NCC EFM CERTIFICATION EXAM 2024-2025, Exams of Nursing

Download NCC EFM CERTIFICATION EXAM 2024-2025 and more Exams Nursing in PDF only on Docsity! 1 | P a g e NCC EFM CERTIFICATION EXAM 2024-2025 WITH ACTUAL CORRECT QUESTIONS AND VERIFIED DETAILED ANSWERS |FREQUENTLY TESTED QUESTIONS AND SOLUTIONS |ALREADY GRADED A+|NEWEST|GUARANTEED PASS |LATEST UPDATE The _____ is the source of all fetal oxygenation. A. Placenta B. Umbilical cord C. Mother D. Amniotic fluid C. Mother FHTs with recurrent variable decelerations, no accelerations, and minimal variability would be categorized as A. Category I B. Category II C. Category III B. Category II FHTs with absent variability and bradycardia would be categorized as A. Category I B. Category II C. Category III C. Category III 2 | P a g e FHTs with moderate variability, no accelerations, and early decelerations would be categorized as A. Category I B. Category II C. Category III A. Category I FHTs with accelerations, no decelerations, and minimal variability would be categorized as A. Category I B. Category II C. Category III B. Category II Sinusoidal pattern is categorized as A. Category I B. Category II C. Category III B. Category III FHTs with absent variability and no accelerations or decelerations would be categorized as A. Category I B. Category II C. Category III B. Category II Absence of accelerations following fetal stimulation (i.e. scalp stimulation) is categorized as A. Category I B. Category II C. Category III B. Category II FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as A. Category I B. Category II C. Category III B. Category II FHTs with minimal variability and a baseline of 95bpm would be categorized as A. Category I B. Category II C. Category III B. Category II 5 | P a g e B. Maternal fever Reduction in FHR variability can result from A. Fetal scalp stimulation B. Medication administration C. Vaginal examination B. Medication administration The primary goal in treatment for late decelerations is to A. Correct cord compression B. Improve maternal oxygenation C. Maximize uteroplacental blood flow C. Maximize uteroplacental blood flow The most frequently observed type of FHR deceleration is A. Early B. Late C. Variable C. Variable Amnioinfusion may be useful in alleviating recurrent decelerations that are A. Early B. Late C. Variable C. Variable Findings indicative of progressive fetal hypoxemia are A. Late decelerations, moderate variability, stable baseline rate B. Prolonged decelerations recovering to baseline and moderate variability C. Loss of variability and recurrent late or variable decelerations C. Loss of variability and recurrent late or variable decelerations Clinically significant fetal metabolic academia is indicated by an arterial cord gas pH of less than or equal to 7.10 and a base deficit of A. 3 B. 6 C. 12 C. 12 Fetal bradycardia can result during A. The sleep state B. Umbilical vein compression C. Vagal stimulation C. Vagal stimulation 6 | P a g e While caring for a 235-lb laboring woman who is HIV-seropositive, the external FHR tracing is difficult to obtain. An appropriate nursing action would be to A. Apply a fetal scalp electrode B. Auscultate for presence of FHR variability C. Notify the attending midwife or physician C. Notify the attending midwife or physician FHR decelerations that are benign and do not require intervention are A. Early B. Late C. Variable A. Early FHR decelerations that results from decreased uteroplacental blood flow are A. Early B. Late C. Variable B. Late FHR decelerations that results from umbilical cord compression are A. Early B. Late C. Variable C. Variable An FHR pattern associated with severe fetal anemia is A. Lambda B. Saltatory C. Sinusoidal C. Sinusoidal A workup for maternal systemic lupus erythematosus would likely be ordered in the presence of A. Complete fetal heart block B. Premature ventricular contractions C. Fetal supraventricular tachycardia A. Complete fetal heart block Which IV fluid is most appropriate for maternal administration for intrauterine resuscitation? A. Lactated Ringer's solution B. D5L/R C. Normal saline C. Normal saline 7 | P a g e The position that best promotes maternal-fetal exchange is A. Left lateral B. Right lateral C. Either right or left lateral C. Either right or left lateral The most appropriate equipment for administration of maternal oxygen for intrauterine resuscitation at 10 L/min is a A. Nasal cannula B. Simple face mask C. Nonrebreather face mask C. Nonrebreather face mask Accurate determination of baseline rate requires A. At least 2 contiguous minutes of FHR in a 10-min window B. Evaluation of the FHR over at least a 10-min window C. Averaging the FHR over 30 min B. Evaluation of the FHR over at least a 10-min window An EFM tracing with absent variability and no decelerations would be classified as A. Category I B. Category II (indeterminate) C. Category III B. Category II (indeterminate) An EFM tracing with absent variability and intermittent late decelerations would be classified as A. Category I B. Category II C. Category III B. Category II Interpretation and classification of FHR patterns are based on predictability of fetal status A. At birth B. At the time the pattern is observed C. Over the previous hour B. At the time the pattern is observed Amnioinfusion is an appropriate measure for A. Thick, meconium-stained fluid B. Oligohydramnios C. Recurrent variable decelerations unresolved by position changes C. Recurrent variable decelerations unresolved by position changes 10 | P a g e 10 In assessing fetal well-being, the most important characteristic of the FHR is A. Rate B. Variability C. Presence of accelerations D. Absence of decelerations B. Variability Stimulation of the _____ _____ _____ releases acetylcholine, resulting in decreased FHR. Parasympathetic nervous system The _____ _____ _____ maintains transmission of beat-to-beat variability. Parasympathetic nervous system Stimulation of the _____ _____ _____ releases catecholamines, resulting in increased FHR. Sympathetic nervous system Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. Baroreceptors Baroreceptors influence _____ decelerations with moderate variability. Variable Following an ultrasound which revealed decreased amniotic fluid, a woman at term is admitted in early labor. It should be recognized that oligohydramnios often results in fetal heart rate decelerations that are A. Late in onset or occur after the peak of the contraction B. Synchronous with that of the contraction C. Varied in depth and duration C. Varied in depth and duration In comparing early and late decelerations, a distinguishing factor between the two is A. Onset time