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2026 Statistics

Key Facts: PNC(C) Exam

165

Exam Questions

CNA

4 hours

Exam Time

CNA

$570 / $756

Exam Fee (CAD)

CNA Member / Non-Member

5 years

Certification Validity

CNA Renewal Cycle

SOGC & NRP

Clinical Guidelines

Primary Reference Standards

1,950 hrs

Specialty Practice Requirement

Eligibility Option A

The CNA Perinatal Nursing Certification (PNC(C)) exam comprises 165 multiple-choice questions with a 4-hour time limit. It requires an active Canadian RN license and at least 1,950 hours of specialty experience (or 1,000 hours with formal post-basic education). The exam is priced at $570 for CNA members and $756 for non-members, testing competence in preconception, prenatal, labor/delivery, postpartum, and newborn clinical management.

Sample PNC(C) Practice Questions

Try these sample questions to test your PNC(C) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A low-risk woman who is planning a pregnancy asks the nurse about the recommended daily dose of folic acid. Which of the following doses should the nurse recommend?
A.0.4 mg/day
B.1.0 mg/day
C.5.0 mg/day
D.0.1 mg/day
Explanation: According to the Society of Obstetricians and Gynaecologists of Canada (SOGC) guidelines, a daily multivitamin containing 0.4 mg of folic acid is recommended for at least two to three months preconception and throughout pregnancy for low-risk women to reduce the risk of neural tube defects (NTDs). Higher doses are reserved for women at increased risk: 1.0 mg/day for moderate-risk women (e.g., pre-existing diabetes, BMI > 35, family history of NTD) and 4.0 mg/day for high-risk women (e.g., a previous pregnancy affected by an NTD, or taking certain anticonvulsants).
2A client is found to be rubella non-immune during a preconception assessment. Which of the following advice should the nurse provide regarding rubella immunization?
A.Receive the MMR vaccine immediately and avoid conceiving for at least 4 weeks
B.Receive the MMR vaccine during the second trimester of the upcoming pregnancy
C.Postpone immunization until immediately after giving birth, regardless of preconception status
D.Receive the MMR vaccine immediately and proceed with conception as planned without delay
Explanation: The measles, mumps, and rubella (MMR) vaccine is a live attenuated vaccine and is contraindicated during pregnancy due to the theoretical risk of congenital rubella syndrome (CRS). Preconception screening allows non-immune women to be vaccinated, but they must be advised to avoid pregnancy for at least 28 days (4 weeks) following vaccination. Live vaccines must not be administered during gestation, but non-immune women should receive the vaccine in the immediate postpartum period before hospital discharge.
3Which of the following lifestyle modifications is the most critical preconception intervention for a client who smokes 15 cigarettes per day?
A.Initiating smoking cessation counseling and discussing nicotine replacement therapies
B.Restricting caffeine intake to less than 400 mg per day
C.Increasing daily exercise to 60 minutes of high-intensity training
D.Switching to electronic cigarettes to eliminate tobacco smoke exposure
Explanation: Smoking preconception and during pregnancy is associated with adverse outcomes such as fetal growth restriction, placental abruption, preterm birth, and stillbirth. Initiating smoking cessation interventions preconception is the most effective way to eliminate these risks. SOGC guidelines support behavioral counseling as the first-line intervention, with discussion of pharmacotherapy (like nicotine replacement) when counseling alone is insufficient. Switching to e-cigarettes is not recommended as their safety in pregnancy is unproven and nicotine itself is a teratogen.
4A client with pre-existing Type 1 Diabetes is planning a pregnancy. The nurse should explain that the target glycated hemoglobin (HbA1c) level preconception should ideally be below which value to minimize congenital anomalies?
A.7.0%
B.8.5%
C.5.0%
D.9.5%
Explanation: According to Diabetes Canada and SOGC guidelines, women with pre-existing diabetes should strive to achieve optimal glycemic control before conception, targeting an HbA1c of 7.0% or less (ideally 6.5% or less if it can be achieved safely) to reduce the risk of congenital anomalies, miscarriage, and preeclampsia. Poor glycemic control in the early weeks of gestation, when organogenesis occurs, is strongly associated with cardiac and neural tube defects. An HbA1c of 5.0% is not a realistic or safe target for most individuals with Type 1 Diabetes due to the high risk of severe hypoglycemia.
5Which of the following statements best describes the primary rationale for offering carrier screening for genetic conditions (such as cystic fibrosis) during the preconception period rather than antenatally?
A.It allows the couple to consider a wider range of reproductive choices and make informed decisions before pregnancy occurs
B.It guarantees that the couple will not have a child affected by any genetic disorder
C.It is significantly less expensive and is fully covered by provincial health plans only before conception
D.It eliminates the need for invasive prenatal diagnostic testing during the subsequent pregnancy
