CNA Perinatal Nursing Certification Exam — Information & Free Practice

About CNA Perinatal Nursing Certification Exam

CNA Perinatal Nursing Certification Exam · CA

Key exam facts

Provider

Canadian Nurses Association (CNA) owns the national certification program. Meazure Learning develops and maintains exams and supports delivery; ProctorU provides remote proctoring, and Meazure Learning provides test centres.

Format

Computer-based multiple-choice knowledge examination, available through remote proctoring at home or at an in-person test centre. The specialty blueprint specifies independent questions (55–65%) and case-based questions (35–45%). The specialty blueprint describes approximately 165 questions; general current CBT guidance gives 160–165.

Exam questions

Total questions: 160–165.

Time limit

Four hours (240 minutes) to answer the exam questions, per CNA CBT guidance.

Passing score

Criterion-referenced pass standard set by the specialty exam committee using a modified Angoff method and statistical review. The numerical pass mark is not published; results are pass or unsuccessful.

Exam fee

Canadian dollars, before applicable taxes: initial application $588 for CNA members or $780 for non-members; appointment fee additional, $85 online or $110 in person. Eligible unsuccessful candidates pay a reduced rewrite application fee of $378 (members) or $500 (non-members), valid for the next two calendar years. Application fees include a non-refundable $130 administrative fee.

Topics covered

The authority publishes percentage ranges for each content area. The practice percentages below use the midpoint of each range, normalized to 100%; they are not exact percentages published by the authority. Practice question counts may differ slightly because of rounding.

• Preconception — Official range: 5–10% (Practice allocation: 7.5%)

  • Interprets the preconceptional health history, including:
  • Selects appropriate nursing interventions for the childbearing person’s and/or family’s health before pregnancy based on:
  • Demonstrates knowledge of:
  • Selects appropriate nursing interventions in response to the following:
  • obstetrical and reproductive health history (e.g., GTPAL, genital mutilation, reproductive surgery);
  • medical history and associated therapies (e.g., diabetes, hypertension, obesity, thyroid disorders, physical challenges); and
  • mental health history and associated therapies (e.g., depression, eating disorders, anxiety).
  • social history and resources (e.g., single or partnered, social supports);
  • lifestyle (e.g., physical activity, sexual health, smoking, alcohol/substance use);
  • nutrition (e.g., folic acid, food security, herbal supplements, cultural and religious practices);
  • immunization (e.g., influenza, rubella, varicella); and
  • environmental and occupational health hazards/exposures (e.g., infectious diseases, toxins, radiation).
  • impaired fertility (e.g., common causes and treatments); and
  • genetic risk (e.g., personal and family history of genetic diseases or disorders).
  • abuse and/or intimate partner violence; and
  • history of perinatal loss.

• Antenatal — Official range: 15–25% (Practice allocation: 20%)