to the nadir of the deceleration B. The number of decelerations that occur C. Timing in relation to contractions C. Timing in relation to contractions The underlying cause of early decelerations is decreased A. Baroceptor response B. Increased peripheral resistance C. Vagal reflex C. Vagal reflex 11 | P a g e Glucose is transferred across the placenta via _____ _____. Facilitated diffusion Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. Simple (passive) diffusion Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. Active transport Well-oxygenated fetal blood enters the _____ ventricle, which supplies the heart and brain. Less- oxygenated blood enters the ______ ventricle, which supplies the rest of the body. Left; right The _____ _____ allows relatively well-oxygenated blood to enter the fetal heart directly, bypassing the liver. Ductus venosus The _____ _____ allows blood to bypass the lungs, flowing from the pulmonary artery to the aorta. Ductus arteriosus The _____ _____ is the shunt that bypasses the fetal lungs, moving blood from the right atrium to the left atrium. Foramen ovale Fetal blood has a _______ hemoglobin concentration compared to adults. A. Higher B. Lower A. Higher Greater oxygen-carrying capacity Fetal blood has a _______ affinity for oxygen compared with the mother's blood, which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus. A. Higher B. Lower A. Higher The fetus has a _______ cardiac output and heart rate than the adult, resulting in rapid circulation. A. Higher B. Lower A. Higher 12 | P a g e As the FHR increases, the myocardium consumes _____ oxygen. A. More B. Less A. More The fetal spiral electrode measures the A. Peaks of the Doppler waveforms B. R to R intervals of the fetal heart C. ST segments of the fetal ECG B. R to R intervals of the fetal heart A woman who is admitted for an induction of labor with oxytocin is questioning the need for continuous electronic fetal monitoring. The appropriate response to this woman is A. Hospital policy requires that all patients have continuous electronic fetal monitoring. B. I would like to answer your questions about continuous monitoring and give you some information about why continuous monitoring is recommended. C. Nurses have more training with continuous electronic fetal monitoring than intermittent auscultation so it is safer for you and your baby to use this method. B. I would like to answer your questions about continuous monitoring and give you some information about why continuous monitoring is recommended. The greater affinity that fetal hemoglobin has for oxygen allows for A. Easier release of oxygen to the tissues B. Greater binding of oxygen C. Stimulation of erythropoietin release B. Greater binding of oxygen The process by which oxygen and carbon dioxide pass from a region of higher concentration to one of a lower concentration is called A. Active transport B. Simple diffusion C. Facilitated diffusion B. Simple diffusion In the healthy fetus, blood flows from the right atrium to the left atrium through the A. Ductus arteriosus B. Ductus venosus C. Foramen ovale C. Foramen ovale In the healthy fetus, the umbilical cord enters the fetal abdomen and bypasses the liver through the A. Ductus arteriosus B. Ductus venosus C. Foramen ovale 15 | P a g e B. The pattern lasts 20 minutes or longer C. There is moderate or minimal variability B. The pattern lasts 20 minutes or longer Vagal stimulation would be manifested as what type of fetal heart rate pattern? A. Acceleration B. Early deceleration C. Tachycardia B. Early deceleration Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? A. Early deceleration B. Late deceleration C. Variable deceleration A. Early deceleration A risk of amnioinfusion is A. Prolonged labor B. Uterine overdistension C. Water intoxication B. Uterine overdistension A fetal heart rate pattern that the NICHD has identified as predictive of current or impending fetal asphyxia so severe that the fetus is at risk of neurologic damage or death is A. Baseline tachycardia with absent variability B. Minimal baseline variability with recurrent late decelerations C. Recurrent late or variable decelerations with absent variability C. Recurrent late or variable decelerations with absent variability A fetal heart rate pattern that can occur when there is a prolapsed cord is A. Marked variability B. Prolonged decelerations C. Tachycardia B. Prolonged decelerations The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the next 15 minutes, there are 18 uterine contractions. Recommended management is to A. Address contraction frequency by reducing pitocin dose B. Continue to increase pitocin as long as FHR is Category I C. Turn the patient on her side and initiate an IV fluid bolus C. Turn the patient on her side and initiate an IV fluid bolus 16 | P a g e A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the fetal heart tracings have been normal. Spontaneous rupture of membranes occurs; fetal heart rate drops to 90 beats per minute for four minutes and then resumes a normal pattern. The most likely etiology for this fetal heart rate change is A. Abnormal fetal presentation B. Impaired placental circulation C. Possible cord compression C. Possible cord compression A 42 week gestation woman has been diagnosed with oligohydramnios. Based on this, a FHR change that can be expected is A. Late deceleration B. Minimal variability C. Variable deceleration C. Variable deceleration Mono-mono zygotic twins are prone to what type of deceleration during labor? A. Early B. Late C. Variable C. Variable During labor, the recommended fetal heart rate assessment interval for auscultation is every A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage B. 15 minutes no matter what stage of labor C. 60 minutes in the active phase of the first stage and every 30 minutes in second stage A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage What fetal heart rate characteristics can be determined with auscultation? A. Baseline B. Early decelerations C. Variability A. Baseline When auscultating the fetal heart rate, the provider/nurse should simultaneously assess the maternal A. Blood pressure B. Pain level C. Radial pulse C. Radial pulse A woman has 10 fetal movements in one hour. This is considered what kind of movement? A. Decreased B. Excessive C. Normal 17 | P a g e C. Normal If the pH is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? A. HCO3 B. PCO2 C. PO2 B. PCO2 The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10 A. Metabolic acidosis B. Mixed acidosis C. Respiratory acidosis C. Respiratory acidosis A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic fluid