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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 - ANSWER B. R to R intervals of the fetal heart The optimal location for the ultrasound transducer for the fetus - ANSWER the fetal back First step when contraction pattern is weird with IUPC in place - ANSWER re zero the IUPC Membranes ruptured 60 minutes ago and now you see prolonged deceleration
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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 - ANSWER B. R to R intervals of the fetal heart The optimal location for the ultrasound transducer for the fetus - ANSWER the fetal back First step when contraction pattern is weird with IUPC in place - ANSWER re zero the IUPC Membranes ruptured 60 minutes ago and now you see prolonged deceleration, first step: - ANSWER perform a vaginal exam A woman who is admitted for an induction of labor with oxytocin is questioning the need for continuous EFM. The appropriate response to the woman is. A. hospital policy requires all patients have continuous EFM B. I would like to answer your questions about continuous monitoring and give you some information about why it is recommended C. Nurses have more training with continuous monitoring than with intermittent auscultation so it is safer for you and baby - ANSWER B. I would like to answer your questions about continuous monitoring and give you some information about why it is recommended The process by which oxygen and carbon dioxide pass from a region of higher concentration to one of lower concentration is called: a. active transport b. simple diffusion c. facilitated diffusion - ANSWER B. simple diffusion 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 - ANSWER b. greater binding of oxygen which statement best describes the relationship between maternal and fetal hemoglobin levels? a. fetal hemoglobin is higher than maternal hemoglobin
b. maternal hemoglobin is higher than fetal hemoglobin c. maternal and fetal hemoglobin is the same - ANSWER a. fetal hemoglobin is higher than maternal hemoglobin In the healthy fetus, blood flows from the right atrium to the left atrium through the: a. ductus arteriosis b. ductus venosus c. Forman ovale - ANSWER c. foramen ovale In the healthy fetus, the umbilical cord enters the fetal abdomen and bypasses the liver through the a. ductus arteriosis b. ductus venosus c. Forman ovale - ANSWER b. ductus venosus Stimulation of the sympathetic nervous system causes the fetal heart rate to a. decrease b. increase c. remain the same - ANSWER b. increase baroreceptors respond mainly to changes in a. blood pressure b. hormonal changes c. oxygen and carbon dioxide levels - ANSWER a. blood pressure Which statement describes normal uterine activity a. frequency of 1.5 - 2 minutes b. intensity of 90mmhg early in labor c. resting tone less than 20-25 mmHg - ANSWER c. resting tone less than 20-25mmhg Greater than 5 contractions in 10 minutes averaged over 30 minutes indicates A. Excessive uterine activity B. Hyperstimulation C. Tachysystole - ANSWER c. tachysystole tracing showing early phase of labor. External toco being used and contractions have "spiky appearance" this is due to: a. artificat b. fetal kicks c. maternal respirations - ANSWER c. maternal respirations Tracing showing minimal variability. 10 minutes prior to this was cat 1. The appropriate action at this time is to: a. apply oxygen b. continue to observe c. perform scalp stimulation - ANSWER b. continue to observe
"this is considered a sleep cycle - sleep cycles can last 15-25 minutes" How to calculate mVU - ANSWER add all the mmHg for contractions during a 10 minute period **subtract the baseline pressure in the above EXTERNAL tracing the intensity of the contraction is: a. 55mmhg b. 70mmhg c. indeterminate - ANSWER c. indeterminate Cannot determine strength with external monitors * A 36 week gestation patient is brought to triage by squad after an MVA on her back. She is not bleeding and denies pain. She is not short of breath, but c/o dizziness and nausea since they put her on the gurney. The most likely cause is A. Abruptio placenta B. Preterm labor C. Supine hypotension - ANSWER c. supine hypotension One compensatory mechanism that helps maintain oxygen availability to the fetus during maternal exercise is