Labor & Delivery Nursing Knowledge Assessment Exam: Study Guide
Review Calculations related to medications and IV drips, Basic Safety and Infection Control,
National Patient Safety Goals, Pain Management, and Blood Administration.
Review assessment, interventions, monitoring, and care for conditions commonly encountered in labor
and delivery nursing, including:
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Abruptio placenta, signs and symptoms, nursing action
APGAR score, given description of newborn
AWHONN standard for monitoring low-risk laboring patient during oxytocin augmentation
Possible abuse, communication with patient
Blood transfusion reaction
Coaching with reassuring tracing, ineffective pushing – open glottis pushing
Hemorrhage, Post-C-section, signs and symptoms, nursing action
HELLP syndrome, signs and symptoms
Nonresponsive newborn after initial measures, neonatal resuscitation
Prodromal labor, non-reassuring FHR pattern
Pain assessment, patient’s perception of pain
Perineal laceration, treatment
PROM, intra-amniotic infection
Primigravida, motor vehicle crash, assessment
Shoulder dystocia, assisting in delivery, McRobert’s maneuver
No urination 6 hours post-delivery, nursing action
Review action, preparation, monitoring, and precautions related to medications commonly used in labor
and delivery, such as
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Antibiotic prophylaxis intrapartum, indications
Anti-retroviral therapy for HIV positive patient
Butorphanol (Stadol®), mL calculation for mg dose
Corticosteroids while delaying delivery preterm infant, purpose
Ephedrine for hypotension during continuous epidural analgesia
Heparin protocol
Magnesium sulfate, mL calculation for g dose; mL/hr for continuous infusion g dose
Methylergonovine (Methergine®), hold for increased BP
Nalbuphine hydrochloride (Nubane®) toxicity
Naloxone (Narcan®), to reverse nalbuphine hydrochloride (Nubane®)
Oxytocin (Pitocin®), contraindicated in fetal distress, EFM monitoring
Terbutaline (Brethine®), adverse effects; risk of hyperglycemia
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Copyright statement
Updated 2013
Labor & Delivery Nursing Knowledge Assessment Exam: Study Guide
Review EFM tracing, parameters, interpretation, nursing action, and documentation including
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Accelerations, definition
Baseline, definition
Early decelerations, definition
Fetal bradycardia, definition
Criteria reactive non-stress test
Pathological sinusoidal baseline rhythm, characteristics
Prolonged decelerations, characteristics
Tracing interpretation, late decelerations, no accelerations, non-reassuring
Tracing interpretation, reactive and reassuring
Tracing documentation, unable to assess
Tracing interpretation, poor tracing, nursing action
Tracing interpretation, emergent situation, nursing action
Tracing interpretation, late decelerations during augmentation, nursing action
Tracing interpretation, uterine hyperstimulation during augmentation, nursing action
Tracing interpretation, action: D/C oxytocin, increase IV fluids, position on left side, contact
provider
Review principles and practices of communication with patients and family, including
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Patient satisfaction
Coaching when patient is pushing
Communicating need for C-section due to failure to progress
Questioning oxytocin order with provider
Communicating in potential abuse situation
Terbutaline (Brethine®), adverse effects to expect
Review documentation requirements, including
 Pain
 Reactive non-stress test
 EFM tracing, unable to assess variability due to absence of baseline; No accelerations; Prolonged
deceleration; Non-reactive: Non- reassuring.
Review safety and infection prevention, including
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Patient identifiers
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Copyright statement
Updated 2013
Labor & Delivery Nursing Knowledge Assessment Exam: Study Guide
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Use of handwashing rather than sanitizer w/C. diff
Reassess need for indwelling urinary catheter
Review calculations, including
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Medication protocols
Sliding scale
mL per dose for order in grams or milligrams
IV drip dosage calculations
IV drip rate, calculating drops per minute
To calculate the infusion rate: IV drip rate in drops per minute =
Volume to be infused (mL) over 1 hour/ Drop factor constant
Common drop factors
Drop factor constant
60 gtt/m/L - minidrip set
1
10 gtt/m/L – regular drip set
6
15 gtt/mL – regular drip set
4
Common drop factors are also known as the clock method – drop factors are obtained by dividing
60 minutes by the number of gtts per mL that the IV set delivers.
Page 3 of 3
Copyright statement
Updated 2013