Question: 1 
A pregnant woman presents with a history of recurrent early pregnancy loss. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Provide counseling and support for the woman. 
B. Order serial hCG levels to monitor pregnancy progress. 
C. Refer the woman for first-trimester ultrasound. 
D. Evaluate the woman's acceptance of pregnancy. 
Answer: A 
Explanation: Providing counseling and support for a woman experiencing recurrent early pregnancy loss is an essential role of a nurse midwife. This includes addressing her emotional needs, providing information about possible causes of pregnancy loss, discussing treatment options, and offering support throughout the process. 

Question: 2 
A pregnant woman is Rh-negative. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Perform nonstress tests (NST) to evaluate fetal well-being. 
B. Order Rh immunoglobulin when indicated during pregnancy. 
C. Order and interpret lab results to diagnose anemias in pregnancy. 
D. Counsel the woman about the use of complementary and alternative therapies in pregnancy. 
Answer: B Explanation: Ordering Rh immunoglobulin when indicated during pregnancy is necessary for Rh-negative women to prevent sensitization and potential complications in future pregnancies. Rh immunoglobulin is administered to Rh-negative women at specific times during pregnancy and postpartum to prevent the development of Rh antibodies. 

Question: 3 
During a prenatal visit, a pregnant woman mentions she has been using tobacco and alcohol. What should the AMCB Certified Nurse Midwife do? 
A. Order ultrasounds to assess fetal growth when indicated. 
B. Order and interpret routine laboratory tests in pregnancy. 
C. Screen for substance use during pregnancy and refer as appropriate. 
D. Counsel about fetal movement awareness and/or counting. 
Answer: C 
Explanation: When a pregnant woman discloses tobacco and alcohol use, the AMCB Certified Nurse Midwife should screen for substance use during pregnancy and refer the woman as appropriate. This helps address the potential risks to the woman and the fetus and provides necessary support and interventions. Ordering and interpreting routine laboratory tests, assessing fetal growth, or counseling about fetal movement awareness are not directly addressing the substance use issue. 

Question: 4 
During a prenatal visit, a nurse midwife is assessing a pregnant woman's nutritional status. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Assess the woman's social support system. 
B. Evaluate the woman's exercise routine during pregnancy. 
C. Recommend the use of herbal supplements for improved nutrition. 
D. Calculate the woman's pre-pregnancy BMI. 
Answer: D 
Explanation: Calculating the woman's pre-pregnancy BMI is an important step in assessing her nutritional status during pregnancy. It helps determine if the woman is underweight, normal weight, overweight, or obese, and guides appropriate recommendations for weight gain and dietary modifications during pregnancy. 

Question: 5 
A pregnant woman is scheduled for a routine ultrasound to assess fetal growth. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Order ultrasounds to assess fetal growth when indicated. 
B. Auscultate fetal heart tones using a pinard, fetoscope, or doppler. 
C. Perform Leopold's maneuvers to determine fetal presentation and position. 
D. Counsel the woman about the use of over-the-counter medications in pregnancy. 
Answer: A 
Explanation: Ordering ultrasounds to assess fetal growth when indicated is an important responsibility of a nurse midwife. Regular monitoring of fetal growth helps ensure appropriate development and can detect any abnormalities or growth restrictions that may require further evaluation or intervention. 

Question: 6 
During a prenatal visit, a nurse midwife is evaluating a woman's risk status during her current pregnancy. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Perform Leopold's maneuvers to determine fetal position. 
B. Screen the woman for violence or abuse during pregnancy. 
C. Order and interpret routine laboratory tests. 
D. Assess the woman's prior obstetric and medical history. 
Answer: D 
Explanation: Assessing the woman's prior obstetric and medical history is crucial in determining her risk status during her current pregnancy. It helps identify any previous complications or medical conditions that may impact the current pregnancy and guides appropriate management and interventions. 

Question: 7 
Which of the following actions should the AMCB Certified Nurse Midwife take to evaluate for signs of pregnancy? 
A. Assesses the woman's acceptance of pregnancy. 
B. Orders and evaluates serial hCG levels when indicated. 
C. Performs basic genetic counseling including genetic screening and diagnostic testing options. 
D. Orders Rh immunoglobulin when indicated during pregnancy. 
Answer: B Explanation: To evaluate for signs of pregnancy, the AMCB Certified Nurse Midwife should order and evaluate serial hCG levels when indicated. hCG (human chorionic gonadotropin) is a hormone that is produced during pregnancy, and its levels can be measured to confirm and monitor pregnancy. 

Question: 8 
A pregnant woman presents with a possible teratogen exposure. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Screen and refer the woman for violence or abuse during pregnancy. 
B. Perform Leopold's maneuvers to determine fetal presentation and estimated weight. 
C. Order and interpret ultrasounds to evaluate fetal anatomy and rule out abnormalities. 
D. Assess and provide counseling for possible teratogen exposure. 
Answer: D 
Explanation: Assessing and providing counseling for possible teratogen exposure is an important responsibility of a nurse midwife. It involves gathering information about the specific teratogen, assessing the timing and extent of exposure, and discussing potential risks and available options with the pregnant woman to facilitate informed decision-making. 

