CEFM Practice Test| Answered 100% Correctly| Updated 2024-2025, Exams of Obstetrics

Download CEFM Practice Test| Answered 100% Correctly| Updated 2024-2025 and more Exams Obstetrics in PDF only on Docsity!

CEFM Practice Test| Answered 100%

Correctly| Updated 2024- 2025

The paper speed used with EFM in North America is: a. 1cm/min b. 2cm/min c. 3cm/min C. 3cm/min The US transducer on the EFM measures the a. Electrical signal of the fetal heart b. Mechanical movement of the fetal heart reflected off of sound waves c. R to R intervals of the fetal heart b. Mechanical movement of the fetal heart reflected off of sound waves The purpose of the autocorrelation in external monitoring is to a. Compare incoming waveforms for comparison b. Decrease signal to noise levels c. Distinguish fetal from maternal heart rate a. Compare incoming waveforms for comparison The area of maximum intensity of FHR is usually the fetal a. Back

b. Chest c. Umbilicus a. Back Palpating the uterus is best performed by using the a. Back of hand b. Fingertips c. Palm B. Fingertips What is the most sensitive method of assessing uterine activity? a. Intrauterine pressure catheter b. Manual palpation c. Maternal perception a. Intrauterine pressure catheter When educating the patient about fetal monitoring, the most appropriate statement is a. A normal tracing indicates that your baby is well-oxygenated b. A normal tracing indicates that you have a healthy baby c. Continuous fetal monitoring will insure a better outcome for your baby a. A normal tracing indicates that your baby is well-oxygenated

In comparison to maternal blood, the affinity of fetal blood for oxygen is a. Higher b. Lower c. The same a. Higher The process that requires energy to accomplish the passage of substances within the intervillous space is a. Active transport b. Diffusion c. Facilitated diffusion a. Active transport The umbilical vein carries a. Carbon dioxide from the fetus back to the placenta b. Deoxygenated blood from the fetus to the placenta c. Oxygenated blood from the placenta to the fetus c. Oxygenated blood from the placenta to the fetus Fetal hypoxia is best described as a condition of a. Decreased oxygen in the blood b. Decreased oxygen in the tissue c. Increased hydrogen ions in the blood

b. Decreased oxygen in the tissue Stimulation of the PNS causes the FHR to a. Decrease b. Increase c. Remain the same a. Decrease Chemoreceptors respond mainly to changes in a. Blood pressure b. Hormonal leves c. Oxygen and CO2 levels c. Oxygen and CO2 levels The fetus responses to a significant drop of PO2 by a. Increasing oxygen consumption b. Reducing lactic acid production c. Shifting blood to vital organs c. Shifting blood to vital organs Activation of fetal peripheral chemoreceptors results in which FHR change a. Decrease b. Increase c. No change

a. Decrease A patient receiving oxytocin has 17 ctx in 30 minutes, according to the NICHD guidelines this is called a. Hyperstimulation b. Hypertonus c. Tachysystole c. Tachysystole Maternal supine hypotension is caused mainly by compression of the a. Inferior vena cava b. Spiral arteries c. Uterine vessels a. Inferior vena cava Which factor influences blood flow to the uterus? a. Fetal arterial pressure b. Intervillous space flow c. Maternal arterial vasoconstriction c. Maternal arterial vasoconstriction BMZ given to the mother can transiently affect the FHR by a. Decreasing the variability

b. Increasing the variability c. Lowering the baseline a. Decreasing the variability A FHR change that can be seen after administration of butophanol (Stadol) is a. Bradycardia b. Marked variability c. Sinusoidal-appearing c. Sinusoidal-appearing Which one of the following statements reflects the predictability of fetal monitoring tracings? a. A category II tracing is highly predictive of a poorly oxygenated fetus b. A category I tracing is highly predictive of a well oxygenated fetus c. There is no difference in the predictability of a category I, II, or III tracing b. A category I tracing is highly predictive of a well oxygenated fetus One FHR pattern that is associated with an abnormal acid-base status is a. Minimal variability with no accels or decels b. Recurrent variable decels with absent variability c. Tachycardia with absent variability b. Recurrent variable decels with absent variability

The NICHD definitions are applicable to a. Antepartum only b. Antepartum and intrapartum c. Intrapartum only b. Antepartum and intrapartum A wandering FHR baseline may be indicative of a. Fetal seizure activity b. Impending fetal death c. Maternal medication administration b. Impending fetal death A fetal heart rate pattern that is likely to be seen with maternal hypothermia is a. Bradycardia b. Marked variability c. Tachycardia a. Bradycardia Tachycardia is associated with increased a. Parasympathetic tone b. Sympathetic tone c. Vagal response b. Sympathetic tone