A. A decrease in maternal hematocrit B. Transient increase in uterine blood flow C. An increase in uterine oxygen uptake - ANSWER c. an increase in uterine oxygen uptake Tracing showing prolonged deceleration after recent epidural and intial bolus just delivered. Underlying cause of this tracing is: a. maternal vasodilation b. parasympathetic blockage c. prolapsed umbilical cord - ANSWER a. maternal vasodilation G3 at 39 weeks undergoing eIOL. SVE 6/90/+1. Toco showing tachysystole. Tracing with prolonged deceleration. Priority action by the nurse would be: a. apply O2 via NRB b. Give 0.25 terbutaline c. turn off pitocin - ANSWER c. turn off pitocin P0 at 39wks undergoing IOL for PEC. She is 6/100/+1. Patient begins SEIZING, at this time a prolonged decel is noted. After discontinuing the pit the appropriate medication to be administered is: a. mag sulfate b. phenobarbital c. terbutaline - ANSWER a. mag sulfate
P0 at 39wks undergoing IOL for PEC. She begins seizing. The priority response is: a. intitiate magnesium sulfatae b. intrauterine resuscitation c. maternal airway establishment - ANSWER c. maternal airway establishment ** ABC's always first!! P0 at 39wks undergoing IOL for PEC. She begins seizing. Prolonged decel noted on tracing. Based on the fetal tracing above the initial response is to: a. administer magnesium sulfate b. initiate intrautrerine mesures c. perform emergency cesarean section - ANSWER b. initiate intrauterine resuscitation measures 28 yo P0 at 35wks IOL cHTN r/o PEC, AFI 2.0. She has ISE and IUPC in place. Pit is at 2mU. Based on above strip (minimal variability, recurrent late decels) what would next intervention be? a. perform a vaginal exam b. reposition the mother c. turn off the pit - ANSWER b. reposition the mother **lates = reposition, tachycardia = turn pit off when the hydrogen ion level in the blood rises, the PH: a. lowers b. neutralizes c. rises - ANSWER lowers P1 with pit at 5mU. Twenty minutes ago tracing was cat 1 and was 1-2/80/-2. She received stadol 1mg minutes prior to this tracing. (Moderate variability, -accels, -decles.) Ctx irregular q 2-5. The appropriate response to the tracing would be to: a. continue to observe b. notify provider c. perform intrauterine resuscitation measures - ANSWER a. continue to observe What affect does magnesium sulfate have on the fetal heart rate? A. Decreases variability B. Increases variability C. No change - ANSWER a. decreases the variability A woman receives terbutaline for an external version. You may expect what on the fetal heart tracing? A. Decrease in variability B. Increase in baseline C. No change - ANSWER b. increase in baseline
Tracing showing early decels with every other ctx, this pattern is called: a. episodic b. periodic c. transitory - ANSWER B. periodic **episodic is not associated with ctx the physiology underlying early decels is fetal autonomic reflex response to: a. changes in cerebral flow during contractions b. transient compression of the cord c. transient hypoxemia during a contraction - ANSWER a. changes in cerebral flow during contractions the physiology underlying Variable decels is fetal autonomic reflex response to: a. changes in cerebral flow during contractions b. transient compression of the cord c. transient hypoxemia during a contraction - ANSWER transient compression of the cord the physiology underlying late decels is fetal autonomic reflex response to: a. changes in cerebral flow during contractions b. transient compression of the cord c. transient hypoxemia during a contraction - ANSWER transient hypoxemia during a contraction NICHD guidelines apply only to A. Intrapartum patients B. Internal monitoring of fetal heart rate C. Interpreting tracings of good quality - ANSWER c. interpreting tracings of good quality Tracing showing absent variability and recurrent late decels. The recommended management of this tracing would be to perform intrauterine resuscitation measures and: a. consider delivery b. continue to observe. c. prepare for delivery - ANSWER c. prepare for delivery tracing with absent variability and recurrent late decels x 30 minutes. This tracing should be labeled as. a. cat 1 b. cat 2 c. cat 3 - ANSWER c. cat 3 Emergent delivery! absent with recurrent lates
