NUR 318 Exam 2 – UPDATED Questions with 100% Verified Answers
NUR 318 Exam 2 – UPDATED Questions with 100%
Verified Answers
Section 1: Fetal, Amniotic, Heart (Q1–Q12)
Question & Answer
Q1 Amniotic sac
A a fluid-filled sac that cushions and protects a developing embryo and fetus in the uterus.
SROM-spontaneous rupture of the membranes AROM-artificial rupture of the membranes (using a
hook; amniohook) SROM-sudden rush of fluid
Q2 What does green amniotic fluid mean
A that the fetus passed the first stool (meconium) into the fluid before birth.
Q3 What does cloudy or foul smelling amniotic fluid indicate
A possible infection
Q4 After the membranes have ruptures what do you assess
A Assess fetal heart rate for decelerations such as cord compression or cord prolapse Assess for
infection by looking at maternal fever, maternal tachycardia, foul odour of vague al discharge, and
increase in WBCs
Q5 How do we confirm that membranes have ruptured
A sample of fluid from the vagina via a nitrazine swab to determine fluid's PH Vaginal fluid-acidic
(yellow to olive green) Amniotic fluid-alkaline (nitrazine swab turns deep blue)
If it has ruptured you will get the amniotic fluid results
Q6 Leopold's Maneuvers
A method for determining the presentation, position, and lie of the fetus through the use of four
specific steps Inspection, and palpation of the maternal abdomen as a screening assessment for
malpresentation
Q7 Questions that leopold's maneuvers answers
A 1. What fetal part is located in the fundus 2. On which maternal side is the fetus back located 3.
What is the presenting part 4. Is the fetal head flexed and engaged in the pelvis
Q8 Fetal adaptations during labor
A Changes in fetal heart rate FHR Decrease in circulation and perfusion Increase in arterial CO2
pressure Decrease in fetal oxygen pressure, decrease in partial pressure of oxygen Decrease in
fetal breathing movements
Q9 Where is the fetal heart rate heard most clearly
A Heard most clearly in the back of the fetus Cephalic presentation best heard in the lower quadrant
of the maternal abdomen Breech presentation-heard in or above umbilicus
Page 1 of 26
,NUR 318 Exam 2 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q10 Why can Fetal oxygen supply decrease during labor
A Because of reduction if blood flow through maternal vessels as a result of: -maternal hypertension:
chronic or pregnancy induced -hypotension caused by supine maternal position, hemorrhage,
epidural analgesia, or anesthesia -hypovolemia caused by hemorrhage
Q11 Fetal heart rate monitoring
A Handheld- Doppler and Pinard stethoscope Electronic-electronic monitor Intermittent-handheld
Continuous-electronic External- FHR: ultrasound transducer Uterine contractions: tocotransducer
Internal (invasive)- spiral electrode
Q12 Guidelines for assessing fetal heart rate
A -Initial 10 to 20 minute continuous FHR assessment on entry into labor/birth area
-Completion of a prenatal and labor risk assessment on all clients
-Intermittent auscultation every 30 minutes during active labor for low-risk women and every 15
minutes for high-risk women
-During second stage of labor intermittent auscultation every 15 minutes for low-risk women and
every 5 minutes for high-risk women
Section 2: Variability, Continuous, Monitoring (Q13–Q24)
Question & Answer
Q13 Continuous Electronic Fetal Monitoring (EFM)
A Uses a machine to produce a continuous tracing of the FHR Produce a graphic record of the FHR
pattern Primary objective - To provide information about fetal oxygenation and prevent fetal injury
from impaired oxygenation - To detect fetal heart rate changes early before they are prolonged and
profound
Q14 Criteria for Using Continuous Internal Monitoring of the FHR
A -Ruptured membranes -Cervical dilation of at least 2 cm -Presenting fetal part low enough to allow
placement of the scalp electrode -Skilled practitioner available to insert spiral electrode
Q15 Baseline FHR
A 110-160 bpm for a healthy term infant. Baseline is the average during 10 minutes
Q16 Bradycardia in the fetus
A Under 110 bpm
Causes: • Congenital heart block • Maternal hypotension • Maternal hypothermia • Severe hypoxia
• Prolonged hypoglycemia • Post dates pregnancy • Second stage labor • Anesthetics •
Beta-adrenergics • Fetal cardiac dysrhythmias • Maternal heart rate
Q17 Tachycardia in the fetus
A > 160 bpm
Causes: • Prematurity • Maternal fever • Chorioamnionitis • Fetal anemia • Cardiac arrhythmias •
Maternal hyperthyroidism • Fetal hypoxia • Drugs
Q18 Different types of variability in the FHR
A Absent Minimal Moderate (normal) Marked fluctuation range
Page 2 of 26
, NUR 318 Exam 2 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q19 Variability
A Normal irregularity of cardiac rhythm resulting from continuous balancing of the sympathetic and
parasympathetic branches of the autonomic nervous system
Q20 Absent variability
A fluctuation undetectable
Q21 minimal variability
A fluctuation range observed at <5 bpm
Q22 moderate variability
A Fluctuations 6-25 bpm
Q23 marked variability
A fluctuation range >25 bpm
Q24 What is the most important characteristic of FHR
A Variability
Section 3: Decelerations, Category, Variability (Q25–Q36)
Question & Answer
Q25 Why is variability important?
