UK NMC CBT Midwives Mock Test (2025 Exam Model) – Part 2

Question 1: A pregnant woman at 38 weeks gestation presents to the maternity unit reporting reduced fetal movements for the past 12 hours. Her vital signs are stable. What is the immediate priority for the midwife?
A) Advise her to drink a cold sugary drink and re-evaluate in one hour.
B) Conduct a comprehensive abdominal palpation to assess fetal position.
C) Perform a cardiotocography (CTG) to assess fetal well-being.
D) Reassure her that reduced movements are common at this stage of pregnancy.

Question 2: A G1P0 woman at 39 weeks gestation arrives in active labour. On admission, she is 4cm dilated, contractions are regular and strong, and her waters are intact. What is the most appropriate initial action for the midwife?
A) Administer analgesia as per trust guidelines.
B) Encourage her to ambulate and use non-pharmacological pain relief methods.
C) Prepare for artificial rupture of membranes (ARM).
D) Assess her pain level using a pain scale.

Question 3: A midwife is caring for a woman who has just given birth. The placenta has delivered, and there is continuous moderate vaginal bleeding. The uterus is soft and boggy on palpation. What is the most likely cause of the bleeding?
A) Retained placental fragments.
B) Uterine atony.
C) Vaginal laceration.
D) Coagulopathy.

Question 4: A woman presents at 10 weeks gestation for her first antenatal appointment. She has a history of severe anxiety and is reluctant to undergo routine blood tests. How should the midwife best approach this situation?
A) Insist on the blood tests, explaining they are mandatory for her care.
B) Refer her immediately to a mental health specialist.
C) Explain the importance of the tests, address her concerns, and offer alternative strategies.
D) Document her refusal and proceed with the rest of the appointment.

Question 5: A primigravida at 34 weeks gestation calls the midwifery unit reporting a sudden onset of severe headache, blurred vision, and epigastric pain. Her blood pressure taken at home was 150/95 mmHg. What is the most appropriate advice for the midwife to give?
A) Advise her to rest at home and monitor her symptoms.
B) Tell her to come to the maternity unit immediately for assessment.
C) Suggest she take over-the-counter pain relief for her headache.
D) Recommend she drink plenty of fluids and lie on her left side.

Question 6: A midwife is reviewing a woman’s antenatal notes and observes she is anemic. What dietary advice should the midwife provide to help improve her iron levels?
A) Increase intake of dairy products and calcium-rich foods.
B) Include more red meat, leafy green vegetables, and fortified cereals in her diet.
C) Focus on consuming more citrus fruits and vitamin C supplements.
D) Advise her to eat more refined carbohydrates for energy.

Question 7: During a postnatal home visit, a woman expresses feelings of sadness, tearfulness, and irritability, stating she feels overwhelmed by motherhood. Her baby is 5 days old. What is the most likely diagnosis?
A) Postnatal depression.
B) Puerperal psychosis.
C) Baby blues.
D) Post-traumatic stress disorder (PTSD).

Question 8: A midwife is preparing to administer an intramuscular injection to a pregnant woman. What is the most appropriate site for this injection?
A) Deltoid muscle.
B) Dorsogluteal muscle.
C) Ventrogluteal muscle.
D) Vastus lateralis muscle.

Question 9: A woman in active labour is experiencing strong, regular contractions and is requesting pain relief. She is 7cm dilated. What is a suitable non-pharmacological pain relief option for the midwife to suggest?
A) Entonox (nitrous oxide and oxygen).
B) Epidural anaesthesia.
C) Transcutaneous electrical nerve stimulation (TENS).
D) Pethidine injection.

Question 10: A midwife is performing a postnatal check on a woman who delivered vaginally 24 hours ago. The woman reports moderate lochia rubra. What is the expected characteristic of lochia rubra?
A) Pinkish-brown discharge.
B) Creamy-white discharge.
C) Bright red discharge with small clots.
D) Yellowish-white discharge.

Question 11: A woman at 41 weeks gestation is admitted for induction of labour. She has a Bishop score of 3. What is the most appropriate method for cervical ripening?
A) Amniotomy.
B) Oxytocin infusion.
C) Prostaglandin pessary.
D) Manual cervical dilation.

