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Galen NSG 3500 / NSG3500 Exam 2
Nursing Practice Maternal Health
Questions & Answers with
Rationales | Grade A
Exam Structure:
Subject: Nursing / Maternal-Newborn Health, Labor and Delivery
Source: NSG3500 EXAM 2
Format: Comprehensive Question and Answer Review with Rationales
Fetal Heart Rate Monitoring
1. What is the normal fetal heart rate (FHR) range?
Answer: 110-160 beats per minute.
Rationale:
1. Baseline FHR between 110-160 bpm indicates adequate oxygenation
and normal autonomic function.
2. Tachycardia (>160) may indicate maternal fever, dehydration, or
infection.
3. Bradycardia (<110) may indicate hypoxia, maternal hypotension, or
hypoglycemia.
2. What are the classifications for variation of fetal heart rate?
Answer: Absent (no fluctuations/flat), minimal (5 bpm variation),
moderate (6-25 bpm variation), marked (>25 bpm variation). You want to
see moderate.
Rationale:
1. Variability reflects the balance between sympathetic and
parasympathetic nervous systems.
2. Moderate variability indicates a well-oxygenated, healthy fetal
nervous system.
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3. Absent or minimal variability may indicate fetal sleep, acidosis, or
central nervous system depression.
3. A sedated baby could show:
Answer: Minimal variability.
Rationale:
1. Medications such as opioids, magnesium sulfate, or anesthetics can
cross the placenta and depress the fetal CNS.
2. This results in decreased variability without necessarily indicating
hypoxia.
3. Effects are typically temporary and resolve as medication wears off.
4. Marked variability in FHR (>25 bpm) is an indication of:
Answer: Distress.
Rationale:
1. Excessive variability can indicate fetal hypoxia or cord compression.
2. May be a compensatory mechanism before decompensation.
3. Requires close monitoring and possible intervention.
5. What are accelerations in FHR?
Answer: Transient increase in FHR (15x15 for term and 10x10 minimum
for preterm). 32 weeks and lower should be about 10x10; 32 weeks and
higher should be about 15x15.
Rationale:
1. Accelerations are abrupt increases above baseline.
2. Duration: 15 seconds for term, 10 seconds for preterm.
3. Magnitude: 15 bpm for term, 10 bpm for preterm.
4. Accelerations indicate fetal well-being and reactive non-stress test.
6. What happens if there are no accelerations?
Answer: Distressed baby.
Rationale:
1. Absence of accelerations may indicate fetal acidemia or CNS
depression.
2. Non-reactive non-stress test requires further evaluation.
3. May indicate need for biophysical profile or contraction stress test.
7. What are decelerations in FHR?
Answer: Periodic decrease in FHR; could be an indication of a problem.
Rationale:
1. Decelerations are transient decreases in FHR from baseline.
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2. Types indicate different underlying causes (head compression, cord
compression, placental insufficiency).
3. Severity and timing guide interventions.
8. What does the mnemonic VEAL CHOP stand for?
Answer:
V- Variable = C- Cord Compression
E- Early Decels = H- Head Compression
A- Accelerations = O - OK
L- Late Decels = P - Placenta
Rationale:
1. Helps associate deceleration patterns with likely causes.
2. Guides nursing interventions based on etiology.
3. Essential for rapid clinical decision-making.
9. What are periodic decelerations?
Answer: Decelerations of fetal heart rate associated with uterine
contractions.
Rationale:
1. Occur in response to contraction-induced stress.
2. Timing relative to contraction helps classify type.
3. Requires assessment of pattern and severity.
10. What are episodic decelerations?
Answer: Drops in the FHR not associated with uterine contractions.
Rationale:
1. May indicate cord compression from fetal movement.
2. Can be caused by maternal position or cord entanglement.
3. Requires investigation of non-contraction-related causes.
11. What are causes for accelerations?
Answer: Spontaneous fetal movement, during vaginal exam, electrode
application, fetal reaction to external sounds, fetal scalp stimulation, breech
presentation, occiput posterior position, uterine contractions, fundal
pressure, abdominal palpation.
