Certified Midwife Exam Prep Certified Midwife 3

Question 1

A primigravida at 41+3 weeks has a Bishop score of 3. What is the most appropriate management?

Accepted Answer

Cervical ripening followed by labor induction

Answer

A Bishop score ≤6 indicates an unfavorable cervix; cervical ripening (e.g., prostaglandins or balloon catheter) before oxytocin induction improves success.

Question 2

During a water birth, the midwife observes tight nuchal cord. The safest initial management is:

Accepted Answer

Attempt to slip the cord over the head or somersault maneuver

Answer

Slipping the cord over the head or the somersault maneuver preserves umbilical circulation while allowing delivery to continue.

Question 3

Regarding placenta accreta spectrum, which maternal history most significantly raises clinical suspicion?

Accepted Answer

Prior uterine surgery combined with anterior low-lying placenta

Answer

The combination of prior uterine scar (especially cesarean) with placenta previa or low-lying anterior placenta is the strongest risk factor for accreta spectrum.

Question 4

What is the maximum recommended cumulative dose of oxytocin during active labor augmentation?

Accepted Answer

There is no recommended maximum dose; titration is based on contraction pattern and fetal response

Answer

Oxytocin is titrated to achieve adequate uterine activity (typically 200–250 Montevideo units) with no absolute upper dose limit, guided by maternal and fetal response.

Question 5

A postpartum client on day 3 develops a temperature of 38.5°C, tachycardia, uterine tenderness, and foul-smelling lochia. The most likely diagnosis is:

Accepted Answer

Endometritis

Answer

Fever, uterine tenderness, tachycardia, and malodorous lochia after delivery are classic signs of postpartum endometritis.

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Certified Midwife 3