Certified Midwife Exam Prep Antepartum Care & Prenatal Assessment 1 — Questions and Answers
Question 1: At what gestational age is a first-trimester ultrasound most accurate for dating a pregnancy?
- 6–10 weeks
- 11–14 weeks (Correct answer)
- 15–18 weeks
- 20–24 weeks
Correct answer: 11–14 weeks
An ultrasound at 11–14 weeks provides the most accurate gestational dating due to the predictable size of the fetus at that stage.
Question 2: Which lab value is routinely checked at the initial prenatal visit to screen for anemia in pregnant patients?
- Serum ferritin only
- Complete blood count (CBC) (Correct answer)
- Reticulocyte count
- Hemoglobin electrophoresis
Correct answer: Complete blood count (CBC)
A CBC is obtained at the first prenatal visit to establish baseline hemoglobin and hematocrit and screen for anemia.
Question 3: A certified midwife is counseling a patient at 16 weeks gestation. Which screening test is typically offered between 15–20 weeks?
- Cell-free fetal DNA
- Quad screen (Correct answer)
- Group B Streptococcus culture
- Glucose challenge test
Correct answer: Quad screen
The quad screen (AFP, hCG, estriol, inhibin A) is a second-trimester maternal serum screen offered between 15–20 weeks.
Question 4: Which finding on fundal height measurement at 28 weeks would prompt further evaluation?
- 28 cm
- 26 cm
- 22 cm (Correct answer)
- 29 cm
Correct answer: 22 cm
Fundal height more than 3 cm below expected gestational age (i.e., ≤25 cm at 28 weeks) suggests intrauterine growth restriction and warrants ultrasound.
Question 5: What is the recommended daily folic acid supplementation dose for a low-risk pregnant patient to prevent neural tube defects?
- 0.4 mg (Correct answer)
- 1 mg
- 4 mg
- 10 mg
Correct answer: 0.4 mg
The standard recommendation for low-risk pregnancies is 0.4 mg (400 mcg) of folic acid daily, ideally starting before conception.
Question 6: A patient at 10 weeks gestation presents with painless vaginal bleeding and an open cervical os. Which term best describes this presentation?
- Threatened abortion
- Inevitable abortion (Correct answer)
- Missed abortion
- Complete abortion
Correct answer: Inevitable abortion
An inevitable abortion is characterized by an open cervical os with bleeding, indicating the pregnancy cannot be retained.
Certified Midwife Exam Prep Antepartum Care & Prenatal Assessment 1
At what gestational age is a first-trimester ultrasound most accurate for dating a pregnancy?