Question 12: A midwife is teaching a group of expectant parents about infant feeding. What is a key benefit of breastfeeding for the baby?
A) Reduced risk of childhood obesity.
B) Guaranteed longer sleep duration.
C) Elimination of all infant allergies.
D) Faster growth rate compared to formula-fed babies.

Question 13: A woman who is 6 hours postpartum reports severe perineal pain despite regular analgesia. On examination, the midwife notes a firm, tender, swollen area in the perineum. What is the most likely cause?
A) Normal bruising from vaginal delivery.
B) Haematoma formation.
C) Infected episiotomy wound.
D) Retained placental tissue.

Question 14: A midwife is caring for a neonate who is jaundiced at 48 hours of age. What is the initial action the midwife should take?
A) Advise the mother to increase the frequency of feeds.
B) Recommend immediate phototherapy.
C) Arrange for a serum bilirubin level to be checked.
D) Reassure the mother that jaundice is normal in newborns.

Question 15: A woman at 36 weeks gestation reports experiencing regular, painful contractions that are not relieved by rest or hydration. On assessment, her cervix is found to be closed. What is this likely indicative of?
A) Braxton Hicks contractions.
B) Preterm labour.
C) False labour.
D) Placental abruption.

Question 16: A midwife is preparing to discharge a new mother and baby. What key information should be provided regarding safe sleeping practices for the infant?
A) Place the baby to sleep on their stomach to prevent aspiration.
B) Ensure the baby sleeps in a separate room from the parents.
C) Place the baby on their back to sleep in a clear cot.
D) Co-sleeping is always recommended for bonding.

Question 17: A pregnant woman at 28 weeks gestation presents with painless vaginal bleeding. Her previous scans indicated a low-lying placenta. What is the most likely diagnosis?
A) Placental abruption.
B) Vasa praevia.
C) Placenta praevia.
D) Cervical erosion.

Question 18: A midwife is supporting a woman during the second stage of labour. The fetal head is crowning. What is the most appropriate next action for the midwife to guide the woman?
A) Encourage her to push continuously and forcefully.
B) Advise her to breathe deeply and gently push with contractions.
C) Instruct her to hold her breath and push as hard as possible.
D) Prepare for an instrumental delivery.

Question 19: A woman who is HIV positive is pregnant and under the care of a midwife. What is a key principle of care for this woman in relation to preventing mother-to-child transmission?
A) Advise her to avoid all vaccinations during pregnancy.
B) Ensure she receives antiretroviral therapy (ART) as prescribed.
C) Encourage exclusive formula feeding after birth.
D) Recommend a vaginal delivery to reduce fetal exposure.

Question 20: A midwife is assessing a newborn and notes a bluish discoloration of the hands and feet, but the central body is pink. What is this condition called?
A) Cyanosis.
B) Jaundice.
C) Acrocyanosis.
D) Pallor.

Question 21: A G2P1 woman at 35 weeks gestation presents with sudden, severe abdominal pain, dark red vaginal bleeding, and a tense, rigid uterus. Her blood pressure is 90/60 mmHg, and her pulse is 110 bpm. What is the most likely diagnosis?
A) Placenta praevia.
B) Uterine rupture.
C) Placental abruption.
D) Preterm labour.

Question 22: A midwife is providing postnatal education to a new mother about contraception. Which method is considered safe and effective immediately postpartum for a breastfeeding woman?
A) Combined oral contraceptive pill (COCP).
B) Intrauterine device (IUD).
C) Progesterone-only pill (POP).
D) Vaginal ring.

Question 23: A woman in established labour has been progressing well, but now her contractions have become less frequent and weaker. On examination, she is 8cm dilated, and the fetal head is at -1 station. What is the most appropriate initial management?
A) Administer oxytocin to augment labour.
B) Perform an artificial rupture of membranes (ARM).
C) Encourage ambulation and position changes.
D) Prepare for a caesarean section.

Question 25: A woman who has just had a caesarean section is complaining of severe pain at the incision site. Her last dose of analgesia was 3 hours ago. What is the most appropriate action for the midwife?
A) Inform her that pain is expected after surgery.
B) Administer the next prescribed dose of analgesia if due.
C) Encourage her to try relaxation techniques only.
D) Assess her pain level and offer additional analgesia if appropriate and prescribed.

