Certification Practice Exam Questions

Certified Nurse Midwife (CNM) Certification Practice Exam Questions And Correct Answers (Verified Answers) Plus Rationales 2026 Q&A | Instant Download Pdf

1. The primary hormone responsible for maintaining pregnancy is:

• Estrogen
• Progesterone
• Oxytocin
• Prolactin

Rationale: Progesterone maintains the uterine lining and prevents

contractions during pregnancy.

2. The normal fetal heart rate range is:

• 100–120 bpm
• 110–160 bpm
• 90–140 bpm 1 / 4

• 120–180 bpm

Rationale: A normal baseline fetal heart rate is between 110–160

bpm, indicating good oxygenation and fetal well-being.

• Which pelvic type is most favorable for vaginal delivery?
• Android
• Anthropoid
• Gynecoid
• Platypelloid

Rationale: The gynecoid pelvis has an ideal shape and dimensions for

vaginal birth.

• The best position to relieve supine hypotensive syndrome in

pregnancy is:

• Supine with legs elevated
• Left lateral position
• Right lateral position
• Sitting upright

Rationale: The left lateral position prevents compression of the

inferior vena cava by the gravid uterus.

5. The most common cause of postpartum hemorrhage is:

• Retained placenta
• Uterine atony
• Vaginal laceration
• Coagulopathy 2 / 4

Rationale: Uterine atony prevents effective uterine contraction,

leading to excessive bleeding.

6. A normal lochia progression postpartum is:

• Serosa → Rubra → Alba
• Rubra → Serosa → Alba
• Alba → Serosa → Rubra
• Serosa → Alba → Rubra

Rationale: Lochia normally changes from rubra (red), to serosa

(pink), to alba (white) as healing progresses.

• Which vitamin is recommended to prevent neural tube defects in early

pregnancy?

• Vitamin C
• Vitamin D
• Folic acid
• Vitamin K

Rationale: Folic acid supplementation before conception and in early

pregnancy reduces neural tube defect risk.

• The normal duration of the first stage of labor for a primigravida is

approximately:

• 4–6 hours
• 12–14 hours
• 2–4 hours
• 18–20 hours 3 / 4

Rationale: The first stage in a first-time mother typically lasts 12–14

hours, depending on labor progress.

• Which fetal presentation is considered optimal for vaginal delivery?
• Brow
• Face
• Vertex
• Shoulder

Rationale: The vertex (occiput anterior) presentation aligns best with

the birth canal.

• During the second stage of labor, the nurse midwife should

encourage the mother to:

• Hold her breath and push continuously
• Push with contractions and rest in between
• Push at random intervals
• Avoid pushing until instructed

Rationale: Coordinating pushing with contractions optimizes fetal

descent and maternal energy.

• A midwife notes a boggy uterus after delivery. The first action

should be to:

• Call the physician
• Massage the uterus
• Increase IV fluids
• Administer antibiotics
• / 4