  • Interprets the following data to establish health status during the antenatal period including:
  • Advocates for the pregnant person’s safety by:
  • Discusses with the pregnant person and the family regarding:
  • Identifies the indications for and implications of prenatal testing (e.g., laboratory tests, ultrasounds, glucose tolerance testing, genetic tests).
  • Identifies key elements of fetal development (e.g., critical periods of development for each body system).
  • Interprets results of fetal health surveillance, including:
  • Selects appropriate nursing interventions based on the following antenatal conditions:
  • Assists the pregnant person and family to adapt to an at-risk pregnancy (e.g., anxiety and stress related to outcome of pregnancy and need for increased surveillance).
  • Selects appropriate nursing interventions when caring for the pregnant adolescent (e.g., developmental tasks of adolescence, health risks, nutrition, body image, social support).
  • Selects appropriate nursing interventions when caring for the pregnant person with advanced age (e.g., health risks, anxiety).
  • Selects appropriate nursing intervention when caring for a person with an unplanned pregnancy (e.g., social/emotional support, community resources, pregnancy choices).
  • Collaborates with the pregnant person to promote informed choice (e.g., infant feeding, antenatal testing, circumcision, VBAC).
  • Selects nursing interventions to promote breastfeeding (e.g., benefits of breastfeeding, risks of breast milk substitutes [formula], skin-to-skin care).
  • Collaborates with the pregnant person and family to identify their learning needs related to labour, birth and transition to parenting (e.g., prenatal education, adoption, surrogate pregnancy).
  • obstetrical and reproductive health history;
  • medical history and associated therapies (e.g., immunization status, Rh status, pre-pregnancy BMI);
  • mental health history and associated therapies (e.g., anxiety, depression, post-traumatic stress disorder [PTSD]);
  • physiological changes (e.g., breast changes, weight gain, fundal height);
  • psychosocial, emotional and developmental issues (e.g., body image, developmental tasks of pregnancy, grief and loss);
  • nutrition (e.g., folic acid, herbal supplements, pica);
  • physical activity;
  • sexual health (e.g., STI screening, sexual activity, at-risk behaviour);
  • culture and ethnicity;
  • social support and resources (e.g., food and housing security, community referral); and
  • communication challenges (e.g., language, hearing or visual impairment, health literacy).
  • screening for intimate partner violence and/or abuse; and
  • selecting appropriate nursing interventions when intimate partner violence and/or abuse has been identified (e.g., referral).
  • common discomforts of pregnancy (e.g., fatigue, heartburn, constipation);
  • warning signs of complications in pregnancy (e.g., bleeding, pain, decreased fetal movement);
  • environmental risks (e.g., chemical exposure, occupational hazards, toxoplasmosis, vector-borne illness); and
  • food safety (e.g., listeriosis, fish, raw foods, unpasteurized foods).
  • fetal movement;
  • fetal heart rate auscultation;
  • biophysical profile; and
  • electronic fetal monitoring (e.g., non-stress test).
  • nausea and vomiting of pregnancy;
  • threatened preterm labour (e.g., fetal fibronectin, fetal lung maturation);
  • rupture of membranes (e.g., preterm or premature);
  • antepartum hemorrhage (e.g., abruptio placenta, placenta previa, spontaneous abortion);
  • physical trauma (e.g., falls, motor vehicle collision, violence);
  • hypertensive disorders of pregnancy (e.g., gestational, preeclampsia);
  • hematological disorders (e.g., anemia, idiopathic thrombocytopenic purpura [ITP], sickle cell anemia, thrombophilias);
  • diabetes (e.g., pre-existing, gestational, type 2);
  • infections (e.g., sexually transmitted infections, group B streptococcus, parvovirus, periodontal disease, influenza, MRSA);
  • multiple gestation (e.g., chorionicity, presentation, higher order);
  • mental health conditions (e.g., depression, eating disorders, anxiety);
  • pre-existing medical conditions (e.g., asthma, obesity, epilepsy, cardiovascular disorders, renal disorders, cancer); and
  • substance use (e.g., smoking, alcohol, prescription and non-prescription drugs, recreational drugs).

• Labour and Birth — Official range: 30–40% (Practice allocation: 35%)

