TEXAS MIDWIFE LICENSING EXAM – PRACTICE QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
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CORE DOMAINS
Antepartum Care and Assessment
Intrapartum Management and Complications
Postpartum Care for Mother and Newborn
Well-Woman Healthcare and Pharmacology
Texas Midwifery Board Rules and Regulations
Professional Ethics and Legal Responsibilities
Neonatal Resuscitation and Emergency Procedures
Laboratory Interpretation and Diagnostic Screening
INTRODUCTION
The Texas Midwife Licensing Exam Practice Assessment is designed to evaluate the
competency and readiness of aspiring midwives to provide safe, evidence-based care
within the state of Texas. This comprehensive tool assesses essential clinical skills, legal
knowledge, and diagnostic reasoning across the reproductive lifespan. The exam utilizes
multiple-choice and complex scenario-based questions to mirror the decision-making
processes required in out-of-hospital birth settings. By emphasizing real-world
application, professional ethics, and adherence to state regulatory standards, this
assessment ensures that candidates can effectively manage normal physiological birth
while identifying and appropriately referring high-risk conditions to ensure maternal and
neonatal safety.
,SECTION ONE: QUESTIONS 1–100
1. Under Texas Midwifery Board rules, which of the following is a mandatory
requirement for a licensed midwife regarding the newborn?
A. Administration of Vitamin K via intramuscular injection
B. Performing a hearing screening within 24 hours
🟢 C. Administration of prophylactic ophthalmic ointment
D. Conduct of a pulse oximetry screening for critical congenital heart disease
🔴 RATIONALE: Texas law requires midwives to administer or offer prophylactic
ophthalmic ointment to prevent ophthalmia neonatorum; while other treatments may
be recommended, this is a specific statutory mandate.
2. A client at 32 weeks gestation presents with a blood pressure of 142/92 mmHg.
According to Texas Midwifery rules, what is the required immediate action?
A. Bed rest and re-evaluation in one week
B. Immediate transfer to a tertiary care facility
🟢 C. Repeat the measurement after a period of rest and consult if elevated
D. Begin administration of magnesium sulfate
🔴 RATIONALE: Initial mild elevations in blood pressure require a repeat measurement
to confirm hypertension; consistent readings of 140/90 or higher necessitate
consultation with a physician under Texas regulatory standards.
3. Which of the following landmarks is used to determine the station of the fetal
head during a vaginal exam?
,A. Sacral promontory
🟢 B. Ischial spines
C. Ischial tuberosities
D. Symphysis pubis
🔴 RATIONALE: Station is defined as the relationship of the presenting part to an
imaginary line drawn between the ischial spines of the maternal pelvis.
4. A midwife is attending a home birth and notes thick meconium-stained fluid
upon rupture of membranes. The fetal heart rate is 140 bpm with moderate
variability. What is the most appropriate next step?
A. Immediate transport to the hospital
B. Deep suctioning of the oropharynx on the perineum
🟢 C. Close monitoring of fetal heart tones and preparation for neonatal resuscitation
D. Amnioinfusion to dilute the meconium
🔴 RATIONALE: In the presence of meconium and a reassuring fetal heart rate, the
midwife should monitor closely and ensure all resuscitation equipment is ready; deep
suctioning on the perineum is no longer recommended.
5. What is the primary purpose of the Leopold Maneuvers?
A. To estimate the weight of the fetus
B. To determine the presence of twins
🟢 C. To determine fetal lie, presentation, and position
D. To assess for pelvic adequacy
, 🔴 RATIONALE: Leopold Maneuvers are a series of four palpations used to determine
the orientation of the fetus within the uterus.
6. A client in the third trimester complains of sudden, painless vaginal bleeding.
What condition should the midwife suspect first?
A. Placental abruption
🟢 B. Placenta previa
C. Bloody show
D. Vasa previa
🔴 RATIONALE: Painless bright red vaginal bleeding in the third trimester is the classic
presentation of placenta previa; placental abruption is typically characterized by
painful bleeding.
7. According to Texas law, how often must a midwife renew their license?
🟢 A. Every two years
B. Every year
C. Every four years
D. Every five years
🔴 RATIONALE: Licensed Midwives in Texas are required to renew their licenses
biennially (every two years).
8. Which of the following is a symptom of magnesium sulfate toxicity in a
preeclamptic patient?