was scored as normal. The expected management is A. Immediate delivery B. Repeat the test in 24 hours C. Schedule the next test in one week B. Repeat the test in 24 hours A woman with gestational diabetes is 38 weeks gestation. Her Biophysical Profile score is 4. This indicates need for A. Follow up in one week B. Induction of labor C. Emergent cesarean section B. Induction of labor A 35 week gestation fetus is having an NST. The fetal heart rate baseline is 130 bpm. The nurse is using vibroacoustic stimulation to reduce the length of time needed to obtain the NST. Fetal well-being requires A. 1 acceleration to 145 bpm B. 2 accelerations to 140 bpm C. 2 accelerations to at least 145 bpm C. 2 accelerations to at least 145 bpm A woman desires a natural childbirth. The nurse puts pressure on her to get an epidural. This is an example of going against which ethical principle? A. Autonomy B. Beneficence C. Justice A. Autonomy 20 | P a g e C. 4, 1, 3, 2 D. 4, 3, 2, 1 C. 4, 1, 3, 2 When the internal mode of monitoring (FSE, IUPC) is used, the information obtained on the uterine activity panel on the fetal monitor should be validated by the clinician by A. Asking the patient to report when she is feeling a contraction B. Ultrasound imaging C. Palpation C. Palpation T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect baseline, rhythm, changes from baseline, and presence of an irregular rhythm. True T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. False T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect accelerations and decelerations from the baseline, and can clarify double-counting of half-counting of baseline rate. True T/F: Auscultation may be used to detect baseline variability and discriminate FHR deceleration patterns. False _______ represents increased sympathetic or decreased parasympathetic autonomic tone. A. Bradycardia B. Tachycardia B. Tachycardia T/F: In the context of moderate variability, late decelerations are considered neurogenic in origin and are typically amenable to intrauterine resuscitation techniques directed towards maximizing uterine blood flow. True When coupling or tripling is apparent on the uterine activity tracing, this may be indicative of a dysfunctional labor process and saturation (down regulation) of uterine oxytocin receptor sites in response to excess exposure to oxytocin. Which of the following interventions would be most appropriate? A. Normal response; continue to increase oxytocin titration 21 | P a g e B. Turn patient on side C. Decrease or discontinue oxytocin infusion C. Decrease or discontinue oxytocin infusion The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. A. 160-200 B. 200-240 C. 240-260 C. 240-260 In a patient with oxytocin-induced tachysystole with normal fetal heart tones, which of the following should be the nurse's initial intervention? A. Assist the patient to lateral position B. Discontinue Pitocin C. Administer IV fluid bolus A. Assist the patient to lateral position In a patient with oxytocin-induced tachysystole with indeterminate or abnormal fetal heart tones, which of the following should be the nurse's initial intervention? A. Assist the patient to lateral position B. Discontinue Pitocin C. Administer IV fluid bolus B. Discontinue Pitocin Fetal hypoxia and acidemia are demonstrated by pH < _____ and base excess < _____. < 7.15; < -8 T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns of moderate to severe late decelerations. False T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns with absent variability. False T/F: Amnioinfusion may be an appropriate intervention for patients with oligohydramnios in the prevention of the development of variable decelerations. False Not for prevention T/F: Meconium-stained amniotic fluid is an indication for amnioinfusion. False 22 | P a g e T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. True _______ denotes a decrease in oxygenation of the fetal tissues. A. Hypercapnia B. Hypoxia C. Hypoxemia B. Hypoxia _______ denotes a decrease in oxygen content of the fetal blood. A. Hypercapnia B. Hypoxia C. Hypoxemia C. Hypoxemia _______ denotes an increase in carbon dioxide in the fetal blood. A. Hypercapnia B. Hypoxia C. Hypoxemia A. Hypercapnia _______ denotes an increase in hydrogen ions in the fetal blood. A. Acidosis B. Acidemia C. Hypercapnia B. Acidemia _______ denotes an increase in hydrogen ions in the fetal tissues. A. Acidosis B. Acidemia C. Hypercapnia A. Acidosis _______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon dioxide (PCO2) values. A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis A. Metabolic acidosis _______ _______ occurs when there is high PCO2 with normal bicarbonate levels. A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis 25 | P a g e C. Mixed acidosis Which is a correct description of daily fetal movement counting? A. Counting should not be started by low-risk mothers until 38 weeks of gestation B. Fetal movement counting is not reliable because the methods of counting vary C. The mother counts the number of movements over a specified length of time C. The mother counts the number of movements over a specified length of time The BPP includes the assessment of FHR along with what other four components? A. Amniotic fluid, fetal breathing, fetal movement, fetal tone B. Amniotic fluid, fetal anomalies, fetal breathing, fetal movement C. Estimated fetal weight, fetal breathing, fetal movement, placental grading A. Amniotic fluid, fetal breathing, fetal movement, fetal tone Which of the following might indicate a potential for chronic fetal hypoxemia? A. Decreased amniotic fluid volume B. Increased amniotic fluid volume C. Intrauterine growth restriction C. Intrauterine growth restriction With the finding of a single umbilical artery, what would you expect to observe with Doppler flow studies? A. Decreased blood perfusion from the fetus to the placenta B. Decreased blood perfusion from the placenta to the fetus C. Homeostatic dilation of the umbilical artery A. Decreased blood perfusion from the fetus to the placenta Two umbilical arteries flow from the fetus to the placenta Primary benefits associated with the use of standardized terminology for fetal heart monitoring interpretation include A. Enhanced communication among health care providers and promotion of patient safety B. Increased nursing time at the bedside and enhanced patient satisfaction C. Increased likelihood of correctly diagnosing fetal acidosis during labor A. Enhanced communication among health care providers and promotion of patient safety A patient presents with a small amount of thick dark blood clots who denies pain and whose