NCC EFM (Electronic Fetal Monitoring) Certification Exam Bundle 2024/2025 Complete Review Pack with 500 Realistic Practice Questions and Correct Detailed Answers || Graded A+ Latest Updated Version

The most appropriate equipment for the administration of maternal oxygen for intrauterine resuscitation at 10 L/min is a A. Nasal cannula B. Simple face mask C. Nonrebreather face mask - Answer️C. Nonrebreather face mask Accurate determination of baseline rate requires A. At least 2 contiguous minutes of FHR in a 10-min window B. Evaluation of the FHR over at least a 10-min window C. Averaging the FHR over 30 min - Answer️B. Evaluation of the FHR over at least a 10-min window An EFM tracing with absent variability and no decelerations would be classified as A. Category I B. Category II (indeterminate) C. Category III - Answer️B. Category II (indeterminate) An EFM tracing with absent variability and intermittent late decelerations would be classified as A. Category I B. Category II C. Category III - Answer️B. Category II Interpretation and classification of FHR patterns are based on predictability of fetal status A. At birth B. At the time the pattern is observed C. Over the previous hour - Answer️B. At the time the pattern is observed Amnioinfusion is an appropriate measure for A. Thick, meconium-stained fluid B. Oligohydramnios C. Recurrent variable decelerations unresolved by position changes - Answer️C. Recurrent variable decelerations unresolved by position changes Baroreceptors respond to changes in fetal A. Blood pressure B. Oxygen status C. Acid-base status - Answer️A. Blood pressure Fetal scalp stimulation is appropriate in the context of A. Minimal variability B. Prolonged deceleration C. Bradycardia - Answer️A. Minimal variability Maternal oxygen administration is appropriate in the context of A. Recurrent variable decelerations/moderate variability B. Intermittent late decelerations/minimal variability C. Prolonged decelerations/moderate variability - Answer️B. Intermittent late decelerations/minimal variability A preterm fetus A. Is more susceptible to hypoxic insults during labor than the term fetus B. Requires internal monitoring if oxytocin is used for labor induction or augmentation C. Should be born via cesarean section unless there are maternal contraindications - Answer️A. Is more susceptible to hypoxic insults during labor than the term fetus Oxygen is transferred from the mother to the fetus via the placenta through A. Active transport B. Passive diffusion C. Facilitated diffusion - Answer️B. Passive diffusion Resting tone and intensity of uterine contractions cannot be assessed by A. External tocodynamometer B. Manual palpation C. Intrauterine pressure catheter - Answer️A. External tocodynamometer The FHR characteristic most predictive of a well-oxygenated baby at the time observed is A. Moderate variability B. Stable baseline rate C. Absence of decelerations - Answer️A. Moderate variability In the context of hypoxemia, fetal blood flow is shifted to the A. Brain B. Liver C. Lungs - Answer️A. Brain Baroreceptor-mediated decelerations are A. Early B. Late C. Variable - Answer️C. Variable The primary goal in the treatment of variable decelerations is to A. Correct umbilical cord compression B. Improve maternal oxygenation C. Maximize blood flow to the uterus - Answer️A. Correct umbilical cord compression Umbilical artery gas results reflect the status of the A. Mother B. Fetus C. Placenta - Answer️B. Fetus An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is A. Amnioinfusion B. Maternal repositioning C. Oxygen at 10L per nonrebreather face mask - Answer️B. Maternal repositioning Most fetal dysrhythmias are not life-threatening, except for _______, which may lead to fetal congestive heart failure. - Answer️Supraventricular tachycardia Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or cardiac anomalies may result in _______ variability. - Answer️Decreased In the presence of late or variable decelerations, two parameters that indicate adequate fetal oxygenation are _____ and _____. - Answer️Moderate variability; normal baseline rate To correctly interpret a baseline FHR as tachycardic or bradycardic, the rate must persist for a minimum of _____ min. - Answer️10 In assessing fetal well-being, the most important characteristic of the FHR is A. Rate B. Variability C. Presence of accelerations D. Absence of decelerations - Answer️B. Variability Stimulation of the _____ _____ _____ releases acetylcholine, resulting in decreased FHR. - Answer️Parasympathetic nervous system The _____ _____ _____ maintains transmission of beat-to-beat variability. - Answer️Parasympathetic nervous system Stimulation of the _____ _____ _____ releases catecholamines, resulting in increased FHR. - Answer️Sympathetic nervous system Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. - Answer️Baroreceptors Baroreceptors influence _____ decelerations with moderate variability. - Answer️Variable Following an ultrasound which revealed decreased amniotic fluid, a woman at term is admitted in early labor. It should be recognized