NCC EFM practice 2023 LATEST UPDATE

NCC EFM practice 2023 LATEST UPDATE Which of the following factors can have a negative effect on uterine blood flow? a. Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above correct answere. All of the above Stimulating the vagus nerve typically produces: a. A decrease in the heart rate b. An increase in the heart rate c. An increase in stroke volume d. No change correct answera. A decrease in the heart rate The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the FHR baseline? a. Increases baseline b. Decreases baseline correct answerb. Decreases baseline T/F: The most common artifact with the ultrasound transducersystem for fetal heart rate isincreased variability. correct answerTrue T/F: All fetal monitors contain a logic system designed to reject artifact. correct answerTrue T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. correct answerTrue T/F: Variability and periodic changes can be detected with both internal and external monitoring. correct answerTrue T/F: Variable decelerations are a vagal response. correct answerTrue T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. correct answerTrue Etiology of a baseline FHR of 165bpm occurring for the last hour can be: 1. Maternalsupine hypotension 2. Maternal fever 3. Maternal dehydration 4. Unknown a. 1 and 2 b. 1, 2 and 3 c. 2, 3 and 4 correct answerc. 2, 3 and 4 The most prevalent risk factor associated with fetal death before the onset of labor is: a. Low socioeconomic status b. Fetal malpresentation c. Uteroplacental insufficiency d. Uterine anomalies correct answerc. Uteroplacental insufficiency Which of the following conditions is not an indication for antepartum fetal surveillance? a. Gestational hypertension b. Diabetes in pregnancy c. Fetus in breech presentation d. Decreased fetal movement correct answerc. Fetus in breech presentation Which of the following does not affect the degree of fetal activity? a. Vibroacoustic stimulation b. Smoking c. Fetal position d. Gestational age correct answera. Vibroacoustic stimulation T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. correct answerTrue T/F: Low amplitude contractions are not an early sign of preterm labor. correct answerFalse T/F: Corticosteroid administration may cause an increase in FHR accelerations. correct answerFalse T/F: Corticosteroid administration may cause an increase in FHR. correct answerTrue T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. correct answerTrue As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flow to vital organs increases. These flow changes along with increased catecholamine secretions have what effect on fetal blood pressure and fetal heart rate? A. Increase BP and increase HR B. Increase BP and decrease HR C. Decrease BP and increase HR D. Decrease BP and decrease HR correct answerB. Increase BP and decrease HR During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the following is the least likely explanation? A. True knot B. Gestational diabetes C. Umbilical cord entanglement D. Oligohydramnios correct answerB. Gestational diabetes All of the following are likely causes of prolonged decelerations except: A. Uterine tachysystole B. Prolapsed cord C. Maternal hypotension D. Maternal fever correct answerD. Maternal fever All of the following could likely cause minimal variability in FHR except A. Magnesium sulfate administration B. Fetalsleep cycle C. Narcotic administration D. Ephedrine administration correct answerD. Ephedrine administration When an IUPC has been placed, Montevideo units must be or greater for adequate cervical change to occur. A. 100 B. 200 C. 300 D. 400 correct answerB. 200 What would be a suspected pH in a fetus whose FHTs included recurrent late decelerations during labor? A. 7.10 B. 7.26 C. 7.32 D. 7.41 correct answerA. 7.10 The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. The correct nursing response is to: a. Give the woman oxygen by facemask at 8-10 L/min b. Position the woman on her opposite side c. Increase the rate of the woman's intravenous fluid d. Continue to observe and record the normal pattern correct answerd. Continue to observe and record the normal pattern Determining the FHR baseline requires the nurse to approximate the mean FHR rounded to increments of 5 bpm during a -minute window (excluding accelerations and decelerations). A. 2 B. 5 C. 10 D. 20 correct answerC. 