AWHONN INTERMEDIATE FETAL MONITORING
TEST 2026 EXAM SCRIPT TEST PAPER
QUESTIONS AND SOLUTIONS GRADED A+
◉ Monitors changes in the contour of the maternal abdomen caused
by uterine contractions, is placed over the fundus. Can measure
relative changes in pressure, duration and frequency of contractions.
Can NOT measure intensity. Women with large amounts of
abdominal adipose tissue can be difficult to monitor..
Answer: Explain what a Tocodynamometer is, what it measures and
its limitations.
◉ Most accurate method of assessing uterine contractions. Inserted
through dilated cervix, its sensor tip monitors changes in pressure of
the amniotic fluid. Measures resting tone, duration, frequency and
intensity of contractions. Can NOT be used unless membranes are
ruptured..
Answer: Explain what an intrauterine pressure catheter is, what it
measures and its limitations.
◉ Fetal heart rate patterns
5 characteristics
1 Baseline heart rate
2 Rhythm
,3 FHR variability
4 Presence of accelerations
5 Periodic or episodic deceleration's.
Answer: How do you determine fetal oxygenation?
Name the 5 characteristics
◉ Must be 2 min of segments.
Range 110-160 BPM (represented in a multiple of 5)
<32 weeks is usually high normal
>32 weeks gradual decrease due to increased vagal tone.
Change in baseline is >10min..
Answer: What are fetal baseline guidelines?
Range?
<32 weeks gest
>32 weeks gest
change in baseline
◉ It is the heart's internal pacemaker. It is specialized clump of cells
at the top of the right atrium that gives electrical impulses to cause
the heart to beat. The intrinsic rate is 110-160 in term fetus. Early in
gestation (15-20 wks) can be much higher. In 26-28 weeks may be in
the upper range of normal..
Answer: What is the SA Node?
,◉ Generated in the fetal brainstem carried via sympathetic fibers to
the heart. Increases FHR, strength of myocardial contraction of the
heart and fetal cardiac output. Sympathetic stimulation influences
FHR variability. The sympathetic branch of the autonomic nervous
system is present very early in fetal development..
Answer: Explain the sympathetic impulses of the fetal central
nervous system.
◉ Generated in the fetal brainstem carried via the vagus nerve to the
fetal heart. Stimulates vagus nerve which increases fetal blood
pressure, decreases firing rate at SA node and decreases FHR. Also
influences the presence of fetal heart variability. The
parasympathetic nervous system matures later in pregnancy. This
balances out the sympathetic branch, the baseline heart rate
gradually decreases toward the middle of the normal range..
Answer: Explain the parasympathetic impulses of the fetal central
nervous system.
◉ Baseline FHR is 130 BPM which falls within the range of normal
baselines 110-160 BPM.
Answer: Is the baseline in this fetal tracing of a fetus at 40 weeks
gestation normal or abnormal?
◉ Baseline FHR is 135 BPM which falls within the range of normal
baselines 110-160 BPM.
, Answer: Is this baseline in this fetal tracing of a fetus at 26 weeks
gestation normal or abnormal?
◉ The baseline heart rate is 210 BPM which is outside the range of
the normal baseline of 110-160 BPM..
Answer: Is this baseline in this fetal tracing of a fetus at 24 weeks
gestation normal or abnormal?
◉ A baseline FHR of 160 BPM for at least 10 min.
Contributing factors include hyperthermia, infections (maternal or
fetal), maternal dehydration, hyperthyroidism, anxiety, drugs that
stimulate the central nervous system, fetal immaturity, a cardiac
conduction defect, or hypoxemia..
Answer: Define fetal tachycardia and factors that contribute to fetal
tachycardia.
◉ A baseline FHR of <110 BPM for at least 10 min.
Contributing factor include stimulation the fetal vagus nerve
possibly due to prolonged head compression or application of the
forceps or vacuum, fetal cardiac conduction defect such as heart
block, maternal hypotension and drugs that timulate the
parasympathetic branch or block the sympathetic branch of the
autonomic nervous system such as anesthesia and regional
analgesia or hypoxemia. Hypoxic causes include maternal
hypotension, placental abruption, cord prolapse or uterine rupture..
