para
2+ women
<100 F - ANSWER-normal temperature during labor, delivery, and immediate
postpartum
epidural - ANSWER-- can artificially elevate temperature