Question 26: A midwife is assessing a 2-day-old infant and notes a distended abdomen, poor feeding, and infrequent bowel movements. What might these signs indicate?
A) Normal newborn variations.
B) Constipation.
C) Intestinal obstruction or pathology.
D) Overfeeding.

Question 27: A pregnant woman at 16 weeks gestation calls the midwifery unit reporting vaginal discharge that is thin, white, and has a fishy odour, especially after intercourse. What is the most likely cause?
A) Thrush.
B) Bacterial vaginosis.
C) Trichomoniasis.
D) Normal physiological discharge.

Question 28: A midwife is teaching a pregnant woman about the signs of true labour. Which of the following is a key characteristic of true labour contractions?
A) Irregular in frequency and intensity.
B) Relieved by walking or resting.
C) Become longer, stronger, and closer together over time.
D) Primarily felt in the lower abdomen.

Question 29: A woman is 3 days postpartum and struggling with breastfeeding. Her baby is not latching well, and she has painful, engorged breasts. What is the most appropriate advice for the midwife to give?
A) Advise her to switch to formula feeding temporarily.
B) Encourage her to hand express some milk to soften the breast before feeding.
C) Recommend applying cold compresses only.
D) Tell her to feed the baby less frequently to reduce engorgement.

Question 30: A midwife is conducting a booking appointment for a woman who has recently immigrated to the UK and speaks limited English. What is the most appropriate way to ensure effective communication?
A) Ask a family member to interpret.
B) Use simple gestures and pictures.
C) Use a professional, unbiased interpreter service.
D) Rely on a translation app on a smartphone.

Question 31: A woman at 30 weeks gestation is diagnosed with gestational diabetes. What is a key lifestyle modification the midwife should emphasize?
A) Eliminating all carbohydrates from her diet.
B) Regular moderate exercise and dietary management.
C) Resting frequently to conserve energy.
D) Increasing intake of sugary snacks to manage blood sugar fluctuations.

Question 32: A midwife is explaining the stages of labour to a pregnant woman. Which stage is characterized by the delivery of the placenta?
A) First stage.
B) Second stage.
C) Third stage.
D) Fourth stage.

Question 33: A new mother is concerned because her baby has lost 8% of its birth weight at 72 hours of age. What is the most appropriate action for the midwife?
A) Advise supplemental formula feeding immediately.
B) Reassure her that this is a normal amount of weight loss.
C) Assess feeding technique and frequency, and monitor baby’s output.
D) Refer the baby for immediate paediatric review.

Question 34: A midwife is caring for a woman who has had an epidural for pain relief in labour. What is a common side effect the midwife should monitor for?
A) Hypertension.
B) Increased fetal heart rate.
C) Maternal hypotension.
D) Rapid cervical dilation.

Question 35: A woman at 24 weeks gestation presents with symptoms of a urinary tract infection (UTI), including dysuria and frequency. What is the primary concern for the midwife in managing a UTI in pregnancy?
A) Risk of preterm labour or pyelonephritis.
B) Development of gestational diabetes.
C) Foetal growth restriction.
D) Anaemia.

Question 36: A midwife is conducting a postnatal examination on a woman who delivered 4 days ago. The woman reports feeling a ‘heavy’ sensation in her vagina. On examination, the midwife notes a mild uterine prolapse. What is the most appropriate initial management?
A) Recommend immediate surgical intervention.
B) Advise pelvic floor exercises.
C) Prescribe hormonal therapy.
D) Refer for a pessary insertion.

Question 37: A pregnant woman at 38 weeks gestation has been diagnosed with oligohydramnios. What is the primary concern associated with this condition?
A) Macrosomia.
B) Fetal lung hypoplasia and cord compression.
C) Polyhydramnios development.
D) Increased risk of maternal haemorrhage.

Question 38: A midwife is providing health education to a pregnant woman about common discomforts in the third trimester. Which of the following is a common physiological change causing heartburn?
A) Increased gastric acid production.
B) Relaxation of the oesophageal sphincter.
C) Decreased stomach size.
D) Rapid bowel motility.

