AWHONN Intermediate Fetal Monitoring
Practice Exam Questions with Well-
Elaborated Answers Latest Versions 2026
Question 1
A laboring patient at 39 weeks has an external fetal monitor showing a
baseline fetal heart rate of 140 bpm. The baseline has remained between
135 and 145 bpm for the past 10 minutes. Which interpretation is most
appropriate?
A. Fetal tachycardia
B. Fetal bradycardia
C. Normal baseline
D. Sinusoidal pattern
Answer: C. Normal baseline
Rationale:
A normal fetal heart rate baseline is generally 110–160 bpm when
determined over a 10-minute window, excluding periodic or episodic
changes. A baseline of 140 bpm is therefore normal. Tachycardia is
>160 bpm, while bradycardia is <110 bpm.
Question 2
Which characteristic is required when determining the fetal heart rate
baseline?
A. It must be determined over 2 minutes.
B. It must be determined over a 10-minute period.
C. Accelerations are included in the baseline calculation.
D. Variable decelerations are included in the baseline calculation.
,Answer: B. It must be determined over a 10-minute period.
Rationale:
The baseline is the approximate mean fetal heart rate rounded to
increments of 5 bpm during a 10-minute window. At least 2 minutes of
identifiable baseline segments are needed within that period.
Accelerations and decelerations are excluded from the baseline
determination.
Question 3
A fetal heart rate tracing has a baseline of 145 bpm with fluctuations of
6–25 bpm around the baseline. How should variability be classified?
A. Absent
B. Minimal
C. Moderate
D. Marked
Answer: C. Moderate
Rationale:
Moderate variability is defined as fluctuations in the fetal heart rate
amplitude of approximately 6–25 bpm. Moderate variability is an
important indicator of intact fetal neurologic function and is generally
reassuring when considered with the entire tracing.
Question 4
Which fetal heart rate characteristic represents minimal variability?
A. Undetectable variability
B. Variability of 1–5 bpm
,C. Variability of 6–25 bpm
D. Variability greater than 25 bpm
Answer: B. Variability of 1–5 bpm
Rationale:
Minimal variability is defined as fluctuations of 1–5 bpm. Absent
variability means there is no detectable fluctuation. Moderate variability
is 6–25 bpm, and marked variability exceeds 25 bpm.
Question 5
A patient receiving an epidural develops maternal hypotension. Shortly
afterward, the fetal monitor shows recurrent late decelerations. What is
the nurse's priority?
A. Encourage pushing
B. Place the patient in a lateral position
C. Increase the oxytocin infusion
D. Perform a vaginal examination immediately
Answer: B. Place the patient in a lateral position
Rationale:
Maternal hypotension can reduce uteroplacental perfusion and contribute
to fetal hypoxia. Repositioning the patient, commonly to a lateral
position, can improve venous return and uteroplacental blood flow.
Other interventions may include correcting hypotension, evaluating
uterine activity, and addressing excessive uterine stimulation.
Question 6
, A fetal heart rate decreases gradually from 150 to 125 bpm and returns
to baseline. The nadir occurs approximately at the same time as the peak
of the contraction. Which type of deceleration is this?
A. Early
B. Late
C. Variable
D. Prolonged
Answer: A. Early
Rationale:
Early decelerations are gradual decreases in fetal heart rate that
typically mirror uterine contractions. They usually begin with the
contraction, reach their nadir near the contraction's peak, and recover by
the end of the contraction. They are commonly associated with fetal
head compression during labor.
Question 7
A tracing shows abrupt decreases in fetal heart rate of 30 bpm lasting 45
seconds. The timing varies in relation to contractions. Which type of
deceleration is most likely?
A. Early
B. Late
C. Variable
D. Sinusoidal
Answer: C. Variable
Rationale:
Variable decelerations are characterized by abrupt onset and recovery
and may vary in timing, duration, and appearance in relation to
Practice Exam Questions with Well-
Elaborated Answers Latest Versions 2026
Question 1
A laboring patient at 39 weeks has an external fetal monitor showing a
baseline fetal heart rate of 140 bpm. The baseline has remained between
135 and 145 bpm for the past 10 minutes. Which interpretation is most
appropriate?
A. Fetal tachycardia
B. Fetal bradycardia
C. Normal baseline
D. Sinusoidal pattern
Answer: C. Normal baseline
Rationale:
A normal fetal heart rate baseline is generally 110–160 bpm when
determined over a 10-minute window, excluding periodic or episodic
changes. A baseline of 140 bpm is therefore normal. Tachycardia is
>160 bpm, while bradycardia is <110 bpm.
Question 2
Which characteristic is required when determining the fetal heart rate
baseline?
A. It must be determined over 2 minutes.
B. It must be determined over a 10-minute period.
C. Accelerations are included in the baseline calculation.
D. Variable decelerations are included in the baseline calculation.
,Answer: B. It must be determined over a 10-minute period.
Rationale:
The baseline is the approximate mean fetal heart rate rounded to
increments of 5 bpm during a 10-minute window. At least 2 minutes of
identifiable baseline segments are needed within that period.
Accelerations and decelerations are excluded from the baseline
determination.
Question 3
A fetal heart rate tracing has a baseline of 145 bpm with fluctuations of
6–25 bpm around the baseline. How should variability be classified?
A. Absent
B. Minimal
C. Moderate
D. Marked
Answer: C. Moderate
Rationale:
Moderate variability is defined as fluctuations in the fetal heart rate
amplitude of approximately 6–25 bpm. Moderate variability is an
important indicator of intact fetal neurologic function and is generally
reassuring when considered with the entire tracing.
Question 4
Which fetal heart rate characteristic represents minimal variability?
A. Undetectable variability
B. Variability of 1–5 bpm
,C. Variability of 6–25 bpm
D. Variability greater than 25 bpm
Answer: B. Variability of 1–5 bpm
Rationale:
Minimal variability is defined as fluctuations of 1–5 bpm. Absent
variability means there is no detectable fluctuation. Moderate variability
is 6–25 bpm, and marked variability exceeds 25 bpm.
Question 5
A patient receiving an epidural develops maternal hypotension. Shortly
afterward, the fetal monitor shows recurrent late decelerations. What is
the nurse's priority?
A. Encourage pushing
B. Place the patient in a lateral position
C. Increase the oxytocin infusion
D. Perform a vaginal examination immediately
Answer: B. Place the patient in a lateral position
Rationale:
Maternal hypotension can reduce uteroplacental perfusion and contribute
to fetal hypoxia. Repositioning the patient, commonly to a lateral
position, can improve venous return and uteroplacental blood flow.
Other interventions may include correcting hypotension, evaluating
uterine activity, and addressing excessive uterine stimulation.
Question 6
, A fetal heart rate decreases gradually from 150 to 125 bpm and returns
to baseline. The nadir occurs approximately at the same time as the peak
of the contraction. Which type of deceleration is this?
A. Early
B. Late
C. Variable
D. Prolonged
Answer: A. Early
Rationale:
Early decelerations are gradual decreases in fetal heart rate that
typically mirror uterine contractions. They usually begin with the
contraction, reach their nadir near the contraction's peak, and recover by
the end of the contraction. They are commonly associated with fetal
head compression during labor.
Question 7
A tracing shows abrupt decreases in fetal heart rate of 30 bpm lasting 45
seconds. The timing varies in relation to contractions. Which type of
deceleration is most likely?
A. Early
B. Late
C. Variable
D. Sinusoidal
Answer: C. Variable
Rationale:
Variable decelerations are characterized by abrupt onset and recovery
and may vary in timing, duration, and appearance in relation to
