NARM Cheat Sheet 2026

The 30 highest-yield NARM facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Which medication is commonly used to control nausea and vomiting during pregnancy, especially in cases of hyperemesis gravidarum? → Ondansetron (Zofran)
2. What is the recommended initial management of uterine inversion before attempting replacement? → Administer a tocolytic agent to relax the uterus, then attempt replacement
3. What is the expected timeframe for a postpartum woman to achieve her first spontaneous void after an uncomplicated vaginal delivery? → Within 6–8 hours of delivery
4. Which of the following is the FIRST-LINE treatment for eclamptic seizures in a laboring client? → Magnesium sulfate 4-6g IV loading dose
5. Which of the following situations requires mandatory reporting by a midwife in all U.S. jurisdictions? → Reasonable suspicion of child abuse or neglect
6. A laboring client's membranes rupture spontaneously and you note green-stained fluid with thick particulate matter. Your immediate priority is: → Assess fetal heart rate and prepare for possible neonatal resuscitation
7. Signs of neonatal jaundice? → Yellow skin and eyes from elevated bilirubin
8. A CPM practicing in a state where CPMs are not licensed receives a complaint from a client. Which entity has jurisdiction to investigate the complaint? → NARM, through its ethics and discipline process
9. What is the primary intervention for managing shoulder dystocia during vaginal delivery? → Using the McRoberts maneuver and applying suprapubic pressure
10. Which screening tool is most widely validated and recommended for postpartum depression screening in midwifery practice? → Edinburgh Postnatal Depression Scale (EPDS)
11. Which clinical finding best differentiates true labor from Braxton Hicks contractions? → Progressive cervical dilation with contractions that increase in frequency and intensity
12. According to NARM standards of practice, when should the first postpartum home visit occur after an uncomplicated home birth? → Within 24–48 hours of delivery
13. What newborn screening tests are done? → Blood spot for metabolic conditions, hearing screen, pulse oximetry
14. A client at 38 weeks develops a temperature of 38.5°C (101.3°F) in active labor with rupture of membranes for 18 hours. The most likely diagnosis is: → Intra-amniotic infection (chorioamnionitis)
15. Which finding during a newborn's initial assessment is a normal variant that requires no intervention? → Epstein's pearls on the hard palate
16. Which station indicates that the leading bony part of the presenting part is at the level of the ischial spines? → 0 station
17. A midwife administers erythromycin ophthalmic ointment to a newborn. What is the primary purpose of this prophylaxis? → Prevention of chlamydial and gonococcal conjunctivitis
18. What is the primary purpose of conducting a non-stress test (NST) in the third trimester of pregnancy? → To evaluate fetal heart rate patterns in response to fetal movements
19. What is neonatal hypoglycemia? → Low blood sugar causing jitteriness, poor feeding, lethargy, possibly seizures
20. What is intermittent auscultation? → Periodic fetal heart rate monitoring during labor using doppler
21. A newborn is born limp and apneic at 1 minute of life. After 30 seconds of positive pressure ventilation, heart rate is 55 bpm. What is the next step? → Begin chest compressions at a 3:1 ratio with PPV
22. When should first breastfeeding occur? → Within first hour during skin-to-skin
23. A client at 39 weeks reports decreased fetal movement. Kick count documentation shows 4 movements in 2 hours. The most appropriate response is: → Perform a non-stress test and consider biophysical profile if non-reactive
24. What is Group B Strep screening? → Test at 35-37 weeks for bacteria that could infect baby during birth
25. What is informed consent in midwifery? → Comprehensive information for voluntary, knowledgeable decisions
26. A newborn's blood glucose at 1 hour of life is 38 mg/dL and the infant is asymptomatic. The best initial management is: → Early breastfeeding or formula feeding followed by glucose recheck in 30–60 minutes
27. Which statement about tranexamic acid (TXA) in postpartum hemorrhage is accurate based on the WOMAN trial? → TXA given within 3 hours of postpartum hemorrhage onset reduces death from bleeding
28. A midwife administers carboprost (Hemabate) for uterine atony. Which condition is an absolute contraindication for this prostaglandin F2α analog? → Asthma
29. After repair of a second-degree perineal laceration, which perineal care instruction is most appropriate? → Use warm sitz baths, keep the perineum clean, and pat dry after voiding
30. What is the recommended hepatitis B vaccine schedule for a newborn born to a hepatitis B surface antigen (HBsAg) POSITIVE mother? → Hepatitis B vaccine AND HBIG, both given within 12 hours of birth at different sites