INDEX NO.
OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: TESTING THE URINE OF A PREGNANT WOMAN FOR SUGAR/PROTEIN
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASKS RATING
1. Puts on mackintosh apron and gloves 0 1 2 3 4
2. Notes quantity, colour and sediments 0 1 2 3 4
3. Smells urine for odour 0 1 2 3 4
4. Measures specific gravity of urine. 0 1 2 3 4
5. Reads instructions on reagent bottle 0 1 2 3 4
6. Picks one strip of reagent and dips into urine 0 1 2 3 4
7. Removes strip immediately and taps the edge of strip against side of urine 0 1 2 3 4 container
8. Reads pH. of urine immediately 0 1 2 3 4
9. Compares test area closely with the corresponding colour chart on bottle 0 1 2 3 4
10. Discards items used according to infection prevention guidelines 0 1 2 3 4
11. Washes and dries hands 0 1 2 3 4
12. Records and reports findings 0 1 2 3 4
________________________________________________________________________
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
INDEX NO. OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: MONITORING A WOMAN IN THE FIRST STAGE OF LABOUR UNDER THE FOLLOWING
HEADINGS:
(a) Timing of contractions (b) Counting the foetal heart rate (c) Assessing descent of
foetal head per-abdomen
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASK RATINGS
(a) Timing Contractions
1. Establishes rapport and explains procedures to client 0 1 2 3 4
2. Asks client to empty bladder and provides privacy – if necessary 0 1 2 3 4
3. Washes and dries hands and assists client to adopt a comfortable position in bed 0 1 2 3 4
4. Sits on a chair by client and exposes client’s abdomen only and places
palm over fundus. 0 1 2 3 4
5. Notes time-of onset of each contraction and when each contraction wears off. 0 1 2 3 4
6. Reports and records, the number and length of each contraction in 10 minutes,
starting from the beginning of the 1st contraction 0 1 2 3 4
(b) Counting Foetal Heart Rate
7. Puts client in dorsal position 0 1 2 3 4
8. Stands by the right side of client and palpates the abdomen to determine
where the foetal back lies 0 1 2 3 4
…/2
- 2 -
COMPONENT TASK RATINGS
9. Locates the position of the shoulders 0 1 2 3 4
10. Warms the foetal stethoscope and listens to foetal heart sound 0 1 2 3 4
11. Counts the beats for one full minute noting the volume and rhythm and
differentiating it from the maternal pulse. 0 1 2 3 4
(c) Assessing Descent of Foetal Head
12. Locates the anterior shoulder and keeps two fingers over it 0 1 2 3 4
13. Locates symphysis pubis and places the ulna border of the right hand just above
the symphysis pubis 0 1 2 3 4
14. Notes the number of finger breadths that can occupy the space between the
symphysis pubis and the anterior shoulder 0 1 2 3 4
15. Covers client’s abdomen and make her comfortable 0 1 2 3 4
16. Communicates findings and thank client 0 1 2 3 4
____________________________________________________________________________________
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
INDEX NO. OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: CONDUCTING THE 2ND STAGE OF LABOUR
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASKS RATING
1. Sets delivery trolley and infant resuscitation tray ready in the delivery room 0 1 2 3 4
2. Informs client she is in 2nd stage and transfers into delivery bed 0 1 2 3 4
3. Ensures bladder of client is emptied 0 1 2 3 4
4. Assists client to assume preferred position for delivery 0 1 2 3 4
5. Scrubs and puts on protective clothing and cleans client’s upper thighs and
vulva – if necessary 0 1 2 3 4
6. Drapes client and confirms full dilatation of cervical os 0 1 2 3 4
7. Applies clean pad to anal region and instructs assistant to check F.H. after
each contraction 0 1 2 3 4
8. Instructs client to bear down with each contraction and to rest in between -
reassuring client 0 1 2 3 4
9. Maintains flexion as head advances 0 1 2 3 4
10. Infiltrates perineum and makes episiotomy if necessary 0 1 2 3 4
11. Instructs client to pant when head crowns and delivers the rest of the head
by extension 0 1 2 3 4
12. Feels for the presence of cord around baby’s neck 0 1 2 3 4
13. Cleans baby’s eyes and face 0 1 2 3 4
14. Reminds mother that baby will be delivered unto her abdomen as she waits restitution and external
rotation of the foetal head to take place 0 1 2 3 4
15. Delivers anterior shoulder first and then posterior shoulder 0 1 2 3 4
…/2
- 2 -
COMPONENT TASK RATINGS
16. Delivers rest of the body gently unto the mother’s abdomen 0 1 2 3 4
