CNM (Certified Nurse-
Midwife) Exam Practice
Questions And Correct
Answers (Verified Answers)
Plus Rationale 2026 Q&A|
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1. A pregnant patient at 10 weeks' gestation asks when the
fetal cardiac activity can usually be detected by transvaginal
ultrasound. Which response is most accurate?
A. 3 weeks
B. 5–6 weeks
C. 8–9 weeks
D. 12 weeks
Answer: B. 5–6 weeks
Rationale: Embryonic cardiac activity is commonly detectable
by transvaginal ultrasound around 5–6 weeks' gestation.
2. Which hormone is primarily responsible for maintaining
the endometrium during early pregnancy?
A. FSH
B. LH
C. Progesterone
D. Prolactin
,Answer: C. Progesterone
Rationale: Progesterone maintains the decidualized
endometrium and supports early pregnancy.
3. A patient with a regular 28-day menstrual cycle reports the
first day of her last menstrual period was June 10. Using
Nägele's rule, what is the estimated date of birth?
A. March 3
B. March 17
C. March 24
D. April 10
Answer: B. March 17
Rationale: Add 7 days and subtract 3 months from the LMP,
then add 1 year.
4. Which finding is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive urine pregnancy test
C. Fetal cardiac activity identified by ultrasound
D. Breast tenderness
Answer: C. Fetal cardiac activity identified by ultrasound
Rationale: Positive signs are findings directly attributable to
the fetus, such as fetal cardiac activity, fetal movement
palpated by an examiner, or visualization of the fetus.
5. A pregnant patient at 20 weeks asks about normal
physiologic changes. Which finding is expected?
A. Decreased cardiac output
B. Increased plasma volume
,C. Decreased glomerular filtration rate
D. Decreased tidal volume
Answer: B. Increased plasma volume
Rationale: Plasma volume increases substantially during
pregnancy to support maternal and fetal circulation.
6. Which nutritional supplement is most important for
reducing the risk of neural tube defects?
A. Vitamin C
B. Vitamin D
C. Folic acid
D. Vitamin K
Answer: C. Folic acid
Rationale: Adequate folate before conception and during
early pregnancy substantially reduces neural tube defects.
7. A patient at 28 weeks' gestation has a fundal height of 28
cm. How should the CNM interpret this finding?
A. Consistent with expected growth
B. Suggestive of fetal growth restriction
C. Suggestive of polyhydramnios
D. Diagnostic of macrosomia
Answer: A. Consistent with expected growth
Rationale: From approximately 20–36 weeks, fundal height in
centimeters generally corresponds closely to gestational age.
8. Which vaccine is routinely recommended during
pregnancy to protect the newborn from pertussis?
A. MMR
B. Varicella
, C. Tdap
D. Live attenuated influenza vaccine
Answer: C. Tdap
Rationale: Tdap during each pregnancy helps provide passive
antibody protection to the newborn against pertussis.
9. Which vaccine is contraindicated during pregnancy?
A. Inactivated influenza vaccine
B. Tdap
C. Hepatitis B vaccine when indicated
D. MMR vaccine
Answer: D. MMR vaccine
Rationale: MMR is a live attenuated vaccine and is generally
contraindicated during pregnancy.
10. A pregnant patient reports urinary frequency during the
first trimester without dysuria or fever. What is the most
appropriate interpretation?
A. Normal physiologic change
B. Pyelonephritis
C. Diabetes mellitus
D. Placental abruption
Answer: A. Normal physiologic change
Rationale: Increased urinary frequency is common in early
pregnancy because of hormonal changes and increased renal
blood flow.
11. Which finding in pregnancy requires prompt evaluation
for preeclampsia?
A. Mild dependent edema
Midwife) Exam Practice
Questions And Correct
Answers (Verified Answers)
Plus Rationale 2026 Q&A|
Instant Download Pdf
1. A pregnant patient at 10 weeks' gestation asks when the
fetal cardiac activity can usually be detected by transvaginal
ultrasound. Which response is most accurate?
A. 3 weeks
B. 5–6 weeks
C. 8–9 weeks
D. 12 weeks
Answer: B. 5–6 weeks
Rationale: Embryonic cardiac activity is commonly detectable
by transvaginal ultrasound around 5–6 weeks' gestation.
2. Which hormone is primarily responsible for maintaining
the endometrium during early pregnancy?
A. FSH
B. LH
C. Progesterone
D. Prolactin
,Answer: C. Progesterone
Rationale: Progesterone maintains the decidualized
endometrium and supports early pregnancy.
3. A patient with a regular 28-day menstrual cycle reports the
first day of her last menstrual period was June 10. Using
Nägele's rule, what is the estimated date of birth?
A. March 3
B. March 17
C. March 24
D. April 10
Answer: B. March 17
Rationale: Add 7 days and subtract 3 months from the LMP,
then add 1 year.
4. Which finding is considered a positive sign of pregnancy?
A. Amenorrhea
B. Positive urine pregnancy test
C. Fetal cardiac activity identified by ultrasound
D. Breast tenderness
Answer: C. Fetal cardiac activity identified by ultrasound
Rationale: Positive signs are findings directly attributable to
the fetus, such as fetal cardiac activity, fetal movement
palpated by an examiner, or visualization of the fetus.
5. A pregnant patient at 20 weeks asks about normal
physiologic changes. Which finding is expected?
A. Decreased cardiac output
B. Increased plasma volume
,C. Decreased glomerular filtration rate
D. Decreased tidal volume
Answer: B. Increased plasma volume
Rationale: Plasma volume increases substantially during
pregnancy to support maternal and fetal circulation.
6. Which nutritional supplement is most important for
reducing the risk of neural tube defects?
A. Vitamin C
B. Vitamin D
C. Folic acid
D. Vitamin K
Answer: C. Folic acid
Rationale: Adequate folate before conception and during
early pregnancy substantially reduces neural tube defects.
7. A patient at 28 weeks' gestation has a fundal height of 28
cm. How should the CNM interpret this finding?
A. Consistent with expected growth
B. Suggestive of fetal growth restriction
C. Suggestive of polyhydramnios
D. Diagnostic of macrosomia
Answer: A. Consistent with expected growth
Rationale: From approximately 20–36 weeks, fundal height in
centimeters generally corresponds closely to gestational age.
8. Which vaccine is routinely recommended during
pregnancy to protect the newborn from pertussis?
A. MMR
B. Varicella
, C. Tdap
D. Live attenuated influenza vaccine
Answer: C. Tdap
Rationale: Tdap during each pregnancy helps provide passive
antibody protection to the newborn against pertussis.
9. Which vaccine is contraindicated during pregnancy?
A. Inactivated influenza vaccine
B. Tdap
C. Hepatitis B vaccine when indicated
D. MMR vaccine
Answer: D. MMR vaccine
Rationale: MMR is a live attenuated vaccine and is generally
contraindicated during pregnancy.
10. A pregnant patient reports urinary frequency during the
first trimester without dysuria or fever. What is the most
appropriate interpretation?
A. Normal physiologic change
B. Pyelonephritis
C. Diabetes mellitus
D. Placental abruption
Answer: A. Normal physiologic change
Rationale: Increased urinary frequency is common in early
pregnancy because of hormonal changes and increased renal
blood flow.
11. Which finding in pregnancy requires prompt evaluation
for preeclampsia?
A. Mild dependent edema
