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Key Facts: EHPLE Midwifery Exam

200

Exam Questions

MoH HHrIPR-LEO Examination Guideline

Two blocks of 100

Exam Time

MoH Implementation Guideline (blocks of <=120 questions, >=30-minute break)

Angoff

Standard Setting

Modified Angoff criterion-referenced method

14%

Intrapartum care share of the blueprint

Official EHPLE Midwifery Information Booklet

62%

Patient Care domain weight

Official EHPLE Midwifery Information Booklet

Not published

Registration Fee

MoH registration portal (hple.moh.gov.et)

The EHPLE Midwifery licensure exam is delivered as 200 four-option MCQs in a morning and an afternoon block of 100 questions each. The official MoH blueprint weights Patient Care at 62% (intrapartum care 14%, antenatal care 11%, gynecologic and abortion care 10%, postpartum care 8%, family planning 6%, neonatal and under-five care 6%, preconception care 4%, basic midwifery skills 3%), with Scholar 12%, Health Promotion and Disease Prevention 12%, Leadership and Management 8%, and Professionalism 6%. The pass mark is set each round by a Modified-Angoff expert panel.

Sample EHPLE Midwifery Practice Questions

Try these sample questions to review concepts for the EHPLE Midwifery exam. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 24-year-old nulliparous woman visits a family planning clinic for preconception counseling. She plans to conceive within the next three months. Which daily dose of folic acid supplementation should the midwife recommend to prevent neural tube defects?
A.400 micrograms (0.4 mg) daily
B.5 milligrams (5.0 mg) daily
C.100 micrograms (0.1 mg) daily
D.1000 micrograms (1.0 mg) daily
Explanation: Standard preconception guidelines recommend that all women planning pregnancy consume 400 micrograms (0.4 mg) of folic acid daily starting at least one month prior to conception and continuing through the first 12 weeks of gestation. This preventive measure significantly reduces the incidence of neural tube defects such as spina bifida and anencephaly. Higher doses like 5 mg daily are reserved for women with specific high-risk indications, such as a prior child with a neural tube defect or maternal antiepileptic drug therapy.
2A pregnant woman presents for her initial antenatal visit. She reports that her last normal menstrual period (LNMP) began on July 14, 2025. Using Naegele's rule, what is her estimated date of delivery (EDD)?
A.April 7, 2026
B.April 21, 2026
C.March 21, 2026
D.May 21, 2026
Explanation: According to Naegele's rule for calculating the estimated date of delivery, the midwife adds 7 days to the first day of the last normal menstrual period, subtracts 3 calendar months, and adds 1 year (or adjusts the year appropriately). Adding 7 days to July 14 yields July 21, and subtracting 3 months gives April 21, resulting in an expected delivery date of April 21, 2026. This assumes a standard 28-day menstrual cycle.
3During a routine antenatal assessment at 28 weeks of gestation, a primigravida exhibits a hemoglobin level of 10.8 g/dL and asks why her hemoglobin dropped from 12.5 g/dL at 8 weeks. What physiological mechanism primarily explains this finding?
A.Accelerated destruction of maternal red blood cells by the placenta
B.Decreased renal erythropoietin production during the second trimester
C.Disproportionate expansion of plasma volume relative to red cell mass
D.Impaired intestinal iron absorption caused by elevated progesterone
Explanation: During normal pregnancy, maternal plasma volume expands by approximately 45% to 50%, whereas red blood cell mass increases by only 20% to 30%. This physiological discrepancy results in hemodilution, commonly referred to as the physiologic anemia of pregnancy. The nadir of hemoglobin concentration typically occurs near the end of the second trimester (around 28 to 32 weeks).
4According to the Ethiopian national antenatal care guidelines adapted from the WHO 2016 model, when should a pregnant woman have her first antenatal care (ANC) contact?
A.Between 16 and 20 weeks of gestation
B.Between 24 and 28 weeks of gestation
C.Whenever quickening is first felt
D.Within the first 12 weeks of gestation
Explanation: The current Ethiopian antenatal care guideline recommends eight contacts, with the first contact occurring within the first 12 weeks of gestation (first trimester). Early initiation allows timely estimation of gestational age, baseline screening for anemia, syphilis, and HIV, early identification of pre-existing medical disorders, and initiation of prophylactic nutritional interventions. Delayed entry into care misses crucial opportunities for early preventive maternal-fetal health interventions.
5A 22-year-old primigravida tests positive for syphilis during a rapid treponemal screening test at her first antenatal visit. She has no genital ulcers or constitutional symptoms. Which treatment regimen is standard for maternal early syphilis to prevent congenital syphilis?
A.Oral Doxycycline 100 mg twice daily for 14 days