abdomen is soft to the touch. Which component of oxygen transport to the fetus could potentially be compromised by this bleeding? A. Affinity B. Saturation C. Delivery C. Delivery 26 | P a g e What is the most appropriate physiologic goal for a patient whose tracing reveals a sinusoidal baseline? A. Maximize umbilical circulation B. Maximize uteroplacental circulation C. Reduce uterine activity B. Maximize uteroplacental circulation Compromised oxygenation - maximize uteroplacental circulation to promote perfusion and oxygenation When recurrent late decelerations are occurring, the correct physiologic interpretation of this event is A. Fetal myocardial acidosis is occurring B. Fetal hypoxemia may be present C. The fetus has oxygen reserves B. Fetal hypoxemia may be present Which intrinsic homeostatic response is the fetus demonstrating when abrupt variable decelerations are present? A. Baroreceptor B. Catecholamine C. Sympathetic A. Baroreceptor An amnioinfusion is intended to relieve which extrinsic factor that compromises oxygen transport? A. Excessive uterine compression B. Structural abnormalities of the placenta C. Umbilical cord compression C. Umbilical cord compression The nurse wants to document her conversation with the attending physician during an emergent situation. The best approach to documentation would be to A. Continue providing care for the patient and write a late entry summarizing the conversation after the cesarean is completed B. Enter an objective transcription of the conversation in the electronic record while colleagues are preparing the patient for surgery C. Report the conversation to the charge nurse, who can make an entry in the medical record A. Continue providing care for the patient and write a late entry summarizing the conversation after the cesarean is completed An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. Which interpretation of these umbilical cord and initial neonatal blood results is correct? A. Base buffers have been used to maintain oxygenation 27 | P a g e B. The mother was probably hypoglycemic C. The neonate is anemic C. The neonate is anemic An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. These umbilical cord blood gases indicate A. Asphyxia related to umbilical and placental abnormalities B. Hypoxia related to neurological damage C. Mixed acidosis C. Mixed acidosis An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. Which phrase best describes acidemia? A. A decrease of oxygen concentration in the blood B. An increase in hydrogen ions in the blood C. An increase of hydrogen ions in the tissues B. An increase in hydrogen ions in the blood Which compromise in fetal oxygenation could be a result of a post-date pregnancy? A. Increased saturation capacity B. Increased fetal oxygen affinity C. Decreased placental perfusion C. Decreased placental perfusion What are the possible implications of an AFI of 3 cm for labor? A. An amnioinfusion will be needed B. Increased risk of uterine hyperstimulation C. Potential umbilical cord compression C. Potential umbilical cord compression Which is a characteristic of a negative CST? A. Absence of late decelerations B. Recurrent late decelerations C. Reactive FHR tracing A. Absence of late decelerations Which FHR tracing features must be assessed to distinguish arrhythmias from artifact? A. Shape and regularity of the spikes B. Spikes and variability C. Spikes and baseline 30 | P a g e B. Low-amplitude high-frequency contractions C. Tetanic contractions B. Low amplitude high-frequency contractions Which medications used with preterm labor can affect the FHR characteristics? A. Terbutaline and antibiotics B. Betamethasone and terbutaline C. Antibiotics and narcotics B. Betamethasone and terbutaline What characterizes a preterm fetal response to stress? A. More frequently occurring late decelerations B. More frequently occurring prolonged decelerations C. More rapid deterioration from Category I to Category II or III C. More rapid deterioration from Category I to Category II or III More likely to be subjected to hypoxia Clinical decision-making at the bedside should include: A. Communication with the primary care provider only during a crisis B. Integration of physiologic concepts with maternal-fetal assessment findings C. Reliance primarily on technology over bedside assessments B. Integration of physiologic concepts with maternal-fetal assessment findings In the United States, the paper speed on the monitor is set at A. 1 cm/min B. 2 cm/min C. 3 cm/min C. 3 cm/min A woman being monitored externally has a suspected fetal arrhythmia. The most appropriate action is to A. Insert a spiral electrode 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 a spiral electrode and turn off the logic The ultrasound transducer on the electronic fetal monitor measures the A. Electrical signal of the fetal heart B. Mechanical movements of the fetal heart reflected off of sound waves C. R-to-R intervals of the fetal heart B. Mechanical movements of the fetal heart reflected off of sound waves 31 | P a g e The purpose of autocorrelation in external monitoring is to A. Compare incoming waveforms for comparison B. Decrease signal to noise levels C. Distinguish fetal from maternal HR A. Compare incoming waveforms for comparison The area of maximum intensity of the 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 the hand B. Fingertips C. Palm B. Fingertips What is the most sensitive method of assessing uterine activity? A. IUPC B. Manual palpation C. Maternal perception A. IUPC 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 32 | P a g e B. Decreased oxygen in the tissue C. Increased hydrogen ions in the blood B. Decreased oxygen in the tissue Stimulation of the parasympathetic nervous system 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 levels C. Oxygen and carbon dioxide levels C. Oxygen and carbon dioxide levels The fetus responds to a significant drop of PO2 by A. Increasing O2 consumption B. Reducing lactic acid production C. Shifting blood to vital organs C. Shifting blood to vital organs Activation of fetal chemoreceptors results in which FHR change? A. Decrease B. Increase C. No change A. Decrease Tachycardia is associated with increased A. Parasympathetic tone B. Sympathetic tone C. Vagal response B. Sympathetic tone A patient receiving oxytocin has 17 contractions 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 35 | P a g e The initial response in treating a primigravida being induced for preeclampsia who has a seizure is A. Administer terbutaline to slow down uterine activity B. Initiate magnesium sulfate C. Perform an immediate cesarean delivery B. Initiate