Prolonged deceleration becomes a bradycardia after __ minutes - ANSWER 10 Physiology underlying a Cat 1 tracing: a. epinephrine response b. fetal compensation c. an intact fetal autonomic system - ANSWER c. an intact fetal autonomic system a fetal scalp electrode is in placed you see significant artifact. Based on this tracing, what nursing intervention would be appropriate? a. auscultate to rule out arrythmia b. Place a maternal pulse ox c. replace scalp electrode - ANSWER a. auscultate to rule out arrythmia ** I guess because it says nursing intervention? When a tracing shows marked variability, the baseline is ________ - ANSWER indeterminate P0 in spontaneous labor. External monitoring of contractions and ISE in place. Tracing showing 6 minute prolonged decel. The appropriate initial response to this tracing would be to: a. apply oxygen by face mask b. perform a vaginal exam c. IV fluid bolus - ANSWER B. Perform a vaginal exam ** if patient ruptured and prolonged decel, think prolapsed cord and first step is exam According to NICHD terminology, variability can be accurately accessed A. Visually, by determining the number of R to R intervals in a one minute period B. Visually, by determining the amplitude of the FHR change in bpm from the baseline C. Only when a fetal spiral electrode is in place - ANSWER B. Visually, by determining the amplitude of the FHR change in bpm from the baseline Tracing showing recurrent late decels. Pit has been infusing for 2 hours. Which pattern characteristic determines fetal oxygen reserve? a. depth of deceleration b. during of deceleration c. presence of variability - ANSWER c. presence of variability When looking at the fetal heart rate, the most important characteristic to determine the absence of metabolic acidemia is A. Absence of late decelerations B. Baseline rate within normal range C. Presence of moderate variability - ANSWER c. presence of moderate variability Tracing showing marked variability and fetal tachycardia. This is categorized as:
C. Water intoxication - ANSWER b. uterine overdistension Tracing showing moderate variability and recurrent variable decels. Management would be a. continue surveillance and intrauterine resuscitative measures b. proceed to delivery c. routine management - ANSWER a. continue surveillance and intrauterine resuscitative measures Moderate variability and recurrent variable decels are considered: a. cat 1 b. cat 2 c. cat 3 - ANSWER b. cat 2 The initial intervention for tracing with moderate varaiability and recurrent variables is: a. continue to observe b. initiate an amnioinfusion c. reposition - ANSWER c. reposition The NICHD states that the clinical significance of an acceleration coming off of a variable requires: a. further research investigation b. preparation for an emergent delivery c. routine surveillance - ANSWER a. further research investigation after epidural you see tracing with moderate variability and recurrent late decels. After she is repositioned in bed, what is the next appropriate step? a. correct maternal blood pressure b. decrease epidural medication c. place internal monitors - ANSWER a. correct maternal BP A fetal heart rate pattern that the NICHD has identified as predictive of current or impending fetal asphyxia so severe is at risk of neurologic damage or death is : a. baseline tachycardia with absent variability b. minimal baseline variability with recurrent late decels c. recurrent late or variable decelerations with absent variability - ANSWER c. recurrent late or variable decelerations with absent variability **This is Cat 3 a fetal heart rate pattern that can occur when there is a prolapsed cord is: a. marked variability b. prolonged decelerations c. tachycardia - ANSWER b. prolonged decelerations