10 Which of the following interventions would best stimulate an acceleration in the FHR? A. Provide juice to patient B. Perform vaginal exam C. Turn patient on left side D. Vibroacoustic stimulation correct answerB. Perform vaginal exam Scalp stimulation The FHR is controlled by the A. Sympathetic nervous system B. Sinoatrial node C. Atrioventricular node D. Parasympathetic nervoussystem correct answerB. Sinoatrial node T/F: Fetal tachycardia is a normal compensatory response to transient fetal hypoxemia. correct answerTrue At how many weeks gestation should FHR variability be normal in manner? A. 24 weeks B. 28 weeks C. 32 weeks D. 36 weeks correct answerB. 28 weeks Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leadsfirst to , then . A. Respiratory alkalosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis C. Respiratory alkalosis; metabolic alkalosis D. Respiratory acidosis; metabolic acidosis correct answerB. Respiratory acidosis; metabolic acidosis Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is typically present in . A. Variable decelerations B. Late decelerations C. Early decelerations D. Accelerations correct answerB. Late decelerations Place the following interventions for a sinusoidal FHR in the correct order: 1. Prepare for cesarean delivery 2. Place patient in lateral position 3. Determine if pattern isrelated to narcotic analgesic administration 4. Provide oxygen via face mask A. 4, 2, 3, 1 B. 3, 1, 2, 4 C. 4, 3, 2, 1 D. 3, 2, 4, 1 correct answerD. 3, 2, 4, 1 FHTs with accelerations, no decelerations, and minimal variability would be categorized as A. Category I B. Category II C. Category III correct answerB. Category II FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as A. Category I B. Category II C. Category III correct answerB. Category II Which of the following is not a likely cause of a sinusoidal FHR pattern? A. Chronic fetal bleeding B. Fetal hypoxia or anemia C. Triple screen positive for Trisomy 21 D. Fetal isoimmunization correct answerC. Triple screen positive for Trisomy 21 Which of the following factors is not likely to cause uteroplacental insufficiency? A. Late-term gestation B. Preeclampsia C. Gestational diabetes D. Polyhydramnios E. Maternalsmoking or drug use correct answerD. Polyhydramnios The normal FHR baseline A. Decreases during labor B. Fluctuates during labor C. Increases during labor correct answerB. Fluctuates during labor Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal A. Hypoxemia B. Rotation C. Vagalstimulation correct answerC. Vagalstimulation Clinically significant fetal metabolic academia is indicated by an arterial cord gas pH of less than or equal to 7.10 and a base deficit of A. 3 B. 6 C. 12 correct answerC. 12 Fetal bradycardia can result during A. The sleep state B. Umbilical vein compression C. Vagalstimulation correct answerC. Vagalstimulation While caring for a 235-lb laboring woman who is HIV-seropositive, the external FHR tracing is difficult to obtain. An appropriate nursing action would be to A. Apply a fetalscalp electrode B. Auscultate for presence of FHR variability C. Notify the attending midwife or physician correct answerC. Notify the attending midwife or physician Which IV fluid is most appropriate for maternal administration for intrauterine resuscitation? A. Lactated Ringer's solution B. D5L/R C. Normal saline correct answerC. Normal saline An EFM tracing with absent variability and no decelerations would be classified as A. Category I B. Category II (indeterminate) C. Category III correct answerB. Category II (indeterminate) An EFM tracing with absent variability and intermittent late decelerations would be classified as A. Category I B. Category II C. Category III correct answerB. Category II Maternal oxygen administration is appropriate in the context of A. Recurrent variable decelerations/moderate variability B. Intermittent late decelerations/minimal variability C. Prolonged decelerations/moderate variability correct answerB. Intermittent late decelerations/minimal variability In the context of hypoxemia, fetal blood flow is shifted to the A. Brain B. Liver C. Lungs correct answerA. Brain Baroreceptor-mediated decelerations are A. Early B. Late C. Variable correct answerC. Variable An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is A. Amnioinfusion B. Maternal repositioning C. Oxygen at 10L per nonrebreather face mask correct answerB. Maternal repositioning Most fetal dysrhythmias are not life-threatening, except for , which may lead to fetal congestive heart failure. correct answerSupraventricular tachycardia Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or cardiac anomalies may result in variability. correct answerDecreased Stimulation of the releases acetylcholine, resulting in decreased FHR. correct answerParasympathetic nervous system The maintainstransmission of beat-to-beat variability. correct answerParasympathetic nervous system Stimulation of the releases catecholamines, resulting