CEFM COMPREHENSIVE EXAM QUESTIONS
AND SOLUTIONS STUDY GUIDE
●● what is the baseline for a category I strip?
Answer: 110 to 160 BPM
●● what is the variability for a category I strip?
Answer: moderate (6 to 25 bpm)
●● what decelerations can be present in a category I strip?
Answer: early decelerations
late and variable decelerations must be absent
●● does a category I tracing have to have accelerations?
Answer: no; accelerations are not required for a category I tracing
●● category I tracing example
Answer:
●● what does a category II tracing mean?
Answer: the acid-base balance is indeterminate
includes anything that is not category I or III
,●● what is the baseline rate of a category II tracing?
Answer: - bradycardia WITHOUT absent variability
- tachycardia
●● what is the variability of a category II tracing?
Answer: - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
●● minimal variability example
Answer: less than 5 BPM
●● marked variability example
Answer: greater than 25 BPM
●● are accelerations present in category II tracings after fetal
stimulations?
Answer: accelerations are not present after fetal stimulation to classify
tracing as category II
●● what are the possible periodic or episodic decelerations present in
category II tracings?
,Answer: - recurrent variable decelerations accompanied by minimal or
moderate baseline variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or
shoulders)
●● variable deceleration example
Answer: an abrupt decrease in FHR below baseline; greater than 15
BPM lasting greater than 15 seconds, but less than 2 minutes from onset
to return to baseline
●● prolonged deceleration example
Answer: a decrease in FHR below the baseline of 15 bpm or more,
lasting at least 2 minutes but < 10 minutes from onset to return to
baseline
●● late deceleration example
Answer: a gradual decrease and return to baseline of the fetal heart rate
associated with uterine contractions
●● what does a category III tracing predict?
Answer: predicts abnormal acid-base status
, ●● a category III tracing includes either of the following...
Answer: - absent baseline FHR variability and ANY of the following:
- recurrent late decelerations
- recurrent variable decelerations
- bradycardia
- sinusoidal pattern
●● what does absent variability with recurrent late decelerations or
variable deceleration indicate?
Answer: predictive of current or impending fetal asphyxia so severe that
fetus is at risk for neurologic damage and death
●● what is a sinusoidal pattern?
Answer: smooth, wave-like baseline appears 3 to 6 time per minute
can be documented if pattern lasts for > 20 minutes
●● what do indeterminate and abnormal (category II or III) tracings
require?
Answer: tracings require evaluation of possible etiology
●● what are some initial assessments and interventions for category II or
III tracings?
Answer: - discontinuation of labor stimulating agents
AND SOLUTIONS STUDY GUIDE
●● what is the baseline for a category I strip?
Answer: 110 to 160 BPM
●● what is the variability for a category I strip?
Answer: moderate (6 to 25 bpm)
●● what decelerations can be present in a category I strip?
Answer: early decelerations
late and variable decelerations must be absent
●● does a category I tracing have to have accelerations?
Answer: no; accelerations are not required for a category I tracing
●● category I tracing example
Answer:
●● what does a category II tracing mean?
Answer: the acid-base balance is indeterminate
includes anything that is not category I or III
,●● what is the baseline rate of a category II tracing?
Answer: - bradycardia WITHOUT absent variability
- tachycardia
●● what is the variability of a category II tracing?
Answer: - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
●● minimal variability example
Answer: less than 5 BPM
●● marked variability example
Answer: greater than 25 BPM
●● are accelerations present in category II tracings after fetal
stimulations?
Answer: accelerations are not present after fetal stimulation to classify
tracing as category II
●● what are the possible periodic or episodic decelerations present in
category II tracings?
,Answer: - recurrent variable decelerations accompanied by minimal or
moderate baseline variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or
shoulders)
●● variable deceleration example
Answer: an abrupt decrease in FHR below baseline; greater than 15
BPM lasting greater than 15 seconds, but less than 2 minutes from onset
to return to baseline
●● prolonged deceleration example
Answer: a decrease in FHR below the baseline of 15 bpm or more,
lasting at least 2 minutes but < 10 minutes from onset to return to
baseline
●● late deceleration example
Answer: a gradual decrease and return to baseline of the fetal heart rate
associated with uterine contractions
●● what does a category III tracing predict?
Answer: predicts abnormal acid-base status
, ●● a category III tracing includes either of the following...
Answer: - absent baseline FHR variability and ANY of the following:
- recurrent late decelerations
- recurrent variable decelerations
- bradycardia
- sinusoidal pattern
●● what does absent variability with recurrent late decelerations or
variable deceleration indicate?
Answer: predictive of current or impending fetal asphyxia so severe that
fetus is at risk for neurologic damage and death
●● what is a sinusoidal pattern?
Answer: smooth, wave-like baseline appears 3 to 6 time per minute
can be documented if pattern lasts for > 20 minutes
●● what do indeterminate and abnormal (category II or III) tracings
require?
Answer: tracings require evaluation of possible etiology
●● what are some initial assessments and interventions for category II or
III tracings?
Answer: - discontinuation of labor stimulating agents