  • Interprets data to establish presenting health status during labour and birth including:
  • Interprets intrapartum data to determine the status of labour, including:
  • Selects appropriate method(s) of fetal surveillance during labour (e.g., intermittent auscultation, continuous fetal heart monitoring).
  • Interprets data related to fetal well-being including:
  • Selects appropriate nursing interventions in the presence of atypical or abnormal fetal heart rate (FHR) patterns.
  • Selects appropriate nursing interventions related to the labouring person’s and family’s adaptation to labour (e.g., coping with labour, birth plan/preferences, pain assessment).
  • Selects appropriate nursing interventions to promote progress of all stages of labour (e.g., continuous labour support, position changes, mobility).
  • Implements appropriate nursing interventions to provide pain management using:
  • Selects appropriate nursing interventions to manage the following actual or potential complications during labour:
  • Selects appropriate nursing interventions to respond to the following urgent and emergent situations in the intrapartum period:
  • Selects appropriate nursing interventions for the person experiencing planned cesarean birth.
  • Identifies indications for and risk factors associated with cervical ripening, induction of labour or augmentation.
  • Selects appropriate nursing interventions for the person receiving the following methods of cervical ripening, labour induction or augmentation:
  • Selects appropriate nursing interventions for assisted vaginal births using vacuum or forceps.
  • Identifies the risk factors for postpartum hemorrhage.
  • Implements appropriate nursing interventions to manage postpartum hemorrhage.
  • Identifies risk factors for newborns who may experience challenges with transition to extrauterine life.
  • Implements nursing interventions for the newborn who requires resuscitation (e.g., neonatal resuscitation [NRP]).
  • Assigns the Apgar score.
  • Implements appropriate nursing interventions to promote optimal newborn transition to extrauterine life (e.g., skin to skin).
  • Selects appropriate nursing interventions when administering medications to the newborn (e.g., vitamin K, erythromycin ointment, prophylaxis based on transmissible infections [HIV, hepatitis]).
  • Facilitates parental and family attachment to the newborn.
  • Selects appropriate nursing interventions to facilitate initiation of breastfeeding.
  • antenatal and obstetrical history;
  • medical history (e.g., asthma, obesity, infectious diseases, cardiovascular disease, physical challenges);
  • mental health history (e.g., depression, anxiety, post-traumatic stress disorder [PTSD]);
  • social history (e.g., substance use, smoking, violence, financial resources, family support);
  • communication challenges (e.g., language, hearing or visual impairment, health literacy); and
  • diagnostic investigations (e.g., laboratory results, ultrasound).
  • Leopold’s manoeuvres;
  • assessment of contractions;
  • vaginal exam (e.g., dilatation, effacement, station, presentation, position); and
  • membrane status.
  • fetal heart rate patterns;
  • amniotic fluid; and
  • fetal scalp sampling.
  • non-pharmacological options (e.g., massage, warm or cold compresses, hydrotherapy, relaxation and distraction, continuous labour support, TENS, sterile water injection);
  • nitrous oxide;
  • opioid analgesia (e.g., patient-controlled analgesia [PCA]); and
  • epidural analgesia (e.g., patient-controlled epidural analgesia [PCEA]).
  • labour dystocia (e.g., augmentation);
  • hypertensive disorders of pregnancy (e.g., seizure prophylaxis);
  • diabetes (e.g., changing insulin requirements);
  • preterm labour (e.g., fetal neuroprotection, extremes of viability);
  • prolonged rupture of membranes;
  • infections (e.g., group B streptococcus, active herpes, HIV);
  • multiple gestation (e.g., presentation, risk for postpartum hemorrhage );
  • fetal compromise (e.g., anomalies, intrauterine growth restriction, amniotic fluid abnormalities);
  • intrauterine fetal demise;
  • gynecological complications (e.g., previous uterine and cervical surgeries, fibroids, genital mutilation, cervical sutures);
  • history of sexual abuse and/or violence;
  • obesity (e.g., slow progress of labour, challenges with monitoring uterine contractions and fetal status);
  • fetal presentation (e.g., occiput posterior, planned breech birth); and
  • trial of labour after cesarean (e.g., VBAC).
  • atypical and abnormal electronic fetal heart rate patterns;
  • complications of hypertensive disorders of pregnancy (e.g., hemolysis, elevated liver enzymes, low platelet count [HELLP] syndrome, eclampsia);
  • hemorrhage (e.g., abruptio placenta, placenta previa, disseminated intravascular coagulation [DIC]);
  • shoulder dystocia;
  • malpresentation (e.g., unexpected breech, transverse lie);
  • uterine rupture;
  • cord complications (e.g., prolapse);
  • precipitous birth;
  • abnormal placentation (e.g., vasa previa, placenta accreta); and
  • urgent or emergent cesarean birth.
  • prostaglandin;
  • mechanical methods (e.g., Foley catheter)
  • artificial rupture of membranes;
  • oxytocin; and
  • misoprostol.

• Postpartum (up to 3 months) — Official range: 15–25% (Practice allocation: 20%)

  • Interprets data to establish health status during the postpartum period including:
  • Selects nursing interventions to promote confidence in parenting and support family development related to:
  • Identifies key elements of postpartum physical assessment (e.g., fundus, lochia, perineum, breasts, vital signs, incision).
  • Identifies key elements of postpartum psychosocial assessment (e.g., birth experience, mood).
  • Selects appropriate nursing interventions to manage the following actual or potential conditions during the postpartum period:
  • Selects appropriate nursing interventions to respond to the following urgent and emergent situations in the postpartum period:
  • Selects appropriate nursing interventions to promote self-care (e.g., physical and emotional).
  • Selects appropriate nursing interventions to support the family experiencing grief and loss related to:
  • Instructs family on follow-up care post-discharge (e.g., postpartum checkup, community resources).
  • pre-existing medical conditions (e.g., diabetes, obesity, hypertension, thyroid dysfunction);
  • pre-existing or new onset mental health conditions (e.g., depression, bipolar);
  • past and present obstetrical history (e.g., cesarean birth, assisted vaginal birth, spontaneous vaginal birth); and
  • lifestyle (e.g., substance use, smoking, violence, financial resources, social supports).
  • promoting attachment;
  • identifying learning opportunities (e.g., infant care, parenting roles);
  • evaluating learning outcomes (e.g., self-care and infant care); and
  • preparing for transition to home.
  • pain (e.g., perineal, incisional);
  • fluid imbalance (e.g., shortness of breath, dehydration, edema);
  • bladder dysfunction (e.g., urinary retention, incontinence);
  • bowel dysfunction (e.g., constipation, hemorrhoids);
  • impaired skin integrity (e.g., perineum, cesarean incision, hematoma, nipples);
  • postpartum emotional adjustment (e.g., “baby blues,” postpartum depression);
  • anemia;
  • immunization status (e.g., rubella, pertussis, varicella);
  • Rh negative;
  • infections (e.g., wound, uterine, breast and urinary tract infections);
  • substance use (e.g., methadone);
  • mobility challenges (e.g., symphysis pubis separation); and
  • risk for venous thromboembolism (e.g., increased BMI, limited mobility).
  • post-epidural/spinal complications (e.g., post-dural puncture headache);
  • hemorrhage (e.g., uterine atony, laceration, retained placental tissue);
  • thromboembolic events (e.g., pulmonary embolism, deep vein thrombosis [DVT]);
  • hypertensive disorders of pregnancy (e.g., seizures, HELLP);
  • sepsis; and
  • postpartum psychosis.
  • admission to intensive care (e.g., postpartum person, newborn);
  • newborn anomalies (e.g., cleft lip, cardiac condition, chromosomal abnormalities);
  • perinatal loss (e.g., fetal or neonatal demise, apprehension, adoption, intrapartum or postpartum death); and
  • unexpected outcome (e.g., birth trauma, loss of idealized infant, loss of idealized birth experience).

