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MIDWIFERY FINAL EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
Midwifery Exam Questions with Detailed Rationales
SECTION 1: ANTEPARTUM CARE (Questions 1-20)
1. A woman at 32 weeks gestation is admitted with a diagnosis of severe pre-
eclampsia. Which of the following is a cardinal sign of impending eclampsia?
A) Weight loss and epigastric pain
B) Sharp rise in blood pressure and occipital headache
C) Sharp rise in blood pressure and decrease in proteinuria
D) Increase in proteinuria and frontal headache
Answer: B
Rationale: Signs of impending eclampsia include a sharp rise in blood pressure,
occipital or frontal headache, visual disturbances (blurring or diplopia), epigastric pain,
and hyperreflexia . These signs indicate worsening pre-eclampsia and increased risk of
seizures. Weight loss is not typical; proteinuria typically increases, not decreases.
2. A midwife is assessing a mother with cord presentation. Which finding would
confirm this diagnosis?
A) Cord in front of the presenting part and intact membranes
B) Cord in front of the presenting part and ruptured membranes
C) Excessive vaginal bleeding
D) Cord lying centrally on the internal cervical os
Answer: A
Rationale: Cord presentation occurs when the umbilical cord lies in front of the
presenting part with intact membranes. This is an obstetric emergency because when
membranes rupture, cord prolapse may occur, leading to cord compression and fetal
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compromise. Ruptured membranes with cord in front is cord prolapse, which is a more
advanced emergency.
3. A 16-year-old adolescent girl is refusing to consent for an emergency caesarean
section. This situation represents:
A) A breach of professional conduct
B) An ethical dilemma
C) A legal requirement for parental consent
D) A midwifery management issue
Answer: B
Rationale: An ethical dilemma arises when there is a conflict between ethical
principles—in this case, respect for the adolescent's autonomy versus beneficence
(protecting the fetus and mother from harm). This is a complex situation requiring
careful ethical reasoning, legal considerations, and multidisciplinary discussion .
4. Features of pre-eclampsia include:
A) Proteinuria, uterine contractions, blurred vision
B) Low blood pressure, convulsions, frontal headaches
C) Proteinuria, high blood pressure, edema
D) Vomiting, vaginal bleeding, uterine contractions
Answer: C
Rationale: Pre-eclampsia is characterized by new-onset hypertension (≥140/90 mmHg)
and proteinuria (≥300 mg/24 hours) after 20 weeks of gestation. Edema may also be
present, though it is no longer considered a diagnostic criterion. Headaches and visual
disturbances are signs of severe disease .
5. A woman is diagnosed with gestational diabetes mellitus at 13 weeks gestation.
Which of the following is a predisposing factor?
A) Maternal age under 25 years
B) Previous normal birth weight infant
C) Family history of diabetes
D) Low pre-pregnancy BMI
Answer: C
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Rationale: Risk factors for gestational diabetes include a family history of diabetes,
obesity (BMI ≥30), previous gestational diabetes, previous macrosomic baby (>4 kg),
polycystic ovary syndrome, and maternal age over 35 years . Early screening is indicated
for women with these risk factors.
6. The outer membrane of the fetal sac is the:
A) Ectoderm
B) Amnion
C) Placenta
D) Chorion
Answer: D
Rationale: The chorion is the outer fetal membrane that surrounds the amnion and
forms the fetal part of the placenta. It is derived from the trophoblast and mesoderm.
The amnion is the inner membrane that contains the amniotic fluid and fetus .
7. Skin and the nervous system develop from which germ layer?
A) Mesoderm
B) Endoderm
C) Yolk sac
D) Ectoderm
Answer: D
Rationale: The ectoderm is the outermost germ layer that gives rise to the skin
(epidermis, hair, nails) and the nervous system (brain, spinal cord, peripheral nerves).
The mesoderm gives rise to muscle, bone, and connective tissue; the endoderm gives
rise to internal organs such as the gastrointestinal tract and lungs.
8. During pregnancy, some women develop deeper, patchy coloring on the face
known as:
A) Chloasma
B) Linea nigra
C) Striae gravidarum
D) Eczema
Answer: A
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Rationale: Chloasma (melasma or "mask of pregnancy") is a hyperpigmentation
condition characterized by blotchy, brownish patches on the face. It is caused by
increased melanocyte-stimulating hormone and estrogen levels. Linea nigra is a dark
line on the abdomen, and striae gravidarum are stretch marks .
9. In the second trimester, a diabetic pregnant woman typically requires:
A) Decreased caloric intake
B) Increased caloric intake
C) Increased insulin
D) Decreased insulin
Answer: C
Rationale: In the second and third trimesters, insulin requirements typically increase
due to placental hormones (human placental lactogen, cortisol) that cause insulin
resistance. Women with pre-existing diabetes often need higher insulin doses during
this period. Caloric intake should be adjusted based on nutritional needs, not simply
increased or decreased .
10. Fetal testes descend into the scrotum between:
A) 8-12 weeks
B) 32-36 weeks
C) 28-32 weeks
D) 36-40 weeks
Answer: B
Rationale: The fetal testes descend from the abdomen into the scrotum between 32 and
36 weeks of gestation. This is why preterm male infants are at higher risk for
undescended testes. By term, both testes should be palpable in the scrotum in most
male newborns.
