Page 1 of 98
VARNEY'S MIDWIFERY, SEVENTH EDITION (PHILLIPPI &
KANTROWITZ-GORDON) EXAM GUIDE AND CORRECT ANSWERS
LATEST EDITION 2026
Part I: Midwifery
Chapter 1: Context of Individuals Seeking Midwifery Care
Question 1: A 24-year-old individual presents for an annual wellness exam. During the history,
she reveals a history of intimate partner violence (IPV). According to trauma-informed care
principles, what is the most appropriate immediate response by the midwife?
A. Document the disclosure, immediately call law enforcement, and provide emergency shelter
contact numbers
B. Validate the disclosure, assess immediate safety, and offer a supportive, nonjudgmental
choice of resources
C. Initiate an immediate psychological consult and contact a social worker to escort the patient
D. Advise the patient on relationship strategies to de-escalate potential conflicts at home
Correct Answer: B
Rationale: Trauma-informed care emphasizes patient autonomy, safety, and empowerment.
Validating the patient's experience and assessing immediate danger respects their agency
without forcing a path of action. Calling law enforcement without consent can escalate danger,
and advising the patient to manage the abuser's behavior shifts responsibility to the victim.
Question 2: A nurse-midwife is conducting genetic counseling with an Ashkenazi Jewish
couple. Which autosomal recessive genetic disease should the midwife discuss with this
couple?
A. Thalassemia
B. Cystic fibrosis
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C. Sickle cell disease
D. Tay-Sachs disease
Correct Answer: D
Rationale: Tay-Sachs disease is an autosomal recessive condition that is more prevalent in
individuals of Ashkenazi Jewish descent. Genetic screening and counseling for this population is
a standard part of preconception and prenatal care.
Question 3: Which patient population has the greatest risk for giving birth to a newborn with
trisomy 21?
A. A 25-year-old Black patient of African descent
B. A 30-year-old white patient of Northern European descent
C. A 35-year-old Black patient of African descent
D. A 40-year-old white patient of Northern European descent
Correct Answer: D
Rationale: Advanced maternal age (≥35 years) is the most significant risk factor for trisomy 21,
regardless of race or ethnicity. Risk increases with maternal age.
Question 4: The nurse-midwife is providing prenatal care to a patient who is diagnosed with
cytomegalovirus (CMV) infection. Which birth defect should the midwife include when
educating the patient on the consequences of this infection?
A. Deafness
B. Microcephaly
C. Hydrocephaly
D. Chorioretinitis
Correct Answer: B
Rationale: Congenital CMV infection is a leading cause of birth defects, with microcephaly being
a significant consequence. Patient education should include potential neurological and
developmental impacts.
Question 5: Which of the following best describes the concept of cultural humility in
midwifery practice?
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A. Memorizing the cultural practices of all patient populations
B. A lifelong commitment to self-evaluation and self-critique, addressing power imbalances, and
developing mutually beneficial partnerships with patients
C. Providing identical care to all patients regardless of cultural background
D. Avoiding discussions of culture to prevent bias
Correct Answer: B
Rationale: Cultural humility is a lifelong commitment to self-evaluation and self-critique,
addressing power imbalances in the patient-provider relationship, and developing mutually
beneficial partnerships with patients and communities.
Question 6: A midwife is caring for a patient from a culture that practices female genital
cutting (FGC). Which of the following is the most appropriate approach?
A. Report the family to law enforcement immediately
B. Provide culturally sensitive care, including education about the health consequences of FGC,
without judgment
C. Refuse to provide care to the patient
D. Perform the procedure if requested by the family
Correct Answer: B
Rationale: Midwives should provide culturally sensitive, nonjudgmental care to patients who
have experienced FGC, including education about health consequences, while respecting the
patient's autonomy and cultural background.
Question 7: Which of the following is a key principle of patient-centered care in midwifery?
A. The midwife makes all decisions for the patient
B. Care is organized around the patient's values, preferences, and needs
C. Care is standardized for all patients regardless of individual circumstances
D. The midwife avoids discussing treatment options to prevent confusion
Correct Answer: B
Rationale: Patient-centered care is organized around the patient's values, preferences, and
needs, ensuring that care is respectful of and responsive to individual patient preferences.
Question 8: A midwife is working with a community that has limited access to prenatal care.
Which of the following strategies would best address this barrier?
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A. Requiring patients to travel to a centralized clinic
B. Establishing mobile prenatal clinics or telehealth services in the community
C. Reducing the number of prenatal visits
D. Referring all patients to obstetricians
Correct Answer: B
Rationale: Establishing mobile prenatal clinics or telehealth services in the community directly
addresses geographic and access barriers, making prenatal care more accessible to underserved
populations.
Question 9: Which of the following best describes the concept of social determinants of
health?
A. Genetic factors that influence health outcomes
B. Conditions in which people are born, grow, live, work, and age that affect health outcomes
C. Individual behaviors that influence health
D. Medical treatments that improve health
Correct Answer: B
Rationale: Social determinants of health are the conditions in which people are born, grow, live,
work, and age, including factors such as housing, education, income, and neighborhood safety,
which significantly influence health outcomes.
Question 10: A midwife is providing care to a patient who is uninsured. Which of the
following resources would be most appropriate to connect the patient with?
A. A private insurance broker
B. Medicaid or CHIP, if eligible
C. A hospital emergency department
D. A specialist who does not accept insurance
Correct Answer: B
Rationale: Medicaid or CHIP provides health coverage for low-income individuals and families,
making it the most appropriate resource for uninsured patients who may be eligible.
