Certified Midwife Exam Prep Technology & Digital Applications 2 — Questions and Answers
Question 1: A midwife receives a patient's EHR access request from a third-party app. Which standard protocol governs secure patient-directed data sharing under the 21st Century Cures Act?
- HL7 FHIR with SMART on FHIR OAuth2 (Correct answer)
- DICOM over TLS
- SOAP with WS-Security
- Direct Messaging via HISP
Correct answer: HL7 FHIR with SMART on FHIR OAuth2
The 21st Century Cures Act requires certified EHRs to support SMART on FHIR with OAuth2 for patient-directed third-party app access.
Question 2: During a home birth, the midwife's cellular signal is weak and the electronic fetal monitor cannot transmit data. What is the most appropriate action?
- Continue monitoring with manual auscultation and document findings on paper (Correct answer)
- Delay documentation until connectivity is restored
- Transfer to hospital immediately due to technology failure
- Use a personal hotspot from the patient's phone
Correct answer: Continue monitoring with manual auscultation and document findings on paper
Manual auscultation with contemporaneous paper documentation maintains patient safety when electronic transmission fails.
Question 3: Which HIPAA technical safeguard specifically requires that PHI stored on portable devices be rendered unreadable if the device is lost?
- Encryption at rest (Correct answer)
- Audit controls
- Automatic logoff
- Integrity controls
Correct answer: Encryption at rest
Encryption at rest protects PHI on lost or stolen portable devices by rendering data unreadable without the decryption key.
Question 4: A midwifery practice wants to implement point-of-care ultrasound (POCUS). Which competency must the midwife demonstrate before independent clinical use?
- Formal training with documented supervised scans and credentialing (Correct answer)
- Completion of an online video course only
- Familiarity with the device manufacturer's manual
- Observation of one trained provider performing the exam
Correct answer: Formal training with documented supervised scans and credentialing
Safe POCUS use requires formal training, supervised scan documentation, and credentialing per organizational and professional standards.
Question 5: A remote patient monitoring platform alerts a midwife that a 34-week patient's blood pressure reading is 148/96 mmHg. What is the first step?
- Contact the patient to verify the reading and assess for other symptoms of preeclampsia (Correct answer)
- Immediately call 911 on the patient's behalf
- Dismiss the alert as likely a cuff error
- Schedule an in-office visit for next week
Correct answer: Contact the patient to verify the reading and assess for other symptoms of preeclampsia
The first step is verification of the reading and clinical assessment for preeclampsia symptoms before escalating care.
Question 6: Which feature of a clinical decision support (CDS) tool is most important for midwifery practice to prevent alert fatigue?
- High specificity so alerts fire only for clinically significant conditions (Correct answer)
- Maximum sensitivity to catch every possible deviation
- Alerts firing for all lab values outside the general reference range
- Daily summary emails instead of real-time alerts
Correct answer: High specificity so alerts fire only for clinically significant conditions
High specificity reduces false-positive alerts, preventing alert fatigue and ensuring clinicians respond to meaningful warnings.
Question 7: A midwife uses a consumer-grade fitness tracker worn by a patient to monitor contraction frequency. What is the primary limitation of this approach?
- Consumer devices lack FDA clearance for clinical diagnostic use and may have unvalidated accuracy (Correct answer)
- The device cannot connect to any EHR system
- Consumer trackers are banned under HIPAA
- The data is automatically shared with insurance companies
Correct answer: Consumer devices lack FDA clearance for clinical diagnostic use and may have unvalidated accuracy
Consumer-grade wearables are not FDA-cleared for clinical diagnostics and have unvalidated accuracy for obstetric monitoring.
Certified Midwife Exam Prep Technology & Digital Applications 2
A midwife receives a patient's EHR access request from a third-party app.
Which standard protocol governs secure patient-directed data sharing under the 21st Century Cures Act?