Fetal Heart Rate Monitoring: Comprehensive Exam Preparation, Exams of Nursing

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NCC EFM Cert. Exam question with correct

answers

Ductus venosus connects ______ to ______? - Answer Umb. vein to IVC Foramen ovale connects _______to______? - Answer R. atrium to L. atrium Ductus arteriosus connects _______ to _______? - Answer Pulm. artery to aorta Normal rate - Answer 110 to 160 BPM Average baseline rate at 15wks gestation - Answer 160 BPM Average rate in fetus with heart block - Answer 60 BPM (intrinsic ventricular or nodal rate) Sympathetic effects - Answer Incr. HR, constricted peripheral and visceral blood vessels, vital organs dilate and receive more blood Gest. age at which autonomic nervous system is fully developed - Answer ~ 32wks Primary indicator of fetal oxygenation - Answer Presence or absence of variability Location of chemoreceptors - Answer aortic arch Chemoreceptors respond to? - Answer Changes in O2 and CO

Location of baroreceptors - Answer Aortic arch and carotid bodies Maximal reactivity occurs when? - Answer Late at night Max duration of fetal nonreactivity? - Answer 80min Sensitivity - Answer Probablity of detecting a true positive Specificity - Answer Probability that true negative will be detected False positive - Answer erroneosly positive when reality is negative False negative - Answer erroneously negative when reality is positive NST - Answer Two 15x15 accels in 20min (up to 40min) % of false positive CSTs? - Answer ~ 30% BPP components - Answer 1) Fetal breathing movements

2. Gross body movements
3. Fetal tone
4. Reactive fetal heart rate
5. Qualitiative amniotic fluid volume

BPP Score of 10 - Answer Normal BPP Score of 8 - Answer Nl infant, low risk of chronic asphyxia BPP Score of 6 - Answer Borderline result - rpt in 24hrs BPP Score of 4 - Answer Suspect chronic asphyxia BPP Score of 0-2 - Answer Strongly suspect chronic asphyxia Early manifestation of fetal acidosis? - Answer Non-reacive NST and loss of FBM Change in FBM with maternal glucose changes? - Answer FBM incr. with rising mGlu FBM decr. with mHYPOglycemia Maternal smoking effects FBM how? - Answer FBM decr. with msmoking Corticosteroids effects FBM? - Answer corticosteroids may decr. FBM Maternal PAO2 at sea level? - Answer ~105mmHg Change in cardiac output and SVR in pre-E? - Answer CO and SVR INCREASED in pre-E Prolonged decels occured in ___% of uterine rupture? - Answer 71%

Signif. neonatal morbidity occured when ____min or longer elapsed between onset of HFR decel and delivery. - Answer 18min Normal arterial pH for healthy vaginal deliveries? - Answer 7.28+/- 0. Normal arterial pO2 for healthy vaginal deliveries? - Answer 18.0 +/- 6. Normal arterial pCO2 for healthy vaginal deliveries? - Answer 49.2 +/- 8. Normal base deficit for healthy vaginal deliveries? - Answer Less than 12 pH at which acidosis - Answer 7.2 (7.1) Tachysystole - Answer >5 contractions in 10min Baseline (defn) - Answer mean FHR rounded to increments of 5 BPM during a 10min perioud excl. periodic or episodic changes, contractions, periods of marked variability, and segments of baseline that differ by >25 BPM Sinusoidal pattern? - Answer Fetal anemia As many as ___% of infants with complete heart block have assoc. congenital cardiac malformations. - Answer 50% Mortality rate for newborns with complete heart block - Answer 25%

Newborn with complete heart block in absence of congen. heart disease frequently has neonatal ___________. - Answer Lupus erthematosus Baseline variability (defn) - Answer Fluctuations in baseline FHR >2 cycles per minute (peak to trough); irregular in amplitude and frequency Minimal baseline variability - Answer > undetectable but <or= 5bpm Moderate baseline variability - Answer 6-25 bpm Marked variability - Answer >25 bpm T/F Performing fetal stimulation is appropriate during decels or bradycardia. - Answer FALSE - Fetal stim should be performed when FHR is at the baseline. Early Decel (defn) - Answer visually apparrent GRADUAL decrease (onset to nadir >=30sec of FHR below baseline), nadir occurs at peak of contraction Early decel (physiology) - Answer Fetal head copmression (vagal reflex), often sen between 4-6cm dilation