TEST 2026 EXAM SCRIPT TEST PAPER
QUESTIONS AND SOLUTIONS GRADED A+
◉ Monitors changes in the contour of the maternal abdomen caused
by uterine contractions, is placed over the fundus. Can measure
relative changes in pressure, duration and frequency of contractions.
Can NOT measure intensity. Women with large amounts of
abdominal adipose tissue can be difficult to monitor..
Answer: Explain what a Tocodynamometer is, what it measures and
its limitations.
◉ Most accurate method of assessing uterine contractions. Inserted
through dilated cervix, its sensor tip monitors changes in pressure of
the amniotic fluid. Measures resting tone, duration, frequency and
intensity of contractions. Can NOT be used unless membranes are
ruptured..
Answer: Explain what an intrauterine pressure catheter is, what it
measures and its limitations.
◉ Fetal heart rate patterns
5 characteristics
1 Baseline heart rate
2 Rhythm
,3 FHR variability
4 Presence of accelerations
5 Periodic or episodic deceleration's.
Answer: How do you determine fetal oxygenation?
Name the 5 characteristics
◉ Must be 2 min of segments.
Range 110-160 BPM (represented in a multiple of 5)
<32 weeks is usually high normal
>32 weeks gradual decrease due to increased vagal tone.
Change in baseline is >10min..
Answer: What are fetal baseline guidelines?
Range?
<32 weeks gest
>32 weeks gest
change in baseline
◉ It is the heart's internal pacemaker. It is specialized clump of cells
at the top of the right atrium that gives electrical impulses to cause
the heart to beat. The intrinsic rate is 110-160 in term fetus. Early in
gestation (15-20 wks) can be much higher. In 26-28 weeks may be in
the upper range of normal..
Answer: What is the SA Node?
,◉ Generated in the fetal brainstem carried via sympathetic fibers to
the heart. Increases FHR, strength of myocardial contraction of the
heart and fetal cardiac output. Sympathetic stimulation influences
FHR variability. The sympathetic branch of the autonomic nervous
system is present very early in fetal development..
Answer: Explain the sympathetic impulses of the fetal central
nervous system.
◉ Generated in the fetal brainstem carried via the vagus nerve to the
fetal heart. Stimulates vagus nerve which increases fetal blood
pressure, decreases firing rate at SA node and decreases FHR. Also
influences the presence of fetal heart variability. The
parasympathetic nervous system matures later in pregnancy. This
balances out the sympathetic branch, the baseline heart rate
gradually decreases toward the middle of the normal range..
Answer: Explain the parasympathetic impulses of the fetal central
nervous system.
◉ Baseline FHR is 130 BPM which falls within the range of normal
baselines 110-160 BPM.
Answer: Is the baseline in this fetal tracing of a fetus at 40 weeks
gestation normal or abnormal?
◉ Baseline FHR is 135 BPM which falls within the range of normal
baselines 110-160 BPM.
, Answer: Is this baseline in this fetal tracing of a fetus at 26 weeks
gestation normal or abnormal?
◉ The baseline heart rate is 210 BPM which is outside the range of
the normal baseline of 110-160 BPM..
Answer: Is this baseline in this fetal tracing of a fetus at 24 weeks
gestation normal or abnormal?
◉ A baseline FHR of 160 BPM for at least 10 min.
Contributing factors include hyperthermia, infections (maternal or
fetal), maternal dehydration, hyperthyroidism, anxiety, drugs that
stimulate the central nervous system, fetal immaturity, a cardiac
conduction defect, or hypoxemia..
Answer: Define fetal tachycardia and factors that contribute to fetal
tachycardia.
◉ A baseline FHR of <110 BPM for at least 10 min.
Contributing factor include stimulation the fetal vagus nerve
possibly due to prolonged head compression or application of the
forceps or vacuum, fetal cardiac conduction defect such as heart
block, maternal hypotension and drugs that timulate the
parasympathetic branch or block the sympathetic branch of the
autonomic nervous system such as anesthesia and regional
analgesia or hypoxemia. Hypoxic causes include maternal
hypotension, placental abruption, cord prolapse or uterine rupture..
