AMCB Certified Midwife (CM) Certification Examination — Questions and Answers

Question 1: Which maternal condition is an absolute contraindication to air travel after 36 weeks gestation?

Mild gestational hypertension
Hypothyroidism on levothyroxine
Iron-deficiency anemia
Placenta previa (Correct answer)

Correct answer: Placenta previa

Placenta previa is an absolute contraindication to air travel after 36 weeks due to the risk of hemorrhage and emergency delivery.

Question 2: According to NARM standards, which of the following is within the CPM's scope of practice for newborn care?

Administering IV antibiotics for suspected neonatal sepsis
Suturing a significant perineal laceration requiring general anesthesia
Performing a neonatal intubation for respiratory distress
Administering vitamin K prophylaxis (Correct answer)

Correct answer: Administering vitamin K prophylaxis

Vitamin K prophylaxis (intramuscular injection) is a standard CPM newborn care procedure within scope of practice.

Question 3: A patient is 41 weeks gestation with intact membranes and Bishop score of 4. Which cervical ripening agent is most commonly used?

Misoprostol (PGE1)
IV oxytocin
Dinoprostone (PGE2) gel (Correct answer)
Mechanical Foley catheter balloon

Correct answer: Dinoprostone (PGE2) gel

Dinoprostone (PGE2) gel or insert is a commonly used pharmacological cervical ripening agent for unfavorable cervices prior to oxytocin induction.

Question 4: What is the recommended timing for the routine postpartum visit, per ACOG's updated guidelines?

Only if the patient has complications
Within 3 weeks, with a comprehensive visit by 12 weeks (Correct answer)
6 weeks postpartum only
At 2 weeks postpartum only

Correct answer: Within 3 weeks, with a comprehensive visit by 12 weeks

ACOG recommends an initial contact within 3 weeks postpartum and a comprehensive postpartum visit no later than 12 weeks after birth.

Question 5: Why is evidence-based practice important in Certified Midwife Exam Prep?

It is a theoretical concept only
It replaces experience
It only applies to academic settings
It integrates best available evidence with professional expertise for optimal outcomes (Correct answer)

Correct answer: It integrates best available evidence with professional expertise for optimal outcomes

This is fundamental to Certified Midwife Exam Prep practice. It integrates best available evidence with professional expertise for optimal outcomes represents the professional standard for research in the Certified Midwife Exam Prep certification framework.

Question 6: Which contraceptive method is safe to initiate immediately postpartum in a breastfeeding patient?

Progestin-only pills (mini-pill) (Correct answer)
Combined vaginal ring
Combined hormonal patch
Combined oral contraceptive pills

Correct answer: Progestin-only pills (mini-pill)

Progestin-only methods are safe for breastfeeding patients immediately postpartum as they do not suppress lactation unlike combined estrogen-progestin methods.

Question 7: What is reflective practice in Certified Midwife Exam Prep professional development?

Avoiding past mistakes
Systematically examining experiences to gain insight and improve future practice (Correct answer)
Writing personal diaries
Only reflecting on successes

Correct answer: Systematically examining experiences to gain insight and improve future practice

This is fundamental to Certified Midwife Exam Prep practice. Systematically examining experiences to gain insight and improve future practice represents the professional standard for practical in the Certified Midwife Exam Prep certification framework.

Question 8: A postpartum patient on day 3 reports a temperature of 38.4°C (101.1°F). Which source of fever is most common in the first 24 hours postpartum?

Urinary tract infection
Breast engorgement/mastitis
Physiologic milk fever (Correct answer)
Endometritis

Correct answer: Physiologic milk fever

A low-grade temperature spike in the first 24 hours postpartum is often attributed to physiologic milk fever or normal inflammatory response, not infection.

Question 9: How should Certified Midwife Exam Prep professionals evaluate new technology tools?

Assess functionality, reliability, security, cost-effectiveness, and alignment with professional needs (Correct answer)
Wait until competitors adopt first
Avoid all new technology
Adopt all new technology immediately

Correct answer: Assess functionality, reliability, security, cost-effectiveness, and alignment with professional needs

This is fundamental to Certified Midwife Exam Prep practice. Assess functionality, reliability, security, cost-effectiveness, and alignment with professional needs represents the professional standard for technology in the Certified Midwife Exam Prep certification framework.

Question 10: Which finding on fundal height measurement at 28 weeks would prompt further evaluation?

22 cm (Correct answer)
28 cm
29 cm
26 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 11: At what gestational age is the glucose challenge test (GCT) routinely performed to screen for gestational diabetes?

