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NEW MODIFIED AIR METHODS CRITICAL CARE
REVIEW
MATERNAL FETAL AND NEONATAL REVIEW EXAM
QUESTIONS WITH ANSWERS
You are transporting a 24 year old female who is 36 weeks pregnant. She is in
pre-term labor and experiencing minor contractions every 20-30 minutes,
lasting 45 seconds.
You note a change in her fetal heart tracing and a change in HR on the fetal
monitor. The waveform appears to have no variability, decels or accelerations
noted on this patient.
You should expect to see what abnormality on the fetal heart monitor? --
ANSWER--Sinusoidal
Sinusoidal rare FHR pattern where a sine wave occurs. Fetal anemia or
hypovolemia is a common cause. No variability, decels, or accelerations can be
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noted on this patient. This critical waveform can be the inital sign of fetal
demise
Minimal variability on a fetal heart tracing can be caused by all of the following
except:
Effects of drugs
Fetal metabolic acidosis
Prematurity
Fetal hypotension -- ANSWER--Fetal hypotension
Causes of minimal variability in fetal heart tracings: Fetal metabolic acidosis.
Neurologic abnormality. Prematurity. Cardiac arrhythmia. Effects of drugs.
You are determining a gravida/para scale on a 32-year-old female who is 25
weeks pregnancy. She tells you she's been pregnant 6 times. She's had 2 term
babies, 1 miscarriage, 2 pre-term babies, and one died from SIDs.
What is the GTPAL?
What is her Gravida Para? -- ANSWER--Gravida 6
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Para 4
G6 T2 P1 A1 L1
While measuring the fundus of a 20 week pregnant female, you expect the
fundal height to be located where? -- ANSWER--The umbilicus
You are transporting a 45 year old female who is 34 weeks pregnant from IVF
treatments. She is G1P0 and going to the OB inpatient unit for antepartum care
before delivering.
She begins having some lower abdominal pain and discomfort. In addition, you
note that she is experiencing variable develer4ations on the fetal monitor. Your
first steps should be:
Place the patient on 15 lpm O2 via NRB
Administer pain management
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Displace the patient on her left lateral side
Prepare for delivery -- ANSWER--Displace the patient on her left lateral side
Variable decelerations: Cord compression. It can occur after the membranes
have ruptured and there is limited fluid to cushion the cord, nuchal cord, short
cord, or cord entanglement. The initial step is to displace mom on her left or
right lateral side at least 15 degrees. Apply oxygen via nasal cannula unless the
patient shows signs of hypoxia. Administer an LR bolus.
Normal fetal HR variability is between -- ANSWER--6-25 bpm
Normal FHR -- ANSWER--120-160bpm
You are assessing a 35 year old femal who is 26 weeks pregnant. After obtaining
baseline set of VS, which quantitative value is most concerning?
HR 108
RR 22
4
NEW MODIFIED AIR METHODS CRITICAL CARE
REVIEW
MATERNAL FETAL AND NEONATAL REVIEW EXAM
QUESTIONS WITH ANSWERS
You are transporting a 24 year old female who is 36 weeks pregnant. She is in
pre-term labor and experiencing minor contractions every 20-30 minutes,
lasting 45 seconds.
You note a change in her fetal heart tracing and a change in HR on the fetal
monitor. The waveform appears to have no variability, decels or accelerations
noted on this patient.
You should expect to see what abnormality on the fetal heart monitor? --
ANSWER--Sinusoidal
Sinusoidal rare FHR pattern where a sine wave occurs. Fetal anemia or
hypovolemia is a common cause. No variability, decels, or accelerations can be
1
, Page 2 of 31
noted on this patient. This critical waveform can be the inital sign of fetal
demise
Minimal variability on a fetal heart tracing can be caused by all of the following
except:
Effects of drugs
Fetal metabolic acidosis
Prematurity
Fetal hypotension -- ANSWER--Fetal hypotension
Causes of minimal variability in fetal heart tracings: Fetal metabolic acidosis.
Neurologic abnormality. Prematurity. Cardiac arrhythmia. Effects of drugs.
You are determining a gravida/para scale on a 32-year-old female who is 25
weeks pregnancy. She tells you she's been pregnant 6 times. She's had 2 term
babies, 1 miscarriage, 2 pre-term babies, and one died from SIDs.
What is the GTPAL?
What is her Gravida Para? -- ANSWER--Gravida 6
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Para 4
G6 T2 P1 A1 L1
While measuring the fundus of a 20 week pregnant female, you expect the
fundal height to be located where? -- ANSWER--The umbilicus
You are transporting a 45 year old female who is 34 weeks pregnant from IVF
treatments. She is G1P0 and going to the OB inpatient unit for antepartum care
before delivering.
She begins having some lower abdominal pain and discomfort. In addition, you
note that she is experiencing variable develer4ations on the fetal monitor. Your
first steps should be:
Place the patient on 15 lpm O2 via NRB
Administer pain management
3
, Page 4 of 31
Displace the patient on her left lateral side
Prepare for delivery -- ANSWER--Displace the patient on her left lateral side
Variable decelerations: Cord compression. It can occur after the membranes
have ruptured and there is limited fluid to cushion the cord, nuchal cord, short
cord, or cord entanglement. The initial step is to displace mom on her left or
right lateral side at least 15 degrees. Apply oxygen via nasal cannula unless the
patient shows signs of hypoxia. Administer an LR bolus.
Normal fetal HR variability is between -- ANSWER--6-25 bpm
Normal FHR -- ANSWER--120-160bpm
You are assessing a 35 year old femal who is 26 weeks pregnant. After obtaining
baseline set of VS, which quantitative value is most concerning?
HR 108
RR 22
4
