Varney's Midwifery |Seventh Edition | All
Chapters 1-39 covered | 2026 Update |A+ Graded
Julia Phillippi, PhD, CNM, FACNM, FAAN
Ira Kantrowitz-Gordon, PhD, CNM, ARNP, FACNM, FAAN
,Part I: Midwifery
Chapter 1: Context of Individuals Seeking Midwifery Care.
1
A 28-year-old primigravida presents to the clinic for her first prenatal visit. She expresses concern about
whether she can have a natural birth after a past history of obesity. Which factor should the midwife
prioritize when assessing her risk for complications during labor?
A. Current body mass index (BMI) and associated comorbidities
B. Maternal age only
C. Previous contraceptive use
D. Ethnic background
ANS: A
Rationale: BMI and comorbidities such as hypertension or diabetes significantly influence labor
outcomes and the risk of complications like cesarean birth or prolonged labor. Ethnic background or
previous contraceptive use are less predictive of labor complications.
2
A midwife is assessing a 35-year-old multiparous woman seeking midwifery care. She has concerns
about how her cultural background may affect her birth experience. What is the most appropriate initial
step for the midwife?
A. Ask open-ended questions about her beliefs and preferences
B. Assume she prefers standard hospital protocols
C. Provide a written handout on midwifery care
D. Refer her to a cultural liaison without discussion
ANS: A
Rationale: Open-ended questions allow the midwife to understand the client’s cultural beliefs and
preferences, which is essential for individualized care. Providing written materials or making
assumptions does not ensure culturally safe care.
3
During a prenatal visit, a woman reports anxiety due to previous traumatic birth experiences. Which
approach aligns best with trauma-informed midwifery care?
A. Discuss her concerns empathetically and involve her in care planning
B. Recommend general relaxation videos without further assessment
C. Encourage her to forget past experiences to avoid fear
D. Focus solely on physical assessments and tests
ANS: A
Rationale: Trauma-informed care prioritizes emotional safety, empowers the client in decision-making,
and addresses past experiences, which reduces anxiety and supports positive birth outcomes.
4
A woman with limited English proficiency comes to the clinic. Which strategy should the midwife
implement to ensure safe and effective communication?
,A. Use a professional medical interpreter for all discussions
B. Rely on family members for interpretation
C. Use only written handouts in English
D. Speak louder and slower
ANS: A
Rationale: Professional interpreters provide accurate and confidential translation, reducing the risk of
miscommunication and ensuring informed consent. Family members may introduce bias or errors.
5
A client expresses interest in home birth but is concerned about safety. Which factor is most critical for
the midwife to assess before supporting her choice?
A. Availability of emergency transport and risk factors
B. Client’s educational background
C. Number of siblings
D. Personal opinion of the midwife
ANS: A
Rationale: Safety planning for home birth requires evaluating maternal and fetal risk factors and
ensuring access to emergency care if complications arise. Non-clinical factors like education or personal
opinion are secondary.
6
During the initial visit, a 22-year-old client reports inconsistent prenatal care during previous
pregnancies. What is the most appropriate midwifery response?
A. Explore barriers to accessing care and collaboratively plan support
B. Reprimand the client for previous missed appointments
C. Ignore past history and start routine care
D. Refer the client immediately to obstetrics
ANS: A
Rationale: Understanding barriers (transport, finances, cultural beliefs) allows the midwife to provide
individualized support, improve engagement, and enhance outcomes.
7
A client requests information about alternative prenatal practices she found online. How should the
midwife respond?
A. Provide evidence-based guidance while respecting client autonomy
B. Discourage all alternative practices immediately
C. Allow unrestricted use of any practices without discussion
D. Ignore the client’s request to focus on standard care
ANS: A
Rationale: Respecting autonomy while providing evidence-based guidance ensures informed decision-
making, reduces potential harm, and maintains trust in the midwife-client relationship.
8
A midwife is reviewing the social determinants of health for a newly referred client. Which factor has
the greatest impact on perinatal outcomes?
