200+ Free CNM Practice Questions

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A 28-year-old pregnant patient at 12 weeks gestation presents for her initial prenatal visit. Which laboratory test is routinely recommended at this visit?

Amniocentesis for chromosomal analysis

Group B Streptococcus screening

Complete blood count and blood type with antibody screen

Glucose tolerance test

to track

2026 Statistics

Key Facts: CNM Exam

80%

First-Time Pass Rate

AMCB 2023

175

Questions

50 pretest

Passing Score

Scaled

$120,880

Median CNM Salary

BLS 2024

42%

Antepartum + Intrapartum

Largest domains

4 hours

Exam Duration

Computer-based

The AMCB CNM exam has approximately an 80% pass rate (2023 data). The 175-question exam covers antepartum and intrapartum care (21% each), postpartum (18%), gynecology (19%), primary care (11%), and newborn care (10%). CNMs earn a median salary of $120,880/year (BLS 2024) with strong job growth driven by demand for personalized maternity care.

Sample CNM Practice Questions

Try these sample questions to test your CNM exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 200+ question experience with AI tutoring.

1A 28-year-old pregnant patient at 12 weeks gestation presents for her initial prenatal visit. Which laboratory test is routinely recommended at this visit?

A.Amniocentesis for chromosomal analysis

B.Group B Streptococcus screening

C.Complete blood count and blood type with antibody screen

D.Glucose tolerance test

Explanation: Initial prenatal laboratory screening includes a complete blood count (to assess for anemia), blood type with Rh factor and antibody screen (to identify potential Rh incompatibility), urinalysis, rubella immunity, hepatitis B, HIV, and syphilis screening. Group B strep screening is done at 36-37 weeks, glucose tolerance testing at 24-28 weeks, and amniocentesis is only offered for specific indications such as advanced maternal age or abnormal screening results.

2A pregnant patient at 16 weeks gestation reports nausea and vomiting that has persisted since week 8. She has lost 3 pounds and shows signs of dehydration. What is the most appropriate initial management?

A.Recommend dietary modifications and ginger supplements

B.Admit for IV hydration and antiemetic therapy

C.Schedule an urgent ultrasound to evaluate for multiples

D.Prescribe oral ondansetron and follow up in 1 week

Explanation: This patient has hyperemesis gravidarum, characterized by persistent vomiting, weight loss (>5% of prepregnancy weight), and dehydration. Initial management requires hospitalization for IV fluid resuscitation, electrolyte replacement, and IV antiemetics. Dietary modifications and oral medications are appropriate for mild nausea and vomiting of pregnancy, but not for hyperemesis gravidarum with dehydration.

3What is the recommended daily folic acid supplementation for a patient planning pregnancy to reduce the risk of neural tube defects?

A.0.4 mg (400 mcg)

B.1 mg (1000 mcg)

C.4 mg (4000 mcg)

D.0.1 mg (100 mcg)

Explanation: The CDC and ACOG recommend that all women of reproductive age consume 400 mcg (0.4 mg) of folic acid daily, beginning at least one month before conception and continuing through the first trimester. A higher dose of 4 mg is recommended only for women with a previous pregnancy affected by a neural tube defect or those taking certain anti-seizure medications.

4A patient at 28 weeks gestation has a blood pressure of 152/96 mmHg on two occasions 4 hours apart, with no proteinuria. What is the appropriate diagnosis?

A.Chronic hypertension

B.Gestational hypertension

C.Preeclampsia

D.Severe hypertension

Explanation: Gestational hypertension is defined as new-onset hypertension (systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg on two occasions at least 4 hours apart) occurring after 20 weeks gestation without proteinuria or other systemic findings. Preeclampsia requires hypertension plus proteinuria or other systemic findings. Chronic hypertension is diagnosed before pregnancy or before 20 weeks gestation.

5Which of the following is a contraindication to vaginal birth after cesarean (VBAC)?

A.One previous low transverse cesarean section

B.Previous classical uterine incision

C.Gestational diabetes requiring insulin

D.Prior vaginal delivery

Explanation: A previous classical (vertical) uterine incision is an absolute contraindication to VBAC due to the high risk of uterine rupture. The risk of rupture with a classical incision is approximately 4-9% compared to 0.5-1% with a low transverse incision. Previous low transverse cesarean and prior vaginal delivery are favorable factors for VBAC success.

6At what gestational age is nuchal translucency screening typically performed?

A.8-10 weeks

B.11-13 weeks + 6 days

C.15-18 weeks

D.20-22 weeks

Explanation: Nuchal translucency (NT) screening is performed between 11 weeks and 13 weeks + 6 days gestation. This first-trimester screening measures the fluid collection at the back of the fetal neck and, when combined with maternal serum markers (PAPP-A and free beta-hCG), can assess the risk for chromosomal abnormalities such as Down syndrome.

7A pregnant patient at 30 weeks reports decreased fetal movement. Fetal heart rate is 140 bpm with moderate variability. What is the next best step in management?

A.Reassure the patient that this is normal

B.Perform a non-stress test (NST)

C.Schedule a biophysical profile for the next day

D.Admit for immediate delivery

Explanation: Decreased fetal movement at 30 weeks requires further evaluation. A non-stress test (NST) is the appropriate initial test to assess fetal well-being. The NST evaluates fetal heart rate patterns in response to fetal movement. A reactive NST provides reassurance, while a non-reactive NST requires further testing such as a biophysical profile or delivery depending on gestational age.

