CERTIFIED NURSE MIDWIFE (CNM)
CERTIFICATION EXAM QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A pregnant client at 10 weeks gestation presents with nausea and vomiting
but is able to tolerate fluids. What is the most appropriate first-line
management?
A. Ondansetron
B. Metoclopramide
C. Vitamin B6 with or without doxylamine
D. Promethazine
Correct Answer: C
Rationale: Vitamin B6, alone or combined with doxylamine, is the recommended
first-line treatment for nausea and vomiting of pregnancy due to safety and
effectiveness.
2. Which hormone is primarily responsible for maintaining early pregnancy?
A. Estrogen
B. Progesterone
C. Human chorionic gonadotropin (hCG)
D. Prolactin
,Correct Answer: C
Rationale: hCG maintains the corpus luteum in early pregnancy, ensuring
continued progesterone production until placental takeover.
3. A gravida 2 para 1 at 32 weeks reports rhythmic uterine tightening without
cervical change. This is best described as:
A. Preterm labor
B. False labor
C. Braxton Hicks contractions
D. Uterine rupture
Correct Answer: C
Rationale: Braxton Hicks contractions are irregular, often painless, and do not
result in cervical change.
4. Which finding is most concerning in a newborn immediately after birth?
A. Acrocyanosis
B. Heart rate of 140 bpm
C. Respiratory rate of 30/min
D. Central cyanosis
Correct Answer: D
Rationale: Central cyanosis indicates inadequate oxygenation and requires
immediate evaluation and intervention.
5. The primary mechanism of action of oxytocin during labor is to:
A. Relax uterine smooth muscle
B. Increase uterine contractions
C. Dilate the cervix directly
D. Decrease fetal heart rate
,Correct Answer: B
Rationale: Oxytocin stimulates uterine smooth muscle to increase the frequency
and strength of contractions.
6. A postpartum client experiences heavy bleeding and a boggy uterus. The
priority intervention is to:
A. Administer antibiotics
B. Perform uterine massage
C. Prepare for surgery
D. Obtain laboratory studies
Correct Answer: B
Rationale: Uterine atony is the most common cause of postpartum hemorrhage,
and fundal massage is the first-line intervention.
7. Which contraceptive method is contraindicated in a woman with a history
of estrogen-sensitive breast cancer?
A. Copper IUD
B. Progestin-only pill
C. Combined oral contraceptive
D. Barrier methods
Correct Answer: C
Rationale: Combined oral contraceptives contain estrogen, which is
contraindicated in estrogen-sensitive breast cancer.
8. The normal fetal heart rate baseline is:
A. 90–110 bpm
B. 110–160 bpm
C. 160–180 bpm
D. 180–200 bpm
, Correct Answer: B
Rationale: A normal fetal heart rate baseline ranges from 110 to 160 beats per
minute.
9. A client at 38 weeks has spontaneous rupture of membranes with clear
fluid. The next step is to:
A. Start antibiotics
B. Assess fetal heart rate
C. Perform vaginal exam immediately
D. Schedule cesarean delivery
Correct Answer: B
Rationale: Fetal heart rate assessment is the priority to evaluate fetal well-being
after rupture of membranes.
10.Which condition is characterized by hypertension and proteinuria after 20
weeks gestation?
A. Gestational diabetes
B. Chronic hypertension
C. Preeclampsia
D. HELLP syndrome
Correct Answer: C
Rationale: Preeclampsia is defined by new-onset hypertension and proteinuria
after 20 weeks gestation.
11.Which vitamin deficiency is associated with neural tube defects?
A. Vitamin D
B. Vitamin B12
C. Folic acid
D. Vitamin C
CERTIFICATION EXAM QUESTION AND
CORRECT ANSWERS (VERIFIED
ANSWERS) PLUS RATIONALES 2026 Q&A
INSTANT DOWNLOAD PDF
1. A pregnant client at 10 weeks gestation presents with nausea and vomiting
but is able to tolerate fluids. What is the most appropriate first-line
management?
A. Ondansetron
B. Metoclopramide
C. Vitamin B6 with or without doxylamine
D. Promethazine
Correct Answer: C
Rationale: Vitamin B6, alone or combined with doxylamine, is the recommended
first-line treatment for nausea and vomiting of pregnancy due to safety and
effectiveness.
2. Which hormone is primarily responsible for maintaining early pregnancy?
A. Estrogen
B. Progesterone
C. Human chorionic gonadotropin (hCG)
D. Prolactin
,Correct Answer: C
Rationale: hCG maintains the corpus luteum in early pregnancy, ensuring
continued progesterone production until placental takeover.
3. A gravida 2 para 1 at 32 weeks reports rhythmic uterine tightening without
cervical change. This is best described as:
A. Preterm labor
B. False labor
C. Braxton Hicks contractions
D. Uterine rupture
Correct Answer: C
Rationale: Braxton Hicks contractions are irregular, often painless, and do not
result in cervical change.
4. Which finding is most concerning in a newborn immediately after birth?
A. Acrocyanosis
B. Heart rate of 140 bpm
C. Respiratory rate of 30/min
D. Central cyanosis
Correct Answer: D
Rationale: Central cyanosis indicates inadequate oxygenation and requires
immediate evaluation and intervention.
5. The primary mechanism of action of oxytocin during labor is to:
A. Relax uterine smooth muscle
B. Increase uterine contractions
C. Dilate the cervix directly
D. Decrease fetal heart rate
,Correct Answer: B
Rationale: Oxytocin stimulates uterine smooth muscle to increase the frequency
and strength of contractions.
6. A postpartum client experiences heavy bleeding and a boggy uterus. The
priority intervention is to:
A. Administer antibiotics
B. Perform uterine massage
C. Prepare for surgery
D. Obtain laboratory studies
Correct Answer: B
Rationale: Uterine atony is the most common cause of postpartum hemorrhage,
and fundal massage is the first-line intervention.
7. Which contraceptive method is contraindicated in a woman with a history
of estrogen-sensitive breast cancer?
A. Copper IUD
B. Progestin-only pill
C. Combined oral contraceptive
D. Barrier methods
Correct Answer: C
Rationale: Combined oral contraceptives contain estrogen, which is
contraindicated in estrogen-sensitive breast cancer.
8. The normal fetal heart rate baseline is:
A. 90–110 bpm
B. 110–160 bpm
C. 160–180 bpm
D. 180–200 bpm
, Correct Answer: B
Rationale: A normal fetal heart rate baseline ranges from 110 to 160 beats per
minute.
9. A client at 38 weeks has spontaneous rupture of membranes with clear
fluid. The next step is to:
A. Start antibiotics
B. Assess fetal heart rate
C. Perform vaginal exam immediately
D. Schedule cesarean delivery
Correct Answer: B
Rationale: Fetal heart rate assessment is the priority to evaluate fetal well-being
after rupture of membranes.
10.Which condition is characterized by hypertension and proteinuria after 20
weeks gestation?
A. Gestational diabetes
B. Chronic hypertension
C. Preeclampsia
D. HELLP syndrome
Correct Answer: C
Rationale: Preeclampsia is defined by new-onset hypertension and proteinuria
after 20 weeks gestation.
11.Which vitamin deficiency is associated with neural tube defects?
A. Vitamin D
B. Vitamin B12
C. Folic acid
D. Vitamin C