B.Benzathine Penicillin G 2.4 million units intramuscularly in a single dose
C.Oral Erythromycin 500 mg four times daily for 14 days
D.Intravenous Ceftriaxone 1 g daily for 10 days
Explanation: Benzathine Penicillin G 2.4 million units administered intramuscularly as a single dose is the drug of choice for primary, secondary, and early latent syphilis in pregnancy. Penicillin reliably crosses the placenta, achieves therapeutic fetal tissue concentrations, and cures both maternal infection and prevents congenital syphilis. Pregnant women with documented penicillin allergies should undergo desensitization because no alternative antibiotic matches penicillin's efficacy across the placenta.
6What is the recommended daily preventive dose of elemental iron and folic acid for an average-risk pregnant woman according to Ethiopian national maternal health guidelines?
A.30 mg elemental iron and 100 mcg folic acid
B.120 mg elemental iron and 800 mcg folic acid
C.60 mg elemental iron and 400 mcg folic acid
D.200 mg elemental iron and 5 mg folic acid
Explanation: The standard daily prophylactic regimen for pregnant women in Ethiopia consists of 60 mg of elemental iron (equivalent to 300 mg of ferrous sulfate heptahydrate or 200 mg of ferrous fumarate) combined with 400 mcg (0.4 mg) of folic acid. This regimen should be initiated as early as possible in pregnancy and continued for at least six months. Routine supplementation prevents maternal iron deficiency anemia, puerperal sepsis, and low infant birth weight.
7A 19-year-old pregnant woman in her second trimester has never received any tetanus toxoid-containing vaccines. She receives her first dose (TT1/Td1) today. When should she receive her second dose (TT2/Td2) to ensure protection against neonatal tetanus?
A.At least 4 weeks after the first dose
B.At least 6 months after the first dose
C.At least 1 year after the first dose
D.During the active stage of labor
Explanation: For a pregnant woman who has never received tetanus vaccination, the second dose (TT2 or Td2) should be administered at least 4 weeks after the first dose (TT1). To ensure protective maternal IgG antibody transmission across the placenta to safeguard the newborn against neonatal tetanus, TT2 should be administered at least 2 weeks before delivery. TT2 provides approximately 80% protection against tetanus for up to three years.
8A 26-week pregnant woman undergoes a 75 g two-hour oral glucose tolerance test (OGTT) for gestational diabetes mellitus (GDM) screening. According to WHO/IADPSG criteria, which plasma glucose threshold is diagnostic of GDM?
A.Fasting plasma glucose >= 126 mg/dL (7.0 mmol/L)
B.1-hour plasma glucose >= 200 mg/dL (11.1 mmol/L)
C.2-hour plasma glucose >= 200 mg/dL (11.1 mmol/L)
D.Fasting plasma glucose >= 92 mg/dL (5.1 mmol/L)
Explanation: According to the WHO and IADPSG diagnostic criteria using a 75 g one-step OGTT, gestational diabetes mellitus is diagnosed if one or more values meet or exceed: fasting plasma glucose of 92 mg/dL (5.1 mmol/L), 1-hour plasma glucose of 180 mg/dL (10.0 mmol/L), or 2-hour plasma glucose of 153 mg/dL (8.5 mmol/L). Identifying and managing GDM mitigates risks of fetal macrosomia, shoulder dystocia, and neonatal hypoglycemia.
9A routine urine culture at 16 weeks reveals >100,000 CFU/mL of Escherichia coli in an asymptomatic pregnant woman. Why is treatment of asymptomatic bacteriuria mandatory in pregnancy?
A.It causes immediate premature closure of the fetal ductus arteriosus
B.It carries a 20% to 40% risk of progressing to acute pyelonephritis if untreated
C.It is a primary cause of neural tube defects during the second trimester
D.It directly triggers maternal autoimmune hemolytic anemia
Explanation: Asymptomatic bacteriuria occurs in 2% to 10% of pregnancies. Due to progesterone-induced ureteral dilation, smooth muscle relaxation, and mechanical compression by the gravid uterus, urinary stasis enables bacteria to ascend easily. Without antibiotic treatment, 20% to 40% of women with asymptomatic bacteriuria develop acute pyelonephritis, which carries substantial risks of maternal sepsis, preterm labor, and low birth weight.
10Which cluster of symptoms represents obstetric danger signs that require a pregnant woman to seek immediate emergency care at a health facility?
A.Mild pedal edema at the end of the day, urinary frequency, and occasional Braxton Hicks contractions
B.Morning sickness during the eighth week, breast tenderness, and fatigue
C.Vaginal bleeding, severe persistent headache, blurred vision, and high fever
D.Increased vaginal discharge without odor, linea nigra, and mild lower backache
Explanation: Obstetric danger signs indicate life-threatening complications that demand immediate facility-based evaluation. Vaginal bleeding suggests placenta previa, placental abruption, or abortion; severe persistent headache and blurred vision signal severe preeclampsia; and high fever indicates serious maternal infection or chorioamnionitis. Midwives must educate every woman and her family on these danger signs during every antenatal visit.