P6 undergoing IOL on pitocin, tracing showing decel from baseline 120 to 100 bpm x 6 minutes. after reposition, the initial response to this tracing is to: a. assess maternal BP b. discontinue pit c. perform vaginal exam - ANSWER b. discontinue pitocin 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 - ANSWER A. Address contraction frequency by reducing pitocin dose 21 yo P0 at 33 wks presents with decreased FM. No pregnancy complication. Tracing showing baseline 140 with absent variability. When volume of EFM is turned up, the FH is too fast to count. These findings are consistent with: a. maternal HR b. normal baseline rate c. SVT - ANSWER c. SVT External monitor is halving the rate 19 yo p0 at 34 weeks presents with nausea and vomitting. Tracing shows baseline of 210bpm, moderate variability, -accels, +variables. IF baseline persists at this rate the fetus is at risk of: a. hydrops b. low output failure c. second degree heart block - ANSWER a. hydrops 19 yo p0 at 34 weeks presents with nausea and vomitting. Tracing shows baseline of 210bpm, if FH continues at this rate, the recommended treatment is maternal administration of a. digoxin b. mag sulfate c. phenobarbital - ANSWER a. dioxin 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 - ANSWER c. possible cord compression 34 wks r/o PTL. Tracing showing baseline 180bpm, moderate variability. The appropriate action in response to the FH baseline is:
a. continue observation based upon normal findings b. interpret with caution; further evaluation needed c. prepare for cesarean section - ANSWER b. interpret with caution; further evaluation needed a 42 week gestation woman is diagnosed with oligohydramnios. A FHR to be expected is: a. late deceleration b. minimal variability c. variable deceleration - ANSWER c. variable deceleration P0 at 42 wks in active labor. AROM 2 hours ago thick meconium, now 4cm dilated. Tracing is Cat 1. The appropriate intervention is: A. continue to monitor and observe b. perform amnioinfusion c. plase ISE - ANSWER a. continue to monitor and observe P1 at 39wks IOL gHTN. Pit at 7mU. SVE 1 hour ago 4cm. Increased dark bloody show and abdominal pain. Tracing showing quivering ctx pattern. After turning off pit. Next intervention is: a. administer terbutaline b. palpate the uterus for rigidity c. perform SVE - ANSWER b. palpate uterus for rigidity P2 at 37 wks, in MVA. Obvious compound fracture to right femur. Hysterical crying, pain everywhere. BP 90/68, RR 45, HR 160. Tracing Cat 3. Priority intervention is: a. administer pain medication b. order ultrasound c. stabilize mother - ANSWER c. stabilize mother TOLAC IOL, 5/70/0, membranes intact. Vomitted and then large amount of blood per vagina. Now with severe abdominal pain and cat 3 tracing. This is characteristic of: a. placenta previa b. uterine rupture c. vasa previa - ANSWER b. uterine rupture MonoMono twins are prone to what type of decelerations during labor - ANSWER variable decels DiDi twins, appear to be tracing same FH, A has ISE and B has external. Appropriate action is: a. apply a different monitor b. continue to observe c. readjust the ultrasound transducer for baby B - ANSWER c. readjust the ultrasound transducer for baby B
P1 IOL, BMI 43, SVE 2cm, cannot trace externally next step: a. continue to readjust external devices b. hand hold monitor in place c. place internal monitors - ANSWER c. place internal monitors 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 - ANSWER A. 15-30 minutes in the active phase of the first stage and every 5- minutes in second stage What fetal heart rate characteristics can be determined with auscultation? A. Baseline B. Early decelerations C. Variability - ANSWER a. baseline If the pH is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? A. HCO B. PCO C. PO2 - ANSWER b.PCO Tracing showing moderate variability, the acid base status of the fetus is: a. academic b. indeterminate c. normal - ANSWER c. normal The following cord blood gasses are consistent with: pH 7.00, pCO2 70, pO2 25, base excess - A. Metabolic acidosis B. Mixed acidosis C. Respiratory acidosis - ANSWER c. respiratory acidosis 36 wks, BPP 6/10. AFI is normal. Expected management is: a. immediate delivery b. repeat test in 24 hours c. schedule the test in 1 week - ANSWER b. repeat test in 24 hours 38 wks, GDM, BPP 4/10. This indicated need for: a. follow up in 24 hours b. IOL c. emergent c/s - ANSWER b. IOL
