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.
Q21Which diagnostic test can confirm a diagnosis of endometriosis?
✓ Correct answer: B. Laparoscopy
Answer: Laparoscopy Endometriosis is a chronic condition where tissue similar to the lining inside the uterus (endometrium) grows outside the uterus. It can cause significant pain and is often associated with infertility. Laparoscopy, a minimally invasive surgical procedure, is considered the gold standard for diagnosing endometriosis. An ultrasound or MRI may help identify the presence of endometriomas or other abnormalities but cannot definitively diagnose endometriosis. A Pap smear is not used for this diagnosis.
Q22A middle-aged woman presents with severe rheumatoid arthritis, affecting her daily activities and involving multiple joints. After evaluating her condition, which of the following is considered a first-line pharmacologic intervention?
✓ Correct answer: A. Methotrexate
Answer: Methotrexate Methotrexate is commonly used as a first-line treatment for rheumatoid arthritis, especially in cases involving multiple joints and significant impact on daily activities. It works by inhibiting DNA synthesis and thus reducing inflammatory cell proliferation. Biologic drugs like adalimumab are also used for severe cases, but systemic medications like ibuprofen and analgesics like acetaminophen are generally used for less severe conditions. Hydroxychloroquine may be used in mild to moderate cases but is not the first-line treatment.
Q23A patient’s history reveals ongoing hypertension due to another underlying condition. What statements are accurate about secondary hypertension and its causes?
✓ Correct answer: C. It can be caused by kidney disease.
Answer: It can be caused by kidney disease. Secondary hypertension occurs as a result of another medical condition. Kidney disease, for example, can lead to hypertension because of impaired renal function, which affects the balance of fluids and salts in the blood. Other causes include conditions such as adrenal gland tumors (which can trigger excessive hormone production) and medications like NSAIDs, corticosteroids, and decongestants.
Q24Which of the following is recommended regarding the timing of newborn feedings immediately postpartum?
✓ Correct answer: D. Newborns should be fed as soon as possible after birth.
Answer: Newborns should be fed as soon as possible after birth. Early newborn feeding, ideally within the first hour of life, is recommended to promote bonding and successful breastfeeding. This practice also helps stabilize the newborn's blood sugar levels and body temperature. Feeding should not be delayed for the first bath or until the umbilical cord falls off, as these practices can hinder initial bonding and nutritional support.
Q25A newborn is admitted to the neonatal intensive care unit (NICU) with a respiratory rate of 70 breaths per minute. Labs are drawn and are as follows: Lab Parameter Result Normal Range Blood Glucose 55 mg/dL 40-60 mg/dL Respiratory Rate 70 breaths/minute 30-60 breaths/minute Heart Rate 130 beats/minute 120-160 beats/minute Oxygen Saturation 94% 92-100% Which of these newborn lab values is abnormal?
✓ Correct answer: B. Respiratory Rate
Answer: Respiratory Rate. The normal respiratory rate for a newborn is 30 to 60 breaths per minute. A rate of 70 breaths per minute is considered tachypnea and may indicate a need for further investigation and intervention. Blood glucose levels of 40-60 mg/dL, heart rates of 120-160 beats per minute, and oxygen saturation of 92-100% are all within normal limits for a newborn.
Q26A midwife performs a newborn assessment on a 3-day old infant and notices jaundice. What could this physical assessment finding indicate?
✓ Correct answer: A. The newborn may have elevated bilirubin levels, leading to jaundice.
Answer: The newborn may have elevated bilirubin levels, leading to jaundice. Newborn jaundice is caused by high levels of bilirubin in the blood and usually requires monitoring and possibly treatment, especially if levels are significantly elevated. While jaundice is common and often resolves on its own, elevated bilirubin levels can sometimes lead to more serious conditions if not monitored.
Q27Which of the following is true about transient tachypnea of the newborn (TTN)?
✓ Correct answer: A. Cesarean section increases the risk for TTN.
Answer: Cesarean section increases the risk for TTN. Transient tachypnea of the newborn (TTN) occurs when a newborn has trouble clearing fluid from their lungs, leading to rapid breathing. The condition is usually temporary and resolves within a few days. Cesarean section increases the risk for TTN because the baby does not experience the compression of the chest that occurs during vaginal delivery, which helps expel lung fluid. TTN is more commonly seen in premature and early-term infants and not typically associated with long-term respiratory issues.
Q28A midwife is evaluating a 6-week-old infant. Based on normal developmental timelines for primitive reflexes, which of the following findings would be most concerning if present during this examination?
✓ Correct answer: D. Palmar grasp reflex
Answer: Palmar grasp reflex The palmar grasp reflex typically disappears by 5-6 weeks of age. Its persistence beyond this timeframe may indicate neurological concerns and should prompt further evaluation. The Babinski reflex can last until the infant is 2 years old. The rooting reflex typically disappears by 4 months of age. The sucking reflex is usually seen until the baby is around 4 months old. Therefore, these reflexes would be normal findings in a 6-week-old infant.
Q29A client in their third trimester of pregnancy has been experiencing reduced fetal movements for the past 24 hours and notes a sudden swelling in their hands and face. During the clinical examination, the following observations are made: Observation Value Blood pressure 155/95 mm Hg Proteinuria 2+ on dipstick Headache Persistent for 2 days, unrelieved by acetaminophen Platelets 150,000 per microliter Liver enzymes Normal What is the probable diagnosis?
✓ Correct answer: D. Preeclampsia with severe features
This client's symptoms and observations indicate preeclampsia with severe features. The persistent headache, proteinuria, and elevated blood pressure are critical indicators. Despite normal liver enzymes and platelets, the combination of symptoms supports this diagnosis.
Q30Which of the following is true about group prenatal care for pregnant women?
✓ Correct answer: D. It provides enhanced social support and shared learning.
Group prenatal care models, such as CenteringPregnancy, provide enhanced social support, shared learning experiences, and a sense of community among participants. They do not reduce the frequency of necessary medical checkups, eliminate the need for individualized care, or limit benefits to only low-risk pregnancies.
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