Rationale:
1. Any stimulus that increases fetal activity can cause accelerations.
2. Demonstrates intact autonomic nervous system.
3. Positive sign of fetal well-being.
Galen NSG 3500 / NSG3500 Exam 2
Nursing Practice Maternal Health
Questions & Answers with
Rationales | Grade A
Exam Structure:
Subject: Nursing / Maternal-Newborn Health, Labor and Delivery
Source: NSG3500 EXAM 2
Format: Comprehensive Question and Answer Review with Rationales
Fetal Heart Rate Monitoring
1. What is the normal fetal heart rate (FHR) range?
Answer: 110-160 beats per minute.
Rationale:
1. Baseline FHR between 110-160 bpm indicates adequate oxygenation
and normal autonomic function.
2. Tachycardia (>160) may indicate maternal fever, dehydration, or
infection.
3. Bradycardia (<110) may indicate hypoxia, maternal hypotension, or
hypoglycemia.
2. What are the classifications for variation of fetal heart rate?
Answer: Absent (no fluctuations/flat), minimal (5 bpm variation),
moderate (6-25 bpm variation), marked (>25 bpm variation). You want to
see moderate.
Rationale:
1. Variability reflects the balance between sympathetic and
parasympathetic nervous systems.
2. Moderate variability indicates a well-oxygenated, healthy fetal
nervous system.
, 2|Page
3. Absent or minimal variability may indicate fetal sleep, acidosis, or
central nervous system depression.
3. A sedated baby could show:
Answer: Minimal variability.
Rationale:
1. Medications such as opioids, magnesium sulfate, or anesthetics can
cross the placenta and depress the fetal CNS.
2. This results in decreased variability without necessarily indicating
hypoxia.
3. Effects are typically temporary and resolve as medication wears off.
4. Marked variability in FHR (>25 bpm) is an indication of:
Answer: Distress.
Rationale:
1. Excessive variability can indicate fetal hypoxia or cord compression.
2. May be a compensatory mechanism before decompensation.
3. Requires close monitoring and possible intervention.
5. What are accelerations in FHR?
Answer: Transient increase in FHR (15x15 for term and 10x10 minimum
for preterm). 32 weeks and lower should be about 10x10; 32 weeks and
higher should be about 15x15.
Rationale:
1. Accelerations are abrupt increases above baseline.
2. Duration: 15 seconds for term, 10 seconds for preterm.
3. Magnitude: 15 bpm for term, 10 bpm for preterm.
4. Accelerations indicate fetal well-being and reactive non-stress test.
6. What happens if there are no accelerations?
Answer: Distressed baby.
Rationale:
1. Absence of accelerations may indicate fetal acidemia or CNS
depression.
2. Non-reactive non-stress test requires further evaluation.
3. May indicate need for biophysical profile or contraction stress test.
7. What are decelerations in FHR?
Answer: Periodic decrease in FHR; could be an indication of a problem.
Rationale:
1. Decelerations are transient decreases in FHR from baseline.
, 3|Page
2. Types indicate different underlying causes (head compression, cord
compression, placental insufficiency).
3. Severity and timing guide interventions.
8. What does the mnemonic VEAL CHOP stand for?
Answer:
V- Variable = C- Cord Compression
E- Early Decels = H- Head Compression
A- Accelerations = O - OK
L- Late Decels = P - Placenta
Rationale:
1. Helps associate deceleration patterns with likely causes.
2. Guides nursing interventions based on etiology.
3. Essential for rapid clinical decision-making.
9. What are periodic decelerations?
Answer: Decelerations of fetal heart rate associated with uterine
contractions.
Rationale:
1. Occur in response to contraction-induced stress.
2. Timing relative to contraction helps classify type.
3. Requires assessment of pattern and severity.
10. What are episodic decelerations?
Answer: Drops in the FHR not associated with uterine contractions.
Rationale:
1. May indicate cord compression from fetal movement.
2. Can be caused by maternal position or cord entanglement.
3. Requires investigation of non-contraction-related causes.
11. What are causes for accelerations?
Answer: Spontaneous fetal movement, during vaginal exam, electrode
application, fetal reaction to external sounds, fetal scalp stimulation, breech
presentation, occiput posterior position, uterine contractions, fundal
pressure, abdominal palpation.
Rationale:
1. Any stimulus that increases fetal activity can cause accelerations.
2. Demonstrates intact autonomic nervous system.
3. Positive sign of fetal well-being.
