PracticeVideosBlogFlashcardsEspañol
All Practice Exams

Free Practice Questions for CNM

Exam-style questions and explanations by OpenExamPrep.

✓ No registration✓ No credit card
Exam pass rate: 80%
234+ Questions
100% Free

Loading practice questions...

Exam Review

Key Facts: CNM Exam

80%

First-Time Pass Rate

AMCB 2024 Annual Report

175

Questions

Includes unscored pretest items

Criterion-referenced

Passing Standard

No published cut score

$134,040

Median CNM Salary

BLS, May 2025

42%

Antepartum + Intrapartum

Largest domains

4 hours

Exam Duration

Computer-based

The AMCB CNM exam had an 80% first-time pass rate in 2024 (AMCB Annual Report). The 175-question, four-hour exam covers antepartum and intrapartum care (21% each), well woman/gyn (19%), postpartum (18%), women's health/primary care (11%), and newborn care (10%). Scoring is criterion-referenced and AMCB does not publish a numeric cut score. Nurse midwives earn a median of $134,040/year (BLS, May 2025).

Sample CNM Practice Questions

Try these sample questions to review concepts for the CNM exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 234+ 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. This patient's fasting glucose of 95 mg/dL is at the upper limit of the target, but the 2-hour postprandial of 145 mg/dL is above the <120 mg/dL target. The appropriate adjustment is to increase the bolus (prandial) insulin to improve postprandial glucose control. No change is needed to basal insulin since fasting is at target.
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.

Exam sponsor: AMCB. The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Questions

175 questions

Time Limit

4 hours

Passing Score

AMCB uses a criterion-referenced passing standard set by an Angoff standard-setting study; it does not publish a fixed numeric or percentage cut score

Exam / Certification Fees

$425 initial examination; $350 re-examination

Exam sponsor website

Reported exam pass rate: 80%. first-time pass rate, 2024 AMCB Annual Report (repeat 51%; overall 73.0%) This describes exam candidates, not OpenExamPrep users or results from using our resources. Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.

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

Preparing for the CNM Exam

What You Need to Know

  • Passing score: AMCB uses a criterion-referenced passing standard set by an Angoff standard-setting study; it does not publish a fixed numeric or percentage cut score
  • Exam length: 175 questions
  • Time limit: 4 hours
  • Exam / certification fees: $425 initial examination; $350 re-examination Official sources

Using Our Practice Resources

  • Work through all 234 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

CNM: Suggested Study Strategy

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?

AMCB reported an 80% first-time pass rate for 2024, with a 51% repeat pass rate and a 73.0% overall pass rate across all attempts (2024 AMCB Annual Report). Graduates of ACME-accredited nurse-midwifery programs generally pass at higher rates. Scoring is criterion-referenced, and AMCB does not publish a numeric cut score.

How many questions are on the CNM exam?

The AMCB CNM exam consists of 175 multiple-choice questions, each with four options, completed in a four-hour session at a PSI testing center. Some items are unscored pretest questions scattered throughout the exam; AMCB does not publish how many. Candidates may review and change previously answered items within the time limit.

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?

AMCB uses a criterion-referenced passing standard established by an Angoff standard-setting study, applied to the test as a whole rather than to individual content areas. Scores are based only on the number of correct answers, with no penalty for guessing, and AMCB does not publish a fixed numeric or percentage cut score. Candidates receive an official pass/fail score report at the testing center.

How much do CNMs earn?

According to the BLS Occupational Outlook Handbook (May 2025 data), nurse midwives earn a median of $134,040 per year. Pay varies substantially by setting and geography, with hospital-based roles and coastal metropolitan areas generally paying more than birth centers or rural practice.

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.