A. Socioeconomic status, including access to nutrition and healthcare
, B. Eye color
C. Hair texture
D. Favorite recreational activity
ANS: A
Rationale: Socioeconomic status influences access to prenatal care, nutrition, and overall maternal-fetal
health, making it a key determinant of perinatal outcomes.
9
During a prenatal assessment, the midwife identifies signs of intimate partner violence (IPV). What is the
most appropriate immediate action?
A. Provide confidential support, assess safety, and discuss resources
B. Ignore signs to avoid offending the client
C. Notify family members immediately
D. Refer to social services without discussion
ANS: A
Rationale: Midwives must provide confidential support, assess immediate risk, and provide information
about resources. Mandatory reporting laws may apply depending on jurisdiction, but client safety and
consent remain central.
10
A 30-year-old client asks about the role of midwives in collaborative care with obstetricians. Which
statement is most accurate?
A. Midwives provide primary care for low-risk pregnancies and consult specialists as needed
B. Midwives always manage all high-risk pregnancies independently
C. Midwives only provide labor support and do not manage prenatal care
D. Midwives work exclusively in hospitals without patient autonomy
ANS: A
Rationale: Midwives manage low-risk pregnancies, provide comprehensive prenatal, labor, and
postpartum care, and consult or refer to specialists when complications arise.
11
A client with a history of preterm birth seeks midwifery care. Which aspect should be included in her
care plan?
A. Enhanced monitoring for preterm labor signs and preventive strategies
B. Standard care with no additional monitoring
C. Immediate recommendation for cesarean birth
D. Avoid discussing previous history to prevent anxiety
ANS: A
Rationale: Previous preterm birth increases recurrence risk. Evidence-based care includes monitoring
cervical length, progesterone therapy if indicated, and counseling to prevent recurrence.
12
A midwife is providing care to a woman from a community with strong traditional birth practices. Which
approach best ensures culturally safe care?
A. Incorporate safe traditional practices while respecting clinical guidelines
B. Discourage all traditional practices without discussion
Chapters 1-39 covered | 2026 Update |A+ Graded
Julia Phillippi, PhD, CNM, FACNM, FAAN
Ira Kantrowitz-Gordon, PhD, CNM, ARNP, FACNM, FAAN
,Part I: Midwifery
Chapter 1: Context of Individuals Seeking Midwifery Care.
1
A 28-year-old primigravida presents to the clinic for her first prenatal visit. She expresses concern about
whether she can have a natural birth after a past history of obesity. Which factor should the midwife
prioritize when assessing her risk for complications during labor?
A. Current body mass index (BMI) and associated comorbidities
B. Maternal age only
C. Previous contraceptive use
D. Ethnic background
ANS: A
Rationale: BMI and comorbidities such as hypertension or diabetes significantly influence labor
outcomes and the risk of complications like cesarean birth or prolonged labor. Ethnic background or
previous contraceptive use are less predictive of labor complications.
2
A midwife is assessing a 35-year-old multiparous woman seeking midwifery care. She has concerns
about how her cultural background may affect her birth experience. What is the most appropriate initial
step for the midwife?
A. Ask open-ended questions about her beliefs and preferences
B. Assume she prefers standard hospital protocols
C. Provide a written handout on midwifery care
D. Refer her to a cultural liaison without discussion
ANS: A
Rationale: Open-ended questions allow the midwife to understand the client’s cultural beliefs and
preferences, which is essential for individualized care. Providing written materials or making
assumptions does not ensure culturally safe care.
3
During a prenatal visit, a woman reports anxiety due to previous traumatic birth experiences. Which
approach aligns best with trauma-informed midwifery care?
A. Discuss her concerns empathetically and involve her in care planning
B. Recommend general relaxation videos without further assessment
C. Encourage her to forget past experiences to avoid fear
D. Focus solely on physical assessments and tests
ANS: A
Rationale: Trauma-informed care prioritizes emotional safety, empowers the client in decision-making,
and addresses past experiences, which reduces anxiety and supports positive birth outcomes.