Question 39: A midwife receives a handover about a woman with a history of recurrent miscarriages who is now 12 weeks pregnant. What is a key aspect of care for this woman?
A) Minimizing antenatal appointments to reduce stress.
B) Providing emotional support and early access to specialist care.
C) Recommending early induction of labour.
D) Advising complete bed rest throughout the pregnancy.

Question 40: A woman presents to the maternity unit with rupture of membranes at 36 weeks gestation. She is not in labour. What is the immediate concern for the midwife?
A) Risk of gestational diabetes.
B) Risk of infection and cord prolapse.
C) Need for immediate pain relief.
D) Assessment for placental abruption.

Question 41: A midwife is assessing a newborn for signs of sepsis. Which of the following is a key early sign of neonatal sepsis?
A) Excessive crying and irritability.
B) Temperature instability (either high or low).
C) Jaundice developing immediately after birth.
D) Strong and vigorous suck reflex.

Question 42: A woman who experienced a significant postpartum haemorrhage is now stable. What is a crucial aspect of ongoing monitoring by the midwife?
A) Limiting fluid intake to prevent fluid overload.
B) Regular assessment of vital signs, fundal height, and lochia.
C) Encouraging early discharge to promote recovery at home.
D) Avoiding ambulation for the first 24 hours.

Question 43: A midwife is providing information about immunizations to a pregnant woman. Which vaccine is routinely recommended during pregnancy in the UK to protect the newborn from a serious illness?
A) MMR (Measles, Mumps, Rubella).
B) Varicella (Chickenpox).
C) Pertussis (Whooping Cough).
D) HPV (Human Papillomavirus).

Question 44: A woman in early labour expresses fear and anxiety about the impending birth. What is the most appropriate supportive action for the midwife?
A) Tell her to distract herself with a book or TV.
B) Offer pharmacological pain relief immediately.
C) Listen to her concerns, provide reassurance, and offer coping strategies.
D) Advise her that fear is normal and she should try to ignore it.

Question 45: A midwife is reviewing a woman’s antenatal risk assessment. Which of the following factors would indicate a higher risk for developing pre-eclampsia?
A) Multiparity.
B) Previous normal pregnancy.
C) First pregnancy.
D) BMI below 20.

Question 46: A midwife is teaching a new mother how to change a baby’s nappy. What is a key principle of nappy changing to prevent nappy rash?
A) Use only baby wipes for cleaning.
B) Change the nappy infrequently to save on supplies.
C) Ensure the baby’s skin is thoroughly dry before applying a new nappy.
D) Use talcum powder generously with each change.

Question 47: A woman in the third stage of labour has been given Syntocinon intravenously. What is the primary purpose of this medication?
A) To reduce pain during placental delivery.
B) To promote cervical dilation.
C) To prevent postpartum haemorrhage by causing uterine contractions.
D) To shorten the duration of the first stage of labour.

Question 48: A midwife is caring for a woman who has a positive Group B Streptococcus (GBS) swab result at 36 weeks gestation. What is the appropriate management during labour?
A) Administer oral antibiotics after birth.
B) Prophylactic intravenous antibiotics during labour.
C) Close monitoring of maternal temperature only.
D) Immediate induction of labour.

Question 49: A woman asks the midwife about suitable exercises during pregnancy. Which type of exercise is generally considered safe and beneficial throughout an uncomplicated pregnancy?
A) High-impact aerobics.
B) Contact sports.
C) Swimming and walking.
D) Scuba diving.

Question 50: A midwife observes a new mother struggling to bond with her baby. She appears withdrawn and is not engaging in eye contact with the infant. What is the most appropriate initial action for the midwife?
A) Immediately refer to child protection services.
B) Suggest the partner takes over all infant care.
C) Discuss her feelings empathetically and explore potential barriers to bonding.
D) Tell her that bonding will happen naturally over time.

Question 51: A woman at 12 weeks gestation attends her booking appointment. Her BMI is 38. What is the most important advice for the midwife to give regarding her diet?
A) Advise strict calorie restriction throughout pregnancy to reduce weight.
B) Encourage a balanced diet focusing on nutrient-dense foods and appropriate portion sizes.
C) Recommend a low-fat diet with increased protein intake.
D) Suggest avoiding all carbohydrates to prevent gestational diabetes.

