AWHONN ADVANCED FETAL MONITORING EXAM
LATEST ACTUAL EXAM 130 QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES
Michelle is a 31-year-old G1P0 at 38 6/7 weeks who arrives to triage
holding her abdomen while moaning in pain. She is accompanied by her
sister. The nurse greets Michelle in triage and accompanies her to the
evaluation room. Michelle reports a history of normal blood pressure
during the pregnancy, opioid use disorder, and attendance at all her
prenatal visits. Her abdominal pain started approximately twelve hours
ago and has increased in intensity. Michelle reports that she had loose
stools while having the abdominal pain and has kept down water and
electrolyte drinks all day but continues to feel the urge to have a bowel
movement. She states that her vaccinations are up-to-date and that
there is no history of recent illness in her home.
With Michelle's presenting history, what are the nurse's priority
interventions in Michelle's care: ......ANSWER......Initiate electronic fetal
monitoring and reassess Michelle's blood pressure in 15 minutes
Michelle's blood pressure continues to be elevated in the 165/105 to
180/110 ranges. Lab work is drawn and results are pending. Anticipated
initial medical care for Michelle includes:
......ANSWER......Antihypertensive therapy
The perinatal team discussed Michelle's clinical picture with Michelle
and her sister, including her abnormal lab results. Her epigastric pain
remains severe. The anticipated best plan of care includes admitting
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Michelle, continuing with antihypertensive therapy, and:
......ANSWER......Starting magnesium sulfate
After a discussion with Michelle and her health care team. The decision
is made to admit Michelle for induction. Magnesium Sulfate is initiated,
and oxytocin is started at 2 mU/min. Over the next two hours, Michelle
received 3 doses of IV Labetalol and 1 dose of IV Hydralazine to reduce
her blood pressure out of the severe range. She received an epidural
approximately 45 minutes ago and the oxytocin is currently infusing at
10 mu/min.
What is the priority nursing intervention at this time?
......ANSWER......Assess Michelle, evaluate her vital signs, and attempt
intrauterine resuscitation
What category is the tracing? ......ANSWER......Category III
Upon entry into the room, Michelle is found to be in the high fowler's
position. Vital signs are as follows: BP 157/89, HR 134, RR 32, SPO2
86%, urine output 200mL for the last 2 hours.
What is the most likely physiologic cause of impaired Oxygen delivery in
Michelle's case? ......ANSWER......Pulmonary edema
A healthcare organization that reflects a culture of safety establishes an
environment that is ......ANSWER......Blame-free and uses non-
threatening processes in the presence of medical errors
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