4
A woman with limited English proficiency comes to the clinic. Which strategy should the midwife
implement to ensure safe and effective communication?
,A. Use a professional medical interpreter for all discussions
B. Rely on family members for interpretation
C. Use only written handouts in English
D. Speak louder and slower
ANS: A
Rationale: Professional interpreters provide accurate and confidential translation, reducing the risk of
miscommunication and ensuring informed consent. Family members may introduce bias or errors.
5
A client expresses interest in home birth but is concerned about safety. Which factor is most critical for
the midwife to assess before supporting her choice?
A. Availability of emergency transport and risk factors
B. Client’s educational background
C. Number of siblings
D. Personal opinion of the midwife
ANS: A
Rationale: Safety planning for home birth requires evaluating maternal and fetal risk factors and
ensuring access to emergency care if complications arise. Non-clinical factors like education or personal
opinion are secondary.
6
During the initial visit, a 22-year-old client reports inconsistent prenatal care during previous
pregnancies. What is the most appropriate midwifery response?
A. Explore barriers to accessing care and collaboratively plan support
B. Reprimand the client for previous missed appointments
C. Ignore past history and start routine care
D. Refer the client immediately to obstetrics
ANS: A
Rationale: Understanding barriers (transport, finances, cultural beliefs) allows the midwife to provide
individualized support, improve engagement, and enhance outcomes.
7
A client requests information about alternative prenatal practices she found online. How should the
midwife respond?
A. Provide evidence-based guidance while respecting client autonomy
B. Discourage all alternative practices immediately
C. Allow unrestricted use of any practices without discussion
D. Ignore the client’s request to focus on standard care
ANS: A
Rationale: Respecting autonomy while providing evidence-based guidance ensures informed decision-
making, reduces potential harm, and maintains trust in the midwife-client relationship.
8
A midwife is reviewing the social determinants of health for a newly referred client. Which factor has
the greatest impact on perinatal outcomes?
A. Socioeconomic status, including access to nutrition and healthcare
, B. Eye color
C. Hair texture
D. Favorite recreational activity
ANS: A
Rationale: Socioeconomic status influences access to prenatal care, nutrition, and overall maternal-fetal
health, making it a key determinant of perinatal outcomes.
9
During a prenatal assessment, the midwife identifies signs of intimate partner violence (IPV). What is the
most appropriate immediate action?
A. Provide confidential support, assess safety, and discuss resources
B. Ignore signs to avoid offending the client
C. Notify family members immediately
D. Refer to social services without discussion
ANS: A
Rationale: Midwives must provide confidential support, assess immediate risk, and provide information
about resources. Mandatory reporting laws may apply depending on jurisdiction, but client safety and
consent remain central.
10
A 30-year-old client asks about the role of midwives in collaborative care with obstetricians. Which
statement is most accurate?
A. Midwives provide primary care for low-risk pregnancies and consult specialists as needed
B. Midwives always manage all high-risk pregnancies independently
C. Midwives only provide labor support and do not manage prenatal care
D. Midwives work exclusively in hospitals without patient autonomy
ANS: A
Rationale: Midwives manage low-risk pregnancies, provide comprehensive prenatal, labor, and
postpartum care, and consult or refer to specialists when complications arise.
11
A client with a history of preterm birth seeks midwifery care. Which aspect should be included in her
care plan?
A. Enhanced monitoring for preterm labor signs and preventive strategies
B. Standard care with no additional monitoring
C. Immediate recommendation for cesarean birth
D. Avoid discussing previous history to prevent anxiety
ANS: A
Rationale: Previous preterm birth increases recurrence risk. Evidence-based care includes monitoring
cervical length, progesterone therapy if indicated, and counseling to prevent recurrence.
12
A midwife is providing care to a woman from a community with strong traditional birth practices. Which
approach best ensures culturally safe care?
A. Incorporate safe traditional practices while respecting clinical guidelines
B. Discourage all traditional practices without discussion
