AWHONN ADVANCED FETAL
MONITORING
PRACTICE EXAM QUESTIONS
WITH CORRECT DETAILED
ANSWERS | ALREADY GRADED
A+<RECENT VERSION>
1) Which of the following is an extrinsic influence on the FHR? -
ANSWER C. Fetal-placental circulation
2) What might a tracing for Supraventricular Tachycardia look like? -
ANSWER a loss of variability and half counting of the FHR
3) Prognosis for Supraventricular Tachycardia? - ANSWER - The
undelivered or untreated fetus may develop cardiac failure and ischemic
cerebral disease
- Treatment via pharmacologic cardioversion usually is successful or
correcting fetal hydrops that is caused by cardiac failure, resultant
of SVT
4) What is SVT due to Atrial Flutter? - ANSWER - FHR is between 300-
460 bpm, a rate too rapid for AV conduction
- A 2:1 AV Block then follows, with a slower ventricular rate present
- The tracing may show half counting of the FHR
,5) Prognosis of SVT due to Atrial Flutter? - ANSWER -
Echocardiography or ECG diagnosis in utero may alter prognosis & plan
of care
6) What are checkmark patterns? - ANSWER Fetal seizures
7) What will a fetal seizure look like on a FHT? - ANSWER - BL:
usually between 100-170 bpm, usually stable, but may be unstable and/or
preceded or followed by a flat BL
- Variability: absent, may look wavy and not "normal" in appearance
- Checkmark pattern
- Accels: absent
- Decels: episodic, repetitive variable decels that are similar in shape
8) What are checkmark variables shaped like? - ANSWER mostly V
shaped. Never U or W shaped.
9) What's the difference between terminal and end-stage bradycardia? -
ANSWER end-stage: common right before the baby is born
Terminal: right before death
10) What are uniform accels indicative of? - ANSWER - mild cord
compression --> move mom
- breech and there's compression of the fetal trunk --> leopold's
11) What extrinsic factor can you identify as a possible cause for the
observed pattern? - ANSWER C. Aging placenta
12) What physiologic goals are priorities for Olivia's care? -
ANSWER B. Maximize oxygenation and maintain appropriate uterine
activity
,13) What bedside interventions are appropriate for Olivia at this time?
- ANSWER C. Position change to a lateral position and initiate a 500-
ml IVFB.
14) What could Olivia's nurse do during second stage of labor to
promote oxygenation? - ANSWER B. Encourage Olivia to push with
every other contraction
15) Did the fetal monitor tracing prior to delivery accurately predict the
cor - ANSWER A> Yes, the presence of moderate variability rules out
the metabolic acidemia.
16) What is the baseline FHR? - ANSWER B. 160 bpm
17) What type of variability is observed? - ANSWER A. Moderate
18) What interventions are appropriate at this time? - ANSWER C.
Reposition Shelby from left lateral to right lateral
19) What type of pattern is observed in the tracing? - ANSWER B.
Variable decelerations
20) What category is this tracing? - ANSWER B. Category II
21) What is the baseline rate? - ANSWER C. Unable to determine
22) Based on your observation of the tracing, what action(s) is (are)
required? - ANSWER B. Palpate Shelby's radial pulse to verify
maternal vs. Fetal heart rate
, 23) Which statement most accurately reflects the EFM tracing? -
ANSWER A. Maternal and fetal heart rates should be verified
24) Which pattern in the fetal heart rate would increase suspicion of a
nuchal cord? - ANSWER C. Variable deceleration
25) What is the correct interpretation of the cod blood gas? -
ANSWER A. Respiratory acidemia
26) The most highly oxygenated blood in fetal circulation is carried by:
- ANSWER C. Ductus venosus
27) If fetal arterial pressure begins to fall below normal levels: -
ANSWER A. Baroreceptors cause vasoconstriction and increase the
FHR
28) Fetal heart rate variability is defined as fluctuations in the baseline
that are irregular in _____ and _____. - ANSWER B. Amplitude and
frequency
29) An increase in the fetal heart rate immediately preceding a variable
deceleration is caused by: - ANSWER A. Occlusion of the umbilical
vein
30) When assessing a FHR tracing, the first step is to: - ANSWER
C. Establish the baseline rate
