Santa Clara County Labor and Delivery Nurse
Examination
– Version 2.0
Advanced Clinical
Competency Assessment
a well detailed one 2025
/ 2026 written and graded A+ upgraded
Examination Instructions
This comprehensive examination consists of 150 multiple-choice questions designed for
experienced perinatal nurses practicing at Santa Clara Valley Medical Center (SCVMC).
Questions reflect the complexity of high-risk obstetrical care in a Level III perinatal center with a
busy, high-acuity Labor and Delivery unit. SCVMC has earned national recognition for maternity
care, including excellence in minimizing avoidable cesarean sections and supporting vaginal
birth after cesarean (VBAC) at rates nearly double the California state average.
Each question requires integration of clinical knowledge, SCVMC-specific policies, evidence-
based practice, and critical decision-making. Select the single best answer. Detailed rationales
are provided for each response.
SECTION A: SCVMC DEPARTMENTAL POLICIES AND PROCEDURES (Questions 1–20)
1. According to SCVMC Labor and Delivery Nursing Policy Manual, which of the following
statements accurately describes the requirements for neonatal resuscitation certification?
,A) NRP certification must be obtained within six months of hire with a one-month grace period
for renewal
B) NRP certification must be maintained every two years with no grace period for renewal
C) NRP certification is optional for nurses working exclusively in the Post Anesthesia Recovery
Room
D) NRP certification requires annual renewal with a 30-day grace period
Correct Answer: B
Rationale: SCVMC policy explicitly states that licensed nurses assigned to NICU, Labor and
Delivery, and MICC must be certified in Neonatal Resuscitation within one year of hire date and
renewal shall be maintained every two years with no grace period granted for renewal
certification. Each nurse must assure their own certification remains current. There is no
exception for PARR nurses who may be called upon for neonatal emergencies.
2. A nurse is preparing to apply a fetal spiral electrode (FSE) on a patient at 6 cm dilation with
ruptured membranes. The attending physician is in a cesarean delivery and cannot be
immediately available. According to SCVMC policy, which of the following is correct regarding
FSE placement by an RN?
A) The nurse may place the FSE only after obtaining a verbal order from the physician
B) The nurse may place the FSE independently if FSE competency has been successfully
completed
C) The nurse must wait for the physician to become available before placing the FSE
D) The nurse may place the FSE only if a second RN verifies the placement
Correct Answer: B
Rationale: SCVMC policy states that registered nurses may apply FSE when indicated. Nurses
must have successfully completed FSE competency prior to insertion of FSE independently. A
qualified nurse can apply an FSE if the MD is not readily available or if requested by an MD.
While competency is required, a second RN verification is not mandated by policy for this
procedure.
3. The charge nurse is delegating the responsibility for checking emergency crash carts in
Labor and Delivery. Which of the following correctly reflects SCVMC policy for crash cart
checks?
,A) Crash carts must be checked every 12 hours by the Anesthesia Department
B) Crash carts must be checked at least every 24 hours by the RN in charge or designated RN,
with responsibility rotated among shifts monthly
C) Crash carts must be checked weekly by the Nurse Manager
D) Crash carts are checked only when a code is called
Correct Answer: B
Rationale: SCVMC policy requires that hospital emergency crash carts be checked at least every
24 hours by the registered nurse in charge or by a designated RN. The responsibility for checking
the cart is rotated among shifts each month. Basic emergency carts in the operating rooms are
maintained by the Anesthesia Department. This distinction is important for the examination.
4. A patient in active labor requests that her 8-year-old daughter be present during the
delivery. According to SCVMC policy regarding sibling attendance, which of the following
conditions must be met?
A) The child must be at least 10 years old to attend delivery
B) There must be one adult support person designated for the children, separate from the
mother's support person
C) The child must have written permission from both parents
D) Only one child total may be present in the delivery room at any time
Correct Answer: B
Rationale: SCVMC policy allows siblings to attend both active labor and delivery. There must be
one adult support person designated for the children, and this should not be the support
person for the mother. If there is a second child present, an additional adult must be available in
the waiting room. Children cannot attend certain procedures including epidural placement.
