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.
Q11A new mother is asking about the resumption of menstrual periods after a postpartum hemorrhage. Which of the following statements would a midwife share?
✓ Correct answer: A. If you experienced a postpartum hemorrhage but are exclusively breastfeeding, prolactin might delay the return of menstruation.
Answer: "If you experienced a postpartum hemorrhage but are exclusively breastfeeding, prolactin might delay the return of menstruation." Exclusive breastfeeding can inhibit ovulation and menstruation through increased prolactin, which suppresses estrogen levels. Despite postpartum hemorrhage, the physiology remains similar where breastfeeding delays menses, often until around six months postpartum.
Q12A midwife is assessing a patient 24 hours postpartum. Which of the following is an abnormal vital sign change?
✓ Correct answer: C. Persistent tachycardia
Persistent tachycardia can indicate underlying complications such as hemorrhage or infection. While a slightly elevated body temperature is common in the immediate postpartum period, persistent fever indicates infection. Mildly elevated blood pressure can be due to pain or stress, and a decreased respiratory rate is often related to normal changes postpartum.
Q13Which of the following postpartum complications is most likely to occur within the first 24 hours after a cesarean section?
✓ Correct answer: C. Endometritis
Answer: Endometritis The most common postpartum complications in the early hours to days following a cesarean section include endometritis, urinary tract infection, and wound infection. Less frequent complications include transfusion reactions and septic pelvic thrombophlebitis (SPT). Mastitis is a common infection in the first six weeks postpartum. However, it is rare in the first 24 hours after a cesarean section.
Q14What is the most significant risk factor for developing postpartum depression?
✓ Correct answer: B. History of depression
Answer: History of depression A history of depression is the most significant risk factor for developing postpartum depression. Women who have experienced depression before are at higher risk. Other contributing factors include lack of support, stressful life events, and hormonal changes.
Q15A postpartum client is 24 hours after a vaginal delivery. Their vital signs are as follows: temperature 100 degrees Fahrenheit, blood pressure 120/80, heart rate 72, and respiratory rate 18 breaths per minute. Which of the following represents the appropriate action to take based on these vital signs?
✓ Correct answer: A. Continue to monitor routine vital signs
Answer: Continue to monitor routine vital signs These vital signs are all within normal limits. A temperature up to 100.4 degrees Fahrenheit is normal within the first 24 hours postpartum and does not require treatment for fever or additional tests unless accompanied by other symptoms.
Q16A patient delivered a baby via cesarean section. Which estimated blood loss volume is considered the threshold for postpartum hemorrhage?
✓ Correct answer: C. 1000 mL
Answer: 1000 mL 1000 mL of estimated blood loss postpartum is considered a hemorrhage for both vaginal and cesarean births. 800 mL and 600 mL are not considered postpartum hemorrhage (PPH). 1200 mL is a hemorrhage but is not the threshold for PPH.
Q17A woman is 3 weeks postpartum. Which type of vaginal discharge should the midwife expect?
✓ Correct answer: D. Lochia alba
Answer: Lochia alba. The final stage of lochia, occurring between week 3 and the cessation of flow (usually between 4 and 6 weeks), is called lochia alba. This discharge is typically yellowish to white and tends to decrease over time.
Q18Which of the following is NOT a risk factor for postpartum hemorrhage?
✓ Correct answer: B. Low blood pressure
Answer: Low blood pressure Multiple gestations and prolonged labor are risk factors for postpartum hemorrhage due to the increased stress on the uterus. Uterine atony is a direct cause of postpartum hemorrhage as the uterus fails to contract properly after delivery. Low blood pressure is not a typical risk factor for postpartum hemorrhage.
Q19A 6-week postpartum patient presents to the office with complaints of breast discomfort and worries about low milk supply. They have been exclusively breastfeeding. Which of the following would the midwife include in their plan of care?
✓ Correct answer: C. Explain that frequent breastfeeding can increase milk supply.
Answer: Explain that frequent breastfeeding can increase milk supply. Frequent breastfeeding helps stimulate milk production through demand and supply principles. Formula supplements might be necessary in some cases but are not the first recommendation. Exclusive pumping is an option but may not be necessary. Decreasing frequency could negatively impact milk production.
Q20A midwife is educating a group of newly graduated nurse practitioners about the signs and risks of intimate partner violence (IPV). Which of the following statements made by one of the nurse practitioners indicates a need for further education?
✓ Correct answer: C. "Intimate partner violence mainly occurs in low-income neighborhoods."
Answer: "Intimate partner violence mainly occurs in low-income neighborhoods." Intimate partner violence (IPV) affects individuals across all socioeconomic backgrounds, not just those in low-income neighborhoods. Indicators of IPV can include emotional abuse and chronic psychological distress.
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