AWHONN ADVANCED FETAL MONITORING EXAM 2024 LATEST
ACTUAL EXAM 130 QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES new !!
Opioids, magnesium, and tobacco (medications or drugs)
Fetal sleep cycles
Fetal acidemia- there will be no accels here - What are things that can cause decreased
variability?
10x10 - What accelerations do gestations less than 32 weeks need?
Fetal head compression leads to altered cerebral blood flow which produces a
vagabond reflex and cardiac slowing - Describe the reasoning for early decels
Uteroplacental insufficiency results in decreased maternal/fetal O2 transfer - Describe
the physiology of a late decel
It's neurogenic
Exclude clinically significant acidemia
Provide interventions to increase perfusion - What do late decels with moderate
variability mean and indicate?
Means myocardial depression
Expedited delivery - What do late decels with decreases variability mean and indicate?
Interruption of uteroplacental perfusion or exchange- tachysystole, maternal
hypotension, maternal hypoxia (seizure or cardiac arrest), placental abruption, or
uterine rupture
Interruption of umbilical blood flow- cord compression, cord prolapse, or ruptured vasa
previa - What are 3 causes of prolonged decels?
Vasa previa - Presence of fetal (not placental) blood vessels that cross the internal
cervical os (marginal or velamentous cord insertions or with succenturiate lobes).
Umbilical cord crosses the internal cervial os
parasympathetic nervous system - What nervous system has control over bradycardia?
Fever
Dehydration
Infection
Medications- terbutaline, albuterol, atropine, cocaine, or caffeine
Medical conditions- hyperthyroidism - What are some maternal conditions that can lead
to fetal tachycardia?
, Fetal bleeding- placental abruption
Fetal anemia
Fetal sepsis
Fetal hypoxia
Arrhythmias - What are some fetal conditions that can cause tachycardia?
Severe fetal anemia- ruptured vasa previa, TTTS, Rh isoimmunization
Severe metabolic acidemia - What are causes of sinusoidal pattens?
Every 30 mins - How often do you chart heart tones for a low risk pt from latent phase
up to the 2nd stage (until pushing)?
Ever 15 mins - How often do you chart heart tones from the latent phase up until the
second stage of labor with a high risk patient?
2 to 4 mu - At what rate is exogenous oxytocin at for the mother during the first stage of
labor?
3 mu - At what rate is exogenous oxytocin at for the fetus during the first stage of labor?
10 to 15 minutes - What is the biologic half-life of oxytocin?
30 to 60 minutes - How long does it take to reach a steady state of plasma
concentration for Pitocin?
During the first stage of labor with recurrent they are both the cells that have not
resolved with position changes - When should an amnioinfusion be used?
Late decelerations, active pushing, meconium, VBAC or TOLAC - When should and
amnioinfusion not be used?
Maintain fetal physiologic reserve and maximize fetal oxygenation - What is the main
goal during the second stage of labor?
Pushing is approximately 6 to 8 seconds and repeated four times - What is open glottis
pushing?
Fergusons reflex - Spontaneous urge to push during labor that occurs when the
presenting part (of the fetus) reaches the pelvic floor; may occur without full cervical
effacement
Any type of bleeding - What is a contraindication for terbutaline?
7.20-7.29
Greater than or equal to 7.10 - What is normal pH in the umbilical artery?
ACTUAL EXAM 130 QUESTIONS AND CORRECT DETAILED ANSWERS
WITH RATIONALES new !!
Opioids, magnesium, and tobacco (medications or drugs)
Fetal sleep cycles
Fetal acidemia- there will be no accels here - What are things that can cause decreased
variability?
10x10 - What accelerations do gestations less than 32 weeks need?
Fetal head compression leads to altered cerebral blood flow which produces a
vagabond reflex and cardiac slowing - Describe the reasoning for early decels
Uteroplacental insufficiency results in decreased maternal/fetal O2 transfer - Describe
the physiology of a late decel
It's neurogenic
Exclude clinically significant acidemia
Provide interventions to increase perfusion - What do late decels with moderate
variability mean and indicate?
Means myocardial depression
Expedited delivery - What do late decels with decreases variability mean and indicate?
Interruption of uteroplacental perfusion or exchange- tachysystole, maternal
hypotension, maternal hypoxia (seizure or cardiac arrest), placental abruption, or
uterine rupture
Interruption of umbilical blood flow- cord compression, cord prolapse, or ruptured vasa
previa - What are 3 causes of prolonged decels?
Vasa previa - Presence of fetal (not placental) blood vessels that cross the internal
cervical os (marginal or velamentous cord insertions or with succenturiate lobes).
Umbilical cord crosses the internal cervial os
parasympathetic nervous system - What nervous system has control over bradycardia?
Fever
Dehydration
Infection
Medications- terbutaline, albuterol, atropine, cocaine, or caffeine
Medical conditions- hyperthyroidism - What are some maternal conditions that can lead
to fetal tachycardia?
, Fetal bleeding- placental abruption
Fetal anemia
Fetal sepsis
Fetal hypoxia
Arrhythmias - What are some fetal conditions that can cause tachycardia?
Severe fetal anemia- ruptured vasa previa, TTTS, Rh isoimmunization
Severe metabolic acidemia - What are causes of sinusoidal pattens?
Every 30 mins - How often do you chart heart tones for a low risk pt from latent phase
up to the 2nd stage (until pushing)?
Ever 15 mins - How often do you chart heart tones from the latent phase up until the
second stage of labor with a high risk patient?
2 to 4 mu - At what rate is exogenous oxytocin at for the mother during the first stage of
labor?
3 mu - At what rate is exogenous oxytocin at for the fetus during the first stage of labor?
10 to 15 minutes - What is the biologic half-life of oxytocin?
30 to 60 minutes - How long does it take to reach a steady state of plasma
concentration for Pitocin?
During the first stage of labor with recurrent they are both the cells that have not
resolved with position changes - When should an amnioinfusion be used?
Late decelerations, active pushing, meconium, VBAC or TOLAC - When should and
amnioinfusion not be used?
Maintain fetal physiologic reserve and maximize fetal oxygenation - What is the main
goal during the second stage of labor?
Pushing is approximately 6 to 8 seconds and repeated four times - What is open glottis
pushing?
Fergusons reflex - Spontaneous urge to push during labor that occurs when the
presenting part (of the fetus) reaches the pelvic floor; may occur without full cervical
effacement
Any type of bleeding - What is a contraindication for terbutaline?
7.20-7.29
Greater than or equal to 7.10 - What is normal pH in the umbilical artery?
