Get AMCB CNM Exam Sample Papers Questions And Answers

1. CertsChief Guaranteed Success with Accurate & Updated Questions. Nursing AMCB CNM Certified Nurse Midwife Questions & Answers PDF For More Information - Visit: https://www.certschief.com/ ProductFull Version Features:  90 Days Free Updates  30 Days Money Back Guarantee  Instant Download Once Purchased  24/7 Online Chat Support Visit us athttps://www.certschief.com/amcb-cnm/

2. Latest Version: 6.0 Question: 1 Clomiphene citrate is prescribed to a woman to stimulate ovulation. Which of the following statements by the nurse midwife is the most appropriate for this client? A. “If no results are obtained after the second course of clomiphene citrate therapy, the therapy will be discontinued.” B. “Blurring of vision is an expected side effect of the medication.” C. “Bruising or bleeding should be reported.” D. “Blood samples are obtained periodically.” Answer: C Explanation: Bruising or bleeding should be reported. In addition, bloating, stomach pain and blurring of vision require consultation. The therapy is discontinued after three unsuccessful courses of clomiphene. The therapy requires 24-hour urine samples. Question: 2 A nurse midwife is creating a care plan for a client who is in early labor. Which of the following guidelines is least important? A. Be certain that the outcomes are realistic. B. Incorporate both the client and her support person. C. Project a definite time limit for labor to be completed. D. Address the discomforts of labor. Answer: C Explanation: The nurse midwife should avoid projecting a definite time limit for labor to be completed. The length of labor can vary from client to client and still be within the normal limits. The outcomes should be realistic. Labors usually occur over a short period of time, and the nurse midwife should ensure that the outcomes are met within this time period. The female client and her support person should be incorporated so that the labor experience is a shared one. Comfort promotion is essential. Question: 3 A nurse midwife is about to perform amniotomy on a client who is in her 39th week of gestation. Which of the following actions of the nurse midwife is the least appropriate before starting the procedure? Visit us athttps://www.certschief.com/amcb-cnm/

3. A. Examine the cervix and measure cervical dilatation. B. Assess the fetal heart tone. C. Maintain aseptic technique. D. Position the client in lithotomy position. Answer: D Explanation: The least appropriate action of the nurse is to place the client in the lithotomy position. The client must be positioned in the dorsal recumbent position. The nurse midwife should examine the cervix and measure cervical dilatation. In most cases, a cervical dilatation of 3 cm is needed before amniotomy. The fetal heart tone is assessed before and after the procedure. Aseptic technique is maintained throughout the procedure. Question: 4 A client is admitted to the labor and delivery unit. A nurse midwife is assessing the fetal heart tone monitor tracing and notes late decelerations. Which of the following is the most effective intervention? A. Administer oxygen through a face mask. B. Position the client in knee-chest position. C. Administer oxytocin. D. Document the findings and continue monitoring the client. Answer: A Explanation: The most effective action for the nurse midwife to take is to administer oxygen through a face mask. The client is most likely experiencing uteroplacental insufficiency, which usually results from decreased flow of oxygenated blood to the fetus during contractions. The client should be placed in the left side lying position to improve fetal circulation and oxygenation. Oxytocin increases uteroplacental insufficiency and should not be administered; it can aggravate or worsen fetal hypoxemia. Question: 5 A nurse midwife induces labor through amniotomy. The amniotic fluid is assessed and the nurse midwife notes that the amniotic fluid is red in color. This finding most likely suggests: A. Fetal trauma. B. Infection. C. A fetal congenital disorder. D. Fetal distress. Answer: A Visit us athttps://www.certschief.com/amcb-cnm/