5. The L&D Staff Developer is updating the annual competency program. According to SCVMC
policy, which of the following correctly describes the competency verification process?
A) Competency checks are administered only during the annual OB update by the Nurse
Manager
B) Competency checks are administered to staff while on duty and during the annual OB update
by Assistant Nurse Managers or designees
C) Competency checks are self-administered and submitted to the Staff Developer for review
D) Competency checks are performed only for new employees during their orientation period
, Correct Answer: B
Rationale: SCVMC policy states that competency checks will be administered to staff while they
are on duty and during the annual OB update. Competency checks will be conducted by the
Assistant Nurse Managers or designees, arranged by the Nurse Manager of L&D. The L&D Staff
Developer develops and updates the competency program.
6. The annual competency list for SCVMC Labor and Delivery nurses includes all of the
following EXCEPT:
A) Noninflatable Antishock Garment
B) Limited OB Ultrasound
C) Fetal Blood Sampling
D) Sterile Speculum Examination
Correct Answer: C
Rationale: The SCVMC Labor and Delivery annual competency list includes: Infant Security,
EMTALA, Electronic Fetal Monitoring, Blood Administration, Glucose Meter, Nitrazine Paper,
Labstix Reagent Strips, Noninflatable Antishock Garment, Prevention of Violence in the
Workplace, Sterile Speculum Examination, and Limited OB Ultrasound. Fetal blood sampling is
not listed as a nursing competency and is typically a physician-performed procedure.
7. According to SCVMC policy, where are policies and procedure manuals located for staff
review?
A) Only in the Nurse Manager's office
B) Electronically on ValleyPages and in hard copy in L&D
C) At the hospital library only
D) Distributed annually to each staff member
Correct Answer: B
Rationale: SCVMC policy states that policies and procedure manuals are located in L&D. L&D
staff are responsible for reviewing all new and revised policies and procedures. Additionally, the
Infection Control Manual can be found electronically on ValleyPages under the Policies &
Procedures section. Staff are required to comply with the Infection Control Manual.
Examination
– Version 2.0
Advanced Clinical
Competency Assessment
a well detailed one 2025
/ 2026 written and graded A+ upgraded
Examination Instructions
This comprehensive examination consists of 150 multiple-choice questions designed for
experienced perinatal nurses practicing at Santa Clara Valley Medical Center (SCVMC).
Questions reflect the complexity of high-risk obstetrical care in a Level III perinatal center with a
busy, high-acuity Labor and Delivery unit. SCVMC has earned national recognition for maternity
care, including excellence in minimizing avoidable cesarean sections and supporting vaginal
birth after cesarean (VBAC) at rates nearly double the California state average.
Each question requires integration of clinical knowledge, SCVMC-specific policies, evidence-
based practice, and critical decision-making. Select the single best answer. Detailed rationales
are provided for each response.
SECTION A: SCVMC DEPARTMENTAL POLICIES AND PROCEDURES (Questions 1–20)
1. According to SCVMC Labor and Delivery Nursing Policy Manual, which of the following
statements accurately describes the requirements for neonatal resuscitation certification?
,A) NRP certification must be obtained within six months of hire with a one-month grace period
for renewal
B) NRP certification must be maintained every two years with no grace period for renewal
C) NRP certification is optional for nurses working exclusively in the Post Anesthesia Recovery
Room
D) NRP certification requires annual renewal with a 30-day grace period
Correct Answer: B
Rationale: SCVMC policy explicitly states that licensed nurses assigned to NICU, Labor and
Delivery, and MICC must be certified in Neonatal Resuscitation within one year of hire date and
renewal shall be maintained every two years with no grace period granted for renewal
certification. Each nurse must assure their own certification remains current. There is no
exception for PARR nurses who may be called upon for neonatal emergencies.
2. A nurse is preparing to apply a fetal spiral electrode (FSE) on a patient at 6 cm dilation with
ruptured membranes. The attending physician is in a cesarean delivery and cannot be
immediately available. According to SCVMC policy, which of the following is correct regarding
FSE placement by an RN?
