NCC ELECTRONIC FETAL MONITORING FINAL EXAM
QUESTIONS AND ANSWERS RATED A+
✔✔T/F: Contractions cause an increase in uterine venous pressure and a decrease in
uterine artery perfusion. - ✔✔True
✔✔As a result of the intrinsic fetal response to oxygen deprivation, increased
catecholamine levels cause the peripheral blood flow to decrease while the blood flow
to vital organs increases. These flow changes along with increased catecholamine
secretions have what effect on fetal blood pressure and fetal heart rate?
A. Increase BP and increase HR
B. Increase BP and decrease HR
C. Decrease BP and increase HR
D. Decrease BP and decrease HR - ✔✔B. Increase BP and decrease HR
✔✔All of the following might indicate a pseudosinusoidal pattern as opposed to a
sinusoidal pattern, except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min - ✔✔D. Frequency of oscillations
of two to five cycles/min
✔✔All of the following are appropriate interventions for fetal tachycardia except:
A. Increase maternal IV fluid rate
B. Assess maternal vital signs
C. Perform SVE
D. Administer oxygen - ✔✔C. Perform SVE
✔✔During a term antepartum NST (non-stress test), you notice several variable
decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the
following is the least likely explanation?
A. True knot
B. Gestational diabetes
C. Umbilical cord entanglement
D. Oligohydramnios - ✔✔B. Gestational diabetes
✔✔All of the following are likely causes of prolonged decelerations except:
A. Uterine tachysystole
B. Prolapsed cord
C. Maternal hypotension
D. Maternal fever - ✔✔D. Maternal fever
✔✔_______ decelerations occur with less than 50% of contractions.
,A. Recurrent
B. Intermittent
C. Repetitive - ✔✔B. Intermittent
✔✔_______ decelerations occur with greater than or equal to 50% of contractions.
A. Recurrent
B. Intermittent
C. Repetitive - ✔✔A. Recurrent
✔✔All of the following could likely cause minimal variability in FHR except
A. Magnesium sulfate administration
B. Fetal sleep cycle
C. Narcotic administration
D. Ephedrine administration - ✔✔D. Ephedrine administration
✔✔When an IUPC has been placed, Montevideo units must be ___ or greater for
adequate cervical change to occur.
A. 100
B. 200
C. 300
D. 400 - ✔✔B. 200
✔✔The ________ increases the heart rate and strengthens myocardial contractions
through the release of epinephrine and nonepinephrine.
A. Sympathetic nervous system
B. Parasympathetic nervous system - ✔✔A. Sympathetic nervous system
✔✔The ________, through stimulation of the vagus nerve, reduces FHR and maintains
variability.
A. Sympathetic nervous system
B. Parasympathetic nervous system - ✔✔B. Parasympathetic nervous system
✔✔What would be a suspected pH in a fetus whose FHTs included recurrent late
decelerations during labor?
A. 7.10
B. 7.26
C. 7.32
D. 7.41 - ✔✔A. 7.10
✔✔What is the most common cause of sinusoidal patterns?
A. Prolapsed cord
B. Rh incompatibility
C. Recurrent late decelerations
D. Oligohydramnios - ✔✔B. Rh incompatibility
,✔✔Before ___ weeks of gestation, an increase in FHR that peaks at least 10 bpm
above the baseline and lasts at least 10 seconds is considered an acceleration.
A. 28
B. 30
C. 32
D. 36 - ✔✔C. 32
✔✔The expected response of the fetal heart rate to active fetal movement of a 31-week
gestational age fetus is:
a. Suppression of normal short term variability for 15 seconds
b. Acceleration of at least 15 beats per minute for 15 seconds
c. Acceleration followed by a 15-second deceleration of the heart rate
d. Acceleration of at least 10 beats per minute for 10 seconds - ✔✔d. Acceleration of at
least 10 beats per minute for 10 seconds
✔✔The nurse notes a pattern of variable decelerations to 75 bpm on the fetal monitor.
