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CPM


NARM Certified Professional Midwife 2025


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Question: 433


Which of the following best describes the role of mentorship and supervision in promoting ethical standards and professional growth within midwifery practice?


  1. Supervision and mentorship provide guidance and support, enabling midwives to uphold ethical standards and continuously improve their skills and knowledge.

    ntorship focuses solely on financial success in midwifery. pervision is only applicable to midwives working in hospitals.


    er: A


    nation: Mentorship and supervision are vital for promoting ethical standards and professional offering guidance and support for continuous improvement in practice.


    ion: 434


    gnant client expresses concern about the risk of developing gestational hypertension. Which o ing factors is considered a significant risk factor for this condition?


    under 25

    gular physical activity pre-pregnancy BMI

    vious history of gestational hypertension er: D

    nation: A previous history of gestational hypertension is a significant risk factor for developi ion in subsequent pregnancies.

    Mentorship is unnecessary as midwives are fully qualified upon graduation.

  2. Me

  3. Su

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Question: 435


In a situation where a midwife is observing a colleague using outdated practices, what is her ethical responsibility?


  1. Ignore the situation to avoid confrontation

  2. Provide constructive feedback and offer to discuss current evidence-based practices

  3. Report the colleague without discussing it first

  4. Assume the colleague is following updated practices Answer: B

Explanation: Providing constructive feedback and discussing current evidence-based practices fosters a culture of continuous improvement and collaboration in the workplace.


Question: 436


gnant woman is inquiring about the importance of kick counts. What should the midwife exp mary purpose of monitoring fetal movements?


etermine fetal sex valuate maternal health redict labor onset

ssess fetal well-being er: D

nation: Monitoring fetal movements through kick counts is primarily to assess fetal well-bein cant decrease in movement may indicate potential issues.


ion: 437


a home visit, a midwife discusses signs of breastfeeding success with a new mother. Which or is most critical for assessing whether the infant is breastfeeding effectively?


ternal comfort during feeding ration of each feeding session quency of feedings

ant weight gain

A pre lain as

the pri


  1. To d

  2. To e

  3. To p

  4. To a Answ

Expla g, as a

signifi


Quest


During indicat


  1. Ma

  2. Du

  3. Fre

  4. Inf Answer: D

Explanation: Infant weight gain is the most critical indicator of effective breastfeeding, as it reflects adequate intake and overall health of the baby.


Question: 438


A 1-week-old newborn is brought in with signs of irritability and poor feeding. The midwife suspects a

potential infection. Which of the following assessments is most critical to perform?


  1. Complete blood count (CBC)

  2. Blood culture

  3. Urinalysis

  4. Skin examination Answer: B


ion: 439


ontext of informed consent, which statement best captures the midwife’s responsibility whe sing treatment options with clients?


midwife must provide only the options she agrees with.

midwife can make decisions on behalf of the client if she believes it is in their best interest. midwife should present all options and their associated risks and benefits, allowing the clie n informed decision.

midwife's role is limited to executing the client's wishes without discussion. er: C

nation: The midwife has the responsibility to present all treatment options, including their ris ts, thus allowing the client to make an informed choice about her care.


ion: 440


of the following interventions is not recommended for managing a laboring woman with a med case of chorioamnionitis?

Explanation: A blood culture is the most critical test to perform in assessing for potential systemic infections in a newborn, as it helps identify the causative organism and guide treatment.


Quest


In the c n

discus


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  2. The

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Quest


Which confir


  1. Continuous fetal monitoring

  2. Administration of antibiotics

  3. Immediate delivery

  4. Hydration through intravenous fluids Answer: C

Explanation: While immediate delivery may be necessary in cases of severe chorioamnionitis, the timing should be based on maternal and fetal stability rather than being a blanket approach.

Question: 441


A midwife is assessing a postpartum client who experienced significant blood loss during delivery. Which of the following assessments is most critical in this scenario?


  1. Maternal emotional well-being

  2. Uterine tone and position

    ternal dietary habits er: B

    nation: Assessing uterine tone and position is critical in a postpartum client who experienced cant blood loss to check for uterine atony, which can lead to hemorrhage.


    ion: 442


    vent of a maternal seizure during labor, which of the following interventions should be prio ure maternal and fetal safety?


    ministering oral medications mediate delivery of the fetus

    nitoring the fetal heart rate continuously itioning the mother to prevent aspiration


    er: D


    nation: Positioning the mother to prevent aspiration is critical during a seizure to ensure airw tion, while monitoring and potential delivery may follow based on the situation's urgency.

    Infant feeding frequency

  3. Ma

Answ Expla

signifi


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to ens


  1. Ad

  2. Im

  3. Mo

  4. Pos Answ

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protec


Question: 443


In cases where a midwife encounters a situation involving a potential breach of confidentiality, which ethical principle is primarily at stake?


  1. Autonomy

  2. Justice

  3. Nonmaleficence

  4. Fidelity

Answer: D


Explanation: Fidelity, or the duty to maintain trust and confidentiality between the midwife and client, is compromised when confidentiality is breached.


Question: 444


ention. How should she ethically handle the situation with the client and her family?


arly communicate the need for intervention and involve them in the decision-making process wnplay the situation to avoid alarming the family

ke the decision unilaterally without consulting the family ay intervention until the family agrees to it


er: A


nation: Clearly communicating the need for intervention and involving the family in decision respects their autonomy and ensures informed consent in a critical situation.


ion: 445


erforming the Apgar assessment at one minute after birth, which of the following compone valuated?


stational age scle tone

art rate spiratory effort


er: A

During a home birth, a midwife encounters unexpected complications that require immediate medical interv


  1. Cle

  2. Do

  3. Ma

  4. Del Answ

Expla -

making


Quest


When p nts is

NOT e


  1. Ge

  2. Mu

  3. He

  4. Re


Answ


Explanation: The Apgar scoring system does not evaluate gestational age; instead, it assesses heart rate, muscle tone, respiratory effort, reflex response, and color to determine the newborn's overall condition at one and five minutes after birth.


