Maternity Fetal Assessment 2026 Study Guide
Practice Test Questions Detailed Rationales FHR
Monitoring Variability Decelerations Nonstress
Testing Nursing Interventions
SECTION 1: FHR MONITORING BASICS (Questions 1–15)
Question 1
A nurse is explaining electronic fetal monitoring to a laboring client. Which
component of the external monitor assesses fetal heart rate?
A. Tocodynamometer
B. Ultrasound transducer
C. Intrauterine pressure catheter
D. Fetal scalp electrode
Correct Answer: B. Ultrasound transducer
Rationale: The ultrasound transducer uses Doppler technology to detect and
record the fetal heart rate externally. The tocodynamometer measures uterine
contractions.
Question 2
Which component of the external fetal monitor measures the frequency and
duration of uterine contractions?
A. Ultrasound transducer
B. Tocodynamometer
C. Intrauterine pressure catheter
D. Fetal scalp electrode
Correct Answer: B. Tocodynamometer
,Rationale: The tocodynamometer (TOCO) is placed over the uterine fundus and
detects changes in abdominal tension to record contraction frequency and duration.
It does not measure contraction intensity.
Question 3
A client has an intrauterine pressure catheter (IUPC) placed. What is the primary
advantage of this device?
A. It can measure contraction intensity and resting uterine tone quantitatively
B. It eliminates the need for fetal heart rate monitoring
C. It can be placed before rupture of membranes
D. It is noninvasive and painless
Correct Answer: A. It can measure contraction intensity and resting uterine
tone quantitatively
Rationale: An IUPC measures the actual pressure of contractions in millimeters of
mercury (mmHg) and resting tone. It is placed after rupture of membranes and
requires cervical dilation.
Question 4
A nurse is preparing to apply a fetal scalp electrode. Which condition is an
absolute contraindication?
A. Maternal obesity
B. Ruptured membranes
C. Placenta previa
D. Cervical dilation of 3 cm
Correct Answer: C. Placenta previa
Rationale: Fetal scalp electrode placement is contraindicated in placenta previa
because it can cause severe hemorrhage. It also is contraindicated with maternal
infections such as HIV or hepatitis.
,Question 5
Which nursing action is essential before applying a fetal scalp electrode?
A. Verify that membranes are ruptured and cervix is dilated
B. Administer oxygen
C. Perform a contraction stress test
D. Insert an indwelling urinary catheter
Correct Answer: A. Verify that membranes are ruptured and cervix is dilated
Rationale: A fetal scalp electrode can only be applied after rupture of membranes
and adequate cervical dilation. It provides a more accurate fetal heart rate tracing
than external monitoring.
Question 6
A nurse uses Leopold maneuvers before applying the fetal monitor. What is the
primary purpose of these maneuvers?
A. To determine fetal position, presentation, and lie
B. To assess cervical dilation
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
Correct Answer: A. To determine fetal position, presentation, and lie
Rationale: Leopold maneuvers are used to palpate the abdomen and determine
fetal lie, presentation, position, and engagement. This helps the nurse place the
ultrasound transducer over the fetal back for optimal FHR auscultation.
Question 7
For a low-risk laboring client in the first stage of labor, how often should
intermittent auscultation be performed?
, A. Every 15 minutes
B. Every 30 minutes
C. Every 60 minutes
D. Every 2 hours
Correct Answer: B. Every 30 minutes
Rationale: For low-risk clients in the first stage of labor, intermittent auscultation
is performed every 30 minutes. In the second stage, it is performed every 15
minutes.
Question 8
For a high-risk laboring client in the second stage of labor, how often should the
fetal heart rate be assessed?
A. Every 5 minutes
B. Every 15 minutes
C. Every 30 minutes
D. Every 60 minutes
Correct Answer: A. Every 5 minutes
Rationale: High-risk clients require more frequent assessment. In the second stage
of labor, the FHR should be assessed every 5 minutes or after every contraction.
Question 9
Which maternal condition is most likely to cause fetal tachycardia?