The initial nursing action is to:
a. Reposition the woman
b. Administer oxygen
c. Increase the intravenous fluid infusion
d. Stimulate the fetal scalp - ✔✔a. Reposition the woman
✔✔The tocotransducer should be placed:
a. In the suprapubic area
b. In the fundal area
c. Over the xiphoid process
d. Within the uterus - ✔✔b. In the fundal area
✔✔The nurse notes a pattern of decelerations on the fetal monitor that begins shortly
after the contraction and returns to baseline just before the contraction is over. The
correct nursing response is to:
a. Give the woman oxygen by facemask at 8-10 L/min
b. Position the woman on her opposite side
c. Increase the rate of the woman's intravenous fluid
d. Continue to observe and record the normal pattern - ✔✔d. Continue to observe and
record the normal pattern
✔✔Determining the FHR baseline requires the nurse to approximate the mean FHR
rounded to increments of 5 bpm during a ___-minute window (excluding accelerations
and decelerations).
A. 2
B. 5
C. 10
D. 20 - ✔✔C. 10
, ✔✔Uterine tachysystole is observed when there are
A. 5 or more contractions in 10 min
B. 6 or more contractions in 10 min
C. 10 or more contractions in 10 min
D. 7 or more contractions in 10 min - ✔✔B. 6 or more contractions in 10 min
✔✔Which of the following interventions would best stimulate an acceleration in the
FHR?
A. Provide juice to patient
B. Perform vaginal exam
C. Turn patient on left side
D. Vibroacoustic stimulation - ✔✔B. Perform vaginal exam
Scalp stimulation
✔✔Assessment of the _____ is an indirect measurement of fetal oxygenation.
A. Fetal heart rate
B. Fetal scalp sampling
C. Uterine activity
D. Direct Coombs - ✔✔A. Fetal heart rate
✔✔T/F: Intrauterine pressure catheters (IUPCs) do not increase risk for infection when
placed on patients with intact membranes. - ✔✔False
Membranes must be ruptured for use; infection is a risk
✔✔What are abnormal fetal heart rate tracings predictive of?
A. Likelihood of spontaneous vaginal delivery
B. Newborn condition at time of delivery
C. Fetal acid-base abnormalities
D. Fetal intrauterine growth - ✔✔C. Fetal acid-base abnormalities
✔✔Which of the following is not an intervention that should be implemented in a patient
with uterine tachysystole?
A. Administer terbutaline
B. Increase IV fluid rate
C. Decrease or discontinue IV oxytocin
D. Prepare patient for cesarean section - ✔✔D. Prepare patient for cesarean section
✔✔Which of the following is most effective in determining the strength of a patient's
contractions?
A. Patient report
B. Tocodynanamometer tracing
QUESTIONS AND ANSWERS RATED A+
✔✔T/F: Contractions cause an increase in uterine venous pressure and a decrease in
uterine artery perfusion. - ✔✔True
✔✔As a result of the intrinsic fetal response to oxygen deprivation, increased
catecholamine levels cause the peripheral blood flow to decrease while the blood flow
to vital organs increases. These flow changes along with increased catecholamine
secretions have what effect on fetal blood pressure and fetal heart rate?
A. Increase BP and increase HR
B. Increase BP and decrease HR
C. Decrease BP and increase HR
D. Decrease BP and decrease HR - ✔✔B. Increase BP and decrease HR
✔✔All of the following might indicate a pseudosinusoidal pattern as opposed to a
sinusoidal pattern, except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min - ✔✔D. Frequency of oscillations
of two to five cycles/min
✔✔All of the following are appropriate interventions for fetal tachycardia except:
A. Increase maternal IV fluid rate
B. Assess maternal vital signs
C. Perform SVE
D. Administer oxygen - ✔✔C. Perform SVE
✔✔During a term antepartum NST (non-stress test), you notice several variable
decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the
following is the least likely explanation?
A. True knot
B. Gestational diabetes
C. Umbilical cord entanglement
D. Oligohydramnios - ✔✔B. Gestational diabetes
✔✔All of the following are likely causes of prolonged decelerations except:
A. Uterine tachysystole
B. Prolapsed cord
C. Maternal hypotension
D. Maternal fever - ✔✔D. Maternal fever
✔✔_______ decelerations occur with less than 50% of contractions.
,A. Recurrent
B. Intermittent
C. Repetitive - ✔✔B. Intermittent
✔✔_______ decelerations occur with greater than or equal to 50% of contractions.
A. Recurrent
B. Intermittent
C. Repetitive - ✔✔A. Recurrent
✔✔All of the following could likely cause minimal variability in FHR except
A. Magnesium sulfate administration
B. Fetal sleep cycle
C. Narcotic administration
D. Ephedrine administration - ✔✔D. Ephedrine administration
✔✔When an IUPC has been placed, Montevideo units must be ___ or greater for
adequate cervical change to occur.