Baseline FHR variability is determined in what amount of time, excluding accels and decels? a. 10 minutes b. 20 minutes c. 30 minutes a. 10 minutes One possible cause of a sinusoidal FHR pattern from fetal hypoxemia is a. Fetal anemia b. Fetal thumb sucking c. Maternal administration of a narcotic a. Fetal anemia According to NICHD definitions, which one of the following decelerations must drop by at least 15 beats per minute a. Early b. Late C. Prolonged c. Prolonged According to the task force of national institute of child health and human development of the NIH, decelerations that have an abrupt onset and a nadir in less than 30 seconds are

a. Early b. Late c. Variable c. Variable Amnioinfusion is recommended for a FHR pattern with recurrent a. Early decelerations b. Late decelerations c. Variable decelerations c. Variable decelerations Which one of the following tachyarrthymias can result in fetal hydrops? a. Persistent SVT b. Premature atrial contractions c. Sinus tachycardia a. Persistent SVT A preterm fetus with persistent PVT that is not hydropic is best treated with maternal administration of a. Digoxin b. Phenobarbital c. Terbutaline a. Digoxin

A maternal medical condition which predisposes the fetus to a heart block is a. Lupus erythematosus b. Marfans disease c. Mitral valve prolapse a. Lupus erythematosus A woman being monitored externally has a suspected fetal arrhythmia. The most appropriate action is to a. Insert an FSE and turn off the logic b. Turn the logic on if an external monitor is in place c. Use a doppler to listen to the ventricular rate a. Insert an FSE and turn off the logic Which fetal heart sounds are counted with a stethoscope or fetoscope? a. Atrial b. Atrial and ventricular c. Ventricular c. Ventricular When using auscultation to determine the DHR baseline, the FHR should be counted after the contractions for a. 5-10 seconds

b. 15-30 seconds c. 30-60 seconds c. 30-60 seconds Which of the following fetal heart characteristics can be determined using auscultation? a. Baseline b. Type of decelerations c. Variability a. Baseline One advantage of using a fetoscope is that it can a. Allow more rapid detection of a baseline change b. More accurately assess the FHR variability c. Verify the presence of an irregular rhythm c. Very the presence of an irregular rhythm According to ACOG, intermittent auscultation is appropriate for a. All pregnancies b. Neither complicated or uncomplicated pregnancies c. Uncomplicated pregnanies c. Uncomplicated pregnancies

A woman who is 34 weeks is counting FM each day. Today she counted 8 FM in 2 hours. Based on her kick counts, she should a. Continue counting for one more hour b. D/C counting until tomorrow c. Notify her provider for further evaluation c. Notify her provider for further evaluation A biophysical score of 6 is considered a. Abnormal b. Normal c. Equivocal c. Equivocal A modified BPP shows the following- NST is reactive with mod variability. AFI is

7. This test would be interpreted as a. Abnormal b. Equivocal c. Normal c. Normal As fetal hypoxia (asphyxia) worsens, the last component of the BPP to disappear is fetal A. Breathing

B. Movement C. Tone c. Tone The legal term that describes a failure to meet the required standard of care is a. Breech of duty b. Negligence c. Proximate cause a. Breech of duty According to ACOG, in a patient without complications, the FHR tracing during the 1st stage of labor should be reviewed apporximately every a. 5 minutes b. 15 minutes c. 30 minutes c. 30 minutes According to ACOG, in a patient with complications, the FHR during the 2nd stage of labor should reviewed approximately every a. 5 minutes b. 15 minutes c. 30 minutes a. 5 minutes

Since the widespread use of EFM, the rate of cerebral palsy has a. Decreased b. Increased c. Remained the same c. Remained the same Regarding the reliability of EFM, there is A. Good interobserver reliability B. Good intraobserver reliability C. Poor interobserver and intraobserver reliability c. Poor interobserver and intraobserver reliability The objective of intrapartum FHR monitoring is to assess for fetal a. Acidemia b. Oxygenation c. Well-being b. Oxygenation What is the NICHD definition of baseline rate? Approximate mean FHR rounded to increments of 5 bpm during a 10-minute window excluding accelerations and decelerations and periods of marked variability. There must be ≥2 minutes of identifiable baseline segments (not necessarily contiguous) in any 10-minute window, or the baseline for that period is

indeterminate. In such cases, one may need to refer to the previous 10-minute window for determination of the baseline. What is the NICHD definition of fetal bradycardia? Baseline rate of <110 bpm. What is the NICHD definition of fetal tachycardia? Baseline rate of >160 bpm. What is the NICHD definition of baseline variability? Determined in a 10-minute window, excluding accelerations and decelerations. Fluctuations in the baseline FHR that are irregular in amplitude and frequency and are visually quantified as the amplitude of the peak-to-trough in bpm. What is the NICHD definition of absent variability? Amplitude range undetectable. What is the NICHD definition of minimal variability? Amplitude range visually detectable but ≤5 bpm. (Greater than undetectable but ≤ bpm) What is the NICHD definition of moderate variability? Amplitude range 6-25 bpm. What is the NICHD definition of marked variability? Amplitude range >25 bpm. What is the NICHD definition of an acceleartion?