A. Maternal fever
B. Maternal hypotension
C. Maternal hypoglycemia
D. Maternal bradycardia
Correct Answer: A. Maternal fever
Practice Test Questions Detailed Rationales FHR
Monitoring Variability Decelerations Nonstress
Testing Nursing Interventions
SECTION 1: FHR MONITORING BASICS (Questions 1–15)
Question 1
A nurse is explaining electronic fetal monitoring to a laboring client. Which
component of the external monitor assesses fetal heart rate?
A. Tocodynamometer
B. Ultrasound transducer
C. Intrauterine pressure catheter
D. Fetal scalp electrode
Correct Answer: B. Ultrasound transducer
Rationale: The ultrasound transducer uses Doppler technology to detect and
record the fetal heart rate externally. The tocodynamometer measures uterine
contractions.
Question 2
Which component of the external fetal monitor measures the frequency and
duration of uterine contractions?
A. Ultrasound transducer
B. Tocodynamometer
C. Intrauterine pressure catheter
D. Fetal scalp electrode
Correct Answer: B. Tocodynamometer
,Rationale: The tocodynamometer (TOCO) is placed over the uterine fundus and
detects changes in abdominal tension to record contraction frequency and duration.
It does not measure contraction intensity.
Question 3
A client has an intrauterine pressure catheter (IUPC) placed. What is the primary
advantage of this device?
A. It can measure contraction intensity and resting uterine tone quantitatively
B. It eliminates the need for fetal heart rate monitoring
C. It can be placed before rupture of membranes
D. It is noninvasive and painless
Correct Answer: A. It can measure contraction intensity and resting uterine
tone quantitatively
Rationale: An IUPC measures the actual pressure of contractions in millimeters of
mercury (mmHg) and resting tone. It is placed after rupture of membranes and
requires cervical dilation.
Question 4
A nurse is preparing to apply a fetal scalp electrode. Which condition is an
absolute contraindication?
A. Maternal obesity
B. Ruptured membranes
C. Placenta previa
D. Cervical dilation of 3 cm
Correct Answer: C. Placenta previa
Rationale: Fetal scalp electrode placement is contraindicated in placenta previa
because it can cause severe hemorrhage. It also is contraindicated with maternal
infections such as HIV or hepatitis.
,Question 5
Which nursing action is essential before applying a fetal scalp electrode?
A. Verify that membranes are ruptured and cervix is dilated
B. Administer oxygen
C. Perform a contraction stress test
D. Insert an indwelling urinary catheter
Correct Answer: A. Verify that membranes are ruptured and cervix is dilated
Rationale: A fetal scalp electrode can only be applied after rupture of membranes
and adequate cervical dilation. It provides a more accurate fetal heart rate tracing
than external monitoring.
Question 6
A nurse uses Leopold maneuvers before applying the fetal monitor. What is the
primary purpose of these maneuvers?
A. To determine fetal position, presentation, and lie
B. To assess cervical dilation
C. To evaluate amniotic fluid volume
D. To measure uterine contraction intensity
Correct Answer: A. To determine fetal position, presentation, and lie
Rationale: Leopold maneuvers are used to palpate the abdomen and determine
fetal lie, presentation, position, and engagement. This helps the nurse place the
ultrasound transducer over the fetal back for optimal FHR auscultation.
Question 7
For a low-risk laboring client in the first stage of labor, how often should
intermittent auscultation be performed?
, A. Every 15 minutes
B. Every 30 minutes
C. Every 60 minutes
D. Every 2 hours
Correct Answer: B. Every 30 minutes
Rationale: For low-risk clients in the first stage of labor, intermittent auscultation
is performed every 30 minutes. In the second stage, it is performed every 15
minutes.
Question 8
For a high-risk laboring client in the second stage of labor, how often should the
fetal heart rate be assessed?
A. Every 5 minutes
B. Every 15 minutes
C. Every 30 minutes
D. Every 60 minutes
Correct Answer: A. Every 5 minutes
Rationale: High-risk clients require more frequent assessment. In the second stage
of labor, the FHR should be assessed every 5 minutes or after every contraction.
Question 9
Which maternal condition is most likely to cause fetal tachycardia?
A. Maternal fever
B. Maternal hypotension
C. Maternal hypoglycemia
D. Maternal bradycardia
Correct Answer: A. Maternal fever