A. 100
B. 200
C. 300
D. 400 - ✔✔B. 200
✔✔The ________ increases the heart rate and strengthens myocardial contractions
through the release of epinephrine and nonepinephrine.
A. Sympathetic nervous system
B. Parasympathetic nervous system - ✔✔A. Sympathetic nervous system
✔✔The ________, through stimulation of the vagus nerve, reduces FHR and maintains
variability.
A. Sympathetic nervous system
B. Parasympathetic nervous system - ✔✔B. Parasympathetic nervous system
✔✔What would be a suspected pH in a fetus whose FHTs included recurrent late
decelerations during labor?
A. 7.10
B. 7.26
C. 7.32
D. 7.41 - ✔✔A. 7.10
✔✔What is the most common cause of sinusoidal patterns?
A. Prolapsed cord
B. Rh incompatibility
C. Recurrent late decelerations
D. Oligohydramnios - ✔✔B. Rh incompatibility
,✔✔Before ___ weeks of gestation, an increase in FHR that peaks at least 10 bpm
above the baseline and lasts at least 10 seconds is considered an acceleration.
A. 28
B. 30
C. 32
D. 36 - ✔✔C. 32
✔✔The expected response of the fetal heart rate to active fetal movement of a 31-week
gestational age fetus is:
a. Suppression of normal short term variability for 15 seconds
b. Acceleration of at least 15 beats per minute for 15 seconds
c. Acceleration followed by a 15-second deceleration of the heart rate
d. Acceleration of at least 10 beats per minute for 10 seconds - ✔✔d. Acceleration of at
least 10 beats per minute for 10 seconds
✔✔The nurse notes a pattern of variable decelerations to 75 bpm on the fetal monitor.
The initial nursing action is to:
a. Reposition the woman
b. Administer oxygen
c. Increase the intravenous fluid infusion
d. Stimulate the fetal scalp - ✔✔a. Reposition the woman
✔✔The tocotransducer should be placed:
a. In the suprapubic area
b. In the fundal area
c. Over the xiphoid process
d. Within the uterus - ✔✔b. In the fundal area
✔✔The nurse notes a pattern of decelerations on the fetal monitor that begins shortly
after the contraction and returns to baseline just before the contraction is over. The
correct nursing response is to:
a. Give the woman oxygen by facemask at 8-10 L/min
b. Position the woman on her opposite side
c. Increase the rate of the woman's intravenous fluid
d. Continue to observe and record the normal pattern - ✔✔d. Continue to observe and
record the normal pattern
✔✔Determining the FHR baseline requires the nurse to approximate the mean FHR
rounded to increments of 5 bpm during a ___-minute window (excluding accelerations
and decelerations).
A. 2
B. 5
C. 10
D. 20 - ✔✔C. 10
, ✔✔Uterine tachysystole is observed when there are
A. 5 or more contractions in 10 min
B. 6 or more contractions in 10 min
C. 10 or more contractions in 10 min
D. 7 or more contractions in 10 min - ✔✔B. 6 or more contractions in 10 min
✔✔Which of the following interventions would best stimulate an acceleration in the
FHR?
A. Provide juice to patient
B. Perform vaginal exam
C. Turn patient on left side
D. Vibroacoustic stimulation - ✔✔B. Perform vaginal exam
Scalp stimulation
✔✔Assessment of the _____ is an indirect measurement of fetal oxygenation.
A. Fetal heart rate
B. Fetal scalp sampling
C. Uterine activity
D. Direct Coombs - ✔✔A. Fetal heart rate
✔✔T/F: Intrauterine pressure catheters (IUPCs) do not increase risk for infection when
placed on patients with intact membranes. - ✔✔False
Membranes must be ruptured for use; infection is a risk
✔✔What are abnormal fetal heart rate tracings predictive of?
A. Likelihood of spontaneous vaginal delivery
B. Newborn condition at time of delivery
C. Fetal acid-base abnormalities
D. Fetal intrauterine growth - ✔✔C. Fetal acid-base abnormalities
✔✔Which of the following is not an intervention that should be implemented in a patient
with uterine tachysystole?
A. Administer terbutaline
B. Increase IV fluid rate
C. Decrease or discontinue IV oxytocin
D. Prepare patient for cesarean section - ✔✔D. Prepare patient for cesarean section
✔✔Which of the following is most effective in determining the strength of a patient's
contractions?
A. Patient report
B. Tocodynanamometer tracing