4. Explanation: Red amniotic fluid most likely suggests fetal trauma. The characteristics of the amniotic fluid, such as color, odor and quantity of fluid, should be noted after amniotomy. A foul odor suggests infection. Excessive or too little amniotic fluid suggests fetal congenital disorder. Fetal distress may be manifested with green-colored amniotic fluid. Question: 6 A nurse midwife is reviewing the fetal heart rate monitor tracing obtained from a G2P1 client who is in labor. The nurse midwife notes decelerations at unpredictable times in relation to contractions. The nurse midwife suspects which of the following conditions? A. Cephalopelvic disproportion B. Good fetal-well being C. Uteroplacental insufficiency D. Cord compression Answer: D Explanation: The nurse midwife suspects cord compression. Variable deceleration is manifested by decelerations occurring at unpredictable times in relation to contractions. This type of variability usually occurs after rupture of the membranes or in cases of oligohydramnios. Cephalopelvic disproportion is manifested by early decelerations before the head is fully descended. Early decelerations normally occur during the final stages of labor. Uteroplacental insufficiency is manifested by late decelerations. Question: 7 A nurse midwife assesses a client who is in her 35th week of gestation. After conducting abdominal inspection and palpation, the nurse midwife notes that the fetus is in the transverse lie. This finding is verified by a sonogram. Which of the following actions by the nurse midwife is the most appropriate before an external version? A. Initially order a contraction stress test. B. Administer a tocolytic agent. C. Monitor the heart rate for vena cava compression. D. Withhold RhoGAM administration. Answer: B Explanation: The most appropriate action by the nurse midwife before an external version is to administer a tocolytic agent. Tocolytics, such as tertbutaline, may be administered through the subcutaneous route to relax the uterus and to allow easier manipulation. External version is the manipulation of the fetus from an abnormal position to a good presentation. This is done after the 34th week of gestation. A non-stress test is ordered to Visit us athttps://www.certschief.com/amcb-cnm/

5. determine fetal well-being. The blood pressure is monitored for vena cava compression. The nurse midwife ensures that the client had a RhoGAM during the 28th week. Question: 8 A client at 39 weeks’ gestation is admitted to the labor and delivery unit. An external fetal heart rate monitor is attached to the client. Physical examination and laboratory test results reveal that the fetus is in breech position, and a cesarean delivery is recommended. Physical examination is conducted and laboratory tests are ordered. Before the pregnancy, the client’s average heart rate was 80 beats per minute. Which of the following assessment findings necessitates immediate physician notification? A. Hematrocrit = 38% B. WBC = 18,000 cells/mm3 C. Maternal heart rate = 95 beats per minute D. Fetal heart rate = 180 beats per minute Answer: D Explanation: A fetal heart rate of 180 beats per minute requires immediate notification of the physician. The normal fetal heart rate is between 120 and 160 beats per minute. A fetal heart rate of 180 beats per minute suggests that the fetus is in respiratory distress. The client’s hematocrit concentration is within the normal limits. The WBC increases above the normal range during the third trimester, and it may increase to 18,000 cells/mm3 during labor. The maternal heart rate may increase by 10 to 15 beats per minute during pregnancy. Question: 9 A nurse midwife conducts an amniotomy on a client to induce labor. Which of the following interventions is the priority of the nurse midwife after the procedure? A. Administer oxygen. B. Obtain the client’s blood pressure. C. Assess the fetal heart tone. D. Position the client in knee-chest position. Answer: C Explanation: The priority action of the nurse after an amniotomy is to assess the fetal heart tone. After the escape of the amniotic fluid, the fetus is at risk of cord prolapse, which may result in brain damage. A decrease in the fetal heart tone suggests cord prolapse. Oxygen is administered and the client is placed in knee-chest position if cord prolapse is present. Visit us athttps://www.certschief.com/amcb-cnm/