About the EHPLE Midwifery Exam

The Ethiopian Health Professionals Licensing Examination (EHPLE) for Midwifery is the mandatory national competency assessment administered by the Federal Ministry of Health (MoH) through the Health and Health-related Institutions and Professionals Regulatory Lead Executive Office (HHrIPR-LEO). It assesses graduating and practicing BSc midwives on essential clinical competencies, safe motherhood, emergency obstetric and newborn care (EmONC), reproductive healthcare, and professional midwifery ethics required for independent clinical licensure in Ethiopia.

Exam sponsor: Federal Ministry of Health (MoH) — Health and Health-related Institutions and Professionals Regulatory Lead Executive Office (HHrIPR-LEO). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The MoH Implementation Guideline allots roughly 1.25 minutes per question and caps a single block at 120 questions / 2 hours 30 minutes, followed by a break of at least 30 minutes before the second block. A 200-item sitting is therefore delivered as a morning and an afternoon block of 100 questions each.

Time Limit

Two 100-question blocks with a break of at least 30 minutes

Passing Score

Set each round by an expert panel using the Modified-Angoff method (no fixed percentage)

Exam / Certification Fees

Not published by MoH as a fixed public tariff. A registration fee is paid through the official portal (hple.moh.gov.et); candidates who miss a sitting without an accepted reason pay the registration fee plus a 50% penalty (MoH Exam Administration Manual). Confirm the current amount on the registration announcement.

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.

62%

Patient Care

Intrapartum care (14%), antenatal care (11%), gynecologic and abortion care (10%), postpartum care (8%), family planning (6%), neonatal and under-five children care (6%), preconception care (4%), and basic midwifery skills (3%).

12%

Scholar

Research literacy, evidence-based midwifery practice, and continuing professional development.

12%

Health Promotion and Disease Prevention

Community diagnosis and community-based maternal, newborn and reproductive health interventions.

8%

Leadership and Management

Team leadership, health system management, and resource stewardship.

6%

Professionalism

Ethical principles, medico-legal practice, communication, collaboration, and standards of professional conduct.