Explanation: Preconception genetic carrier screening allows couples to identify their risk of passing on autosomal recessive or X-linked conditions before conceiving. This timing provides the maximum range of options, including preimplantation genetic testing (PGT) via in vitro fertilization (IVF), using donor gametes, planning for prenatal diagnosis (e.g., CVS or amniocentesis), adoption, or accepting the risk and preparing for the birth of an affected child. Carrier screening does not guarantee a healthy child as it only tests for specific conditions, and positive carrier status may still necessitate invasive testing if they proceed with pregnancy.
6A 38-year-old client attends a preconception clinic. When counseling this client, the nurse should identify that advanced maternal age (35 years or older) is associated with an increased risk of which combination of conditions?
A.Chromosomal abnormalities, gestational diabetes, and preeclampsia
B.Neural tube defects, neonatal hyperbilirubinemia, and maternal hyperthyroidism
C.Fetal gastroschisis, maternal asthma, and Rh incompatibility
D.Neonatal hypoglycemia, maternal placenta accreta, and shoulder dystocia
Explanation: Advanced maternal age (AMA), defined as age 35 or older at the estimated date of delivery, is epidemiologically associated with an increased risk of chromosomal abnormalities (e.g., Down syndrome), gestational diabetes mellitus, preeclampsia, placenta previa, cesarean delivery, and stillbirth. The decline in oocyte quality increases aneuploidy risks, while vascular changes associated with aging increase preeclampsia and gestational diabetes risks. Neural tube defects, gastroschisis, and Rh incompatibility are not directly linked to maternal age.
7A client who is taking enalapril (an ACE inhibitor) for chronic hypertension presents to a preconception counseling session. Which of the following interventions should the nurse prioritize?
A.Advise the client to discuss transitioning to an alternative antihypertensive, such as labetalol, with their prescriber before attempting conception
B.Instruct the client to immediately discontinue enalapril and monitor blood pressure at home without replacing the medication
C.Reassure the client that enalapril is safe to continue until a positive pregnancy test is obtained
D.Recommend increasing the dose of enalapril preconception to ensure blood pressure is strictly below 120/80 mmHg
Explanation: Angiotensin-converting enzyme (ACE) inhibitors, such as enalapril, are teratogenic. Exposure during the first trimester is associated with cardiovascular and central nervous system anomalies, while second- and third-trimester exposure causes fetal renal dysgenesis, oligohydramnios, skull hypoplasia, and neonatal renal failure. The nurse must prioritize counseling the client to transition to a safer agent (e.g., labetalol, methyldopa, or nifedipine) preconception. Abrupt discontinuation without replacement is unsafe as severe maternal hypertension must be avoided.
8A pregnant client reports that the first day of their last menstrual period (LMP) was October 10, 2025. Using Naegele's rule, what is the client's estimated date of birth (EDB)?
A.July 17, 2026
B.July 3, 2026
C.July 10, 2026
D.August 17, 2026
Explanation: Naegele's rule is a standard method used to estimate the date of birth: add 7 days to the first day of the last menstrual period (LMP), subtract 3 months, and adjust the year if necessary. October 10 + 7 days = October 17. Subtracting 3 months from October gives July. Therefore, the EDB is July 17, 2026.
9Which of the following physiological cardiovascular changes is normal during pregnancy?
A.Increased blood volume, with plasma volume increasing more than red blood cell mass
B.Decreased cardiac output and increased systemic vascular resistance
C.Increased blood pressure, peaking in the second trimester
D.Decreased heart rate and increased blood viscosity
Explanation: During pregnancy, maternal blood volume increases by 30% to 50% to support the uteroplacental circulation. Plasma volume increases by approximately 50%, whereas red blood cell (RBC) mass increases by only 20% to 30%. This disproportionate increase leads to hemodilution, commonly referred to as the physiological anemia of pregnancy. Cardiac output increases by 30% to 50%, systemic vascular resistance decreases due to progesterone-induced vasodilation, and blood pressure typically drops slightly in the second trimester before returning to baseline in the third.
10For a low-risk pregnant client, what is the standard recommended schedule for prenatal care visits in Canada?
A.Every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly thereafter until birth
B.Weekly until 28 weeks, every 2 weeks until 36 weeks, and monthly thereafter
C.Every 2 weeks until 32 weeks, and weekly thereafter until birth
D.Every 6 weeks until 36 weeks, and weekly thereafter until birth
Explanation: The standard prenatal visit schedule for a low-risk pregnant client in Canada consists of monthly (every 4 weeks) visits up to 28 weeks' gestation, biweekly (every 2 weeks) visits from 28 to 36 weeks, and weekly visits from 36 weeks until delivery. This schedule allows for timely screening, physical assessments (e.g., fundal height, blood pressure, fetal heart rate), and patient education as gestational age advances.