35 wks having NST. Baseline 130 bpm. RN uses VAS to reduce the length of time needed to obtain the NST. Fetal well being requires: a. 1 accel to 145 b. 2 accels to 140 c. 2 accels to 145 - ANSWER c. 2 accels to 145 One characteristic of a high reliability perinatal unit is: a. alarms can only be called by unit leaders b. reliance on memorization of protocols c. the organization creates a safety oriented culture - ANSWER c. the organization creates a safety oriented culture Supporting the parents decision to choose no extraordinary measures on their baby who is about to deliver at 24 3/7 weeks gestation despite the nurses personal opinion is an example of A. Autonomy B. Beneficence C. Non-maleficence - ANSWER a. autonomy a woman desires a natural childbirth. the nurse puts pressure on her to get an epidural. This is on example of going against which ethical principal? a. autonomy b. beneficence c. justice - ANSWER a. autonomy One example of evidence-based practice related to fetal monitoring is A. Diagnosis of uterine rupture with an IUPC B. Intermittent auscultation for the low-risk patient C. Using electronic fetal monitoring to prevent cerebral palsy - ANSWER 20 minutes into an NST, the patient still has not felt the baby move. You have 2 accelerations of 15 beats by 15 beats. You would a. have her ambulate for 20 minutes then reapply the monitor to see if the baby is more active b. consider this a reactive NST and discontinue monitoring c. continue to monitor until the mother perceives fetal movement that correlates to acceleration - ANSWER b. consider this a reactive NST and discontinue monitoring Betamethasone given to the mother can transiently affect the fetal heart rate by a. decreasing the variability b. increasing the variability c. lowering the baseline - ANSWER a. decreasing the variability tracing showing recurrent late decels, moderate variability. Patient is FD/+2, after repositioning, increasing the IV and administering O2 the most appropriate action would be to
a. assess maternal blood pressure b. employ modified pushing techniques c. initiate pitocin - ANSWER b. employ modified pushing techniques
pH 6. pCO2 28 pO2 2. HCO3 14 B.D. 16 the umbilical arterial cord blood gas values reflect A. metabolic acidemia B. mixed acidemia C. respiratory acidemia - ANSWER a. metabolic acidemia Stimulation of the parasympathetic nervous system causes the fetal heart rate to: a. decrease b. increase c. remain the same - ANSWER a. decrease When variable decelerations persist despite intrauterine resuscitation, a factor that would lead to consideration of letting labor continue to delivery is a. accelerate after VAS b. regular fetal breathing motions c. no tachysystole - ANSWER A. acceleration after VAS Tracing showing minimal variability. The acid-base balance of this fetal strip is: a. abnormal b. indeterminate c. normal - ANSWER b. indeterminate 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 - ANSWER c. notify her provider for further evaluation ++ should be 10 in 2 hours Tracing showing minimal variability intermittent late decels. 25 yo P0 at 39wks IOL GDMA1. She had cervidil inserted at 1928 the evenuning prior to this tracing at which time her cervix was 0/20/-2 with a bishop score of 2. FHR Cat 1 until 60 minutes ago, now minimal with lates. Appropriate action is to: a. administer terbutaline
b. apply oxygen c. remove the cervidil - ANSWER c. remove the cervidil Tracing is Cat 3. 7cm dilated.The appropriate management is? a. amnioinfusion b. continued surveillance c. prepare for prompt delivery - ANSWER c. prepare for prompt delivery AROM -> recurrent variables, after maternal repositioning the next step is to: a. administer terbutaline b. initiate an amnioinfusion c. perform a vaginal exam - ANSWER c. perform a vaginal exam What is the most sensitive method of assessing uterine activity? a. intrauterine pressure catheter b. manual palpation c. maternal perception - ANSWER a. intrauterine pressure catheter Tracing showing minimal variability and recurrent lates. P1 at 39wks with PEC, she is 2/90/-3. The etiology of this pattern is most likely a. cord compression b. head compression c. transient fetal hypoxemia - ANSWER c. transient fetal hypoxemia P0 at 34 weeks admitted for decreased fetal movement. Patient is not in labor. The tracing showing Cat 2, minimal variability, (-)accels, (-)decels, it looks like this x 1. hours. The most appropriate action in response to this tracing is to. a. continue to observe b. have the mother drink some orange juice c. notify the provider - ANSWER c. notify the provider P0 at 38wks thinks she has been leaking fluid for two days. She is 1-2/90. GBS positive. Tracing showing baseline 185, moderate variability, (-)accels, (-)decels. The first response it to. a. administer terbutaline b. assess the maternal temperature c. prepare for an amnioninfusion - ANSWER b. assess the maternal temperature The above external tracing is of a 40 weeks P1 who is pushing in the second stage of labor. The appropriate action in response to this tracing is to. (showing accelerations while pushing). a. assess the maternal pulse b. continue routine fetal surveillance c. initiate fetal resuscitation measures - ANSWER a. assess the maternal
