AWHONN ADVANCED FHM COURSE NEWEST UPDATED
EXAM ARPRIL 2024 QUESTIONS & ANSWERS 2024 ( A+
GRADED 100% VERIFIED)
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by sonogram,
and her partner arrived on the labor unit at 0730 for scheduled induction for IUGR/FGR.
Silvia's family history is negative for medical problems with the exception of her
mother's long-term history of diabetes. Silvia has no history of medical problems and
she has never had any surgeries. She developed gestational diabetes with this
pregnancy, but her other prenatal labs were all normal. During one of the ultrasound
examinations performed to evaluate the IUGR/FGR, a single umbilical artery was noted.
On her most recent biophysical profile (BPP), the amniotic fluid index (AFI) was 11 cm
(AFI less than 5 cm is defined as oligohydramnios) and the estimated fetal weight
(EFW) was 2524 grams (7th percentile). WHAT FETAL HEART RATE
DECELERATION IS MORE LIKELY TO OCCUR IN THE PRESENCE OF SILVIA'S
SINGLE UMBILICAL ARTERY? - correct answer✔✔Variable decelerations
The single umbilical artery impacts which component of the oxygen transfer system? -
correct answer✔✔Oxygen delivery
Which of Silvia's findings indicates a potential for chronic fetal hypoxemia? - correct
answer✔✔Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to occur wi th fetal
perfusion? - correct answer✔✔Decreased blood perfusion from the fetus to the
placenta
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations 18/minute,
temperature 97F (36.6C). Vaginal examination findings were 2-3 cm dilated, 50%
effaced, -1 station, membranes intact, and cephalic presentation. External electronic
fetal monitor devices were placed (ultrasound and tocodynamometer). She denied
having contractions, vaginal leaking or bleeding. Following this admission tracing,
oxytocin was ordered and initiated at 2 mU/min. Within an hour, the rate was increased
to 5 mU/min. PRIMARY BENEFITS ASSOCIATED WITH THE USE OF
STANDARDIZED TERMINOLOGY FOR FHM INTERPRETATION IN THE CLINICAL
SETTING INCLUDE: - correct answer✔✔Enhanced communication among health
care providers and promotion of patient safety
Refer to tracing A-1. Which is the correct assessment of the admission tracing? - correct
answer✔✔Moderate variability
, Refer to tracing A-1. Based on this tracing, a necessary intervention would be to: -
correct answer✔✔Readjust the toco
Refer to tracing A-2. Oxytocin was infusing at 5 mU/min when the provider arrived and
ordered the oxytocin increased to 8 mU/min. A CORRECT INTERPRETATION OF
THIS TRACING IS: - correct answer✔✔An oxygenated, neurologically intact fetus
Refer to tracing A-2. A high-priority intervention at this time is to: - correct
answer✔✔Readjust the toco
One hour later, the nurse observed two 3 cm sized, thick dark blood clots on the under
pad. Silvia denied pain and her abdomen was soft to palpation. Which component of
oxygen transport to the fetus could potentially be compromised by this bleeding? -
correct answer✔✔Delivery
Refer to tracing A-3. Silvia's vital signs were BP 123/70, pulse 86 bpm, respirations
18/minute. The oxytocin was infusing at 11 mU/min and VE findings were 3-4 cm, 80%
effaced, -2 station, membranes intact and cephalic presentation, with a moderate
amount of blood on vaginal exam. WHICH OF THE FOLLOWING IS AN
APPROPRIATE PHYSIOLOGIC GOAL BASED ON TRACING A-3? - correct
answer✔✔Maximize utero-placental circulation
Refer to tracing A-3. The correct assessment of this tracing includes: - correct
answer✔✔Sinusoidal pattern
Refer to tracing A-4. At the time of tracing 4, the resident performed an AROM and fluid
was clear. A vaginal exam indicated the cervix was unchanged. The resident placed a
fetal spiral electrode and had difficulty placing an IUPC. The nurse could palpate
contractions but could not determine the frequency and duration by palpation. The
oxytocin was discontinued, an intravenous fluid bolus was administered, and Silvia was
repositioned. WHAT FHR CHARACTERISTICS SHOULD THE NURSE REPORT TO
THE PROVIDER? - correct answer✔✔Recurrent decelerations
Refer to tracing A-4. The correct physiologic interpretation of this tracing is: - correct
answer✔✔Fetal hypoxemia may be present
Refer to tracing A-5. At 1332, the resident successfully placed the IUPC and an
amnioinfusion was initiated at 1430. The resident telephoned the provider to report the
initiation of the amnioinfusion. WHICH INTRINSIC HOMEOSTATIC RESPONSE IS
THE FETUS DEMONSTRATING? - correct answer✔✔Baroreceptor
Refer to tracing A-5. An amnioinfusion is intended to relieve which extrinsic factor that
compromises oxygen transport? - correct answer✔✔Umbilical cord compression
EXAM ARPRIL 2024 QUESTIONS & ANSWERS 2024 ( A+
GRADED 100% VERIFIED)
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by sonogram,
and her partner arrived on the labor unit at 0730 for scheduled induction for IUGR/FGR.