Question: 9 
A pregnant woman is experiencing common discomforts during pregnancy and seeks guidance from the nurse midwife.Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Order and interpret routine laboratory tests in pregnancy. 
B. Assess the woman's acceptance of pregnancy. 
C. Evaluate the woman's nutritional status by calculating pre-pregnancy BMI. 
D. Counsel the woman about the use of over-the-counter medications for symptom relief. 
Answer: D 
Explanation: Counseling the woman about the use of over-the-counter medications for symptom relief is an appropriate action to address common discomforts during pregnancy. It is important to provide guidance on safe and appropriate medications that can alleviate discomfort while considering the potential risks and benefits for both the woman and the fetus. 

Question: 10 
A pregnant woman presents with first-trimester bleeding. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Counsel the woman about normal physiology of pregnancy. 
B. Order immunizations for the woman. 
C. Perform pelvimetry to evaluate the bony pelvis. 
D. Assess for causes of first-trimester bleeding. 
Answer: D 
Explanation: Assessing for causes of first-trimester bleeding is a critical step in the evaluation and management of a pregnant woman with vaginal bleeding. It helps determine the underlying cause, such as threatened abortion, ectopic pregnancy, or cervical pathology, and guides appropriate treatment and referral as indicated. 
Question: 11 
A pregnant woman has a history of substance use, including tobacco, alcohol, and cannabis. Which of the following actions would be most appropriate for the nurse midwife to take? 
A. Counsel the woman about fetal movement awareness and counting. 
B. Evaluate the woman's nutritional status by calculating pre-pregnancy BMI. 
C. Screen the woman for substance use and refer as appropriate. 
D. Order and interpret routine laboratory tests in pregnancy. 
Answer: C 
Explanation: Screening the pregnant woman for substance use and referring her for appropriate interventions and support is an essential role of a nurse midwife. Substance use during pregnancy can have significant adverse effects on both the woman and the fetus, and early identification and intervention are crucial for optimizing outcomes. 

Question: 12 
Which of the following actions should the AMCB Certified Nurse Midwife take to assess a woman's risk status during her current pregnancy? 
A. Refers to community resources as indicated. 
B. Orders and evaluates serial hCG levels when indicated. 
C. Evaluate prior obstetric and medical history. 
D. Counsels about the use of over-the-counter medications in pregnancy. 
Answer: C 
Explanation: To assess a woman's risk status during her current pregnancy, the AMCB Certified Nurse Midwife should evaluate her prior obstetric and medical history. This helps identify any potential risk factors that may require additional monitoring or interventions. Ordering and evaluating hCG levels, referring to community resources, or counseling about the use of over-thecounter medications are not directly addressing the assessment of risk status. 

Question: 13 
A pregnant woman comes for a prenatal visit and reports experiencing domestic violence. What should the AMCB Certified Nurse Midwife do? 
A. Evaluate historical, physical, and laboratory data to determine current gestational age and due date. 
B. Assess the woman's acceptance of pregnancy. 
C. Screen and refer as indicated for violence or abuse during pregnancy. 
D. Counsel about normal physiology of pregnancy, common discomforts, and self-care during pregnancy. 
Answer: C 
Explanation: When a pregnant woman reports experiencing domestic violence, it is essential for the AMCB Certified Nurse Midwife to screen for violence or abuse during pregnancy and refer the woman as indicated. This ensures the woman's safety and connects her with appropriate resources and support. Assessing the woman's acceptance of pregnancy, evaluating gestational age, or counseling about normal physiology of pregnancy are not directly addressing the issue of domestic violence. 

Question: 14 
A pregnant woman presents with symptoms of anemia. Which of the following actions should the AMCB Certified Nurse Midwife take? 
A. Orders immunizations in pregnancy. 
B. Orders and interprets routine laboratory tests in pregnancy. 
C. Orders ultrasounds to assess fetal growth when indicated. 
D. Performs pelvimetry to evaluate the bony pelvis. 
Answer: B 
Explanation: When a pregnant woman presents with symptoms of anemia, the AMCB Certified Nurse Midwife should order and interpret routine laboratory tests in pregnancy to diagnose anemias. This helps determine the specific type of anemia and guide appropriate treatment and management. Ordering immunizations, assessing fetal growth, or performing pelvimetry are not directly addressing the issue of anemia. 
Question 15: 
A pregnant woman presents with vaginal bleeding in the first trimester. Which of the following actions should the AMCB Certified Nurse Midwife take? 
A. Order a first-trimester ultrasound to establish gestational age. 
B. Assess for causes of first trimester bleeding and refer for treatment as indicated. 
C. Perform Leopold's maneuvers to determine presentation, lie, position of fetus, and estimated weight of fetus. 
D. Auscultate fetal heart tones with a pinard, fetoscope, or doppler. 
Answer: A, B 
Explanation: In the case of vaginal bleeding in the first trimester, it is important to establish the gestational age and assess the causes of bleeding. Therefore, the AMCB Certified Nurse Midwife should order a first-trimester ultrasound to establish gestational age and assess for causes of bleeding and refer for treatment if necessary. Leopold's maneuvers are used to determine the position of the fetus and estimate its weight, while auscultating fetal heart tones is done to assess fetal well-being, but these actions are not directly related to addressing vaginal bleeding in the first trimester.