MIDWIFERY COMPREHENSIVE EXAM 2026
CERTIFICATION EVALUATION TEST PAPER
QUESTIONS SOLUTIONS GRADED A PLUS
◉ Name two prevention techniques for nocturnal leg cramps
Answer: Hydration, stretching, avoid long periods of sitting or
standing, warm baths, exercise
◉ What is the most important differential diagnosis to rule out
when a pregnant patient comes in with complaints of leg cramping?
Answer: Deep Vein Thrombosis:
Look for warm red tender swollen leg.
◉ Conflicting evidence supports taking which supplement for leg
cramps ?
Answer: Magnesium
◉ True or false. Women with NVP have lower rates of preterm
births, low birth weight babies, congenital anomalies, and stillbirths.
Answer: True
◉ How does progesterone contribute to NVP?
,Answer: Slows peristalsis and gastric emptying
◉ If dietary measures, lifestyle changes, and OTC remedies do not
help with NVP, what medicine has shown to be effective with NVP?
Answer: Antiemetics such Zofran (Ondansetron). Note: Not
mentioned in Varney's
◉ True of False. Effective therapy for NVP will always remain the
same for a woman throughout her pregnancy and subsequent
pregnancies.
Answer: False. Effectiveness of therapy may fluctuate over the
course of pregnancy and varies greatly from pregnancy to
pregnancy.
◉ True or False. To combat nausea during pregnancy, one should
brush their teeth immediately after they eat.
Answer: False. Brushing your teeth can stimulate the gag reflex,
aggravating nausea and vomiting.
◉ What pre-existing conditions can contribute to NVP?
Answer: H. pylori and GERD
◉ What is the most important differential diagnosis to rule out with
leg cramps during pregnancy?
,Answer: Deep vein thrombosis
◉ True/false: Leg cramps during pregnancy are not normal and
should be reported immediately to provider.
Answer: False. Leg cramps are completely normal during pregnancy
and occur more frequently during the 2nd and 3rd trimesters.
◉ How can your pregnant patient prevent leg cramps (select all that
apply)?
a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time
Answer: A, B, C, D
◉ True/false: Dorsiflexion of the affected foot when a cramp begins
helps to alleviate the pain.
Answer: True
◉ True/false: Magnesium supplements have been found to help with
leg cramps.
, Answer: False. Research is mixed and taking magnesium
supplements seem to have little effect on preventing leg cramps in
pregnant women.
◉ True or False: Back pain may be a sign of preterm labor only if
cramping is present.
Answer: False: Cramping may or may not accompany preterm labor.
◉ What are some of the contributing factors causing back pain
during pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
D. All of the above
Answer: D
◉ True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief.
Answer: False: One study found that 60% of women reported a
decrease in back pain after receiving acupuncture.
◉ True or False: It is safe to receive chiropractic manipulation
during pregnancy.
CERTIFICATION EVALUATION TEST PAPER
QUESTIONS SOLUTIONS GRADED A PLUS
◉ Name two prevention techniques for nocturnal leg cramps
Answer: Hydration, stretching, avoid long periods of sitting or
standing, warm baths, exercise
◉ What is the most important differential diagnosis to rule out
when a pregnant patient comes in with complaints of leg cramping?
Answer: Deep Vein Thrombosis:
Look for warm red tender swollen leg.
◉ Conflicting evidence supports taking which supplement for leg
cramps ?
Answer: Magnesium
◉ True or false. Women with NVP have lower rates of preterm
births, low birth weight babies, congenital anomalies, and stillbirths.
Answer: True
◉ How does progesterone contribute to NVP?
,Answer: Slows peristalsis and gastric emptying
◉ If dietary measures, lifestyle changes, and OTC remedies do not
help with NVP, what medicine has shown to be effective with NVP?
Answer: Antiemetics such Zofran (Ondansetron). Note: Not
mentioned in Varney's
◉ True of False. Effective therapy for NVP will always remain the
same for a woman throughout her pregnancy and subsequent
pregnancies.
Answer: False. Effectiveness of therapy may fluctuate over the
course of pregnancy and varies greatly from pregnancy to
pregnancy.
◉ True or False. To combat nausea during pregnancy, one should
brush their teeth immediately after they eat.
Answer: False. Brushing your teeth can stimulate the gag reflex,
aggravating nausea and vomiting.
◉ What pre-existing conditions can contribute to NVP?
Answer: H. pylori and GERD
◉ What is the most important differential diagnosis to rule out with
leg cramps during pregnancy?
,Answer: Deep vein thrombosis
◉ True/false: Leg cramps during pregnancy are not normal and
should be reported immediately to provider.
Answer: False. Leg cramps are completely normal during pregnancy
and occur more frequently during the 2nd and 3rd trimesters.
◉ How can your pregnant patient prevent leg cramps (select all that
apply)?
a. Walking or other exercise
b. Drink plenty of water
c. Stretch before bed
d. Taking a warm bath
e. Sitting for long periods of time
Answer: A, B, C, D
◉ True/false: Dorsiflexion of the affected foot when a cramp begins
helps to alleviate the pain.
Answer: True
◉ True/false: Magnesium supplements have been found to help with
leg cramps.
, Answer: False. Research is mixed and taking magnesium
supplements seem to have little effect on preventing leg cramps in
pregnant women.
◉ True or False: Back pain may be a sign of preterm labor only if
cramping is present.
Answer: False: Cramping may or may not accompany preterm labor.
◉ What are some of the contributing factors causing back pain
during pregnancy?
A. The weight of a growing uterus
B. A shift in her center of gravity
C. Relaxation of sacroiliac ligaments
D. All of the above
Answer: D
◉ True or False: Acupuncture is a holistic method that has not been
correlated with effective pain relief.
Answer: False: One study found that 60% of women reported a
decrease in back pain after receiving acupuncture.
◉ True or False: It is safe to receive chiropractic manipulation
during pregnancy.