Silvia's family history is negative for medical problems with the exception of her
mother's long-term history of diabetes. Silvia has no history of medical problems and
she has never had any surgeries. She developed gestational diabetes with this
pregnancy, but her other prenatal labs were all normal. During one of the ultrasound
examinations performed to evaluate the IUGR/FGR, a single umbilical artery was noted.
On her most recent biophysical profile (BPP), the amniotic fluid index (AFI) was 11 cm
(AFI less than 5 cm is defined as oligohydramnios) and the estimated fetal weight
(EFW) was 2524 grams (7th percentile). WHAT FETAL HEART RATE
DECELERATION IS MORE LIKELY TO OCCUR IN THE PRESENCE OF SILVIA'S
SINGLE UMBILICAL ARTERY? - correct answer✔✔Variable decelerations
The single umbilical artery impacts which component of the oxygen transfer system? -
correct answer✔✔Oxygen delivery
Which of Silvia's findings indicates a potential for chronic fetal hypoxemia? - correct
answer✔✔Intrauterine growth restriction (IUGR)
With the finding of a single umbilical artery, what would you expect to occur wi th fetal
perfusion? - correct answer✔✔Decreased blood perfusion from the fetus to the
placenta
Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations 18/minute,
temperature 97F (36.6C). Vaginal examination findings were 2-3 cm dilated, 50%
effaced, -1 station, membranes intact, and cephalic presentation. External electronic
fetal monitor devices were placed (ultrasound and tocodynamometer). She denied
having contractions, vaginal leaking or bleeding. Following this admission tracing,
oxytocin was ordered and initiated at 2 mU/min. Within an hour, the rate was increased
to 5 mU/min. PRIMARY BENEFITS ASSOCIATED WITH THE USE OF
STANDARDIZED TERMINOLOGY FOR FHM INTERPRETATION IN THE CLINICAL
SETTING INCLUDE: - correct answer✔✔Enhanced communication among health
care providers and promotion of patient safety
Refer to tracing A-1. Which is the correct assessment of the admission tracing? - correct
answer✔✔Moderate variability
, Refer to tracing A-1. Based on this tracing, a necessary intervention would be to: -
correct answer✔✔Readjust the toco
Refer to tracing A-2. Oxytocin was infusing at 5 mU/min when the provider arrived and
ordered the oxytocin increased to 8 mU/min. A CORRECT INTERPRETATION OF
THIS TRACING IS: - correct answer✔✔An oxygenated, neurologically intact fetus
Refer to tracing A-2. A high-priority intervention at this time is to: - correct
answer✔✔Readjust the toco
One hour later, the nurse observed two 3 cm sized, thick dark blood clots on the under
pad. Silvia denied pain and her abdomen was soft to palpation. Which component of
oxygen transport to the fetus could potentially be compromised by this bleeding? -
correct answer✔✔Delivery
Refer to tracing A-3. Silvia's vital signs were BP 123/70, pulse 86 bpm, respirations
18/minute. The oxytocin was infusing at 11 mU/min and VE findings were 3-4 cm, 80%
effaced, -2 station, membranes intact and cephalic presentation, with a moderate
amount of blood on vaginal exam. WHICH OF THE FOLLOWING IS AN
APPROPRIATE PHYSIOLOGIC GOAL BASED ON TRACING A-3? - correct
answer✔✔Maximize utero-placental circulation
Refer to tracing A-3. The correct assessment of this tracing includes: - correct
answer✔✔Sinusoidal pattern
Refer to tracing A-4. At the time of tracing 4, the resident performed an AROM and fluid
was clear. A vaginal exam indicated the cervix was unchanged. The resident placed a
fetal spiral electrode and had difficulty placing an IUPC. The nurse could palpate
contractions but could not determine the frequency and duration by palpation. The
oxytocin was discontinued, an intravenous fluid bolus was administered, and Silvia was
repositioned. WHAT FHR CHARACTERISTICS SHOULD THE NURSE REPORT TO
THE PROVIDER? - correct answer✔✔Recurrent decelerations
Refer to tracing A-4. The correct physiologic interpretation of this tracing is: - correct
answer✔✔Fetal hypoxemia may be present
Refer to tracing A-5. At 1332, the resident successfully placed the IUPC and an
amnioinfusion was initiated at 1430. The resident telephoned the provider to report the
initiation of the amnioinfusion. WHICH INTRINSIC HOMEOSTATIC RESPONSE IS
THE FETUS DEMONSTRATING? - correct answer✔✔Baroreceptor
Refer to tracing A-5. An amnioinfusion is intended to relieve which extrinsic factor that
compromises oxygen transport? - correct answer✔✔Umbilical cord compression
