NARM STUDY QUESTIONS (THE
700 SET QUESTION NARM STUDY
GUIDE) VERIFIED ANSWERS 2026
UPDATE 100% CORRECT -
NARM STUDY QUESTIONS (THE 700 SET QUESTION |
Comprehensive Examination
NARM STUDY QUESTIONS (THE 700 SET QUESTION
NARM STUDY GUIDE) VERIFIED ANSWERS 2026
UPDATE 100% CORRECT - MIDWIVES COLLEGE OF
INTRODUCTION
This document is an important and very helpful preparation
resource for NARM STUDY QUESTIONS (THE 700 SET
QUESTION NARM STUDY GUIDE) VERIFIED ANSWERS
2026 UPDATE 100% CORRECT - MIDWIVES COLLEGE OF
UTAH. Every item uses a focused exam stem, four response
options, a keyed response, and a clear rationale, making it
easier to understand the subject, spot distractors, and build real
exam confidence.
Page 1
, Question 1
A primigravida at 41 weeks presents with spontaneous rupture of membranes
and clear fluid; cervical exam is 2 cm/50%/-2. Which combination of findings
would most strongly indicate the need for immediate transfer of care rather
than continued out-of-hospital management?
A. Meconium-stained fluid with a Category I FHR tracing and 3 cm
dilation after 4 hours
B. Persistent late decelerations with minimal variability despite maternal
repositioning and IV fluid bolus
C. Contractions every 3-4 minutes with moderate variability and
accelerations present
D. Arrest of dilation at 6 cm for 2 hours with adequate contractions and
reassuring FHR
Correct Answer: B - Persistent late decelerations with minimal
variability despite maternal repositioning and IV fluid bolus
RATIONALE
Persistent late decelerations with minimal variability indicate
uteroplacental insufficiency and fetal hypoxemia, requiring immediate
obstetric intervention. Options A, C, and D represent either reassuring
or manageable findings that do not mandate immediate transfer per
ACOG/NARM guidelines.
Question 2
Which statement best reflects the current evidence regarding delayed cord
clamping in term and preterm neonates, and how should a midwife integrate
this into practice?
A. Delayed clamping for 30-60 seconds is recommended for term infants
only; preterm infants benefit from immediate clamping to reduce
jaundice.
B. Delayed clamping for at least 30-60 seconds is recommended for both
Page 2
, term and preterm infants, improving iron stores and reducing
intraventricular hemorrhage in preterm infants.
C. Delayed clamping increases the risk of polycythemia and should be
avoided in all neonates requiring resuscitation.
D. Delayed clamping has no significant benefit in high-resource settings
and is not recommended by ACOG.
Correct Answer: B - Delayed clamping for at least 30-60 seconds
is recommended for both term and preterm infants, improving
iron stores and reducing intraventricular hemorrhage in preterm
infants.
RATIONALE
ACOG and WHO recommend delayed cord clamping for at least
30-60 seconds for both term and preterm infants, with evidence of
improved iron status and reduced IVH in preterm infants. Immediate
clamping is not supported, and delayed clamping is compatible with
resuscitation when needed.
Question 3
A client at 28 weeks presents with a fundal height of 24 cm and a history of
two prior first-trimester losses. Which combination of findings would most
increase suspicion for a condition requiring referral for targeted ultrasound and
possible cerclage?
A. Fundal height lag with normal fetal movement and no cervical changes
B. Shortened cervix (<25 mm) on transvaginal ultrasound with funneling
and prior second-trimester loss
C. Fundal height lag with normal amniotic fluid and no prior pregnancy
losses
D. Normal cervical length with history of two first-trimester losses and no
current symptoms
Correct Answer: B - Shortened cervix (<25 mm) on transvaginal
Page 3
, ultrasound with funneling and prior second-trimester loss
RATIONALE
A shortened cervix with funneling and a history of second-trimester
loss is classic for cervical insufficiency, warranting cerclage
consideration. Fundal height lag alone or first-trimester losses without
cervical changes do not meet criteria for cerclage.
Question 4
Which of the following best explains the physiologic rationale for using a
hands-and-knees position during labor when a persistent occiput posterior
position is suspected?
A. It increases pelvic outlet diameter by 1-2 cm through sacral nutation.
B. It reduces pressure on the vena cava and improves placental perfusion.
C. It uses gravity to encourage fetal rotation by altering the angle of the
pelvic inlet and reducing lumbar lordosis.
D. It decreases uterine contractility to allow fetal descent.
Correct Answer: C - It uses gravity to encourage fetal rotation by
altering the angle of the pelvic inlet and reducing lumbar lordosis.
RATIONALE
The hands-and-knees position can facilitate fetal rotation by changing
the pelvic inlet angle and reducing lumbar lordosis, which may
dislodge a persistently posterior fetal head. Options A and B describe
other mechanisms not specific to rotation, and D is incorrect as it
would not promote descent.
Question 5
A postpartum client at 24 hours post-vaginal delivery has a hematocrit drop
from 34% to 26%, heart rate 118, BP 98/60, and reports dizziness. Which
finding is most consistent with a delayed postpartum hemorrhage secondary to
uterine atony?