in increased FHR. correct answerSympathetic nervous system Stimulation of results in abrupt decreases in FHR, CO, and BP. correct answerBaroreceptors Baroreceptors influence decelerations with moderate variability. correct answerVariable In comparing early and late decelerations, a distinguishing factor between the two is A. Onset time to the nadir of the deceleration B. The number of decelerations that occur C. Timing in relation to contractions correct answerC. Timing in relation to contractions The underlying cause of early decelerations is decreased A. Baroceptor response B. Increased peripheral resistance C. Vagal reflex correct answerC. Vagal reflex Glucose is transferred across the placenta via . correct answerFacilitated diffusion Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via . correct answerSimple (passive) diffusion Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via . correct answerActive transport Well-oxygenated fetal blood enters the ventricle, which suppliesthe heart and brain. Less-oxygenated blood enters the ventricle, which supplies the rest of the body. correct answerLeft; right Fetal blood has a affinity for oxygen compared with the mother's blood, which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus. A. Higher B. Lower correct answerA. Higher The fetus has a cardiac output and heart rate than the adult, resulting in rapid circulation. A. Higher B. Lower correct answerA. Higher Which statement best describes the relationship between maternal and fetal hemoglobin levels? A. Fetal hemoglobin is higher than maternal hemoglobin B. Maternal hemoglobin is higher than fetal hemoglobin C. Maternal and fetal hemoglobin are the same correct answerA. Fetal hemoglobin is higher than maternal hemoglobin A 36 week gestation patient is brought to triage by squad after an MVA on her back. She is not bleeding and denies pain. She is not short of breath, but c/o dizziness and nausea since they put her on the gurney. The most likely cause is A. Abruptio placenta B. Preterm labor C. Supine hypotension correct answerC. Supine hypotension When the hydrogen ion content in the blood rises, the pH A. Lowers B. Neutralizes C. Rises correct answerA. Lowers ***A woman receives terbutaline for an external version. You may expect what on the fetal heart tracing? A. Decrease in variability B. Increase in baseline C. No change correct answerB. Increase in baseline What affect does magnesium sulfate have on the fetal heart rate? A. Decreases variability B. Increases variability C. No change correct answerA. Decreases variability Sinusoidal pattern can be documented when A. Cycles are 4-6 beats per minute in frequency B. The pattern lasts 20 minutes or longer C. There is moderate or minimal variability correct answerB. The pattern lasts 20 minutes or longer Vagalstimulation would be manifested as what type of fetal heart rate pattern? A. Acceleration B. Early deceleration C. Tachycardia correct answerB. Early deceleration Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? A. Early deceleration B. Late deceleration C. Variable deceleration correct answerA. Early deceleration A risk of amnioinfusion is A. Prolonged labor B. Uterine overdistension C. Water intoxication correct answerB. Uterine overdistension A fetal heart rate pattern that can occur when there is a prolapsed cord is A. Marked variability B. Prolonged decelerations C. Tachycardia correct answerB. Prolonged decelerations The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the next 15 minutes, there are 18 uterine contractions. Recommended management is to A. Address contraction frequency by reducing pitocin dose B. Continue to increase pitocin as long as FHR is Category I C. Turn the patient on her side and initiate an IV fluid bolus correct answerC. Turn the patient on her side and initiate an IV fluid bolus A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the fetal heart tracings have been normal. Spontaneous rupture of membranes occurs; fetal heart rate drops to 90 beats per minute for four minutes and then resumes a normal pattern. The most likely etiology for this fetal heart rate change is A. Abnormal fetal presentation B. Impaired placental circulation C. Possible cord compression correct answerC. Possible cord compression A woman has 10 fetal movements in one hour. This is considered what kind of movement? A. Decreased B. Excessive C. Normal correct answerC. Normal If the pH is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? A. HCO3 B. PCO2 C. PO2 correct answerB. PCO2 The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10 A. Metabolic acidosis B. Mixed acidosis C. Respiratory acidosis correct answerC. Respiratory acidosis