magnesium sulfate Which FHR sounds are counted with a stethoscope and a fetoscope? A. Atrial B. Atrial and ventricular C. Ventricular C. Ventricular When using auscultation to determine FHR baseline, the FHR should be counted after the contractions for A. 5-10 sec B. 15-30 sec C. 30-60 sec C. 30-60 sec Which of the following characteristics can be determined using FHR 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. Verify the presence of an irregular rhythm According to ACOG, intermittent auscultation is appropriate for A. All pregnancies B. Neither complicated nor uncomplicated pregnancies C. Uncomplicated pregnancies C. Uncomplicated pregnancies A woman who is 34 weeks' gestation is counting fetal movements each day. Today she counted eight fetal movements in a two-hour period. Based on her kick counts, this woman should A. Continue counting for one more hour B. Discontinue counting until tomorrow C. Notify her provider for further evaluation C. Notify her provider for further evaluation 36 | P a g e A BPP score of 6 is considered A. Abnormal B. Normal C. Equivocal C. Equivocal A modified BPP reveals the following: reactive NST with moderate variability; AFI of 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. Breach of duty B. Negligence C. Proximate cause A. Breach of duty According to ACOG, in a patient without complications, the FHR tracing during the first stage of labor should be reviewed approximately every A. 5 min B. 15 min C. 30 min C. 30 min According to ACOG, in a patient without complications, the FHR tracing during the second stage of labor should be reviewed approximately every A. 5 min B. 15 min C. 30 min B. 15 min Since the widespread use of EFM, the rate of cerebral palsy has A. Decreased B. Increased C. Remained the same 37 | P a g e 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 At 32 weeks and beyond, FHR accelerations are defined as increases in FHR that must be at least A. 10 bpm above the baseline and the accel must last at least 10 sec B. 15 bpm above the baseline and the accel must last at least 10 sec C. 15 bpm above the baseline and the accel must last at least 15 sec C. 15 bpm above the baseline and the accel must last at least 15 sec Use of the terms "beat-to-beat" variability and "long-term" variability is not recommended by the NICHD because in clinical practice A. They are visually determined as a unit B. Both signify an intact cerebral cortex C. Clinical management is unchanged A. They are visually determined as a unit Variable decelerations in FHR are defined as visually apparent, abrupt decreases in FHR. The time from onset to nadir is less than A. 15 sec B. 30 sec C. 2 min B. 30 sec According to NICHD definitions of FHR variability, which of the following is accurate? A. Range 1-5 bpm = absent variability B. Range 6-25 bpm = average variability C. Range visually detectable but </=5 bpm = minimal variability C. Range visually detectable but </=5 bpm = minimal variability Late decelerations of the FHR are associated most specifically with A. Transient fetal tissue metabolic acidosis during a contraction B. Transient fetal hypoxemia during a contraction C. Transient fetal asphyxia during a contraction 40 | P a g e B. They may have fewer accels, and if <35 weeks, may be 10x10 One of the side effects of terbutaline as a tocolytic is A. Fetal bradycardia B. Increased oxygen consumption C. Marked variability B. Increased oxygen consumption Common problems seen during monitoring of postterm fetuses include all of the following except A. Baseline may be 100-110bpm B. Increased variables C. Polyhydramnios C. Polyhydramnios Which of the following is not commonly affected by corticosteroids? A. Doppler flow studies B. FHR baseline C. Frequency of FHR accelerations A. Doppler flow studies A fetus of a diabetic mother may commonly develop A. Polyhydramnios B. Supraventricular tachycardia C. Third-degree heart block A. Polyhydramnios The fetus of a mother with preeclampsia is at high risk for developing A. Intrauterine growth restriction (IUGR) B. Macrosomia C. Polyhydramnios A. Intrauterine growth restriction (IUGR) Maternal infection most often results in A. Fetal tachycardia B. Moderate variability C. Placenta previa A. Fetal tachycardia Uncontrolled maternal hypertension is often a causative factor in A. Postmaturity B. Preterm contractions C. Placental abruption C. Placental abruption 41 | P a g e EFM is an excellent _____ test for determining the presence or absence of neurological injury. A. Definitive B. Diagnostic C. Screening C. Screening The primary assumption when using EFM is that _____ produces physiological changes that can be detected by changes in the FHR. A. Disruption of oxygen B. Labor induction C. Parity A. Disruption of oxygen The primary difference between intermittent auscultation (IA) and EFM is A. EFM is primarily a visual assessment B. IA is associated with worse outcomes C. IA is less labor-intensive than EFM A. EFM is primarily a visual assessment The tocodynamometer is completely unreliable for A. Contraction duration B. Contraction frequency C. Contraction intensity C. Contraction intensity High resting tone may occur with an IUPC because of all of the following except A. Extraovular placement B. Maternal BMI C. Multiple gestations B. Maternal BMI All of the following are disadvantages of the ultrasound transducer for monitoring the FHR except A. It is noninvasive B. It may half or double the actual FHR C. It restricts patient movement A. It is noninvasive The internal scalp electrode works by A. Detecting heart motion B. Measuring the R-to-R interval of the fetal ECG C. Sensing the opening and closing of the fetal heart valves B. Measuring the R-to-R interval of the fetal ECG 42 | P a g e When educating the patient about the ultrasound transducer, the nurse should include the following: A. Contraction strength can alter the ability to monitor the FHR B. If baby moves, the tracing may "drop" or become erratic C. The ultrasound detects electrical activity of the fetal heart B. If baby moves, the tracing may "drop" or become erratic When educating the patient about the IUPC, the nurse should include the following: A. Can't get out of bed B. Does not accurately measure contraction strength C. Measures the FHR more accurately A. Can't get out of bed Intrinsic factors are those that are A. External to the fetus B. Internal to the fetus C. Related to the mother B. Internal to the fetus The parasympathetic branch of the autonomic nervous system A. Decreases FHR B. Increases contractility of the fetal heart C. Increases FHR A. Decreases FHR Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system? A. Acetylcholine