FETAL HEALTH SURVEILLANCE EXAM
QUESTIONS AND ANSWERS GRADED A+
2026
What were the 3 main findings of the Cochrane review on intrapartum EFM vs IA? - ANS 1.
EFM associated with higher C/S
2. No difference in neo or mat mortality or morbidity
3. EFM reduction 50% of neonatal seizures, but no long term differences (cerebral palsy,
mortality or well-being)
The following are outcomes related to which type of labour support?:
Increased spontaneous vaginal birth
Shorter duration of labour
Decreased operative births (cesarean and instrumental vaginal birth)
Decreased use of any analgesia and/or regional analgesia
Fewer low 5-minute Apgar scores
Fewer negative feelings about childbirth experience - ANS Continuous labour support (1-to-1)
When a normal tracing is identified it may be appropriate to interrupt the EFM tracing for up to
_____________ minutes to facilitate periods of ambulation, bathing, or position change,
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
,providing that a) the maternal fetal condition is stable and b) if Oxytocin is being administered,
the infusion rate is not increased. (III-B) - ANS 30 minutes
Is EFM or IA recommended for the labour admission assessment of a low risk individual? -
ANS IA
Sympathetic Nervous System - ANS 1. nerves - medulla oblongata --> ventricles
2. neurotransmitter is norepinephrine
3. stimulation = increase FHR
Parasympathetic Nervous System - ANS 1. vagus nerve from medulla oblongata innervates
the sino-atrial (SA) and atrioventricular (AV) nodes in the heart
2. neurotransmitter is acetylcholine
3. stimulation = decrease FHR
Where are baroreceptors located? - ANS 1. Aortic arch
2. Carotid sinus
Are barometric responses abrupt or gradual? - ANS abrupt (<30 seconds from onset to nadir)
Are chemoreceptor changes abrupt or gradual? - ANS gradual (>30 seconds from onset to
nadir
Where are the peripheral and central chemoreceptors located? - ANS peripherally in the
aortic arch and carotid sinus
centrally in medulla
Peripheral chemoreceptors produce (slowing/increase) of the FHR, while central
chemoreceptors produce (slowing/increase) of FHR - ANS slowing, increase
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
, Which of the following fetal heart rate regulatory factors gradually matures and can be expected
to be functional at 28 to 32 weeks gestation?
A) Parasympathetic nervous system
B) Chemoreceptors
C) Baroreceptors
D) Sympathetic nervous system - ANS A) Parasympathetic nervous system
Supine positioning in labour:
A) Increases maternal arterial blood pressure
B) Results in increased uterine activity and dysfunctional labour
C) Causes vena-cava compression and poor placental perfusion
D) Causes catecholamine release and increased maternal heart rate - ANS C) Causes vena-
cava compression and poor placental perfusion
Variability of the FHR is affected by:
A) Upright positioning during labour
B) Fetal rest and activity cycles
C) Maternal weight gain of 40 lbs
D) Occasional umbilical cord compression - ANS B) Fetal rest and activity cycles
All of the following hormones influence the FHR except:
A) Norepinephrine
B) Estrogen
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
3
QUESTIONS AND ANSWERS GRADED A+
2026
What were the 3 main findings of the Cochrane review on intrapartum EFM vs IA? - ANS 1.
EFM associated with higher C/S
2. No difference in neo or mat mortality or morbidity
3. EFM reduction 50% of neonatal seizures, but no long term differences (cerebral palsy,
mortality or well-being)
The following are outcomes related to which type of labour support?:
Increased spontaneous vaginal birth
Shorter duration of labour
Decreased operative births (cesarean and instrumental vaginal birth)
Decreased use of any analgesia and/or regional analgesia
Fewer low 5-minute Apgar scores
Fewer negative feelings about childbirth experience - ANS Continuous labour support (1-to-1)
When a normal tracing is identified it may be appropriate to interrupt the EFM tracing for up to
_____________ minutes to facilitate periods of ambulation, bathing, or position change,
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
1
,providing that a) the maternal fetal condition is stable and b) if Oxytocin is being administered,
the infusion rate is not increased. (III-B) - ANS 30 minutes
Is EFM or IA recommended for the labour admission assessment of a low risk individual? -
ANS IA
Sympathetic Nervous System - ANS 1. nerves - medulla oblongata --> ventricles
2. neurotransmitter is norepinephrine
3. stimulation = increase FHR
Parasympathetic Nervous System - ANS 1. vagus nerve from medulla oblongata innervates
the sino-atrial (SA) and atrioventricular (AV) nodes in the heart
2. neurotransmitter is acetylcholine
3. stimulation = decrease FHR
Where are baroreceptors located? - ANS 1. Aortic arch
2. Carotid sinus
Are barometric responses abrupt or gradual? - ANS abrupt (<30 seconds from onset to nadir)
Are chemoreceptor changes abrupt or gradual? - ANS gradual (>30 seconds from onset to
nadir
Where are the peripheral and central chemoreceptors located? - ANS peripherally in the
aortic arch and carotid sinus
centrally in medulla
Peripheral chemoreceptors produce (slowing/increase) of the FHR, while central
chemoreceptors produce (slowing/increase) of FHR - ANS slowing, increase
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
2
, Which of the following fetal heart rate regulatory factors gradually matures and can be expected
to be functional at 28 to 32 weeks gestation?
A) Parasympathetic nervous system
B) Chemoreceptors
C) Baroreceptors
D) Sympathetic nervous system - ANS A) Parasympathetic nervous system
Supine positioning in labour:
A) Increases maternal arterial blood pressure
B) Results in increased uterine activity and dysfunctional labour
C) Causes vena-cava compression and poor placental perfusion
D) Causes catecholamine release and increased maternal heart rate - ANS C) Causes vena-
cava compression and poor placental perfusion
Variability of the FHR is affected by:
A) Upright positioning during labour
B) Fetal rest and activity cycles
C) Maternal weight gain of 40 lbs
D) Occasional umbilical cord compression - ANS B) Fetal rest and activity cycles
All of the following hormones influence the FHR except:
A) Norepinephrine
B) Estrogen
@COPYRIGHT 2026/2027 ALL RIGHTS RESERVED
3