Page 4
700 SET QUESTION NARM STUDY
GUIDE) VERIFIED ANSWERS 2026
UPDATE 100% CORRECT -
NARM STUDY QUESTIONS (THE 700 SET QUESTION |
Comprehensive Examination
NARM STUDY QUESTIONS (THE 700 SET QUESTION
NARM STUDY GUIDE) VERIFIED ANSWERS 2026
UPDATE 100% CORRECT - MIDWIVES COLLEGE OF
INTRODUCTION
This document is an important and very helpful preparation
resource for NARM STUDY QUESTIONS (THE 700 SET
QUESTION NARM STUDY GUIDE) VERIFIED ANSWERS
2026 UPDATE 100% CORRECT - MIDWIVES COLLEGE OF
UTAH. Every item uses a focused exam stem, four response
options, a keyed response, and a clear rationale, making it
easier to understand the subject, spot distractors, and build real
exam confidence.
Page 1
, Question 1
A primigravida at 41 weeks presents with spontaneous rupture of membranes
and clear fluid; cervical exam is 2 cm/50%/-2. Which combination of findings
would most strongly indicate the need for immediate transfer of care rather
than continued out-of-hospital management?
A. Meconium-stained fluid with a Category I FHR tracing and 3 cm
dilation after 4 hours
B. Persistent late decelerations with minimal variability despite maternal
repositioning and IV fluid bolus
C. Contractions every 3-4 minutes with moderate variability and
accelerations present
D. Arrest of dilation at 6 cm for 2 hours with adequate contractions and
reassuring FHR
Correct Answer: B - Persistent late decelerations with minimal
variability despite maternal repositioning and IV fluid bolus
RATIONALE
Persistent late decelerations with minimal variability indicate
uteroplacental insufficiency and fetal hypoxemia, requiring immediate
obstetric intervention. Options A, C, and D represent either reassuring
or manageable findings that do not mandate immediate transfer per
ACOG/NARM guidelines.
Question 2
Which statement best reflects the current evidence regarding delayed cord
clamping in term and preterm neonates, and how should a midwife integrate
this into practice?
A. Delayed clamping for 30-60 seconds is recommended for term infants
only; preterm infants benefit from immediate clamping to reduce
jaundice.
B. Delayed clamping for at least 30-60 seconds is recommended for both
Page 2
, term and preterm infants, improving iron stores and reducing
intraventricular hemorrhage in preterm infants.
C. Delayed clamping increases the risk of polycythemia and should be
avoided in all neonates requiring resuscitation.
D. Delayed clamping has no significant benefit in high-resource settings
and is not recommended by ACOG.
Correct Answer: B - Delayed clamping for at least 30-60 seconds
is recommended for both term and preterm infants, improving
iron stores and reducing intraventricular hemorrhage in preterm
infants.
RATIONALE
ACOG and WHO recommend delayed cord clamping for at least
30-60 seconds for both term and preterm infants, with evidence of
improved iron status and reduced IVH in preterm infants. Immediate
clamping is not supported, and delayed clamping is compatible with
resuscitation when needed.
Question 3
A client at 28 weeks presents with a fundal height of 24 cm and a history of
two prior first-trimester losses. Which combination of findings would most
increase suspicion for a condition requiring referral for targeted ultrasound and
possible cerclage?
A. Fundal height lag with normal fetal movement and no cervical changes
B. Shortened cervix (<25 mm) on transvaginal ultrasound with funneling
and prior second-trimester loss
C. Fundal height lag with normal amniotic fluid and no prior pregnancy
losses
D. Normal cervical length with history of two first-trimester losses and no
current symptoms
Correct Answer: B - Shortened cervix (<25 mm) on transvaginal
Page 3
, ultrasound with funneling and prior second-trimester loss
RATIONALE
A shortened cervix with funneling and a history of second-trimester
loss is classic for cervical insufficiency, warranting cerclage
consideration. Fundal height lag alone or first-trimester losses without
cervical changes do not meet criteria for cerclage.
Question 4
Which of the following best explains the physiologic rationale for using a
hands-and-knees position during labor when a persistent occiput posterior
position is suspected?
A. It increases pelvic outlet diameter by 1-2 cm through sacral nutation.
B. It reduces pressure on the vena cava and improves placental perfusion.
C. It uses gravity to encourage fetal rotation by altering the angle of the
pelvic inlet and reducing lumbar lordosis.
D. It decreases uterine contractility to allow fetal descent.
Correct Answer: C - It uses gravity to encourage fetal rotation by
altering the angle of the pelvic inlet and reducing lumbar lordosis.
RATIONALE
The hands-and-knees position can facilitate fetal rotation by changing
the pelvic inlet angle and reducing lumbar lordosis, which may
dislodge a persistently posterior fetal head. Options A and B describe
other mechanisms not specific to rotation, and D is incorrect as it
would not promote descent.
Question 5
A postpartum client at 24 hours post-vaginal delivery has a hematocrit drop
from 34% to 26%, heart rate 118, BP 98/60, and reports dizziness. Which
finding is most consistent with a delayed postpartum hemorrhage secondary to
uterine atony?
Page 4
