Certified Midwife Exam Prep Certified Nurse Midwife 3

Question 1

A patient at 41+3 weeks gestation has a Bishop score of 4. Which management approach is most appropriate?

Accepted Answer

Cervical ripening followed by induction of labor

Answer

An unfavorable cervix (Bishop score <6) at post-term gestation warrants cervical ripening with agents like misoprostol or Foley balloon prior to oxytocin augmentation.

Question 2

During a prenatal visit, a patient discloses that her partner monitors all her phone calls and controls access to money. What is the CNM's most appropriate initial response?

Accepted Answer

Express concern, validate her experience, provide safety resources, and document

Answer

The CNM should respond with empathy, validate the patient's experience, provide information about local resources, create a safety plan, and document findings without mandating a specific course of action.

Question 3

Which maternal serum screening result pattern is most consistent with trisomy 18 (Edwards syndrome)?

Accepted Answer

Low AFP, low hCG, low estriol

Answer

Trisomy 18 typically shows a triple-screen pattern of low AFP, low hCG, and low unconjugated estriol — the 'triple low' pattern.

Question 4

A patient at 38 weeks in active labor has a sudden onset of severe abdominal pain, rigid uterus, and fetal bradycardia after receiving oxytocin. What complication should the CNM suspect first?

Accepted Answer

Placental abruption

Answer

Sudden severe abdominal pain, a rigid (board-like) uterus, and fetal distress in the context of oxytocin use are classic signs of placental abruption.

Question 5

The CNM is preparing to suture a second-degree perineal laceration. Which tissue layer must be repaired to achieve adequate hemostasis and support?

Accepted Answer

Vaginal mucosa and perineal muscles

Answer

A second-degree laceration extends into the perineal muscles (bulbocavernosus, transverse perinei) and vaginal mucosa, and both layers must be repaired.

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Certified Nurse Midwife 3