Preparing for the EHPLE Midwifery Exam

What You Need to Know

  • Passing score: Set each round by an expert panel using the Modified-Angoff method (no fixed percentage)
  • Assessment: The MoH Implementation Guideline allots roughly 1.25 minutes per question and caps a single block at 120 questions / 2 hours 30 minutes, followed by a break of at least 30 minutes before the second block. A 200-item sitting is therefore delivered as a morning and an afternoon block of 100 questions each.
  • Time limit: Two 100-question blocks with a break of at least 30 minutes
  • Exam / certification fees: Not published by MoH as a fixed public tariff. A registration fee is paid through the official portal (hple.moh.gov.et); candidates who miss a sitting without an accepted reason pay the registration fee plus a 50% penalty (MoH Exam Administration Manual). Confirm the current amount on the registration announcement. Official sources

Using Our Practice Resources

  • Work through all 100 available questions
  • Review every answer and explanation
  • Track weak areas and revisit them
  • Use our AI tutor for tough concepts

EHPLE Midwifery: Suggested Study Strategy

1Master the WHO/Ethiopian Modified Partograph: Practice plotting cervical dilation, descent, and contraction frequency against the alert and action lines to make prompt referral decisions.
2Memorize standard emergency obstetric protocols: Be completely fluent in active management of the third stage of labor (AMTSL), magnesium sulfate loading and maintenance regimens for severe preeclampsia/eclampsia, and oxytocin dosing for PPH.
3Review the Helping Babies Breathe (HBB) algorithm: Focus on the Golden Minute steps—drying, warmth, airway clearing, stimulation, and bag-and-mask ventilation within 60 seconds of birth.
4Study Medical Eligibility Criteria (MEC) for Contraception: Know contraindications, initiation timings (including postpartum and post-abortion), and side-effect management for implants, IUCDs, and injectable contraceptives.
5Simulate timed 100-question blocks: the MoH Implementation Guideline allows roughly 1.25 minutes per question, so rehearse at that pace to develop endurance across the morning and afternoon blocks of the national examination.

Frequently Asked Questions

What is the EHPLE Midwifery examination?

The EHPLE Midwifery is the national licensing examination administered by the Ethiopian Ministry of Health (MoH) HHrIPR-LEO to certify that BSc Midwifery graduates possess the clinical competencies, judgment, and ethical foundation required to practice safely across Ethiopian health facilities.

How many questions are on the EHPLE Midwifery exam and what is the time limit?

The examination consists of 200 multiple-choice questions split in a morning and an afternoon block of 100 questions each, providing a total examination duration of Two 100-question blocks.

How is the passing score determined for the EHPLE Midwifery exam?

The passing standard is not a fixed percentage; instead, it is determined for each test round using the Modified Angoff standard-setting method by a panel of Ethiopian maternal health and midwifery subject matter experts.

What competency domains are covered on the EHPLE Midwifery blueprint?

The official MoH Midwifery Information Booklet weights five key professional roles: Patient Care 62%, broken down into intrapartum care (14%), antenatal care (11%), gynecologic and abortion care (10%), postpartum care (8%), family planning (6%), neonatal and under-five children care (6%), preconception care (4%) and basic midwifery skills (3%); followed by Scholar 12%, Health Promotion and Disease Prevention 12%, Leadership and Management 8%, and Professionalism 6%.

What is the exam registration fee and how do candidates apply?

The registration fee is not published as a fixed public tariff and is announced by the Ministry of Health for each round; and candidates apply online through the official MoH Health Professional Licensure Examination portal at https://hple.moh.gov.et/ after completing their accredited university degrees and institutional clearances.

Are these practice questions an official EHPLE paper?

No. The EHPLE is set and delivered only by the Federal Ministry of Health; these questions are an independent study aid written against the official Information Booklet blueprint and Ethiopian national clinical guidelines. The official examination is delivered in English as computer-based, four-option, single-best-answer MCQs, so the item format here matches the real assessment, but this bank is not an official past paper, a released item pool, or a simulation of the live testing environment. Always confirm registration dates, fees, and exam-day rules on moh.gov.et/ehple and hple.moh.gov.et.