8What is the recommended weight gain for a patient with a normal prepregnancy BMI (18.5-24.9 kg/m²)?

A.11-20 pounds

B.15-25 pounds

C.25-35 pounds

D.28-40 pounds

Explanation: The Institute of Medicine (IOM) recommends a total weight gain of 25-35 pounds (11.5-16 kg) for women with a normal prepregnancy BMI (18.5-24.9 kg/m²). Underweight women (BMI <18.5) should gain 28-40 pounds; overweight women (BMI 25-29.9) should gain 15-25 pounds; and obese women (BMI ≥30) should gain 11-20 pounds.

9A patient at 32 weeks gestation with type 1 diabetes has a fasting blood glucose of 95 mg/dL and 2-hour postprandial glucose of 145 mg/dL. What adjustment is needed?

A.No adjustment needed - these values are at target

B.Increase basal insulin - fasting is above target

C.Increase bolus insulin - postprandial is above target

D.Decrease insulin doses to prevent hypoglycemia

Explanation: During pregnancy, target glucose levels are: fasting <95 mg/dL, 1-hour postprandial <140 mg/dL, and 2-hour postprandial <120 mg/dL. However, this patient's fasting of 95 mg/dL is at the upper limit of target, and 2-hour postprandial of 145 mg/dL is slightly above the <120 mg/dL target. The correct answer should be to increase bolus insulin for better postprandial control. Target fasting is <95 mg/dL and 2-hour postprandial is <120 mg/dL.

10Which vaccine is recommended during every pregnancy, regardless of prior vaccination status?

A.MMR (Measles, Mumps, Rubella)

B.Varicella

C.Tdap (Tetanus, Diphtheria, Pertussis)

D.HPV (Human Papillomavirus)

Explanation: Tdap vaccine is recommended between 27-36 weeks gestation during every pregnancy, regardless of prior vaccination status. This provides passive immunity to the newborn against pertussis (whooping cough), which is most dangerous in the first months of life. MMR and varicella are live vaccines and contraindicated in pregnancy. HPV is not recommended during pregnancy.

About the CNM Exam

The AMCB Certified Nurse-Midwife exam certifies nurse-midwives for entry-level practice. The exam covers six content domains: Antepartum (21%), Intrapartum (21%), Postpartum (18%), Newborn (10%), Gynecology (19%), and Primary Care (11%). Passing demonstrates competency in providing comprehensive midwifery care.

Questions

175 scored questions

Time Limit

4 hours

Passing Score

75 (scaled score)

Exam Fee

$500 (AMCB)

CNM Exam Content Outline

21%

Antepartum Care

Prenatal care, pregnancy complications, fetal assessment, and management of normal and high-risk pregnancies

21%

Intrapartum Care

Labor management, delivery techniques, pain management, complications, and operative delivery

18%

Postpartum Care

Postpartum recovery, lactation support, complications, and newborn transition

19%

Gynecology

Well-woman care, contraception, menstrual disorders, menopause, and gynecologic conditions

11%

Primary Care

Common health problems, health promotion, disease prevention, and primary care across the lifespan

10%

Newborn Care

Immediate newborn assessment, resuscitation, normal newborn care, and recognition of complications

How to Pass the CNM Exam

What You Need to Know

Passing score: 75 (scaled score)
Exam length: 175 questions
Time limit: 4 hours
Exam fee: $500

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

CNM Study Tips from Top Performers

1Focus on antepartum and intrapartum - these two domains make up 42% of the exam combined

2Master common complications: preeclampsia, preterm labor, hemorrhage, and fetal distress management

3Know pharmacology: medications used in pregnancy, labor, and postpartum including dosing and contraindications

4Practice newborn resuscitation protocols (NRP) - know the steps for positive pressure ventilation and chest compressions

5Study gynecologic conditions and contraceptive methods - this is 19% of the exam and includes complex decision-making

Frequently Asked Questions

What is the CNM exam pass rate?

The AMCB CNM exam pass rate is approximately 80% for first-time test-takers (AMCB 2023 data). Graduates of ACME-accredited nurse-midwifery programs generally have higher pass rates. The exam uses a scaled scoring system with 75 as the passing score.

How many questions are on the CNM exam?

The AMCB CNM exam consists of 175 multiple-choice questions. Of these, 50 questions are pretest items that are not scored. Candidates have 4 hours to complete the computer-based examination at PSI testing centers.

How long should I study for the CNM exam?

Most graduates study for 6-10 weeks before the CNM exam, completing 1,500-2,500 practice questions. Focus on all six content domains, with extra attention to antepartum and intrapartum (21% each). Clinical experience during your program provides the foundation - practice questions help apply that knowledge.

What is the CNM exam passing score?

The CNM exam uses a scaled scoring system where 75 is the passing score. Raw scores are converted to scaled scores to account for slight variations in exam difficulty. Results are provided immediately at the testing center.

How much do CNMs earn?

According to BLS 2024 data, nurse midwives earn a median salary of $120,880/year, with top earners exceeding $170,000. CNMs working in hospitals typically earn more than those in birth centers or private practice. Geographic location significantly impacts salary, with higher wages on the coasts.

What are the CNM exam content areas?

The CNM exam covers six domains: Antepartum (21%): prenatal care, complications; Intrapartum (21%): labor management, delivery; Postpartum (18%): recovery, complications, lactation; Gynecology (19%): well-woman care, contraception, menopause; Primary Care (11%): common conditions, health promotion; Newborn (10%): assessment, resuscitation, normal care.