Chapter 2: Professional Foundations of Midwifery
4|Page
VARNEY'S MIDWIFERY, SEVENTH EDITION (PHILLIPPI &
KANTROWITZ-GORDON) EXAM GUIDE AND CORRECT ANSWERS
LATEST EDITION 2026
Part I: Midwifery
Chapter 1: Context of Individuals Seeking Midwifery Care
Question 1: A 24-year-old individual presents for an annual wellness exam. During the history,
she reveals a history of intimate partner violence (IPV). According to trauma-informed care
principles, what is the most appropriate immediate response by the midwife?
A. Document the disclosure, immediately call law enforcement, and provide emergency shelter
contact numbers
B. Validate the disclosure, assess immediate safety, and offer a supportive, nonjudgmental
choice of resources
C. Initiate an immediate psychological consult and contact a social worker to escort the patient
D. Advise the patient on relationship strategies to de-escalate potential conflicts at home
Correct Answer: B
Rationale: Trauma-informed care emphasizes patient autonomy, safety, and empowerment.
Validating the patient's experience and assessing immediate danger respects their agency
without forcing a path of action. Calling law enforcement without consent can escalate danger,
and advising the patient to manage the abuser's behavior shifts responsibility to the victim.
Question 2: A nurse-midwife is conducting genetic counseling with an Ashkenazi Jewish
couple. Which autosomal recessive genetic disease should the midwife discuss with this
couple?
A. Thalassemia
B. Cystic fibrosis
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,Page 2 of 98
C. Sickle cell disease
D. Tay-Sachs disease
Correct Answer: D
Rationale: Tay-Sachs disease is an autosomal recessive condition that is more prevalent in
individuals of Ashkenazi Jewish descent. Genetic screening and counseling for this population is
a standard part of preconception and prenatal care.
Question 3: Which patient population has the greatest risk for giving birth to a newborn with
trisomy 21?
A. A 25-year-old Black patient of African descent
B. A 30-year-old white patient of Northern European descent
C. A 35-year-old Black patient of African descent
D. A 40-year-old white patient of Northern European descent
Correct Answer: D
Rationale: Advanced maternal age (≥35 years) is the most significant risk factor for trisomy 21,
regardless of race or ethnicity. Risk increases with maternal age.
Question 4: The nurse-midwife is providing prenatal care to a patient who is diagnosed with
cytomegalovirus (CMV) infection. Which birth defect should the midwife include when
educating the patient on the consequences of this infection?
A. Deafness
B. Microcephaly
C. Hydrocephaly
D. Chorioretinitis
Correct Answer: B
Rationale: Congenital CMV infection is a leading cause of birth defects, with microcephaly being
a significant consequence. Patient education should include potential neurological and
developmental impacts.
Question 5: Which of the following best describes the concept of cultural humility in
midwifery practice?
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,Page 3 of 98
A. Memorizing the cultural practices of all patient populations
B. A lifelong commitment to self-evaluation and self-critique, addressing power imbalances, and
developing mutually beneficial partnerships with patients
C. Providing identical care to all patients regardless of cultural background
D. Avoiding discussions of culture to prevent bias
Correct Answer: B
Rationale: Cultural humility is a lifelong commitment to self-evaluation and self-critique,
addressing power imbalances in the patient-provider relationship, and developing mutually
beneficial partnerships with patients and communities.
Question 6: A midwife is caring for a patient from a culture that practices female genital
cutting (FGC). Which of the following is the most appropriate approach?
A. Report the family to law enforcement immediately
B. Provide culturally sensitive care, including education about the health consequences of FGC,
without judgment
C. Refuse to provide care to the patient
D. Perform the procedure if requested by the family
Correct Answer: B
Rationale: Midwives should provide culturally sensitive, nonjudgmental care to patients who
have experienced FGC, including education about health consequences, while respecting the
patient's autonomy and cultural background.
Question 7: Which of the following is a key principle of patient-centered care in midwifery?
A. The midwife makes all decisions for the patient
B. Care is organized around the patient's values, preferences, and needs
C. Care is standardized for all patients regardless of individual circumstances
D. The midwife avoids discussing treatment options to prevent confusion
Correct Answer: B
Rationale: Patient-centered care is organized around the patient's values, preferences, and
needs, ensuring that care is respectful of and responsive to individual patient preferences.
Question 8: A midwife is working with a community that has limited access to prenatal care.
Which of the following strategies would best address this barrier?
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, Page 4 of 98
A. Requiring patients to travel to a centralized clinic
B. Establishing mobile prenatal clinics or telehealth services in the community
C. Reducing the number of prenatal visits
D. Referring all patients to obstetricians
Correct Answer: B
Rationale: Establishing mobile prenatal clinics or telehealth services in the community directly
addresses geographic and access barriers, making prenatal care more accessible to underserved
populations.
Question 9: Which of the following best describes the concept of social determinants of
health?
A. Genetic factors that influence health outcomes
B. Conditions in which people are born, grow, live, work, and age that affect health outcomes
C. Individual behaviors that influence health
D. Medical treatments that improve health
Correct Answer: B
Rationale: Social determinants of health are the conditions in which people are born, grow, live,
work, and age, including factors such as housing, education, income, and neighborhood safety,
which significantly influence health outcomes.
Question 10: A midwife is providing care to a patient who is uninsured. Which of the
following resources would be most appropriate to connect the patient with?
A. A private insurance broker
B. Medicaid or CHIP, if eligible
C. A hospital emergency department
D. A specialist who does not accept insurance
Correct Answer: B
Rationale: Medicaid or CHIP provides health coverage for low-income individuals and families,
making it the most appropriate resource for uninsured patients who may be eligible.
Chapter 2: Professional Foundations of Midwifery
4|Page