MONITORING
PRACTICE EXAM QUESTIONS
WITH CORRECT DETAILED
ANSWERS | ALREADY GRADED
A+<RECENT VERSION>
1) Which of the following is an extrinsic influence on the FHR? -
ANSWER C. Fetal-placental circulation
2) What might a tracing for Supraventricular Tachycardia look like? -
ANSWER a loss of variability and half counting of the FHR
3) Prognosis for Supraventricular Tachycardia? - ANSWER - The
undelivered or untreated fetus may develop cardiac failure and ischemic
cerebral disease
- Treatment via pharmacologic cardioversion usually is successful or
correcting fetal hydrops that is caused by cardiac failure, resultant
of SVT
4) What is SVT due to Atrial Flutter? - ANSWER - FHR is between 300-
460 bpm, a rate too rapid for AV conduction
- A 2:1 AV Block then follows, with a slower ventricular rate present
- The tracing may show half counting of the FHR
,5) Prognosis of SVT due to Atrial Flutter? - ANSWER -
Echocardiography or ECG diagnosis in utero may alter prognosis & plan
of care
6) What are checkmark patterns? - ANSWER Fetal seizures
7) What will a fetal seizure look like on a FHT? - ANSWER - BL:
usually between 100-170 bpm, usually stable, but may be unstable and/or
preceded or followed by a flat BL
- Variability: absent, may look wavy and not "normal" in appearance
- Checkmark pattern
- Accels: absent
- Decels: episodic, repetitive variable decels that are similar in shape
8) What are checkmark variables shaped like? - ANSWER mostly V
shaped. Never U or W shaped.
9) What's the difference between terminal and end-stage bradycardia? -
ANSWER end-stage: common right before the baby is born
Terminal: right before death
10) What are uniform accels indicative of? - ANSWER - mild cord
compression --> move mom
- breech and there's compression of the fetal trunk --> leopold's
11) What extrinsic factor can you identify as a possible cause for the
observed pattern? - ANSWER C. Aging placenta
12) What physiologic goals are priorities for Olivia's care? -
ANSWER B. Maximize oxygenation and maintain appropriate uterine
activity
,13) What bedside interventions are appropriate for Olivia at this time?
- ANSWER C. Position change to a lateral position and initiate a 500-
ml IVFB.
14) What could Olivia's nurse do during second stage of labor to
promote oxygenation? - ANSWER B. Encourage Olivia to push with
every other contraction
15) Did the fetal monitor tracing prior to delivery accurately predict the
cor - ANSWER A> Yes, the presence of moderate variability rules out
the metabolic acidemia.
16) What is the baseline FHR? - ANSWER B. 160 bpm
17) What type of variability is observed? - ANSWER A. Moderate
18) What interventions are appropriate at this time? - ANSWER C.
Reposition Shelby from left lateral to right lateral
19) What type of pattern is observed in the tracing? - ANSWER B.
Variable decelerations
20) What category is this tracing? - ANSWER B. Category II
21) What is the baseline rate? - ANSWER C. Unable to determine
22) Based on your observation of the tracing, what action(s) is (are)
required? - ANSWER B. Palpate Shelby's radial pulse to verify
maternal vs. Fetal heart rate
, 23) Which statement most accurately reflects the EFM tracing? -
ANSWER A. Maternal and fetal heart rates should be verified
24) Which pattern in the fetal heart rate would increase suspicion of a
nuchal cord? - ANSWER C. Variable deceleration
25) What is the correct interpretation of the cod blood gas? -
ANSWER A. Respiratory acidemia
26) The most highly oxygenated blood in fetal circulation is carried by:
- ANSWER C. Ductus venosus
27) If fetal arterial pressure begins to fall below normal levels: -
ANSWER A. Baroreceptors cause vasoconstriction and increase the
FHR
28) Fetal heart rate variability is defined as fluctuations in the baseline
that are irregular in _____ and _____. - ANSWER B. Amplitude and
frequency
29) An increase in the fetal heart rate immediately preceding a variable
deceleration is caused by: - ANSWER A. Occlusion of the umbilical
vein
30) When assessing a FHR tracing, the first step is to: - ANSWER
C. Establish the baseline rate