that oligohydramnios often results in fetal heart rate decelerations that are A. Late in onset or occur after the peak of the contraction B. Synchronous with that of the contraction C. Varied in depth and duration - Answer️C. Varied in depth and duration In comparing early and late decelerations, a distinguishing factor between the two is A. Onset time to the nadir of the deceleration B. The number of decelerations that occur C. Timing in relation to contractions - Answer️C. Timing in relation to contractions The underlying cause of early decelerations is decreased A. Baroceptor response B. Increased peripheral resistance C. Vagal reflex - Answer️C. Vagal reflex Glucose is transferred across the placenta via _____ _____. - Answer️Facilitated diffusion Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via _____ _____. - Answer️Simple (passive) diffusion Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via _____ _____. - Answer️Active transport Well-oxygenated fetal blood enters the _____ ventricle, which supplies the heart and brain. Less-oxygenated blood enters the ______ ventricle, which supplies the rest of the body. - Answer️Left; right The _____ _____ allows relatively well-oxygenated blood to enter the fetal heart directly, bypassing the liver. - Answer️Ductus venosus The _____ _____ allows blood to bypass the lungs, flowing from the pulmonary artery to the aorta. - Answer️Ductus arteriosus The _____ _____ is the shunt that bypasses the fetal lungs, moving blood from the right atrium to the left atrium. - Answer️Foramen ovale Fetal blood has a _______ hemoglobin concentration compared to adults. A. Higher B. Lower - Answer️A. Higher Greater oxygen-carrying capacity Fetal blood has a _______ affinity for oxygen compared with the mother's blood, which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus. A. Higher B. Lower - Answer️A. Higher The fetus has a _______ cardiac output and heart rate than the adult, resulting in rapid circulation. A. Higher B. Lower - Answer️A. Higher As the FHR increases, the myocardium consumes _____ oxygen. A. More B. Less - Answer️A. More The fetal spiral electrode measures the A. Peaks of the Doppler waveforms B. R to R intervals of the fetal heart C. ST segments of the fetal ECG - Answer️B. R to R intervals of the fetal heart A woman who is admitted for an induction of labor with oxytocin is questioning the need for continuous electronic fetal monitoring. The appropriate response to this woman is A. Hospital policy requires that all patients have continuous electronic fetal monitoring. B. I would like to answer your questions about continuous monitoring and give you some information about why continuous monitoring is recommended. C. Nurses have more training with continuous electronic fetal monitoring than intermitte - Answer️B. I would like to answer your questions about continuous monitoring and give you some information about why continuous monitoring is recommended. The greater affinity that fetal hemoglobin has for oxygen allows for A. Easier release of oxygen to the tissues B. Greater binding of oxygen C. Stimulation of erythropoietin release - Answer️B. Greater binding of oxygen The process by which oxygen and carbon dioxide pass from a region of higher concentration to one of a lower concentration is called A. Active transport B. Simple diffusion C. Facilitated diffusion - Answer️B. Simple diffusion In the healthy fetus, blood flows from the right atrium to the left atrium through the A. Ductus arteriosus B. Ductus venosus C. Foramen ovale - Answer️C. Foramen ovale In the healthy fetus, the umbilical cord enters the fetal abdomen and bypasses the liver through the A. Ductus arteriosus B. Ductus venosus C. Foramen ovale - Answer️B. Ductus venosus Which statement best describes the relationship between maternal and fetal hemoglobin levels? A. Fetal hemoglobin is higher than maternal hemoglobin B. Maternal hemoglobin is higher than fetal hemoglobin C. Maternal and fetal hemoglobin are the same - Answer️A. Fetal hemoglobin is higher than maternal hemoglobin Baroreceptors respond mainly to changes in A. Blood pressure B. Hormonal changes C. Oxygen and carbon dioxide levels - Answer️A. Blood pressure Stimulation of the sympathetic nervous system causes the fetal heart rate to A. Decrease B. Increase C. Remain the same - Answer️B. Increase Which statement describes normal uterine activity? A. Frequency of 1-1/2 to 2 minutes B. Intensity of 90 mmHg early in labor C. Resting tone less than 20-25 mmHg - Answer️C. Resting tone less than 20-25 mmHg Greater than 5 contractions in 10 minutes averaged over 30 minutes indicates A. Excessive uterine activity B. Hyperstimulation C. Tachysystole - Answer️C. Tachysystole A 36 week gestation patient is brought to triage by squad after an MVA on her back. She is not bleeding and denies pain. She is not short of breath, but c/o dizziness and nausea since they put her on the gurney. The most likely cause is A. Abruptio placenta B. Preterm labor C. Supine hypotension - Answer️C. Supine hypotension One compensatory mechanism that helps maintain