NCC Electronic Fetal Monitoring
Certification
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 - ANSe. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. - ANSb. Increases cardiac output
by increasing it's heart rate.
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 - ANSa. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D - ANSg. C & D
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 - ANSb. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. - ANSTrue
T/F: The parasympathetic nervous system is a cardioaccelerator. - ANSFalse
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood
pressure. - ANSTrue
,T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the
ultrasound transducer and the fetal spiral electrode. - ANSTrue
T/F: Variability can be determined with the fetoscope. - ANSFalse
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be
dipped in warm water to make cleaning easier. - ANSFalse
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
increased variability. - ANSTrue
T/F: All fetal monitors contain a logic system designed to reject artifact. - ANSTrue
T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. - ANSTrue
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - ANSFalse
T/F: Both internal and external monitoring methods are equally accurate means of obtaining
the fetal heart rate and contraction patterns. - ANSFalse
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. -
ANSTrue
T/F: The external toco gives measurable uterine pressure. - ANSFalse
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is
present. - ANSFalse
T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's
back, as the fetal heart is heard best there. - ANSTrue
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. - ANSFalse
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. -
ANSFalse
T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ANSFalse
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. -
ANSTrue
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. -
ANSTrue
T/F: Variability and periodic changes can be detected with both internal and external
monitoring. - ANSTrue
,T/F: Variable decelerations are a result of cord compression. - ANSTrue
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign
of adequate fetal oxygenation. - ANSTrue
T/F: Variable decelerations are a vagal response. - ANSTrue
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are
delayed in timing with the nadir of the deceleration occurring after the peak of the
contraction. - ANSTrue
T/F: The fetal heart rate baseline can be determined during periods of marked variability. -
ANSFalse
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow
through the placenta. - ANSTrue
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern
in labor. - ANSTrue
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated.
- ANSFalse
What is your first intervention in management of a patient experiencing variable
decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion - ANSb. Change maternal position
Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 - ANSc. 2, 3 and 4
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change - ANSa. Utero-placental insufficiency
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 - ANSc. Uteroplacental insufficiency
Which of the following is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels - ANSd. Maternal HCG levels
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 - ANSc. 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 - ANSa. Vibroacoustic stimulation
To be considered reactive, a nonstress test must have:
a. 4 fetal heart rate accelerations in a 20 minute window
b. 2 fetal heart rate accelerations in a 10 minute window
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window - ANSd. 2 fetal heart rate
accelerations in a 20 minute window
If a nonstress test is nonreactive after 40 minutes, the next step should be:
a. Have the client go home and do fetal movement counts
b. Do a biophysical profile or contraction stress test
c. Repeat the nonstress test within a week
d. Admit the client for delivery - ANSb. Do a biophysical profile or contraction stress test
All of the following are components of a biophysical profile except:
a. Contraction stress test
b. Assessment of fetal breathing
c. Amniotic fluid volume measurement
d. Fetal movement assessment - ANSa. Contraction stress test
A modified biophysical profile includes a nonstress test and:
a. Contraction stress test
b. Ultrasound assessment of fetal movement
c. Ultrasound assessment of amniotic fluid volume
d. Fetal movement counts - ANSc. Ultrasound assessment of amniotic fluid volume
Certification
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 - ANSe. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. - ANSb. Increases cardiac output
by increasing it's heart rate.
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 - ANSa. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D - ANSg. C & D
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 - ANSb. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. - ANSTrue
T/F: The parasympathetic nervous system is a cardioaccelerator. - ANSFalse
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood
pressure. - ANSTrue
,T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the
ultrasound transducer and the fetal spiral electrode. - ANSTrue
T/F: Variability can be determined with the fetoscope. - ANSFalse
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be
dipped in warm water to make cleaning easier. - ANSFalse
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
increased variability. - ANSTrue
T/F: All fetal monitors contain a logic system designed to reject artifact. - ANSTrue
T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. - ANSTrue
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - ANSFalse
T/F: Both internal and external monitoring methods are equally accurate means of obtaining
the fetal heart rate and contraction patterns. - ANSFalse
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. -
ANSTrue
T/F: The external toco gives measurable uterine pressure. - ANSFalse
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is
present. - ANSFalse
T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's
back, as the fetal heart is heard best there. - ANSTrue
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. - ANSFalse
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. -
ANSFalse
T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ANSFalse
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. -
ANSTrue
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. -
ANSTrue
T/F: Variability and periodic changes can be detected with both internal and external
monitoring. - ANSTrue
,T/F: Variable decelerations are a result of cord compression. - ANSTrue
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign
of adequate fetal oxygenation. - ANSTrue
T/F: Variable decelerations are a vagal response. - ANSTrue
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are
delayed in timing with the nadir of the deceleration occurring after the peak of the
contraction. - ANSTrue
T/F: The fetal heart rate baseline can be determined during periods of marked variability. -
ANSFalse
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow
through the placenta. - ANSTrue
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern
in labor. - ANSTrue
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated.
- ANSFalse
What is your first intervention in management of a patient experiencing variable
decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion - ANSb. Change maternal position
Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 - ANSc. 2, 3 and 4
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change - ANSa. Utero-placental insufficiency
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 - ANSc. Uteroplacental insufficiency
Which of the following is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels - ANSd. Maternal HCG levels
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 - ANSc. 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 - ANSa. Vibroacoustic stimulation
To be considered reactive, a nonstress test must have:
a. 4 fetal heart rate accelerations in a 20 minute window
b. 2 fetal heart rate accelerations in a 10 minute window
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window - ANSd. 2 fetal heart rate
accelerations in a 20 minute window
If a nonstress test is nonreactive after 40 minutes, the next step should be:
a. Have the client go home and do fetal movement counts
b. Do a biophysical profile or contraction stress test
c. Repeat the nonstress test within a week
d. Admit the client for delivery - ANSb. Do a biophysical profile or contraction stress test
All of the following are components of a biophysical profile except:
a. Contraction stress test
b. Assessment of fetal breathing
c. Amniotic fluid volume measurement
d. Fetal movement assessment - ANSa. Contraction stress test
A modified biophysical profile includes a nonstress test and:
a. Contraction stress test
b. Ultrasound assessment of fetal movement
c. Ultrasound assessment of amniotic fluid volume
d. Fetal movement counts - ANSc. Ultrasound assessment of amniotic fluid volume