17. Notes time of delivery and assesses condition of baby 0 1 2 3 4
18. Assesses the presence of another foetus, if any 0 1 2 3 4
19. Gives oxytocin within one minute of delivery of baby 0 1 2 3 4
20. Clamps cord and separates baby 0 1 2 3 4
21. Clears airway if necessary and provides warmth 0 1 2 3 4
22. Shows baby to mother and congratulates her 0 1 2 3 4
23. Applies identification band and keeps baby comfortable 0 1 2 3 4
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
INDEX NO. OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: ACTIVE MANAGEMENT OF THE THIRD STAGE OF LABOUR
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASK RATINGS
1. Explains procedure to client . 0 1 2 3 4
2. Places hand on fundus to feel for contraction 0 1 2 3 4
3. Releases the forceps and clamps cord closer to the vulva 0 1 2 3 4
4. Places had just above symphysis pubis with palm facing the umbilicus 0 1 2 3 4 5.
Applies gentle counter traction in an upward direction 0 1 2 3 4 6.
Holds the forceps horizontally and applies traction on the cord 0 1 2 3 4
7. Receives placenta into both hands and coaxes membranes out 0 1 2 3 4
8. Examines placenta and membranes 0 1 2 3 4
9. Examines the genital tract 0 1 2 3 4
10. Rubs up uterus to expel clots and to initiate contraction 0 1 2 3 4
11. Measure blood loss 0 1 2 3 4
12. Tidies up client, applies clean perineal pad and congratulates her 0 1 2 3 4
13. Communicates findings and thanks her 0 1 2 3 4
14. Makes client comfortable or moves client into 4th stage room 0 1 2 3 4
15. Observes infection prevention techniques 0 1 2 3 4
16. Records findings and reports to the in-charge 0 1 2 3 4
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
INDEX NO. OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: EXAMINING A NEW BORN BABY IN THE LABOUR WARD
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASK RATINGS
1. Establish rapport and explains procedure to the client 0 1 2 3 4
2. Washes and dries hands. 0 1 2 3 4
3. Puts on examination gloves 0 1 2 3 4
4. Positions baby on a safe flat surface 0 1 2 3 4
5. Unwraps the baby, does general observation and covers with a clean sheet 0 1 2 3 4
6. Examines baby’s head, face and neck 0 1 2 3 4
7. Examines the chest, abdomen and cord 0 1 2 3 4
8. Examines the arms and hands 0 1 2 3 4
9. Examines the genitalia and tests patency of rectum 0 1 2 3 4
10. Examines hips and lower extremities 0 1 2 3 4
11. Examines the back of the baby 0 1 2 3 4
12. Wrap and places baby back into cot or sends to mother 0 1 2 3 4
13. Communicates findings and thanks her 0 1 2 3 4
14. Washes and dries hands 0 1 2 3 4
15. Records and report findings 0 1 2 3 4
________________________________________________________________________________
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
INDEX NO. OF CANDIDATE……………………………………………: DATE:………………………………………
SIGNATURE OF CANDIDATE:…………………………………..: CENTRE:………………………………………..
TASK: EXAMINING THE VAGINA DURING LABOUR
RATING SCALE: 0 - This step was omitted
1 - The basic technique was not done well
2 - The technique was performed correctly but with hesitation
3 - The technique was performed correctly and without hesitation
4 - The technique, speed and style are excellent
INSTRUCTION: For each of the observations circle the appropriate number on the scale
that best indicates level of performance
COMPONENT TASKS RATING
1. Establishes rapport and explains the procedure to the client 0 1 2 3 4
2. Helps client to empty bladder and provides privacy 0 1 2 3 4
3. Places mackintosh and towel under client and puts client in dorsal position
with knees flexed 0 1 2 3 4
4. Washes and dries hands and wears protective clothing 0 1 2 3 4 5.
Drapes client and asks client to expose vulva 0 1 2 3 4
6. Inspects and swabs vulva 0 1 2 3 4
7. Separates the labia minora and swabs vestibule using a swab for each stroke 0 1 2 3 4
8. Using the right hand, the middle and index fingers are inserted gently into the
Vagina pressing firmly downwards 0 1 2 3 4
9. Performs the vaginal examination gently 0 1 2 3 4 10. Withdraws examining fingers and
observes 0 1 2 3 4 11. Tidies up client, applies clean perineal pad 0 1 2 3 4
12. Removes gloves, washes and dry hands 0 1 2 3 4
13. Puts client back in a comfortable position 0 1 2 3 4
14. Communicates findings and thanks her 0 1 2 3 4
15. Observes infection prevention procedure 0 1 2 3 4
16. Records and reports findings 0 1 2 3 4
SCORE OBTAINED…….………………………………… .. DATE:…………………………………………………………..
NAME OF EXAMINER……………………………………………. SIGNATURE …………….…………………………….
