Certified Midwife Exam Prep Intrapartum Management & Labor Support

Question 1

A patient in active labor has a Category II fetal heart rate tracing. What is the midwife's priority action?

Accepted Answer

Apply intrauterine resuscitation measures and continue monitoring

Answer

Immediately prepare for cesarean delivery

Answer

Document and reassess in 30 minutes without intervention

Answer

Administer oxytocin augmentation

Question 2

Which Bishop score indicates a favorable cervix for labor induction?

Accepted Answer

Score ≥8

Answer

Score ≤3

Answer

Score 4–5

Answer

Score 6–7

Question 3

Which fetal heart rate pattern is most reassuring during active labor?

Accepted Answer

Early decelerations with moderate variability

Answer

Late decelerations with moderate variability

Answer

Variable decelerations without return to baseline

Answer

Prolonged deceleration lasting 4 minutes

Question 4

A laboring patient at 7 cm dilation suddenly reports a severe, tearing abdominal pain with cessation of contractions and fetal bradycardia. What is the most likely diagnosis?

Accepted Answer

Uterine rupture

Answer

Placental abruption

Answer

Cord prolapse

Answer

Amniotic fluid embolism

Question 5

What is the recommended maximum dose of oxytocin for labor augmentation according to standard low-dose protocols?

Accepted Answer

20 mU/min

Answer

10 mU/min

Answer

40 mU/min

Answer

60 mU/min

Question 6

Cord prolapse is identified in a patient at 9 cm dilation. What is the immediate management priority?

Accepted Answer

Prepare for emergency cesarean and elevate the presenting part off the cord

Answer

Apply firm fundal pressure to expedite vaginal delivery

Answer

Administer tocolytics and reassess in 10 minutes

Answer

Place the patient in Trendelenburg and push the cord back