Question: 446


Which of the following maternal factors is known to significantly affect the duration of the second stage

of labor?


  1. Use of pain relief methods

  2. Maternal body mass index (BMI)

  3. Maternal age

  4. Presence of a support person Answer: A


ion: 447


a home birth, a mother in active labor suddenly expresses feelings of overwhelming anxiet bout the delivery process. Which of the following techniques would be most appropriate for the fe to use to support the mother's emotional well-being while ensuring fetal stability?


courage deep breathing exercises and provide continuous emotional support minister an anxiolytic medication as per protocol

ggest immediate transport to a hospital for epidural pain relief

commend the mother to focus solely on contractions and ignore her feelings er: A

nation: Deep breathing exercises and emotional support can help alleviate anxiety and enhanc r's sense of control during labor, which is crucial for both maternal and fetal well-being.


ion: 448


wife discovers that a colleague has been practicing outside of their scope of practice. What e tion does the midwife have in this scenario?

Explanation: The use of pain relief methods, especially epidurals, can significantly prolong the second stage of labor due to decreased maternal urge to push.


Quest


During y and

fear a midwi


  1. En

  2. Ad

  3. Su

  4. Re


Answ


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mothe


Quest


A mid thical

obliga


  1. Ignore the situation to maintain workplace harmony

  2. Report the colleague to the appropriate regulatory body

  3. Confront the colleague and suggest they seek further training

  4. Discuss the issue with clients to make them aware Answer: B

Explanation: Reporting a colleague practicing outside their scope is an ethical obligation to protect client safety and uphold professional standards.

Question: 449


During a prenatal appointment, the midwife discusses the importance of monitoring maternal weight gain. Which of the following weight gain recommendations is appropriate for a client with a normal pre- pregnancy BMI?


  1. 11-20 pounds

    25 pounds

    40 pounds er: B

    nation: The recommended weight gain for women with a normal pre-pregnancy BMI is typic ounds during pregnancy to support healthy fetal growth.


    ion: 450


    a prenatal visit, a midwife explains the importance of the Rh factor. If a Rh-negative mothe ng a Rh-positive fetus, what intervention is necessary to prevent complications?


    se monitoring of fetal heart rate ministration of Rho(D) immune globulin reased dietary iron intake

    gular ultrasound assessments er: B

    nation: Administration of Rho(D) immune globulin is necessary to prevent Rh sensitization, ad to hemolytic disease of the newborn in subsequent pregnancies.

    25-35 pounds

  2. 15-

  3. 30-


Answ


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Quest


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carryi


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Question: 451


During a birth, the midwife notices that the placenta has not delivered within 30 minutes of the baby's birth. What is the most appropriate next step?


  1. Wait for another 15 minutes before intervention

  2. Administer oxytocin to facilitate placental delivery

  3. Perform a manual extraction of the placenta

  4. Prepare for emergency surgery Answer: B

Explanation: Administering oxytocin is appropriate to promote uterine contractions and facilitate the delivery of the placenta before considering more invasive measures.


Question: 452


wife is educating a mother about the signs of mastitis. Which of the following symptoms sh instructed to monitor closely?


reased milk supply and engorgement

sistent low-grade fever and localized breast pain dden onset of a hard lump in the breast with no pain ndice in the infant after breastfeeding


er: B


nation: Mastitis typically presents with symptoms such as persistent low-grade fever and loca ain, requiring prompt treatment.


ion: 453


a community health outreach event, a midwife encounters a client who is hesitant to engag guage barriers and cultural differences. What is the most effective way for the midwife to bu nd ensure effective communication?


eak loudly and use simple words to communicate on family members to translate the information ume the client understands basic healthcare terms

A mid ould

she be


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  2. Per

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  4. Jau Answ

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trust a


  1. Sp

  2. Rely

  3. Ass

  4. Use a trained interpreter and culturally appropriate materials Answer: D

Explanation: Utilizing a trained interpreter and culturally appropriate materials ensures accurate communication and shows respect for the client’s cultural context, which is essential for building trust.


Question: 454

During the active phase of labor, a midwife notes that the mother exhibits signs of shoulder dystocia during delivery. What is the most critical maneuver the midwife should perform to resolve this complication?


  1. McRoberts maneuver (flexing the mother's legs toward her abdomen)

  2. Fundal pressure to push the baby down

  3. Immediate episiotomy


    nation: The McRoberts maneuver is effective in resolving shoulder dystocia by increasing pe er and allowing the shoulders to pass more easily.


    ion: 455


    year-old woman at 28 weeks gestation presents with swelling in her legs and feet. Which of ing assessments is most important for the midwife to conduct in this scenario?


    asure blood pressure eck maternal weight gain aluate fetal heart tones

    sess for protein in the urine er: D

    nation: Assessing for protein in the urine is essential to rule out preeclampsia, which can pre dema and is a significant concern during pregnancy.


    ion: 456

    Rotate the mother onto her side Answer: A

Expla lvic

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  2. Ch

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Quest


Which of the following physiological changes during the postpartum period can significantly affect a woman's emotional state, specifically in relation to the onset of postpartum depression?


  1. Elevated cortisol levels

  2. Decreased progesterone levels

  3. Increased estrogen levels

  4. Stabilization of prolactin levels Answer: A

Explanation: Elevated cortisol levels can contribute to mood fluctuations and are associated with increased stress responses, which may heighten the risk of postpartum depression.