About the PNC(C) Exam

The Perinatal Nursing Certification (PNC(C)) is the professional credential awarded by the Canadian Nurses Association (CNA) to registered nurses who demonstrate specialized knowledge and clinical expertise in perinatal care. The exam evaluates competencies across the entire perinatal spectrum, including preconception health, prenatal assessments, labor and delivery, postpartum recovery, and neonatal transition. Aligned with guidelines from the Society of Obstetricians and Gynaecologists of Canada (SOGC) and the Canadian Association of Perinatal and Women's Health Nurses (CAPWHN), this certification represents the standard of excellence for Canadian obstetrical and neonatal nurses.

Assessment

165 multiple-choice questions

Time Limit

4 hours

Passing Score

Criterion-referenced passing score

Exam Fee

$588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra. (CNA (Canadian Nurses Association))

PNC(C) Exam Content Outline

5-10%

Preconception

Covers family planning, pre-pregnancy health promotion, genetic screening, fertility assessment, and management of pre-existing chronic conditions.

15-25%

Antenatal

Focuses on maternal anatomy/physiology, gestational changes, routine prenatal screening, risk assessment, antenatal surveillance, and complications like gestational hypertension or diabetes.

30-40%

Labour and Birth

Focuses on normal stages of labor, SOGC fetal health surveillance guidelines, pain management (pharmacological/non-pharmacological), high-risk labor patterns, and obstetrical emergencies (e.g., shoulder dystocia, cord prolapse).

15-25%

Postpartum

Covers physiological uterine involution, laceration care, postpartum hemorrhage management, lactation support, postpartum depression/psychosis, and discharge planning.

15-25%

Newborn

Focuses on neonatal transition, APGAR scoring, neonatal resuscitation program (NRP) standards, head-to-toe newborn assessment, hyperbilirubinemia, hypoglycemia, and neonatal abstinence syndrome.

How to Pass the PNC(C) Exam

What You Need to Know

  • Passing score: Criterion-referenced passing score
  • Assessment: 165 multiple-choice questions
  • Time limit: 4 hours
  • Exam fee: $588 CAD (CNA member) / $780 CAD (non-member) application fee, plus $85 online (ProctorU) or $110 in-person writing appointment fee; rewrite $378 (member) / $500 (non-member). Applicable taxes extra.

Keys to Passing

  • Complete 500+ practice questions
  • Score 80%+ consistently before scheduling
  • Focus on highest-weighted sections
  • Use our AI tutor for tough concepts

PNC(C) Study Tips from Top Performers

1Familiarize yourself with the SOGC guidelines, especially those on Fetal Health Surveillance (FHS) and Hypertensive Disorders of Pregnancy.
2Review the Neonatal Resuscitation Program (NRP) guidelines, focusing on the sequence of interventions and ventilation corrective steps (MR. SOPA).
3Understand the physiological changes of pregnancy and how to distinguish normal adaptations from pathological complications in all stages of gestation.
4Study pharmacological agents commonly used in obstetrics, including oxytocin titration protocols, magnesium sulfate indications/toxicity, and anti-hypertensive regimens.
5Focus on obstetric emergencies: shoulder dystocia maneuvers, cord prolapse interventions, amniotic fluid embolism, and uterine rupture.
6Practice maternal and newborn assessment protocols, including APGAR scoring, gestational age assessments, and postpartum fundal assessments.

Frequently Asked Questions

What is the PNC(C) certification?

The PNC(C) (Perinatal Nursing Certification) is a professional designation offered by the Canadian Nurses Association (CNA). It certifies that a registered nurse has met the rigorous national standards and demonstrated specialized knowledge, clinical judgment, and experience in caring for families throughout the childbearing continuum (preconception to newborn care).

Who is eligible to take the CNA Perinatal Nursing exam?

Candidates must be registered nurses with an active license in Canada. They must also have either: (Option A) at least 1,950 hours of perinatal nursing experience within the last 5 years, or (Option B) at least 1,000 hours of experience plus a completed post-basic perinatal specialty program of at least 300 hours within the last 10 years.

What is the cost of the CNA certification exam?

The exam fee is $570 CAD for CNA members and $756 CAD for non-members. In addition, there may be a local test booking fee or remote proctoring fees. Discounts are sometimes available for members of provincial/territorial associations or CAPWHN.

How long is the exam and how many questions does it contain?

The exam consists of 165 multiple-choice questions and has a time limit of 4 hours. It can be taken at an authorized Meazure Learning test center or online via live remote proctoring.

What content areas are tested on the PNC(C) exam?

The exam is divided into five main sections based on the childbearing continuum: Preconception (5-10%), Antenatal (15-25%), Labour and Birth (30-40%), Postpartum (15-25%), and Newborn Care (15-25%). Questions test application of clinical guidelines, such as those from the SOGC and CAPWHN.

How is the passing score determined?

The CNA uses a criterion-referenced scoring method where the passing standard is set by a panel of national specialty experts. This standard is translated into a scaled score to account for minor variations in difficulty across different exam forms.

How long is the certification valid?

The PNC(C) credential is valid for five years. To maintain the credential, nurses must renew every five years either by completing 100 continuous learning (CL) hours or by retaking the certification exam.