30 yo P0 at 40wks IOL cHTN, on pitocin. BP 178/89 just before test dose of epidural. Tracing now with prolonged decel. After repositioning the pateitn the first action is to a. administer a 1L bolus b. Apply o c. d/c the pit - ANSWER c. stop the pit Since the widespread use of EFM, the rate of cerebral palsy has A. Decreased B. Increased C. Remained the same - ANSWER c. remained the same Tracing showing recurrent variables. The decelerations of this tracing are the result of a. cord compression b. decreased uteroplacental perfusion c. head compression - ANSWER a. cord compression P1 at 39 weeks with internal monitoring. her last exam 30 minutes ago showed 6/100/-
One fetal heart rate pattern that is associated with an abnormal acid-base status is A. Minimal variability with no accelerations or decelerations B. Recurrent variable decelerations with absent variability C. Tachycardia with absent variability - ANSWER b. recurrent variable decelerations with absent variability a 15 yo homeless p0 in active labor. no prenatal care. very anxious. BP 148/88, pulse
In a twin delivery the second twin is at higher risk for a. cord prolapse b. precipitous delivery c. uterine tachysystole - ANSWER a. cord prolapse NICHD defines decelerations that occur with greater than 50% of contractions in 20 minute pperiod as a. intermittent b. recurrent c. repetitive - ANSWER b. recurrent` The NICHD definitions are applicable to a. antepartum only b. antepartum and intrapartum c. intrapartum only - ANSWER b. antepartum and intrapartum According to NICHD, decelations that have an abrupt onset and a nadir in less than 30 seconds are a. early b. late c. variable - ANSWER c. variable tracing showing minimal variability. Just ten minutes prior to this tracing it weas cat 1. At this time the most appropriate action is to a. continue to observe b. perform scalp stim c. prepare for c/s - ANSWER a. continue to observe P0 at 34 wks presenting with abdominal pain and vaginal bleeding. She smokes 1 PPD. the tracing shows recurrent lates and tachysystole. The most appropriate action for this tracing is to a. administer terbutaline b. perform a vaginal exam c. prepare for immediate cesarean - ANSWER c. prepare for immediate cesarean following administration of terbutaline, the baseline may a. decrease b. increase c. remain the same - ANSWER b. increase Prolonged decel after epidural. This fetal response reflects a. fetal response to effects of methyldopa b. decreased uteroplacental blood flow secondary to maternal blood pressure drop and uterine activity
c. stimulation of the fetal sympathetic nervous system in response to stress - ANSWER b. decreased uteroplacental blood flow secondary to maternal blood pressure drop and uterine activity accelerations on the electronic fetal monitoring in the intrapartum period a. are not required for the tracing to be considered normal b. must show 15 x 15 acceleeration to be categorized as such c. normal EFM tracing without accelerations are assigned a cat 1 designation - ANSWER a. are not required for the tracing to be considered normal 34 yo GDMA2 admitted with nausea vomiting abdominal pain. glucose is 515. Tracing with minimal variability. Suspect: a. DKA b. Euglycemia c. insulin shock - ANSWER a. DKA One way to promote safety and reduce risks related to electronic fetal monitoring is to a. memorize fetal monitoring language b. standardize fetal monitoring language c. use fetal monitoring language preferred by the provider - ANSWER b. standardize fetal monitoring language a P0 at 39wks IOL PEC. Not receiving any medication. on admission, her blood pressure is 157/91 and the FHR tracing is above. The initial action for this tracing (recurrent variables, moderate variability) is to a. change maternal position b. initiate an amnioinfusion c. reduce uterine activity - ANSWER a. change maternal position the mechanism for movement of CO2 and O2 through the placenta is a. active transport b. simple diffusion c. facilitated diffusion - ANSWER b. simple diffusion the fetal heart rate pattern that is likely to be seen with maternal hypothermia is a. bradycardia b. marked variability c. tachycardia - ANSWER a. bradycardia A woman at 35 weeks comes to L&D for decreased fetal movement. NST has been cat 1 but without any accelerations for 40 minutes. The next step is to: a. deliver by c/s b. dismiss to home c. perform a BPP - ANSWER c. perform a BPP