B. Dopamine C. Norepinephrine C. Norepinephrine Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous system? A. Acetylcholine B. Dopamine C. Norepinephrine A. Acetylcholine Which of the following is responsible for variations in the FHR and fetal behavioral states? A. Cerebellum B. Cerebral cortex C. Medulla oblongata B. Cerebral cortex 45 | P a g e Which of the following is most responsible for producing FHR variability as the fetus grows? A. Maturation of the parasympathetic nervous system B. Maturation of the sympathetic nervous system C. Release of maternal prostaglandins A. Maturation of the parasympathetic nervous system Using the NICHD terminology, tachysystole is defined as A. More than 5 contractions in 10 minutes averaged over a 20-minute period B. More than 5 contractions in 15 minutes averaged over a 30-minute period C. More than 5 contractions in 10 minutes averaged over a 30-minute period C. More than 5 contractions in 10 minutes averaged over a 30-minute period When a patient reports that she is feeling contractions but the nurse does not note any on the toco tracing, what is the first intervention that should be performed? A. Ask the provider to place an IUPC B. Reposition the toco C. Palpate the uterus C. Palpate the uterus Which of the following represents the normal range for FHR baseline? A. 120-160 bpm B. 110-160 bpm B. 110-160 bpm Which of the following is not a type of supraventricular dysrhythmia? A. Premature atrial contraction (PAC) B. Premature ventricular contraction (PVC) C. Supraventricular tachycardia (SVT) B. Premature ventricular contraction (PVC) Which is the most common type of fetal dysrhythmia? A. Premature atrial contraction (PAC) B. Premature ventricular contraction (PVC) C. Third-degree heart block A. Premature atrial contraction (PAC) What is the most common cause of third-degree heart block in the fetus? A. Maternal HIV infection B. Maternal lupus C. Tocolysis B. Maternal lupus All of the following are traits of fetal supraventricular tachycardia (SVT), but which is most problematic? A. Decreases diastolic filling time 46 | P a g e B. Dramatically increases oxygen consumption C. Often leads to ventricular tachycardia (VT) C. Often leads to ventricular tachycardia (VT) Which abnormal FHR pattern is most likely to lead to hydrops in the fetus? A. Marked variability B. A premature ventricular contraction (PVC) C. Supraventricular tachycardia (SVT) C. Supraventricular tachycardia (SVT) Which of the following is an irregular FHR pattern associated with normal conduction and rate? A. Premature atrial contractions (PACs) B. Sinus arrhythmias C. Sinus tachycardias B. Sinus arrhythmias Which method of assessing FHR allows the clinician to hear the opening and closing of heart valves, which helps detect dysrhythmias? A. A fetoscope B. An internal scalp electrode (FSE) C. An ultrasound transducer A. A fetoscope Which method of assessment allows the clinician to visually see cardiac wall movements? A. A fetal echocardiogram B. A fetal pulse oximetry reading C. A nonstress test (NST) A. A fetal echocardiogram _____ denotes the spontaneous, rhythmic depolarization of cardiac cells. A. Automaticity B. Excitability C. Conductivity A. Automaticity _____ denotes the readiness of cardiac cells to receive and respond to electrical stimuli. A. Automaticity B. Excitability C. Conductivity B. Excitability _____ denotes the ability of cardiac cells to conduct electrical impulses from one cell to another. A. Automaticity 47 | P a g e B. Excitability C. Conductivity C. Conductivity Which of the following is the most common type of fetal tachyarrhythmia? A. Atrial flutter B. Supraventricular tachycardia (SVT) C. Premature ventricular contraction (PVC) B. Supraventricular tachycardia (SVT) Which of the following is one example of a fetal tachyarrhythmia? A. Second-degree heart block, Type I B. Atrial fibrillation C. Premature atrial contraction (PAC) B. Atrial fibrillation (T/F) Sinus bradycardias, sinus tachycardias, and sinus arrhythmias are all associated with normal conduction (normal P-waves followed by narrow QRS complexes). True (T/F) An internal scalp electrode will detect the actual fetal ECG. True (T/F) An internal scalp electrode can solely diagnose a fetal dysrhythmia. False _____ are patterns of abnormal FHR associated with variability in R-to-R intervals, but with normal P- waves preceding normal QRS complexes. A. Arrhythmias B. Complete heart blocks C. Dysrhythmias A. Arrhythmias _____ are abnormal FHR rhythms associated with disordered impulse formation, conduction, or both. A. Arrhythmias B. Supraventricular tachycardias C. Dysrhythmias C. Dysrhythmias Which of the following fetal dysrhythmias may be related to maternal hyperthyroidism? A. Sinus tachycardia B. Premature atrial contractions (PACs) C. Third-degree heart block 50 | P a g e distinctly different C. Twins must be identified and monitored as A or B throughout the entire antenatal and intrapartum periods B. Twins rarely have accelerations and decelerations simultaneously, and tracings should appear distinctly different pH 6.9, PO2 15, PCO2 55, HCO3 18, BE -22 The nurse reviews the arterial gas results and concludes that the fetus had _____ acidosis. With results such as these, you would expect a _____ resuscitation. A. Metabolic; lengthy B. Metabolic; short C. Respiratory; lengthy A. Metabolic; lengthy Which of the following umbilical artery cord gases would most likely result in a fetus who had a Category I strip, then had a cord prolapse and was delivered within 3 minutes? A. pH 7.17, PO2 22, PCO2 70, HCO3 24, BE -5 B. pH 7.25, PO2 23, PCO2 46, HCO3 22, BE -8 C. pH 7.02, PO2 18, PCO2 56, HCO3 15, BE -18 A. pH 7.17, PO2 22, PCO2 70, HCO3 24, BE -5 Cord blood gases from one of the umbilical arteries best represent A. The status of fetal acid-base balance B. The status of maternal oxygenation C. The status of placental function A. The status of fetal acid-base balance A modified biophysical profile (mBPP) is considered normal if A. NST is reactive and mother reports at least 10 fetal movements in 2 hours B. NST is reactive and the amniotic fluid index (AFI) is greater than 5 cm C. There are no decelerations following contractions B. NST is reactive and the amniotic fluid index (AFI) is greater than 5 cm Which of the following is not a component of a BPP? A. Amniotic fluid index (AFI) B. Fetal breathing C. Nonstress test (NST) A. Amniotic fluid index (AFI) (Should be volume, not index) A contraction stress test (CST) is done. During the testing, there were three contractions in 10 minutes, no decels, the baseline was 145, and there was moderate variability. This is