oxygen availability to the fetus during maternal exercise is A. A decrease in maternal hematocrit B. Transient increase in uterine blood flow C. An increase in uterine oxygen uptake - Answer️C. An increase in uterine oxygen uptake When the hydrogen ion content in the blood rises, the pH A. Lowers B. Neutralizes C. Rises - Answer️A. Lowers A woman receives terbutaline for an external version. You may expect what on the fetal heart tracing? A. Decrease in variability B. Increase in baseline C. No change - Answer️B. Increase in baseline What affect does magnesium sulfate have on the fetal heart rate? A. Decreases variability B. Increases variability C. No change - Answer️A. Decreases variability NICHD guidelines apply only to A. Intrapartum patients B. Internal monitoring of fetal heart rate C. Interpreting tracings of good quality - Answer️C. Interpreting tracings of good quality According to NICHD terminology, variability can be accurately accessed A. Visually, by determining the number of R to R intervals in a one minute period B. Visually, by determining the amplitude of the FHR change in bpm from the baseline C. Only when a fetal spiral electrode is in place - Answer️B. Visually, by determining the amplitude of the FHR change in bpm from the baseline When looking at the fetal heart rate, the most important characteristic to determine the absence of metabolic acidemia is A. Absence of late decelerations B. Baseline rate within normal range C. Presence of moderate variability - Answer️C. Presence of moderate variability Sinusoidal pattern can be documented when A. Cycles are 4-6 beats per minute in frequency B. The pattern lasts 20 minutes or longer C. There is moderate or minimal variability - Answer️B. The pattern lasts 20 minutes or longer Vagal stimulation would be manifested as what type of fetal heart rate pattern? A. Acceleration B. Early deceleration C. Tachycardia - Answer️B. Early deceleration Which fetal monitoring pattern is characteristic of cephalopelvic disproportion, especially when seen at the onset of labor? A. Early deceleration B. Late deceleration C. Variable deceleration - Answer️A. Early deceleration A risk of amnioinfusion is A. Prolonged labor B. Uterine overdistension C. Water intoxication - Answer️B. Uterine overdistension A fetal heart rate pattern that the NICHD has identified as predictive of current or impending fetal asphyxia so severe that the fetus is at risk of neurologic damage or death is A. Baseline tachycardia with absent variability B. Minimal baseline variability with recurrent late decelerations C. Recurrent late or variable decelerations with absent variability - Answer️C. Recurrent late or variable decelerations with absent variability A fetal heart rate pattern that can occur when there is a prolapsed cord is A. Marked variability B. Prolonged decelerations C. Tachycardia - Answer️B. Prolonged decelerations The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the next 15 minutes, there are 18 uterine contractions. Recommended management is to A. Address contraction frequency by reducing pitocin dose B. Continue to increase pitocin as long as FHR is Category I C. Turn the patient on her side and initiate an IV fluid bolus - Answer️C. Turn the patient on her side and initiate an IV fluid bolus A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the fetal heart tracings have been normal. Spontaneous rupture of membranes occurs; fetal heart rate drops to 90 beats per minute for four minutes and then resumes a normal pattern. The most likely etiology for this fetal heart rate change is A. Abnormal fetal presentation B. Impaired placental circulation C. Possible cord compression - Answer️C. Possible cord compression A 42 week gestation woman has been diagnosed with oligohydramnios. Based on this, a FHR change that can be expected is A. Late deceleration B. Minimal variability C. Variable deceleration - Answer️C. Variable deceleration Mono-mono zygotic twins are prone to what type of deceleration during labor? A. Early B. Late C. Variable - Answer️C. Variable During labor, the recommended fetal heart rate assessment interval for auscultation is every A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage B. 15 minutes no matter what stage of labor C. 60 minutes in the active phase of the first stage and every 30 minutes in second stage - Answer️A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage What fetal heart rate characteristics can be determined with auscultation? A. Baseline B. Early decelerations C. Variability - Answer️A. Baseline When auscultating the fetal heart rate, the provider/nurse should simultaneously assess the maternal A. Blood pressure B. Pain level C. Radial pulse - Answer️C. Radial pulse A woman has 10 fetal movements in one hour. This is considered what kind of movement? A. Decreased B. Excessive C. Normal - Answer️C. Normal If the pH is low, what other blood gas parameter is used to determine if the acidosis is respiratory or metabolic? A. HCO3 B. PCO2 C. PO2 - Answer️B. PCO2 The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10 A. Metabolic