Question 52: A midwife is caring for a woman in active labour. The woman’s partner expresses distress and fear about the process. How should the midwife best support the partner?
A) Ask the partner to leave the room if they are feeling distressed.
B) Reassure them that everything will be fine and dismiss their concerns.
C) Acknowledge their feelings, provide information, and offer practical ways they can support the woman.
D) Focus solely on the woman, as she is the primary patient.

Question 53: A G3P2 woman at 39 weeks gestation reports a sudden gush of clear fluid from her vagina. What is the midwife’s immediate priority?
A) Advise her to stay home and monitor for contractions.
B) Check for fetal heart rate and signs of cord prolapse.
C) Perform a vaginal examination to assess cervical dilation.
D) Prepare for immediate induction of labour.

Question 54: A newborn, 1 hour old, is vigorously crying and appears hungry. The mother wishes to breastfeed. What is the optimal time for the first breastfeed?
A) Within 6 hours of birth, after the baby has rested.
B) As soon as possible after birth, ideally within the first hour, during the “golden hour.”
C) After the baby has received a formula top-up to ensure initial satiation.
D) Only after the midwife has completed all newborn checks.

Question 55: A midwife is assessing a woman 48 hours postpartum. The woman reports feeling feverish and has tenderness in one breast, which appears red and swollen. What is the most likely diagnosis?
A) Mastitis.
B) Engorgement.
C) Blocked milk duct.
D) Nipple thrush.

Question 56: A woman at 32 weeks gestation, with a history of gestational hypertension in her previous pregnancy, asks the midwife about measures to prevent it this time. What is the most appropriate advice?
A) Advise strict bed rest from 30 weeks onwards.
B) Emphasize regular antenatal check-ups for early detection and monitoring.
C) Recommend a low-salt diet and fluid restriction.
D) Suggest taking aspirin only if her blood pressure starts to rise.

Question 57: A midwife is teaching a pregnant woman about reducing the risk of deep vein thrombosis (DVT) during and after pregnancy. What is a key piece of advice?
A) Avoid walking for long periods.
B) Stay well-hydrated and mobilize regularly.
C) Wear tight clothing around the legs.
D) Elevate legs only when experiencing swelling.

Question 58: A woman in active labour is being monitored. The fetal heart rate (FHR) tracing shows recurrent late decelerations. What is the midwife’s immediate action?
A) Reassure the woman and continue monitoring.
B) Increase oxytocin infusion rate.
C) Change maternal position, administer oxygen, and notify the medical team.
D) Prepare for an immediate vaginal examination.

Question 59: A midwife is discussing infant feeding with a new mother. The mother expresses concerns about her milk supply. What is the best initial advice to increase milk production?
A) Supplement with formula feeds to give breasts a rest.
B) Increase the frequency and duration of breastfeeding or pumping.
C) Drink large quantities of water throughout the day.
D) Consume specific “lactation cookies” or supplements.

Question 60: A woman who had a vaginal delivery 2 days ago complains of burning and stinging during urination. What is the most likely cause, and what should the midwife advise?
A) Normal postpartum discomfort; encourage fluid intake.
B) Urethral trauma or UTI; encourage fluid intake and consider urine dipstick.
C) Perineal laceration; advise warm baths.
D) Kidney stones; refer for immediate imaging.

Question 61: A midwife is caring for a primigravida at 40 weeks gestation. She requests information about perineal massage in late pregnancy. What is the primary aim of perineal massage?
A) To induce labour.
B) To soften the perineum and potentially reduce the risk of tearing during birth.
C) To prevent the need for an episiotomy.
D) To shorten the second stage of labour.

Question 62: A newborn is experiencing respiratory distress, characterized by grunting, nasal flaring, and subcostal recession. What is the midwife’s immediate action?
A) Reassure the parents and observe for an hour.
B) Administer oxygen via nasal cannula and notify the paediatrician.
C) Attempt to clear the airway with a bulb syringe.
D) Offer a breastfeed or bottle feed.

Question 63: A woman at 37 weeks gestation attends an antenatal appointment. She reports feeling anxious and overwhelmed, often crying for no reason. She admits to feeling unable to cope and has thoughts of harming herself, though no specific plan. What is the midwife’s most appropriate response?
A) Document her feelings and schedule a follow-up appointment next week.
B) Advise her to try relaxation techniques and exercise.
C) Immediately refer her to mental health crisis services and ensure her safety.
D) Tell her it’s normal to feel overwhelmed in late pregnancy.