11. The nurse-midwife understands that the first stage of HIV infection, when the
virus establishes itself in the body, is:
A) Seroconversion
B) Latent or Asymptomatic
C) Symptomatic
D) Late HIV
MIDWIFERY FINAL EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
Midwifery Exam Questions with Detailed Rationales
SECTION 1: ANTEPARTUM CARE (Questions 1-20)
1. A woman at 32 weeks gestation is admitted with a diagnosis of severe pre-
eclampsia. Which of the following is a cardinal sign of impending eclampsia?
A) Weight loss and epigastric pain
B) Sharp rise in blood pressure and occipital headache
C) Sharp rise in blood pressure and decrease in proteinuria
D) Increase in proteinuria and frontal headache
Answer: B
Rationale: Signs of impending eclampsia include a sharp rise in blood pressure,
occipital or frontal headache, visual disturbances (blurring or diplopia), epigastric pain,
and hyperreflexia . These signs indicate worsening pre-eclampsia and increased risk of
seizures. Weight loss is not typical; proteinuria typically increases, not decreases.
2. A midwife is assessing a mother with cord presentation. Which finding would
confirm this diagnosis?
A) Cord in front of the presenting part and intact membranes
B) Cord in front of the presenting part and ruptured membranes
C) Excessive vaginal bleeding
D) Cord lying centrally on the internal cervical os
Answer: A
Rationale: Cord presentation occurs when the umbilical cord lies in front of the
presenting part with intact membranes. This is an obstetric emergency because when
membranes rupture, cord prolapse may occur, leading to cord compression and fetal
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compromise. Ruptured membranes with cord in front is cord prolapse, which is a more
advanced emergency.
3. A 16-year-old adolescent girl is refusing to consent for an emergency caesarean
section. This situation represents:
A) A breach of professional conduct
B) An ethical dilemma
C) A legal requirement for parental consent
D) A midwifery management issue
Answer: B
Rationale: An ethical dilemma arises when there is a conflict between ethical
principles—in this case, respect for the adolescent's autonomy versus beneficence
(protecting the fetus and mother from harm). This is a complex situation requiring
careful ethical reasoning, legal considerations, and multidisciplinary discussion .
4. Features of pre-eclampsia include:
A) Proteinuria, uterine contractions, blurred vision
B) Low blood pressure, convulsions, frontal headaches
C) Proteinuria, high blood pressure, edema
D) Vomiting, vaginal bleeding, uterine contractions
Answer: C
Rationale: Pre-eclampsia is characterized by new-onset hypertension (≥140/90 mmHg)
and proteinuria (≥300 mg/24 hours) after 20 weeks of gestation. Edema may also be
present, though it is no longer considered a diagnostic criterion. Headaches and visual
disturbances are signs of severe disease .
5. A woman is diagnosed with gestational diabetes mellitus at 13 weeks gestation.
Which of the following is a predisposing factor?
A) Maternal age under 25 years
B) Previous normal birth weight infant
C) Family history of diabetes
D) Low pre-pregnancy BMI
Answer: C
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Rationale: Risk factors for gestational diabetes include a family history of diabetes,
obesity (BMI ≥30), previous gestational diabetes, previous macrosomic baby (>4 kg),
polycystic ovary syndrome, and maternal age over 35 years . Early screening is indicated
for women with these risk factors.
6. The outer membrane of the fetal sac is the:
A) Ectoderm
B) Amnion
C) Placenta
D) Chorion
Answer: D
Rationale: The chorion is the outer fetal membrane that surrounds the amnion and
forms the fetal part of the placenta. It is derived from the trophoblast and mesoderm.
The amnion is the inner membrane that contains the amniotic fluid and fetus .
7. Skin and the nervous system develop from which germ layer?
A) Mesoderm
B) Endoderm
C) Yolk sac
D) Ectoderm
Answer: D
Rationale: The ectoderm is the outermost germ layer that gives rise to the skin
(epidermis, hair, nails) and the nervous system (brain, spinal cord, peripheral nerves).
The mesoderm gives rise to muscle, bone, and connective tissue; the endoderm gives
rise to internal organs such as the gastrointestinal tract and lungs.
8. During pregnancy, some women develop deeper, patchy coloring on the face
known as:
A) Chloasma
B) Linea nigra
C) Striae gravidarum
D) Eczema
Answer: A
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Rationale: Chloasma (melasma or "mask of pregnancy") is a hyperpigmentation
condition characterized by blotchy, brownish patches on the face. It is caused by
increased melanocyte-stimulating hormone and estrogen levels. Linea nigra is a dark
line on the abdomen, and striae gravidarum are stretch marks .
9. In the second trimester, a diabetic pregnant woman typically requires:
A) Decreased caloric intake
B) Increased caloric intake
C) Increased insulin
D) Decreased insulin
Answer: C
Rationale: In the second and third trimesters, insulin requirements typically increase
due to placental hormones (human placental lactogen, cortisol) that cause insulin
resistance. Women with pre-existing diabetes often need higher insulin doses during
this period. Caloric intake should be adjusted based on nutritional needs, not simply
increased or decreased .
10. Fetal testes descend into the scrotum between:
A) 8-12 weeks
B) 32-36 weeks
C) 28-32 weeks
D) 36-40 weeks
Answer: B
Rationale: The fetal testes descend from the abdomen into the scrotum between 32 and
36 weeks of gestation. This is why preterm male infants are at higher risk for
undescended testes. By term, both testes should be palpable in the scrotum in most
male newborns.
11. The nurse-midwife understands that the first stage of HIV infection, when the
virus establishes itself in the body, is:
A) Seroconversion
B) Latent or Asymptomatic
C) Symptomatic
D) Late HIV