A - Reflects an intact neurological system - Optimal fetal oxygenation - Measure of fetal oxygenation
reserve - Single MOST important characteristic of FHR
Q26 Causes of decreased variability
A Hypoxia/acidosis Drugs (narcotics, magnesium sulfate) Fetal sleep ( fetal sleep cycle lasts
approximately. 20-40 min ) Congenital abnormalities Extreme prematurity Fetal tachycardia and
other dysrhythmias
Q27 Nadir
A FHRs lowest point, at the peak of the contraction
Q28 Accelerations
A Response to the environment by a transient sympathetic stimulation • Transitory abrupt Increase in
the FHR above the baseline • Increase baseline: • More than 15 bpm above the baseline, and •
Duration is > 15 seconds but less than 2 minutes
Q29 Signs of fetal well being
A Fetal movement Contractions Vaginal exam
Q30 Decelerations
A -Early decelerations in response to fetal head compression -Late decelerations due to
uteroplacental insufficiency -Variable decelerations due to umbilical cord compression
Page 3 of 26
NUR 318 Exam 2 – UPDATED Questions with 100%
Verified Answers
Section 1: Fetal, Amniotic, Heart (Q1–Q12)
Question & Answer
Q1 Amniotic sac
A a fluid-filled sac that cushions and protects a developing embryo and fetus in the uterus.
SROM-spontaneous rupture of the membranes AROM-artificial rupture of the membranes (using a
hook; amniohook) SROM-sudden rush of fluid
Q2 What does green amniotic fluid mean
A that the fetus passed the first stool (meconium) into the fluid before birth.
Q3 What does cloudy or foul smelling amniotic fluid indicate
A possible infection
Q4 After the membranes have ruptures what do you assess
A Assess fetal heart rate for decelerations such as cord compression or cord prolapse Assess for
infection by looking at maternal fever, maternal tachycardia, foul odour of vague al discharge, and
increase in WBCs
Q5 How do we confirm that membranes have ruptured
A sample of fluid from the vagina via a nitrazine swab to determine fluid's PH Vaginal fluid-acidic
(yellow to olive green) Amniotic fluid-alkaline (nitrazine swab turns deep blue)
If it has ruptured you will get the amniotic fluid results
Q6 Leopold's Maneuvers
A method for determining the presentation, position, and lie of the fetus through the use of four
specific steps Inspection, and palpation of the maternal abdomen as a screening assessment for
malpresentation
Q7 Questions that leopold's maneuvers answers
A 1. What fetal part is located in the fundus 2. On which maternal side is the fetus back located 3.