Question 64: A midwife is explaining the importance of folic acid to a newly pregnant woman. What is the primary reason for folic acid supplementation in early pregnancy?
A) To prevent maternal anaemia.
B) To reduce the risk of neural tube defects (NTDs) in the baby.
C) To improve fetal brain development.
D) To prevent gestational diabetes.

Question 65: A woman in the third stage of labour has a well-contracted uterus, but the placenta has not delivered after 30 minutes despite active management. What is this condition called, and what is the midwife’s next step?
A) Retained succenturiate lobe; manual removal of placenta.
B) Retained placenta; prepare for manual removal in theatre.
C) Placenta accreta; immediate hysterectomy.
D) Physiological third stage; wait another 30 minutes.

Question 66: A midwife is providing postnatal care to a woman who had a third-degree perineal tear. What is a crucial aspect of her care planning for discharge?
A) Advise her to avoid all physical activity for six weeks.
B) Ensure she understands proper perineal hygiene and bowel management to prevent constipation.
C) Recommend only sitting on a donut cushion for several weeks.
D) Provide only general postpartum care advice.

Question 67: A woman at 20 weeks gestation undergoes an anomaly scan. The sonographer identifies a potential fetal abnormality. What is the midwife’s ethical responsibility when communicating this to the parents?
A) Provide immediate, detailed information about the abnormality, even if uncertain.
B) Withhold information until a definitive diagnosis is made to avoid distress.
C) Inform them sensitively about the finding, offer support, and explain next steps for further investigation and counselling.
D) Ask the sonographer to explain the findings directly to the parents without midwifery presence.

Question 68: A midwife is performing newborn resuscitation. The baby is apneic and bradycardic (heart rate < 60 bpm). What is the immediate next step after initiating positive pressure ventilation (PPV)?
A) Administer chest compressions.
B) Administer epinephrine.
C) Check for response after 30 seconds of effective PPV.
D) Suction the airway vigorously.

Question 69: A woman at 36 weeks gestation reports experiencing an itchy rash, particularly on her palms and soles, which worsens at night. Blood tests reveal elevated bile acids. What is the most likely diagnosis?
A) Polymorphic eruption of pregnancy (PEP).
B) Pemphigoid gestationis.
C) Intrahepatic cholestasis of pregnancy (ICP).
D) Eczema.

Question 70: A midwife is preparing to administer Syntometrine to a woman in the third stage of labour. What is a key contraindication for administering Syntometrine?
A) History of asthma.
B) Pre-eclampsia or hypertension.
C) Previous caesarean section.
D) Multiple pregnancy.

Question 71: A woman who is 5 days postpartum presents with persistent fever, offensive lochia, and lower abdominal pain. Her uterus is tender and subinvoluted. What is the most likely diagnosis?
A) Postpartum depression.
B) Endometritis.
C) Perineal infection.
D) Urinary tract infection.

Question 72: A midwife is caring for a baby born prematurely at 32 weeks gestation. What is a key developmental challenge this baby is likely to face regarding feeding?
A) Overly strong suck reflex.
B) Immature suck-swallow-breathe coordination.
C) Early satiety and refusal to feed.
D) Rapid weight gain requiring reduced feeds.

Question 73: A pregnant woman at 28 weeks gestation, who is Rhesus-negative, has a small bleed. What is the most appropriate action for the midwife?
A) Advise reassurance and monitor.
B) Administer anti-D immunoglobulin immediately.
C) Schedule an urgent scan.
D) Check her blood group again.

Question 74: A midwife is discussing pain relief options with a woman in labour. The woman is concerned about the impact of an epidural on her ability to push. What information should the midwife provide?
A) An epidural completely removes the sensation of pushing, making it impossible.
B) An epidural can reduce the urge to push, but strategies like delayed pushing or guided pushing can still be used.
C) An epidural significantly increases the risk of caesarean section.
D) An epidural will always prolong labour indefinitely.

Question 75: A woman at 35 weeks gestation presents with persistent vomiting and weight loss, unresponsive to initial dietary changes. What is the most appropriate next step for the midwife?
A) Advise her to eat smaller, more frequent meals.
B) Refer for medical review and potential antiemetic medication.
C) Reassure her that this is common in pregnancy.
D) Advise her to avoid all fluids.