10–14 weeks
32–36 weeks
15–20 weeks
24–28 weeks (Correct answer)

Correct answer: 24–28 weeks

The 1-hour 50g GCT is routinely administered between 24–28 weeks gestation when insulin resistance peaks.

Question 12: How should Certified Midwife Exam Prep professionals stay current with regulatory changes?

Rely on colleagues for updates
Monitor regulatory updates, participate in professional associations, and attend continuing education (Correct answer)
Regulations rarely change
Wait until audited

Correct answer: Monitor regulatory updates, participate in professional associations, and attend continuing education

This is fundamental to Certified Midwife Exam Prep practice. Monitor regulatory updates, participate in professional associations, and attend continuing education represents the professional standard for regulatory in the Certified Midwife Exam Prep certification framework.

Question 13: What generates HCG?

Placenta (Correct answer)
Kidney
Spinal cord
Womb

Correct answer: Placenta

Human Chorionic Gonadotropin (hCG) is a hormone primarily generated by the placenta after implantation of the fertilized egg in the uterus. This hormone is vital for maintaining the corpus luteum, which in turn produces progesterone to support the early stages of pregnancy. hCG is also the hormone detected by most pregnancy tests.

Question 14: Which vaccine is recommended during each pregnancy, ideally between 27–36 weeks gestation?

MMR
Hepatitis A
Varicella
Tdap (Correct answer)

Correct answer: Tdap

Tdap is recommended during every pregnancy between 27–36 weeks to provide passive immunity to the newborn against pertussis.

Question 15: Which medication is the preferred first-line treatment for postpartum hemorrhage caused by uterine atony?

Oxytocin (Pitocin) (Correct answer)
Methylergonovine (Methergine)
Carboprost tromethamine (Hemabate)
Misoprostol

Correct answer: Oxytocin (Pitocin)

Oxytocin is the first-line uterotonic agent for postpartum hemorrhage due to its safety profile, effectiveness, and rapid onset.

Question 16: A patient receiving both nifedipine (tocolysis) and magnesium sulfate (seizure prophylaxis) should be monitored for which drug interaction?

Increased risk of postpartum hemorrhage
Reduced seizure threshold
Enhanced neuromuscular blockade and excessive hypotension (Correct answer)
Increased uterine contractility

Correct answer: Enhanced neuromuscular blockade and excessive hypotension

Concurrent nifedipine and magnesium sulfate can produce enhanced neuromuscular blockade and severe hypotension because both drugs interfere with calcium-dependent processes.

Question 17: A newborn's weight at 5 days of life is 7% below birth weight. How should the midwife respond?

Supplement with formula immediately
Order IV fluids
Continue current feeding support and reassess (Correct answer)
Recommend weaning from breastfeeding

Correct answer: Continue current feeding support and reassess

Up to 7–10% weight loss in the first week of life is normal; 7% loss warrants close monitoring and feeding support but not immediate supplementation.

Question 18: A client in active labor at 41 weeks has meconium-stained amniotic fluid with thick, particulate consistency. The fetal heart rate is 100 bpm. What action should the CPM take?

Administer oxygen via face mask and recheck FHR in 15 minutes
Initiate immediate transport to a hospital (Correct answer)
Continue monitoring and prepare for birth at home
Perform amnioinfusion to dilute the meconium

Correct answer: Initiate immediate transport to a hospital

Thick meconium combined with fetal bradycardia (100 bpm) indicates fetal compromise requiring immediate hospital transfer for neonatal resuscitation capability.

Question 19: Which non-pharmacological comfort measure has the strongest evidence for reducing labor pain and improving satisfaction?

Acupuncture only
Continuous labor support by a doula or midwife (Correct answer)
Sterile water injections
Hot showers alone

Correct answer: Continuous labor support by a doula or midwife

Continuous labor support is the intervention with the strongest evidence base, shown to reduce cesarean rates, labor duration, and pain medication use.

Question 20: A client at 38 weeks gestation presents with a blood pressure of 160/110 mmHg and 3+ proteinuria. What is the most appropriate next step?

Administer magnesium sulfate and arrange immediate transfer (Correct answer)
Continue monitoring at home with daily BP checks
Schedule a non-stress test for next week
Recommend bed rest and reduced sodium intake

Correct answer: Administer magnesium sulfate and arrange immediate transfer

BP ≥160/110 with proteinuria meets criteria for severe preeclampsia requiring magnesium sulfate prophylaxis and urgent hospital transfer.

Question 21: At what gestational age is a first-trimester ultrasound most accurate for dating a pregnancy?