Visually apparent abrupt increase in FHR. Abrupt increase is defined as an increase from onset of acceleration to peak is <30 seconds. Peak must be ≥15 bpm, must last ≥15 seconds, but <2 minutes from the onset to return. Before 32 weeks of gestation, accelerations are defined as having a peak ≥10 bpm and duration of ≥ seconds. What is the NICHD definition of a prolonged acceleration? Acceleration ≥2 minutes but <10 minutes in duration. Acceleration lasting ≥ minutes is defined as a baseline change. What is the NICHD definition of an early deceleration? Visually apparent, usually symmetrical, gradual decrease and return of FHR associated with a uterine contraction. The gradual FHR decrease is defined as one from the onset to FHR nadir of ≥30 seconds. The decrease in FHR is calculated from onset to nadir of deceleration. The nadir of the deceleration occurs at the same time as the peak of the contraction. In most cases, the onset, nadir, and recovery of the deceleration are coincident with the beginning, peak, and ending of the contraction, respectively. What is the NICHD definition of a late deceleration? Visually apparent, usually symmetrical, gradual decrease and return of FHR associated with a uterine contraction. The gradual FHR decrease is defined as from the onset to FHR nadir of ≥30 seconds. The decrease in FHR is calculated from

onset to the nadir of deceleration. The deceleration is delayed in timing, with nadir of the deceleration occurring after the peak of the contraction. In most cases, the onset, nadir, and recovery of the deceleration occur after the beginning, peak, and ending of the contraction, respectively. What is the NICHD definition of a variable deceleration? Visually apparent abrupt decrease in FHR. An abrupt FHR decrease is defined as from the onset of the deceleration to the beginning of the FHR nadir of < seconds. The decrease in FHR is calculated from the onset to the nadir of deceleration. The decrease in FHR is ≥15 bpm, lasting ≥15 seconds, and < minutes in duration. When variable decelerations are associated with uterine contractions, their onset, depth, and duration commonly vary with successive uterine contractions. Variable decelerations have a depth criteria; they must drop at least 15 or more bpm to be considered a variable deceleration. What is the NICHD definition of a prolonged deceleration? Visually apparent decrease in FHR from baseline that is ≥15 bpm, lasting ≥ minutes, but <10 minutes. A deceleration that lasts ≥10 minutes is baseline change. Prolonged decelerations have a depth criteria; they must drop at least 15 or more bpm to be considered a prolonged deceleration. What is the NICHD definition of recurrent decelerations? Occurring with ≥50% of contractions in any 20 minute window.

What is the NICHD definition of intermittent decelerations? Occurring with <50% of contractions in any 20 minute window. What is the NICHD definition of sinusoidal pattern? Visually apparent, smooth, sine wave-like undulating pattern in FHR baseline with cycle frequency of 3-5/minutes that persists for ≥20 minutes. What is the NICHD definition of uterine activity? Uterine activity is assessed based on the number of contractions that are occurring in a 10 minute segment, averaged over a 30 minute period. What is the NICHD definition of normal uterine activity? 5 or less contractions in a 10 minute segment, averaged over a 30 minute period. What is the NICHD definition of tachysystole? Excessive uterine activity; more than 5 contractions in a 10 minute segment averaged over a 30 minute period. Tachysystole can be the result of both spontaneous and stimulated labor How do narcotics influence FHR? Decrease in variability, decrease in frequency of accelerations How does butorphanol influence FHR? Transient sinusoidal fetal heart rate pattern, slight increase in baseline rate How does cocaine influence FHR? Decrease in FHR variability

How do corticosteroids influence FHR? Decrease in FHR variability with betamethasone, but not dexamethasone How does magnesium sulfate influence FHR? Decrease in FHR variability, clinically insignificant decrease in baseline rate; inhibition of increasing accelerations as gestational age advances How does terbutaline influence FHR? Increase in baseline rate How does zidovudine influence FHR? No change How does prematurity influence FHR? Higher baseline rate than term fetus, less variability than term fetus, less frequency and amplitude of accelerations than term fetus How does a sleep cycle influence FHR? Minimal variability, reduced frequency and amplitude of accelerations How does sponatneous fetal movement influence FHR? Accelerations How does scalp or vibracoustic stimulation influence FHR? Accelerations How does vaginal examination influence FHR? Accelerations

How does maternal fever influence FHR? Increase in baseline rate, minimal variability How does intraamniotic infection/ chorioamnionitis influence FHR? Increase in baseline rate, minimal variability How does maternal hyperthyroidism influence FHR? Tachycardia How does maternal hypothermia influence FHR? Bradycardia How does maternal hypoglyemia influence FHR? Bradycardia How does maternal hypotension influence FHR? Late decelerations, prolonged How does maternal hypoxemia and poor cardiac output influence FHR? Late decelerations How does maternal pushing efforts influence FHR? Variable decelerations Prolonged decelerations Increase in baseline rate How does excessive uterine activity influence FHR?

Late decelerations Prolonged decelerations Increase in baseline rate Minimal variability How does oligohydramnios (less than normal level of amniotic fluid) influence FHR? Variable decelerations How does a uterine rupture influence FHR? Variable decelerations Prolonged decelerations Minimal variability Bradycardia How does fetal anemia influence FHR? Sinusoidal pattern Tachycardia Minimal variability Absence of accelerations How does fetal heart block influence FHR? Bradycardia Minimal variability

How does fetal cardiac failure influence FHR? Bradycardia Minimal variability