Question 76: A midwife is conducting a postnatal visit and notes that the woman has developed a painful, tender, red, and swollen area on her calf. What is the immediate concern?
A) Varicose veins.
B) Cellulitis.
C) Deep vein thrombosis (DVT).
D) Muscle strain.

Question 77: A midwife is planning care for a pregnant woman with Type 1 Diabetes. What is a key aspect of her antenatal care that requires particular attention?
A) Weekly scans to monitor fetal growth.
B) Strict blood glucose control and regular monitoring of fetal growth and well-being.
C) Early induction of labour at 37 weeks for all cases.
D) Limiting protein intake to prevent kidney complications.

Question 78: A woman in active labour is experiencing back pain. What is a common non-pharmacological technique the midwife can suggest to alleviate back pain?
A) Lying flat on her back.
B) Applying counter-pressure to the sacrum.
C) Walking continuously without rest.
D) Taking a very hot shower for extended periods.

Question 79: A midwife is observing a new mother interacting with her baby. The mother seems withdrawn and avoids holding the baby close. What is the most supportive initial approach for the midwife?
A) Take the baby away to give the mother a break.
B) Gently encourage skin-to-skin contact and talk about the baby’s positive cues.
C) Inform her that she needs to bond with her baby immediately.
D) Document as “lack of maternal instinct” and monitor.

Question 80: A woman at 39 weeks gestation arrives at the hospital stating she thinks her waters have broken, but there is no fluid leakage upon arrival. What diagnostic test can the midwife use to confirm rupture of membranes?
A) Ultrasound scan.
B) Vaginal pH test (e.g., litmus paper or Amnisure).
C) Blood test for infection markers.
D) Digital vaginal examination.

Question 81: A midwife is providing discharge advice to a mother who has experienced a stillbirth. What is a crucial aspect of post-bereavement care?
A) Advise her to try for another pregnancy as soon as possible.
B) Provide information on support groups and counselling services, and offer follow-up care.
C) Minimize discussion about the baby to avoid upsetting her further.
D) Suggest she quickly return to her normal routine to cope.

Question 82: A newborn is noted to have a bulging fontanelle and high-pitched cry. What is the immediate concern for the midwife?
A) Dehydration.
B) Normal variation.
C) Increased intracranial pressure.
D) Low blood sugar.

Question 83: A woman at 25 weeks gestation presents with vaginal spotting. On examination, the cervix is closed, and there is no abdominal pain. What is the most appropriate initial action?
A) Perform a digital vaginal examination.
B) Advise strict bed rest.
C) Arrange for an ultrasound scan to assess placental position and fetal well-being.
D) Prescribe antibiotics empirically.

Question 84: A midwife is teaching a group of expectant mothers about newborn care. What is a key recommendation for umbilical cord care?
A) Apply alcohol to the cord stump daily.
B) Keep the cord stump clean and dry.
C) Cover the cord stump with a plaster.
D) Bathe the baby frequently to keep the cord wet.

Question 85: A woman who has just had an uncomplicated vaginal birth is reporting severe shivering (physiological chills). What is the most appropriate action for the midwife?
A) Administer a warm blanket and reassure her this is a normal physiological response.
B) Check her temperature for signs of infection.
C) Prepare for immediate blood transfusion.
D) Administer antipyretic medication.

Question 86: A midwife is assessing a newborn for potential developmental dysplasia of the hip (DDH). What manoeuvre is performed as part of this assessment?
A) Moro reflex.
B) Ortolani manoeuvre.
C) Rooting reflex.
D) Grasp reflex.

Question 87: A woman at 18 weeks gestation, who is a known smoker, asks the midwife about the risks of continuing to smoke during pregnancy. What is a significant risk for the baby?
A) Macrosomia.
B) Increased risk of spina bifida.
C) Low birth weight and preterm birth.
D) Gestational diabetes.

Question 88: A midwife is conducting a postnatal check on a woman 6 weeks postpartum. The woman reports persistent heavy bleeding and passage of clots. What is the most likely cause?
A) Normal variation of lochia.
B) Retained products of conception (RPOC).
C) Endometriosis.
D) Menstrual period resumption.