interpreted as A. Negative 51 | P a g e B. Positive C. Suspicious A. Negative Which of the following is most likely to result in absent end diastolic flow during umbilical artery velocimetry? A. Preeclampsia B. Preterm labor C. Previous cesarean delivery A. Preeclampsia Which of the following best describes a condition in which there is decreased oxygen in the tissues? A. Acidosis B. Hypoxemia C. Hypoxia C. Hypoxia What is the maximum amount of time allotted for a nonstress test? A. 20 minutes B. 40 minutes C. 60 minutes B. 40 minutes A nonstress test (NST) is nonreactive after 40 minutes. The nurse should A. Call the physician to plan for a possible induction B. Call the physician to arrange for a BPP or CST C. Perform vibroacoustic stimulation and monitor patient for 20 additional minutes B. Call the physician to arrange for a BPP or CST (T/F) Contractions during a contraction stress test (CST) may be spontaneous or induced with oxytocin or nipple stimulation. True A contraction stress test (CST) is performed. Late decelerations were noted in three out of the five contractions in 10 minutes. This is interpreted as A. Positive B. Negative C. Suspicious A. Positive A contraction stress test (CST) is performed. Late decelerations were noted in two out of the five contractions in 10 minutes. This is interpreted as A. Positive 52 | P a g e B. Negative C. Suspicious C. Suspicious A contraction stress test (CST) is performed. Two variable decelerations were seen on the FHR tracing and there were four contractions in 10 minutes. This is interpreted as A. Positive B. Negative C. Suspicious B. Negative A contraction stress test (CST) is performed. No decelerations were noted with the two contractions that occurred over 10 minutes. This is interpreted as A. Positive B. Negative C. Unsatisfactory C. Unsatisfactory A patient has a reactive NST and negative CST. Select the appropriate followup. A. Prepare patient for delivery B. Repeat in 24 hours C. Repeat in one week C. Repeat in one week A patient has a nonreactive NST and negative CST. Select the appropriate followup. A. Prepare patient for delivery B. Repeat in 24 hours C. Repeat in one week B. Repeat in 24 hours For a patient with a suspicious or unsatisfactory CST, select the appropriate followup. A. Prepare patient for delivery B. Repeat in 24 hours C. Repeat in one week B. Repeat in 24 hours In a patient whose CST reveals late decelerations with three out of the four induced contractions, which of the following would be the least appropriate plan for treatment? A. Obtain physician order for BPP B. Prepare for possible induction of labor C. Repeat CST in 24 hours C. Repeat CST in 24 hours 55 | P a g e How does the fetus compensate for decreased maternal circulating volume? a. Increases cardiac output by increasing stroke volume. b. Increases cardiac output by increasing it's heart rate. c. Increases cardiac output by increasing fetal movement. b. Increases cardiac output by increasing it's heart rate. Stimulating the vagus nerve typically produces: a. A decrease in the heart rate b. An increase in the heart rate c. An increase in stroke volume d. No change a. A decrease in the heart rate What initially causes a chemoreceptor response? a. Epidurals b. Supine maternal position c. Increased CO2 levels d. Decreased O2 levels e. A & C f. A & B g. C & D g. C & D The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the FHR baseline? a. Increases baseline b. Decreases baseline b. Decreases baseline T/F: Oxygen exchange in the placenta takes place in the intervillous space. True T/F: The parasympathetic nervous system is a cardioaccelerator. False T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood pressure. True T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound transducer and the fetal spiral electrode. True T/F: Variability can be determined with the fetoscope. 56 | P a g e False T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped in warm water to make cleaning easier. False T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased variability. True T/F: All fetal monitors contain a logic system designed to reject artifact. True T/F: The monitor should always be tested before starting a tracing, either external or internal mode and labeled a test. True T/F: The paper speed on the fetal monitor should always be set at 1cm/min. False T/F: Both internal and external monitoring methods are equally accurate means of obtaining the fetal heart rate and contraction patterns. False T/F: The external toco is usually placed over the uterine fundus to pick up contractions. True T/F: The external toco gives measurable uterine pressure. False T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present. False T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's back, as the fetal heart is heard best there. True T/F: The spiral electrode is used to more accurately determine the frequency, duration, and intensity of uterine contractions. False T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. False 57 | P a g e T/F: The intrauterine catheter is used to pick up the fetal heart rate. False T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. True T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. True T/F: Variability and periodic changes can be detected with both internal and external monitoring. True T/F: Variable decelerations are a result of cord compression. True T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of adequate fetal oxygenation. True T/F: Variable decelerations are a vagal response. True T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are delayed in timing with the nadir of the deceleration occurring after the peak of the contraction. True T/F: The fetal heart rate baseline can be determined during periods of marked variability. False T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through the placenta. True T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. True T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated. False What is your first intervention in management of a patient experiencing variable decelerations? a. Immediate delivery b. Change maternal position c. No treatment indicated 60 | P a g e c. There are no fetal heart rate late decelerations with the contractions d. There is one fetal heart rate deceleration seen c. There are no fetal heart rate late decelerations with the contractions According to AWHONN, the normal baseline Fetal Heart Rate (FHR) is A. 90-150 bpm B. 100-170 bpm C. 110-160 bpm D. 120-140 bpm C. 110-160 bpm What are the two most important characteristics of the FHR? A. Rate and decelerations B. Variability and accelerations C. Variability