• Newborn and Infant Care (up to 3 months) — Official range: 15–20% (Practice allocation: 17.5%)

  • Identifies key elements of newborn physical assessment (e.g., expected findings and variants, vital signs).
  • Selects appropriate nursing interventions to promote thermal stability of the newborn (e.g., skin to skin).
  • Selects appropriate nursing interventions based on the following actual or potential newborn complications:
  • Selects appropriate nursing interventions to address newborn care related to:
  • Selects appropriate nursing interventions to address newborn safety in the hospital and/or at home related to:
  • Demonstrates knowledge of normal infant growth and development including:
  • Selects appropriate nursing interventions for effective breastfeeding (e.g., cues, latch, feeding assessment, feeding patterns, adequate intake and output).
  • Selects appropriate nursing interventions to support exclusive breastfeeding (e.g., hand expression, skin-to-skin contact).
  • Identifies medical indications and appropriate methods for supplementation of breastfed infants.
  • Selects appropriate nursing interventions to address common breastfeeding challenges related to the:
  • Selects appropriate nursing interventions related to milk expression (e.g., techniques, indications, handling and storage).
  • Selects appropriate nursing interventions for the new parent and/or family choosing to use breast milk substitute (e.g., preparation, safe storage, feeding cues and amount, output).
  • Selects nursing interventions to support the new parent(s) in the transition to parenthood (e.g., accessing community resources, social supports, shaken baby syndrome prevention).
  • Instructs family on follow-up care (e.g., immunization, infant checkup).
  • hypoglycemia;
  • hypothermia or hyperthermia;
  • hyperbilirubinemia;
  • abnormal physical assessment (e.g., birth trauma, cardiac irregularities, subgaleal hemorrhage);
  • infections (e.g., group B streptococcus, sepsis);
  • neonatal abstinence syndrome;
  • manifestations of illness (e.g., lethargy, poor feeding, regurgitation, tachypnea, indrawing); and
  • pain or stress (e.g., procedural, birth trauma).
  • infant hygiene (e.g., bathing, skin care, cord care);
  • newborn screening (e.g., metabolic, hearing, pulse oximetry); and
  • prevention of plagiocephaly (e.g., tummy time).
  • infant security (e.g., unattended infant);
  • safe infant sleep (e.g., flat surface, place on back to sleep);
  • environment (e.g., second- and third-hand smoke, room temperature);
  • equipment (e.g., car seat, crib); and
  • infant behaviours (e.g., crying, cluster feeding).
  • physical (e.g., growth spurts, weight gain);
  • neurological (e.g., reflexes);
  • social (e.g., smile); and
  • behavioural states (active alert, quiet alert, sleeping, drowsy).
  • newborn (e.g., sleepy or fussy, prematurity, tongue tie, candidiasis); and
  • breastfeeding person (e.g., sore nipples, engorgement, breast surgery, mastitis, candidiasis, flat or inverted nipples).

How to prepare

Work through the topics, read the explanation after each answer, and revisit the areas where you miss questions. Use the official outline and reference materials below to guide your study.

These independent practice questions are not actual exam items and do not guarantee a passing result.

Frequently asked questions

Official sources and references

• CNA blueprints

  Exam Competencies & Blueprints

• Perinatal Nursing Certification — Exam Blueprint and Specialty Competencies

  p. 3, Table 1

• Perinatal Nursing Certification — Exam Blueprint and Specialty Competencies

  p. 1

• Perinatal Nursing Certification — Exam Blueprint and Specialty Competencies

  p. 4, Structural Variables

• CNA tips

  CBT exam tips

• CNA results

  Exam Results and Retesting

• CNA fees

  Initial Exam Fees, table and footnotes

• CNA fees

  Initial Exam Fees, amounts

• CNA roles

  competency development/review working group

• CNA process

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