A. Hyperreflexia
B. Tachycardia
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A | INSTANT
DOWNLOAD PDF.
CORE DOMAINS
Antepartum Care and Assessment
Intrapartum Management and Complications
Postpartum Care for Mother and Newborn
Well-Woman Healthcare and Pharmacology
Texas Midwifery Board Rules and Regulations
Professional Ethics and Legal Responsibilities
Neonatal Resuscitation and Emergency Procedures
Laboratory Interpretation and Diagnostic Screening
INTRODUCTION
The Texas Midwife Licensing Exam Practice Assessment is designed to evaluate the
competency and readiness of aspiring midwives to provide safe, evidence-based care
within the state of Texas. This comprehensive tool assesses essential clinical skills, legal
knowledge, and diagnostic reasoning across the reproductive lifespan. The exam utilizes
multiple-choice and complex scenario-based questions to mirror the decision-making
processes required in out-of-hospital birth settings. By emphasizing real-world
application, professional ethics, and adherence to state regulatory standards, this
assessment ensures that candidates can effectively manage normal physiological birth
while identifying and appropriately referring high-risk conditions to ensure maternal and
neonatal safety.
,SECTION ONE: QUESTIONS 1–100
1. Under Texas Midwifery Board rules, which of the following is a mandatory
requirement for a licensed midwife regarding the newborn?
A. Administration of Vitamin K via intramuscular injection
B. Performing a hearing screening within 24 hours
🟢 C. Administration of prophylactic ophthalmic ointment
D. Conduct of a pulse oximetry screening for critical congenital heart disease
🔴 RATIONALE: Texas law requires midwives to administer or offer prophylactic
ophthalmic ointment to prevent ophthalmia neonatorum; while other treatments may
be recommended, this is a specific statutory mandate.
2. A client at 32 weeks gestation presents with a blood pressure of 142/92 mmHg.
According to Texas Midwifery rules, what is the required immediate action?
A. Bed rest and re-evaluation in one week
B. Immediate transfer to a tertiary care facility
🟢 C. Repeat the measurement after a period of rest and consult if elevated
D. Begin administration of magnesium sulfate
🔴 RATIONALE: Initial mild elevations in blood pressure require a repeat measurement
to confirm hypertension; consistent readings of 140/90 or higher necessitate
consultation with a physician under Texas regulatory standards.
3. Which of the following landmarks is used to determine the station of the fetal
head during a vaginal exam?
,A. Sacral promontory
🟢 B. Ischial spines
C. Ischial tuberosities
D. Symphysis pubis
🔴 RATIONALE: Station is defined as the relationship of the presenting part to an
imaginary line drawn between the ischial spines of the maternal pelvis.
4. A midwife is attending a home birth and notes thick meconium-stained fluid
upon rupture of membranes. The fetal heart rate is 140 bpm with moderate
variability. What is the most appropriate next step?
A. Immediate transport to the hospital
B. Deep suctioning of the oropharynx on the perineum
🟢 C. Close monitoring of fetal heart tones and preparation for neonatal resuscitation
D. Amnioinfusion to dilute the meconium
🔴 RATIONALE: In the presence of meconium and a reassuring fetal heart rate, the
midwife should monitor closely and ensure all resuscitation equipment is ready; deep
suctioning on the perineum is no longer recommended.
5. What is the primary purpose of the Leopold Maneuvers?
A. To estimate the weight of the fetus
B. To determine the presence of twins
🟢 C. To determine fetal lie, presentation, and position
D. To assess for pelvic adequacy
, 🔴 RATIONALE: Leopold Maneuvers are a series of four palpations used to determine
the orientation of the fetus within the uterus.
6. A client in the third trimester complains of sudden, painless vaginal bleeding.
What condition should the midwife suspect first?
A. Placental abruption
🟢 B. Placenta previa
C. Bloody show
D. Vasa previa
🔴 RATIONALE: Painless bright red vaginal bleeding in the third trimester is the classic
presentation of placenta previa; placental abruption is typically characterized by
painful bleeding.
7. According to Texas law, how often must a midwife renew their license?
🟢 A. Every two years
B. Every year
C. Every four years
D. Every five years
🔴 RATIONALE: Licensed Midwives in Texas are required to renew their licenses
biennially (every two years).
8. Which of the following is a symptom of magnesium sulfate toxicity in a
preeclamptic patient?
A. Hyperreflexia
B. Tachycardia
