Prometric Exam Questions for Midwives 2026: 15 Practice MCQs with Answers and Rationale

The registered midwife Prometric paper covers the whole childbearing journey: antenatal assessment, normal and complicated labour, obstetric emergencies, postnatal care, newborn care and the drugs a midwife gives. Most Gulf authorities set 100 to 150 single-best-answer MCQs over 2.5 to 3 hours, with a pass mark of about 60%.

The fifteen questions below follow that blueprint. Allow about 70 seconds each. Obstetric emergencies and newborn resuscitation come up in every paper, so learn the sequence of actions, not just the diagnosis.

For titles, requirements by authority and the full syllabus, read the Prometric exam for midwives and assistant nurses guide. For timed papers, the maternal and child health sections of the Registered Nurse bank cover the same ground.

Antenatal care

Question 1

A woman's last menstrual period began on 10 March. Using Naegele's rule, her expected date of delivery is:

1. 10 December
2. 17 December
3. 3 January
4. 17 November

Answer: B. Add seven days and nine months (or subtract three months and add a year): 10 March plus 7 days is 17 March, plus 9 months is 17 December. The rule assumes a regular 28-day cycle; dating ultrasound overrides it when they differ.

Question 2

A woman at 32 weeks has a blood pressure of 150/100 mmHg, proteinuria and a headache. The most likely diagnosis is:

1. Gestational hypertension
2. Pre-eclampsia
3. Chronic hypertension
4. Normal pregnancy

Answer: B. New hypertension after 20 weeks with proteinuria, and symptoms such as headache, visual disturbance or epigastric pain, is pre-eclampsia. She needs urgent medical review, blood pressure control and assessment for magnesium sulfate if there are severe features.

Question 3

An RhD-negative woman with no antibodies should receive anti-D immunoglobulin:

1. Only if the baby is RhD negative
2. After any sensitising event in pregnancy and within 72 hours of delivering an RhD-positive baby
3. Only at the first antenatal visit
4. Never, if this is her first pregnancy

Answer: B. Anti-D prevents the mother forming antibodies that would affect future RhD-positive babies. It is given after sensitising events such as bleeding, trauma or amniocentesis, routinely in the third trimester in many programmes, and within 72 hours of birth if the baby is RhD positive.

Question 4

Fundal height is normally expected to reach the umbilicus at about:

1. 12 weeks
2. 16 weeks
3. 20–22 weeks
4. 36 weeks

Answer: C. The fundus reaches the symphysis pubis at about 12 weeks, the umbilicus at about 20–22 weeks and the xiphisternum at about 36 weeks. After 24 weeks the height in centimetres roughly matches the weeks of gestation, give or take 2–3 cm.

Labour and delivery

Question 5

In the first stage of labour, the active phase is usually defined as beginning at a cervical dilatation of:

1. 1 cm
2. 3 cm
3. 4–6 cm, depending on the guideline used
4. 10 cm

Answer: C. Older guidance used 4 cm; WHO and several national guidelines now use 5 or 6 cm, because many women progress slowly before that point. Know which definition your unit uses, because partograph alert lines depend on it.

Question 6

A cardiotocograph shows late decelerations with reduced variability. The most appropriate first action is:

1. Continue observation and record the trace
2. Change the maternal position, stop oxytocin if running, check blood pressure and call for medical review
3. Give oral fluids
4. Encourage the woman to push

Answer: B. Late decelerations suggest uteroplacental insufficiency, and reduced variability adds to the concern. Intrauterine resuscitation measures are started immediately and an obstetrician is called, because expedited birth may be needed.

Question 7

Active management of the third stage of labour includes:

1. Waiting up to 60 minutes for the placenta with no drugs
2. A uterotonic (usually oxytocin 10 IU IM) after the birth of the baby, controlled cord traction and uterine massage after delivery of the placenta
3. Fundal pressure as soon as the baby is born
4. Pulling on the cord before signs of separation

Answer: B. Prophylactic oxytocin is the single most effective step in preventing postpartum haemorrhage. Controlled cord traction is applied only with counter-traction on the uterus after signs of placental separation.

Question 8

The anterior shoulder does not deliver with gentle traction after the head is born. The first manoeuvre is:

1. Fundal pressure
2. Call for help and perform McRoberts' manoeuvre (hyperflexion of the maternal hips)
3. Pull harder on the head
4. Cut an episiotomy immediately

Answer: B. Shoulder dystocia is managed with the HELPERR sequence: call for help, evaluate for episiotomy, legs into McRoberts' position, suprapubic pressure, then internal manoeuvres. Fundal pressure and traction on the head cause injury and are avoided.