A) The nurse may place the FSE only after obtaining a verbal order from the physician
B) The nurse may place the FSE independently if FSE competency has been successfully
completed
C) The nurse must wait for the physician to become available before placing the FSE
D) The nurse may place the FSE only if a second RN verifies the placement
Correct Answer: B
Rationale: SCVMC policy states that registered nurses may apply FSE when indicated. Nurses
must have successfully completed FSE competency prior to insertion of FSE independently. A
qualified nurse can apply an FSE if the MD is not readily available or if requested by an MD.
While competency is required, a second RN verification is not mandated by policy for this
procedure.
3. The charge nurse is delegating the responsibility for checking emergency crash carts in
Labor and Delivery. Which of the following correctly reflects SCVMC policy for crash cart
checks?
,A) Crash carts must be checked every 12 hours by the Anesthesia Department
B) Crash carts must be checked at least every 24 hours by the RN in charge or designated RN,
with responsibility rotated among shifts monthly
C) Crash carts must be checked weekly by the Nurse Manager
D) Crash carts are checked only when a code is called
Correct Answer: B
Rationale: SCVMC policy requires that hospital emergency crash carts be checked at least every
24 hours by the registered nurse in charge or by a designated RN. The responsibility for checking
the cart is rotated among shifts each month. Basic emergency carts in the operating rooms are
maintained by the Anesthesia Department. This distinction is important for the examination.
4. A patient in active labor requests that her 8-year-old daughter be present during the
delivery. According to SCVMC policy regarding sibling attendance, which of the following
conditions must be met?
A) The child must be at least 10 years old to attend delivery
B) There must be one adult support person designated for the children, separate from the
mother's support person
C) The child must have written permission from both parents
D) Only one child total may be present in the delivery room at any time
Correct Answer: B
Rationale: SCVMC policy allows siblings to attend both active labor and delivery. There must be
one adult support person designated for the children, and this should not be the support
person for the mother. If there is a second child present, an additional adult must be available in
the waiting room. Children cannot attend certain procedures including epidural placement.
5. The L&D Staff Developer is updating the annual competency program. According to SCVMC
policy, which of the following correctly describes the competency verification process?
A) Competency checks are administered only during the annual OB update by the Nurse
Manager
B) Competency checks are administered to staff while on duty and during the annual OB update
by Assistant Nurse Managers or designees
C) Competency checks are self-administered and submitted to the Staff Developer for review
D) Competency checks are performed only for new employees during their orientation period
, Correct Answer: B
Rationale: SCVMC policy states that competency checks will be administered to staff while they
are on duty and during the annual OB update. Competency checks will be conducted by the
Assistant Nurse Managers or designees, arranged by the Nurse Manager of L&D. The L&D Staff
Developer develops and updates the competency program.
6. The annual competency list for SCVMC Labor and Delivery nurses includes all of the
following EXCEPT:
A) Noninflatable Antishock Garment
B) Limited OB Ultrasound
C) Fetal Blood Sampling
D) Sterile Speculum Examination
Correct Answer: C
Rationale: The SCVMC Labor and Delivery annual competency list includes: Infant Security,
EMTALA, Electronic Fetal Monitoring, Blood Administration, Glucose Meter, Nitrazine Paper,
Labstix Reagent Strips, Noninflatable Antishock Garment, Prevention of Violence in the
Workplace, Sterile Speculum Examination, and Limited OB Ultrasound. Fetal blood sampling is
not listed as a nursing competency and is typically a physician-performed procedure.
7. According to SCVMC policy, where are policies and procedure manuals located for staff
review?
A) Only in the Nurse Manager's office
B) Electronically on ValleyPages and in hard copy in L&D
C) At the hospital library only
D) Distributed annually to each staff member
Correct Answer: B
Rationale: SCVMC policy states that policies and procedure manuals are located in L&D. L&D
staff are responsible for reviewing all new and revised policies and procedures. Additionally, the
Infection Control Manual can be found electronically on ValleyPages under the Policies &
Procedures section. Staff are required to comply with the Infection Control Manual.
