Certified Midwife Exam Prep Certified Nurse Midwife 4

Question 1

A patient with a BMI of 32 at her first prenatal visit asks how much weight she should gain during pregnancy. What is the IOM-recommended range?

Accepted Answer

15–25 lbs (7–11 kg)

Answer

The Institute of Medicine recommends a gestational weight gain of 15–25 lbs for women with a pre-pregnancy BMI of 30–39.9 (obese class I and II).

Question 2

Which intrapartum intervention is most strongly associated with reducing the risk of group B Streptococcus (GBS) transmission to the neonate?

Accepted Answer

Intrapartum IV penicillin G given at least 4 hours before delivery

Answer

IV penicillin G given at least 4 hours before delivery is the gold standard for intrapartum GBS prophylaxis and most effectively reduces vertical transmission.

Question 3

A patient at 32 weeks presents with painless loss of fluid per vagina. Ferning on microscopy and pooling are positive. What is the most likely diagnosis?

Accepted Answer

Premature rupture of membranes (PROM)

Answer

Ferning (arborization pattern on drying) and pooling of fluid in the posterior fornix are classic clinical signs confirming premature rupture of membranes.

Question 4

Which approach to pain management is most consistent with a CNM's midwifery philosophy during an uncomplicated labor?

Accepted Answer

Informing the patient of all pain management options and supporting her informed choice

Answer

The CNM role centers on informed consent and shared decision-making; supporting the patient's autonomous choice — whether pharmacologic or non-pharmacologic — is foundational.

Question 5

A patient at 16 weeks gestation is found to have a hemoglobin of 9.8 g/dL and a mean corpuscular volume (MCV) of 72 fL. What is the most likely diagnosis?

Accepted Answer

Iron-deficiency anemia

Answer

Microcytic anemia (low MCV) in a pregnant patient is most commonly caused by iron deficiency, which is the leading cause of anemia in pregnancy.

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Practice Test

Certified Midwife Exam Prep Certified Nurse Midwife 4