What is the presenting part 4. Is the fetal head flexed and engaged in the pelvis
Q8 Fetal adaptations during labor
A Changes in fetal heart rate FHR Decrease in circulation and perfusion Increase in arterial CO2
pressure Decrease in fetal oxygen pressure, decrease in partial pressure of oxygen Decrease in
fetal breathing movements
Q9 Where is the fetal heart rate heard most clearly
A Heard most clearly in the back of the fetus Cephalic presentation best heard in the lower quadrant
of the maternal abdomen Breech presentation-heard in or above umbilicus
Page 1 of 26
,NUR 318 Exam 2 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q10 Why can Fetal oxygen supply decrease during labor
A Because of reduction if blood flow through maternal vessels as a result of: -maternal hypertension:
chronic or pregnancy induced -hypotension caused by supine maternal position, hemorrhage,
epidural analgesia, or anesthesia -hypovolemia caused by hemorrhage
Q11 Fetal heart rate monitoring
A Handheld- Doppler and Pinard stethoscope Electronic-electronic monitor Intermittent-handheld
Continuous-electronic External- FHR: ultrasound transducer Uterine contractions: tocotransducer
Internal (invasive)- spiral electrode
Q12 Guidelines for assessing fetal heart rate
A -Initial 10 to 20 minute continuous FHR assessment on entry into labor/birth area
-Completion of a prenatal and labor risk assessment on all clients
-Intermittent auscultation every 30 minutes during active labor for low-risk women and every 15
minutes for high-risk women
-During second stage of labor intermittent auscultation every 15 minutes for low-risk women and
every 5 minutes for high-risk women
Section 2: Variability, Continuous, Monitoring (Q13–Q24)
Question & Answer
Q13 Continuous Electronic Fetal Monitoring (EFM)
A Uses a machine to produce a continuous tracing of the FHR Produce a graphic record of the FHR
pattern Primary objective - To provide information about fetal oxygenation and prevent fetal injury
from impaired oxygenation - To detect fetal heart rate changes early before they are prolonged and
profound
Q14 Criteria for Using Continuous Internal Monitoring of the FHR
A -Ruptured membranes -Cervical dilation of at least 2 cm -Presenting fetal part low enough to allow
placement of the scalp electrode -Skilled practitioner available to insert spiral electrode
Q15 Baseline FHR
A 110-160 bpm for a healthy term infant. Baseline is the average during 10 minutes
Q16 Bradycardia in the fetus
A Under 110 bpm
Causes: • Congenital heart block • Maternal hypotension • Maternal hypothermia • Severe hypoxia
• Prolonged hypoglycemia • Post dates pregnancy • Second stage labor • Anesthetics •
Beta-adrenergics • Fetal cardiac dysrhythmias • Maternal heart rate
Q17 Tachycardia in the fetus
A > 160 bpm
Causes: • Prematurity • Maternal fever • Chorioamnionitis • Fetal anemia • Cardiac arrhythmias •
Maternal hyperthyroidism • Fetal hypoxia • Drugs
Q18 Different types of variability in the FHR
A Absent Minimal Moderate (normal) Marked fluctuation range
Page 2 of 26
, NUR 318 Exam 2 – UPDATED Questions with 100% Verified Answers
Question & Answer
Q19 Variability
A Normal irregularity of cardiac rhythm resulting from continuous balancing of the sympathetic and
parasympathetic branches of the autonomic nervous system
Q20 Absent variability
A fluctuation undetectable
Q21 minimal variability
A fluctuation range observed at <5 bpm
Q22 moderate variability
A Fluctuations 6-25 bpm
Q23 marked variability
A fluctuation range >25 bpm
Q24 What is the most important characteristic of FHR
A Variability
Section 3: Decelerations, Category, Variability (Q25–Q36)
Question & Answer
Q25 Why is variability important?
A - Reflects an intact neurological system - Optimal fetal oxygenation - Measure of fetal oxygenation
reserve - Single MOST important characteristic of FHR
Q26 Causes of decreased variability
A Hypoxia/acidosis Drugs (narcotics, magnesium sulfate) Fetal sleep ( fetal sleep cycle lasts
approximately. 20-40 min ) Congenital abnormalities Extreme prematurity Fetal tachycardia and
other dysrhythmias
Q27 Nadir
A FHRs lowest point, at the peak of the contraction
Q28 Accelerations
A Response to the environment by a transient sympathetic stimulation • Transitory abrupt Increase in
the FHR above the baseline • Increase baseline: • More than 15 bpm above the baseline, and •
Duration is > 15 seconds but less than 2 minutes
Q29 Signs of fetal well being
A Fetal movement Contractions Vaginal exam
Q30 Decelerations
A -Early decelerations in response to fetal head compression -Late decelerations due to
uteroplacental insufficiency -Variable decelerations due to umbilical cord compression
Page 3 of 26