6. Question: 10 A few weeks before labor, the client may experience subtle signs that indicate the onset of labor. One of these signs is lightening. The nurse midwife teaches the client to recognize the signs of lightening. Which of the following is not a sign of lightening? A. Relief from diaphragmatic pressure and shortness of breath. B. Abdominal contour changes. C. Increased urinary frequency. D. Decreased amounts of vaginal discharge. Answer: D Explanation: Increased amounts of vaginal discharge are commonly reported when lightening has occurred. Lightening may occur 10 to 14 days before labor. The client may report relief from diaphragmatic pressure and shortness of breath as the uterus becomes lower and more anterior. Although the client may report relief, the abdominal pressure increases, resulting in increased urinary frequency, shooting leg pains and increased amounts of vaginal discharge. Question: 11 A nurse midwife is caring for a client who is in the first stage of labor. The client’s amniotic membranes have not ruptured. Which of the following interventions is the most effective during this stage of labor? A. Apply distraction techniques during contractions. B. Instruct the client to lie on her left side and to avoid frequent change of positions. C. Instruct the client to void at least every two hours. D. Limit therapeutic touch. Answer: C Explanation: The most effective intervention during the first stage of labor is to instruct the client to void at least every two hours. Bladder fullness may be misinterpreted as sensations of labor by the client. The nurse midwife must learn not to interrupt the client during contraction time. If the amniotic membranes have not ruptured, the client must be encouraged to ambulate. Therapeutic touch is recommended. Question: 12 A nurse midwife is about to perform an amniotomy on a client who is in the active phase of labor. Before performing the procedure, the nurse midwife informs the client that after the amniotomy, she can expect: Visit us athttps://www.certschief.com/amcb-cnm/

7. A. Increased efficiency of uterine contractions. B. Increased number of uterine contractions. C. Fluttery feeling in the chest. D. Decreased number of uterine contractions. Answer: A Explanation: The nurse midwife should inform the client that after amniotomy, she can expect increased efficiency of uterine contractions. Amniotomy is an artificial method of rupturing the membrane to induce labor. Rupturing of the membranes allows direct contact of the fetal head with the cervix, increasing the efficiency of the contractions. Fluttery feeling in the chest is expected after the administration of tertbutaline. Question: 13 A nurse midwife is managing the care of a G3P2 client. The birthing room is converted into a birth room when the cervix is dilated to: A. 5 cm B. 5 to 7 cm C. 7 to 9 cm D. 10 cm Answer: C Explanation: The birthing room is converted into a birth room when the client’s cervix is dilated to 7 to 9 cm. The second stage of labor is usually shorter for multipara clients. For primipara clients, this action may be delayed until the head of the fetus has crowned to the size of a quarter, or when the cervix is fully dilated and descent has occurred. Question: 14 A client with a multiple pregnancy is scheduled for cesarean delivery and is transported to the delivery operating room. The nurse midwife reminds the staff nurse to position the client in which of the following positions in the operating room? A. Left side-lying position B. Semi-Fowler position C. Supine position, with a wedge placed under the right hip. D. Supine position, with a wedge placed under the left hip. Answer: C Visit us athttps://www.certschief.com/amcb-cnm/

8. Explanation: The nurse midwife reminds the staff nurse to position the client in supine position, with a wedge placed under the right hip, in the operating room. The enlarging uterus compresses the vena cava and the descending aorta of the client, which impedes blood flow to the lower extremities and uterus. The side-lying position is the most ideal position during pregnancy, as it displaces the uterus off the compressed structures. In an abdominal surgery, the client should be positioned in supine position. To displace the uterus and to prevent decreased blood flow to the uterus, a wedge should be placed under the right hip. Question: 15 A nurse midwife is managing the care of a G1P0 client who is about to be placed in the lithotomy position. A registered nurse is positioning the client correctly and safely if which of the following nursing actions is observed by the nurse midwife? A. The strap holding the leg in the stirrups is secured tightly. B. The top portion of the table is raised to 15 to 20 degrees for effective pushing once the client is in the lithotomy position. C. The legs are raised one at a time. D. The registered nurse places the client’s legs in the stirrups only when the nurse midwife is scrubbing. Answer: D Explanation: The registered nurse is correctly and safely positioning the client in lithotomy position only when the nurse midwife is scrubbing. Lying longer for more than an hour in the lithotomy position may cause pelvic congestion and hemorrhage, so it is important that the client is placed in this position only when the procedure is about start. To prevent constriction, the strap holding the leg should not be secured too tightly . Once the client is in lithotomy, the top portion of the table is raised to 30 to 60 degrees for more effective pushing. The legs must be raised at the same time to prevent straining the client’s back and abdominals. Visit us athttps://www.certschief.com/amcb-cnm/

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