and decelerations D. Rate and variability B. Variability and accelerations You recognize that an FHR tracing has been showing a decrease in variability for the last 45 minutes. Your first intervention should be to A. Encourage ambulation B. Administer oxygen C. Discontinue IV fluids D. Increase Pitocin rate B. Administer oxygen Resuscitation measures improves the baby's variability, but the FHR is still not reactive. You attempt fetal scalp stimulation (FSE) because you know that a well-oxygenated fetus will respond to FSE with a(n) A. Acceleration B. Deceleration C. Fetal movement D. Sleep pattern A. Acceleration You are evaluating a patient in the Prenatal Testing Department who has just completed a biophysical profile (BPP). You suspect that there could be chronic fetal asphyxia because the score is below A. 10 B. 6 C. 8 B. 6 When using a fetal scalp electrode (FSE), you notice an abnormally low FHR on the monitor. You should first 61 | P a g e A. Compare maternal pulse simultaneously with FHR B. Remove FSE C. Call the doctor immediately D. Turn off the monitor A. Compare maternal pulse simultaneously with FHR T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. True T/F: Low amplitude contractions are not an early sign of preterm labor. False T/F: Preterm contractions are usually painful. False T/F: Corticosteroid administration may cause an increase in FHR accelerations. False T/F: Corticosteroid administration may cause an increase in FHR. True T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. True As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flow to vital organs increases. These flow changes along with increased catecholamine secretions have what effect on fetal blood pressure and fetal heart rate? A. Increase BP and increase HR B. Increase BP and decrease HR C. Decrease BP and increase HR D. Decrease BP and decrease HR B. Increase BP and decrease HR All of the following might indicate a pseudosinusoidal pattern as opposed to a sinusoidal pattern, except: A. Recent administration of narcotics to mother B. Accelerations in FHR C. Moderate variability D. Frequency of oscillations of two to five cycles/min D. Frequency of oscillations of two to five cycles/min 62 | P a g e All of the following are appropriate interventions for fetal tachycardia except: A. Increase maternal IV fluid rate B. Assess maternal vital signs C. Perform SVE D. Administer oxygen C. Perform SVE During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the following is the least likely explanation? A. True knot B. Gestational diabetes C. Umbilical cord entanglement D. Oligohydramnios B. Gestational diabetes All of the following are likely causes of prolonged decelerations except: A. Uterine tachysystole B. Prolapsed cord C. Maternal hypotension D. Maternal fever D. Maternal fever _______ decelerations occur with less than 50% of contractions. A. Recurrent B. Intermittent C. Repetitive B. Intermittent _______ decelerations occur with greater than or equal to 50% of contractions. A. Recurrent B. Intermittent C. Repetitive A. Recurrent All of the following could likely cause minimal variability in FHR except A. Magnesium sulfate administration B. Fetal sleep cycle C. Narcotic administration D. Ephedrine administration D. Ephedrine administration When an IUPC has been placed, Montevideo units must be ___ or greater for adequate cervical change to occur. A. 100 65 | P a g e B. Perform vaginal exam C. Turn patient on left side D. Vibroacoustic stimulation B. Perform vaginal exam Scalp stimulation Assessment of the _____ is an indirect measurement of fetal oxygenation. A. Fetal heart rate B. Fetal scalp sampling C. Uterine activity D. Direct Coombs A. Fetal heart rate T/F: Intrauterine pressure catheters (IUPCs) do not increase risk for infection when placed on patients with intact membranes. False Membranes must be ruptured for use; infection is a risk What are abnormal fetal heart rate tracings predictive of? A. Likelihood of spontaneous vaginal delivery B. Newborn condition at time of delivery C. Fetal acid-base abnormalities D. Fetal intrauterine growth C. Fetal acid-base abnormalities Which of the following is not an intervention that should be implemented in a patient with uterine tachysystole? A. Administer terbutaline B. Increase IV fluid rate C. Decrease or discontinue IV oxytocin D. Prepare patient for cesarean section D. Prepare patient for cesarean section Which of the following is most effective in determining the strength of a patient's contractions? A. Patient report B. Tocodynanamometer tracing C. RN palpation D. Sterile vaginal exam during a contraction C. RN palpation The FHR is controlled by the A. Sympathetic nervous system 66 | P a g e B. Sinoatrial node C. Atrioventricular node D. Parasympathetic nervous system B. Sinoatrial node How do baseline heart rates differ in premature fetuses? A. They are often lower B. They are often higher C. They are less likely to have decelerations D. They experience longer accelerations B. They are often higher T/F: If etiology of fetal tachycardia is secondary to extrauterine infection, FHR will return to normal as maternal fever resolves. True T/F: Fetal tachycardia is a normal compensatory response to transient fetal hypoxemia. True Fetal heart rate bradycardia is defined as A. FHR <110bpm lasting 10 min or greater B. FHR <110bpm lasting 2 min or greater C. FHR <110bpm lasting 20 min or greater A. FHR <110bpm lasting 10 min or greater _______ variability warrants cesarean section delivery. A. Minimal B. Moderate C. Marked D. Absent D. Absent At how many weeks gestation should FHR variability be normal in manner? A. 24 weeks B. 28 weeks C. 32 weeks D. 36 weeks B. 28 weeks A deceleration from 145bpm down to 100bpm lasting 12 minutes may be defined as a A. Prolonged deceleration B. Variable deceleration C. Late deceleration D. Baseline change 67 | P a g e D. Baseline change Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leads first to _______ _______, then _______ _______. A. Respiratory alkalosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis C. Respiratory alkalosis; metabolic alkalosis D. Respiratory acidosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is typically present in _______. A. Variable decelerations B. Late decelerations C. Early decelerations D. Accelerations B. Late decelerations Place the following interventions for a sinusoidal FHR in the correct order: 1. Prepare for cesarean delivery 2. Place patient in lateral position 3. Determine if pattern is related to narcotic analgesic administration 4. Provide oxygen via face mask A. 4, 2, 3, 1 B. 3, 1, 2, 4 C. 4, 3, 2, 1 D. 3, 2, 4, 1 D. 3, 2, 4, 1