15–18 weeks
11–14 weeks (Correct answer)
6–10 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 22: Which analgesic is contraindicated in a breastfeeding mother due to the risk of Reye's syndrome in the infant?

Ibuprofen
Aspirin (Correct answer)
Acetaminophen
Naproxen

Correct answer: Aspirin

Aspirin is contraindicated during breastfeeding because salicylates are excreted in breast milk and have been associated with Reye's syndrome in nursing infants.

Question 23: Which fetal presentation requires cesarean delivery and cannot be safely delivered vaginally?

Frank breech
Transverse lie (Correct answer)
Occiput posterior
Occiput anterior

Correct answer: Transverse lie

Transverse lie (shoulder presentation) is incompatible with vaginal delivery and requires cesarean section.

Question 24: Who are the primigravida?

A pregnant woman
A female who is pregnant for the first time (Correct answer)
A woman that has never given birth
A female pregnant for the second time

Correct answer: A female who is pregnant for the first time

The term 'primigravida' specifically refers to a woman who is pregnant for the first time. This designation is important in obstetrics as primigravid women often have different labor patterns, potential risks, and require specific considerations compared to multiparous women (those who have been pregnant before).

Question 25: A patient requests epidural analgesia at 5 cm dilation. Which assessment must be completed before epidural placement?

Cervical culture for GBS
Fetal scalp pH
IV access confirmation and hydration bolus (Correct answer)
Amniotomy

Correct answer: IV access confirmation and hydration bolus

IV access and a fluid bolus are required before epidural placement to reduce the risk of hypotension from sympathetic blockade.

Question 26: Which Bishop score indicates a favorable cervix for labor induction?

Score ≤3
Score 4–5
Score 6–7
Score ≥8 (Correct answer)

Correct answer: Score ≥8

A Bishop score of ≥8 indicates a favorable cervix and predicts successful labor induction similar to spontaneous labor outcomes.

Question 27: A patient at 32 weeks reports decreased fetal movement. Which initial assessment tool should the midwife recommend?

Kick count (fetal movement count) (Correct answer)
Contraction stress test
Non-stress test
Biophysical profile

Correct answer: Kick count (fetal movement count)

Kick counts are the first-line, non-invasive tool recommended to monitor fetal well-being when a patient reports decreased movement.

Question 28: What is the expected uterine fundal position at 24 hours postpartum?

2 cm above the umbilicus
2 cm below the umbilicus
At the symphysis pubis
At the level of the umbilicus (Correct answer)

Correct answer: At the level of the umbilicus

The uterine fundus is typically at the level of the umbilicus in the first 24 hours after delivery, then descends approximately 1 cm per day.

Question 29: What role does data analytics play in Certified Midwife Exam Prep practice?

It supports evidence-based decision making by identifying patterns and trends in relevant data (Correct answer)
It is only for IT professionals
It replaces professional judgment
It creates unnecessary complexity

Correct answer: It supports evidence-based decision making by identifying patterns and trends in relevant data

This is fundamental to Certified Midwife Exam Prep practice. It supports evidence-based decision making by identifying patterns and trends in relevant data represents the professional standard for technology in the Certified Midwife Exam Prep certification framework.

Question 30: A patient at 10 weeks gestation presents with painless vaginal bleeding and an open cervical os. Which term best describes this presentation?

Inevitable abortion (Correct answer)
Threatened abortion
Complete abortion
Missed abortion

Correct answer: Inevitable abortion

An inevitable abortion is characterized by an open cervical os with bleeding, indicating the pregnancy cannot be retained.

AMCB Certified Midwife (CM) Certification Examination

The AMCB Certified Midwife (CM) exam assesses entry-level competency for the practice of midwifery, covering antepartum, intrapartum, postpartum, newborn, and women's health care. Administered by the American Midwifery Certification Board, it validates clinical knowledge and judgment for safe beginning midwifery practice.

Questions

45 min

Time Limit

75%

To Pass

Checking for saved progress...

Exam Rules

You can skip questions and return to them later
Flag questions for review before submitting
No feedback shown until you submit the entire exam
Unanswered questions count as wrong — answer everything
10 pretest questions are mixed in and don't affect your score
Timer auto-submits when time runs out
Your progress is auto-saved every 30 seconds

These practice questions were written with AI tools. They are not real exam questions. Exam facts are checked against the official sources listed below. Not reviewed by a subject-matter expert. Editorial policy

Sources & references

Exam facts on this page (fees, format, dates, passing scores) are checked against these official sources; the date is our last check. Editorial policy

amcbmidwife.org — Test delivery, eligibility, fees, exam format, renewal, score release, time limit, score validity, passing score, retake fee · verified Oct 2026