CNM Nurse Midwife Exam Prep practice questions and answers 2026. Tap an option to test yourself — you'll see the correct answer and a plain-English explanation for every question. Free, no login.
Q1For which patient is misoprostol contraindicated?
✓ Correct answer: D. A patient with a history of cesarean section
Answer: A patient with a history of cesarean section Misoprostol is contraindicated in patients with a history of cesarean section or major uterine surgery due to the increased risk of uterine rupture. Misoprostol is commonly used for medical management of various obstetric conditions, such as labor induction and treatment of postpartum hemorrhage.
Q2Which of the following measures has been shown to reduce the duration of the second stage of labor?
✓ Correct answer: B. Upright positions during pushing
Answer: Upright positions during pushing. Upright positions during pushing, such as squatting or sitting, utilize gravity to assist in the descent of the baby, often shortening the second stage of labor. Cold compresses are not shown to reduce the duration of labor, although they might provide comfort. Frequent position changes and continuous vocal coaching are beneficial practices but do not specifically decrease the duration of the second stage.
Q3A 40-year-old woman presents to the midwifery clinic with a 3-month history of heavy and irregular menstrual periods. Which of the following is the priority intervention?
✓ Correct answer: C. Perform a transvaginal ultrasound
Answer: Perform a transvaginal ultrasound The primary concern with heavy and irregular menstrual periods could be endometrial hyperplasia or carcinoma, so assessing the endometrial lining is critical. While oral contraceptives may help to regulate menstruation, it is essential to first rule out potential serious conditions like endometrial pathology. Endometrial ablation can be considered after other causes have been ruled out. Iron supplementation addresses blood loss but does not address the underlying cause of the irregular bleeding.
Q4A patient presents with cervicitis. What is one of the bacterial pathogens that can cause this condition?
✓ Correct answer: B. Chlamydia trachomatis
Answer: Chlamydia trachomatis Chlamydia trachomatis is a common bacterial cause of cervicitis. Human Papillomavirus (HPV) is a viral infection that can cause genital warts and cervical cancer but is not typically a cause of cervicitis. Candida albicans is a fungal pathogen that causes yeast infections, not cervicitis. Herpes Simplex Virus (HSV) causes genital herpes, not cervicitis.
Q5A 30-year-old patient comes in for her annual check-up and mentions she wants to start on oral contraceptive pills. She is concerned about needing a mammogram first because her mother had breast cancer. The midwife proceeds with the consultation. Which statement by the patient indicates that she requires further education?
✓ Correct answer: D. "I will need a mammogram before I can get started on oral contraceptive pills."
Answer: "I will need a mammogram before I can get started on oral contraceptive pills." A mammogram is not required before starting oral contraceptive pills. Breast cancer screening typically starts at age 40 or earlier for those with a significant family history, but it is not a prerequisite for contraception initiation. Oral contraceptives do not protect against STIs, need to be taken consistently, and any severe side effects should be reported immediately.
Q6A midwife has identified a patient with endometriosis. What should be the primary focus of the midwife’s education?
✓ Correct answer: A. Management of chronic pelvic pain with hormone therapy or surgery
Answer: Management of chronic pelvic pain with hormone therapy or surgery Patients with endometriosis often suffer from chronic pelvic pain. Treatment options include hormone therapy and surgical interventions to remove endometrial tissue. Over-the-counter pain relief can provide temporary comfort but is not a primary strategy. Frequent pelvic exams are important for monitoring but must be coupled with appropriate treatment. Dietary changes alone cannot manage endometriosis symptoms.
Q7A 52-year-old woman is inquiring about treatment options for her symptoms of menopause, including night sweats and vaginal dryness. She has not had a hysterectomy. Which of the following is the most appropriate treatment?
✓ Correct answer: D. Combined estrogen-progesterone therapy
Answer: Combined estrogen-progesterone therapy Combined estrogen-progesterone therapy is the most appropriate treatment for menopausal symptoms in women who have an intact uterus. Estrogen helps alleviate vasomotor symptoms such as night sweats, while progesterone reduces the risk of endometrial hyperplasia associated with unopposed estrogen therapy.
Q8A midwife is caring for a 40-year-old patient who has obesity and a history of deep vein thrombosis (DVT). The patient is interested in starting a highly effective method of contraception but reports heavy menstrual bleeding and states she prefers to avoid any invasive procedures. Which of the following types of contraception is the midwife most likely to recommend?
✓ Correct answer: C. Progesterone-only pills
Answer: Progesterone-only pills The progesterone-only pill (POP) contains no estrogen and is a good choice for a woman with a history of DVT and obesity. It can also help reduce menstrual bleeding which addresses the patient's concern about heavy menstrual bleeding. Combined oral contraceptives (COCs) and vaginal contraceptive rings both contain estrogen and are contraindicated in someone with a history of DVT due to an increased risk of blood clots. A copper IUD would be medically appropriate for DVT history but is invasive and tends to increase menstrual bleeding, making it unsuitable given the patient's specific preferences and existing heavy menstrual bleeding.
Q9A patient presents with a history of heavy and painful menstrual periods (menorrhagia). They are seeking a long-term contraceptive solution. Which option is the most appropriate considering their medical history?
✓ Correct answer: B. Levonorgestrel-releasing intrauterine system (LNG-IUS)
Answer: Levonorgestrel-releasing intrauterine system (LNG-IUS) The LNG-IUS is effective in reducing menorrhagia by thinning the endometrial lining, thereby decreasing menstrual blood loss and pain. The copper IUD is nonhormonal and does not address menorrhagia. Progestin-only injections can lead to irregular bleeding and are less effective in managing heavy menstrual periods. Vaginal diaphragms do not influence menstrual flow or pain.
Q10A patient visits for her routine gynecological exam. She shares that she experiences excessive menstrual bleeding. The midwife suspects she has uterine fibroids and provides information about this condition. Which of the following statements indicates that the patient needs further education?
✓ Correct answer: A. "I can't have fibroids because I don't feel any pain."
Answer: "I can't have fibroids because I don't feel any pain." Uterine fibroids are non-cancerous growths in the uterus that can cause symptoms such as heavy menstrual bleeding, pelvic pressure, and longer menstrual cycles. Pain is not always a symptom of fibroids, so the absence of pain does not rule out their presence.
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