Question 89: A pregnant woman at 30 weeks gestation is diagnosed with a singleton breech presentation. What is the most appropriate management plan for the midwife to discuss?
A) Schedule an immediate elective caesarean section.
B) Encourage external cephalic version (ECV) at 37 weeks gestation.
C) Advise her that a vaginal breech birth is always the safest option.
D) Recommend strict bed rest until term.

Question 90: A midwife is providing antenatal education on healthy eating. What is a key piece of advice regarding safe food practices during pregnancy?
A) Avoid all dairy products.
B) Ensure all meat is thoroughly cooked.
C) Eat soft cheeses, as they are a good source of calcium.
D) Consume raw eggs for protein.

Question 91: A woman in active labour requests an amniotomy. Her cervix is 5cm dilated, and the fetal head is well applied. What is the primary purpose of performing an amniotomy?
A) To provide pain relief.
B) To reduce the risk of infection.
C) To augment labour by enhancing contractions.
D) To prevent fetal scalp electrode placement.

Question 92: A midwife is conducting a postnatal examination of a newborn. The baby’s skin appears mottled, and the extremities are cool. What is the most important immediate action?
A) Wrap the baby in extra blankets and ensure warmth.
B) Take the baby’s temperature.
C) Feed the baby immediately.
D) Refer for blood tests.

Question 93: A woman who has recently migrated to the UK and has no prior antenatal care presents in labour at term. What is the midwife’s initial priority?
A) Focus on getting consent for all procedures before starting care.
B) Provide compassionate care, assess her and the baby’s immediate needs, and address any language barriers.
C) Immediately contact social services due to lack of antenatal care.
D) Criticize her for not attending antenatal appointments.

Question 94: A midwife is explaining the symptoms of pre-eclampsia to a pregnant woman. Which of the following symptoms should the woman be advised to report immediately?
A) Mild leg swelling.
B) Occasional heartburn.
C) Persistent severe headache and visual disturbances.
D) Fatigue and nausea.

Question 95: A new mother is expressing colostrum for her premature baby. What is a key characteristic of colostrum?
A) It is thin and watery, primarily for hydration.
B) It is high in fat and lactose, providing rapid energy.
C) It is rich in antibodies and protective factors, offering crucial immunity.
D) It is produced in large quantities from birth.

Question 96: A midwife identifies that a pregnant woman is a victim of domestic abuse. What is the midwife’s professional responsibility according to the NMC Code?
A) Advise her to leave her partner immediately.
B) Respect her decision if she chooses not to disclose anything further.
C) Provide a safe space, listen without judgment, offer support services, and ensure her safety.
D) Inform her family members about the abuse for her protection.

Question 97: A woman in the second stage of labour is pushing effectively, but the fetal head is not descending as expected. The midwife suspects cephalopelvic disproportion (CPD). What is the definitive action in this situation?
A) Continue encouraging her to push harder.
B) Administer more oxytocin to increase contractions.
C) Prepare for a trial of instrumental delivery.
D) Prepare for caesarean section.

Question 98: A midwife is providing care to a woman who has experienced a stillbirth at 30 weeks gestation. She is due to be discharged home. What is a key consideration for the midwife regarding her breast milk production?
A) Advise immediate breast binding to stop milk production.
B) Offer medication to suppress lactation if desired and provide emotional support for breast changes.
C) Encourage expression and donation of breast milk.
D) Reassure her that milk will not come in after a stillbirth.

Question 99: A pregnant woman at 34 weeks gestation presents with itching, but no rash. Her liver function tests are normal. What condition should the midwife still consider, warranting further investigation?
A) Pruritic urticarial papules and plaques of pregnancy (PUPPP).
B) Cholestasis of pregnancy (early stage or mild).
C) Herpes gestationis.
D) Scabies.

Question 100: A midwife is preparing to discharge a new mother and baby. The mother has a history of opioid dependence. What is a critical aspect of the discharge plan regarding the baby?
A) Advise exclusive formula feeding.
B) Ensure appropriate referral to paediatric services for monitoring of neonatal abstinence syndrome (NAS).
C) Recommend immediate cessation of all maternal medications.
D) Send the baby home with the mother without further follow-up to promote bonding.

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