Obstetric emergencies

Question 9

Primary postpartum haemorrhage is defined as blood loss of:

1. More than 200 mL within 24 hours of birth
2. More than 500 mL within 24 hours of birth
3. Any loss after 24 hours
4. More than 100 mL in the first hour

Answer: B. Primary PPH is loss of 500 mL or more within 24 hours of birth (1,000 mL after caesarean in some definitions), and secondary PPH occurs from 24 hours to 12 weeks. The causes are the four Ts: tone, tissue, trauma and thrombin.

Question 10

The uterus feels soft and boggy with heavy bleeding after delivery of the placenta. The first action is:

1. Massage the fundus and give a uterotonic while calling for help
2. Give an oral iron tablet
3. Encourage early breastfeeding only
4. Wait 30 minutes

Answer: A. Uterine atony is the most common cause of PPH. Fundal massage, emptying the bladder, uterotonics (oxytocin, then ergometrine, carboprost or misoprostol according to protocol), IV access and fluids are started at once, with tranexamic acid given early.

Question 11

A woman with severe pre-eclampsia has a seizure. The drug of choice is:

1. Diazepam
2. Magnesium sulfate (4 g IV loading dose over 5–15 minutes, then an infusion)
3. Phenytoin
4. Oral labetalol only

Answer: B. Magnesium sulfate both treats and prevents eclamptic seizures. The midwife monitors reflexes, respiratory rate and urine output for toxicity and keeps calcium gluconate available as the antidote.

Question 12

On vaginal examination after membrane rupture, the midwife feels a pulsating cord below the presenting part. The immediate actions are:

1. Push the cord back into the uterus and continue labour
2. Call for help, relieve pressure on the cord by elevating the presenting part and position the woman knee-chest or in exaggerated Sims, and prepare for urgent delivery
3. Clamp and cut the cord
4. Give oxytocin to speed delivery

Answer: B. Cord prolapse is an emergency for the baby. Pressure on the cord is relieved by elevating the presenting part with the examining hand or filling the bladder, the mother is positioned to use gravity, and birth is expedited, usually by caesarean unless vaginal birth is imminent.

Newborn and postnatal care

Question 13

A newborn at one minute has a heart rate of 90/min, slow irregular breathing, some flexion, a grimace and blue extremities with a pink body. The Apgar score is:

1. 3
2. 5
3. 7
4. 9

Answer: B. Heart rate under 100 scores 1, slow irregular breathing 1, some flexion 1, grimace 1 and acrocyanosis 1, totalling 5. A score of 4–6 means the baby needs support such as stimulation and ventilation breaths while reassessing.

Question 14

After drying and stimulation, a newborn is not breathing and the heart rate is 50/min. The next step is:

1. Give five inflation breaths, reassess, and if the heart rate stays below 60 despite effective ventilation, start chest compressions at 3:1
2. Start chest compressions immediately without ventilation
3. Give adrenaline first
4. Wait another minute

Answer: A. Newborn resuscitation is ventilation-led, because most newborn arrests are respiratory. Effective lung inflation usually raises the heart rate. Compressions at a 3:1 ratio are added only if the heart rate remains below 60 despite good ventilation.

Question 15

Magnesium sulfate is supplied as 50% solution (5 g in 10 mL). To draw up a 4 g loading dose, the volume is:

1. 4 mL
2. 8 mL
3. 10 mL
4. 20 mL

Answer: B. 50% means 0.5 g per mL, so 4 g is 8 mL, which is then diluted according to protocol and given slowly. Drug calculation questions appear in every nursing and midwifery paper.

How to use these questions

• Learn emergency sequences in order. PPH, shoulder dystocia, cord prolapse, eclampsia and newborn resuscitation are tested as "what do you do first".
• Know the numbers. Definitions, doses, Apgar components and partograph thresholds are reliable marks.
• Practise under time with the Registered Nurse bank, the nursing sample questions and the high-yield nursing topics.

Authority pages: DOH, MOHAP and Kuwait MOH exams for midwives. Pay is in nurse and midwife salary comparison. When you have eligibility, join the midwife talent pool.

Frequently asked questions

How many questions are in the Prometric midwifery exam?

Usually 100 to 150 MCQs over 2.5 to 3 hours for a registered midwife. Your eligibility notice gives the exact format.

What is the pass mark?

About 60% for most Gulf authorities.

Can a nurse-midwife choose the nursing exam instead?

Your title decides your exam. A dual-qualified nurse applying as a Registered Nurse sits the nursing paper; applying as a Registered Midwife means the midwifery paper. Discuss the better title for your experience before applying.

Which topics come up most?

Labour and delivery, obstetric emergencies and newborn care carry the most marks, followed by antenatal and postnatal care, pharmacology and infection control.

Are these real exam questions?

No. They are original practice questions written to the published blueprint. Real exam content is confidential.