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AWHONN Advanced Fetal Monitoring Exam
2025 – Latest Practice Test, Study Guide &
Answer Key for Labor and Delivery Nurses
Prepare for the AWHONN Advanced Fetal Monitoring Exam with the latest 2025 study
materials, including updated practice tests, real exam-style questions, and evidence-based
rationales. Covers electronic fetal monitoring (EFM), interpretation of fetal heart rate
patterns, interventions, and maternal-fetal care — essential for labor and delivery nurses
and perinatal specialists.
• AWHONN Advanced Fetal Monitoring Exam 2025
• AWHONN Advanced Fetal Monitoring test questions
• AWHONN fetal monitoring practice test
• AWHONN Advanced Fetal Monitoring study guide
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
,2|Page
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
What does the Tocodynamometer measure? - ANSWER-Contractions by detecting abdominal wall
contour changes. The device converts this to electronic impulses that register and print out on paper.
Toco does NOT quantify resting tone or intensity of contractions. Changes of the abd wall can be caused
by a number of events besides contractions (mat. respirations, pushing, vomiting, seizures, fetal activity
and movement). A normal contraction creates a smooth and even fall on the tracing
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
,3|Page
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
, 4|Page
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform related to placement of toco
What are the advantages and limitation of Toco? - ANSWER-Advantages- it is external so it is non invasive
and ROM is not necessary
Limitations- it is location sensitive so improper placement or movement can cause uninterpretable
tracing. It is not a means of assessing true resting tone or intensity so must use in conjunction with direct
palpation. Toco only gives an approximate measure of duration and frequency. Reading can vary greatly
based on mat. weight, mat. position, and position of belt.
Select the best location for placement of Toco for a term pregnancy. - ANSWER-top center is where you
should receive the most accurate reading of uterine contractions as term.
What is an Intrauterine pressure catheter (IUPC) and what does it measure? - ANSWER-It is the only
method that directly measures the uterine resting tone, contraction intensity, frequency and duration. It
is an invasive procedure that requires ROM and cervical dilation. IUPC is used when there is a need for
more detailed information than palpation or toco can provide.
The IUPC measures hydrostatic pressure in the uterus, measuring intrauterine pressure during and
between contractions.
What are indications for IUPC monitoring? - ANSWER-1. When labor and not progressing & assessment
of the adequacy of the contraction is needed.
2. When the nature or event of previous uterine scarring necessitates internal monitoring
3. Amnioinfusion is required
AWHONN Advanced Fetal Monitoring Exam
2025 – Latest Practice Test, Study Guide &
Answer Key for Labor and Delivery Nurses
Prepare for the AWHONN Advanced Fetal Monitoring Exam with the latest 2025 study
materials, including updated practice tests, real exam-style questions, and evidence-based
rationales. Covers electronic fetal monitoring (EFM), interpretation of fetal heart rate
patterns, interventions, and maternal-fetal care — essential for labor and delivery nurses
and perinatal specialists.
• AWHONN Advanced Fetal Monitoring Exam 2025
• AWHONN Advanced Fetal Monitoring test questions
• AWHONN fetal monitoring practice test
• AWHONN Advanced Fetal Monitoring study guide
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
,2|Page
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
What does the Tocodynamometer measure? - ANSWER-Contractions by detecting abdominal wall
contour changes. The device converts this to electronic impulses that register and print out on paper.
Toco does NOT quantify resting tone or intensity of contractions. Changes of the abd wall can be caused
by a number of events besides contractions (mat. respirations, pushing, vomiting, seizures, fetal activity
and movement). A normal contraction creates a smooth and even fall on the tracing
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
,3|Page
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
, 4|Page
h. Inverted waveform r/t placement of toco
Identify the uterine contraction variation: - ANSWER-a. Uterine contraction wave form normal
b. Maternal respiration
c. Valsalva maneuver or pushing
d. Maternal activity such as vomiting or seizure
e. Fetal movement/activity
f. Maternal position change or sudden baseline shift
g. Obscured or low baseline setting
h. Inverted waveform related to placement of toco
What are the advantages and limitation of Toco? - ANSWER-Advantages- it is external so it is non invasive
and ROM is not necessary
Limitations- it is location sensitive so improper placement or movement can cause uninterpretable
tracing. It is not a means of assessing true resting tone or intensity so must use in conjunction with direct
palpation. Toco only gives an approximate measure of duration and frequency. Reading can vary greatly
based on mat. weight, mat. position, and position of belt.
Select the best location for placement of Toco for a term pregnancy. - ANSWER-top center is where you
should receive the most accurate reading of uterine contractions as term.
What is an Intrauterine pressure catheter (IUPC) and what does it measure? - ANSWER-It is the only
method that directly measures the uterine resting tone, contraction intensity, frequency and duration. It
is an invasive procedure that requires ROM and cervical dilation. IUPC is used when there is a need for
more detailed information than palpation or toco can provide.
The IUPC measures hydrostatic pressure in the uterus, measuring intrauterine pressure during and
between contractions.
What are indications for IUPC monitoring? - ANSWER-1. When labor and not progressing & assessment
of the adequacy of the contraction is needed.
2. When the nature or event of previous uterine scarring necessitates internal monitoring
3. Amnioinfusion is required