P0 at 35 weeks admitted for gHTN on labetalol 100mg q12. The baby is breech. Tracing showing reactive NST. This depicts: a. an oxygenated fetus b. hypoxemic effects on the fetus c. the effects of labetalol on the fetus - ANSWER a. an oxygenated fetus The legal term that describes a failure to meet the required standard of care is A. Breach of duty B. Negligence C. Proximate cause - ANSWER a. breach of dury The area of maximum intensity of the FHR is usually the fetal A. Back B. Chest C. Umbilicus - ANSWER a. back tachycardia is associated with increased a. parasympathetic tone b. sympathetic tone c. vagal response - ANSWER b. sympathetic tone the fetal heart rate baseline reflects what physiologic process a. a parasympathetic response alone b. a sympathetic response alone c. both parasympathetic and sympathetic response - ANSWER c. both parasympathetic and sympathetic response A patient on pit has 17 ctx in 30 minutes, according to NICHD guidelines this is called a. hyperstimulation b. hypertonus c. tachysystole - ANSWER c. tachysystole 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 - ANSWER C. Shifting blood to vital organs the NICHD definition of tachysystole refers to contractions from a. both spontaneous and stimulated labor b. cervical ripening and induction agents c. spontaneous labor contractions - ANSWER a. both spontaneous and stimulated labor A wandering FHR baseline may be indicative of A. Fetal seizure activity B. Impending fetal death C. Maternal medication administration - ANSWER b. impending fetal death
Tracing showing baseline 60bpm, minimal variability. The above strip suggests that the fetus has a. complete heart block b. premature atrial contractions c. sinus bradycardia - ANSWER a. complete heart block leopold maneuvers are utilized to assess fetal a. station b. presentation c. tone - ANSWER b. presentation chemoreceptors respond to changes in a. blood pressure b. hormonal levels c. O2 and CO2 levels - ANSWER c. O2 and CO2 levels The magnitude of vagal nerve stimulation correlates with the magnitude of pressure applied against the fetal heart rate resulting in decelerations that a. mirror the image of contraction b. occur prior to peak of contraction c. show profound depth but quick return - ANSWER a. mirror the image of contraction **early's a reliable method for confirming the presence of an irregular fetal heart rhythm is a a. doppler device b. external EFM c. fetoscope - ANSWER c. fetoscope **need to liscen a BPP score of 6 with a normal fluid is considered: a. abnormal b. normal c. equivocal - ANSWER b. normal according to nichd, which deceleration must drop at least 15 beats per minute? a. early b. late c. prolonged - ANSWER c. prolonged umbilical artery carry deoxygenated blood ______ from uterus - ANSWER away umbilical vein carries ___________ blood _______ the fetus - ANSWER oxygenated to
oxygen is released from maternal hemoglobin and attaches to fetal hemoglobin via - ANSWER simple diffusion baroreceptors respond to _________ changes - ANSWER pressure chemoreceptors respond to ________ changes - ANSWER chemical the ____ the base deficit/excess, the greater the acidemia - ANSWER higher the shorter the beat to beat interval the _______ the FHR - ANSWER higher the longer the beat to beat interval the _______ the FHR - ANSWER lower ISE may half count if FHR > ____ - ANSWER 200 changes in cerebral blood flow cause ___ decels - ANSWER early mono-mono twins have increased risk of having ___ decels - ANSWER variable likely to see ___ decels with baroreceptor response - ANSWER variable likely to see __ decels with chemoreceptor response - ANSWER late Mother with connective tissue disease, what can this cause in the fetus./ - ANSWER dysrhuthmia which part of fetal circulation carriest the MOST oxygenated blood? - ANSWER ductus venosus