acidosis B. Mixed acidosis C. Respiratory acidosis - Answer️C. Respiratory acidosis A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic fluid was scored as normal. The expected management is A. Immediate delivery B. Repeat the test in 24 hours C. Schedule the next test in one week - Answer️B. Repeat the test in 24 hours A woman with gestational diabetes is 38 weeks gestation. Her Biophysical Profile score is 4. This indicates need for A. Follow up in one week B. Induction of labor C. Emergent cesarean section - Answer️B. Induction of labor A 35 week gestation fetus is having an NST. The fetal heart rate baseline is 130 bpm. The nurse is using vibroacoustic stimulation to reduce the length of time needed to obtain the NST. Fetal well-being requires A. 1 acceleration to 145 bpm B. 2 accelerations to 140 bpm C. 2 accelerations to at least 145 bpm - Answer️C. 2 accelerations to at least 145 bpm A woman desires a natural childbirth. The nurse puts pressure on her to get an epidural. This is an example of going against which ethical principle? A. Autonomy B. Beneficence C. Justice - Answer️A. Autonomy One characteristic of a high reliability perinatal unit is A. Alarms can only be called by unit leaders B. Reliance on memorization of protocols C. The organization creates a safety-oriented culture - Answer️C. The organization creates a safety-oriented culture One example of evidence-based practice related to fetal monitoring is A. Diagnosis of uterine rupture with an IUPC B. Intermittent auscultation for the low-risk patient C. Using electronic fetal monitoring to prevent cerebral palsy - Answer️B. Intermittent auscultation for the low-risk patient Supporting the parents decision to choose no extraordinary measures on their baby who is about to deliver at 24 3/7 weeks gestation despite the nurses personal opinion is an example of A. Autonomy B. Beneficence C. Non-maleficence - Answer️A. Autonomy _______ primarily function(s) to regulate respiratory activity and control circulation by responding to changes in arterial PO2, PCO2, and acid-base balance. A. Baroreceptors B. Chemoreceptors C. Cardioregulatory center - Answer️B. Chemoreceptors _______ are protective stretch receptors located in the aortic arch and the carotid sinuses at the bifurcation of the external and internal carotid arteries. A. Baroreceptors B. Chemoreceptors C. Arteries - Answer️A. Baroreceptors _______ respond to increases in fetal arterial blood pressure by detecting the amount of stretch and sending impulses via the vagus nerve to the midbrain, decreasing FHR, CO, and BP. A. Baroreceptors B. Chemoreceptors C. Veins - Answer️A. Baroreceptors As a contraction beings, partial umbilical cord compression causes occlusion of the low-pressure vein and decreased return of blood to the fetal heart, resulting in decreased CO, hypotension, and a compensatory FHR _____. A. Acceleration B. Early deceleration C. Late deceleration D. Variable deceleration - Answer️A. Acceleration With complete umbilical cord occlusion, the two umbilical arteries also become occluded, resulting in sudden fetal hypertension, stimulation of the baroreceptors, and a sudden _______ in FHR. A. Increase B. Decrease - Answer️B. Decrease Central _______ are located in the medulla oblongata; peripheral _______ are found in the carotid sinuses and aortic arch. A. Baroreceptors B. Chemoreceptors - Answer️B. Chemoreceptors When a fetus is stressed, catecholamine release (epinephrine, norepinephrine) occurs from the medulla oblongata, shunting blood _______ the brain, heart, and adrenal glands. A. Toward B. Away from - Answer️A. Toward Because stroke volume in the fetus does not fluctuate significantly, fetal cardiac output is _______ fetal heart rate. A. Greater than B. Less than C. Approximately equal to - Answer️C. Approximately equal to In _____ sleep, the fetus may be observed to have infrequent or absent body movements, normal FHR baseline, minimal variability, and a nonreactive NST, but may respond to external stimuli. Such typically occurs by 28 to 32 weeks' gestation. A. REM (active sleep state) B. Non-REM (quiet sleep state) - Answer️B. Non-REM (quiet sleep state) Place the following steps for performing Leopold's maneuver in the appropriate order. 1. Assess location of fetal back 2. Determine the descent of the presenting part 3. Identify the presenting part 4. Assess part of the fetus in the upper uterus A. 1, 3, 2, 4 B. 2, 4, 1, 2 C. 4, 1, 3, 2 D. 4, 3, 2, 1 - Answer️C. 4, 1, 3, 2 When the internal mode of monitoring (FSE, IUPC) is used, the information obtained on the uterine activity panel on the fetal monitor should be validated by the clinician by A. Asking the patient to report when she is feeling a contraction B. Ultrasound imaging C. Palpation - Answer️C. Palpation T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect baseline, rhythm, changes from baseline, and presence of an irregular rhythm. - Answer️True T/F: A Doppler device used for intermittent auscultation of the fetal heart rate may be used to identify rhythm irregularities, such as supraventricular tachycardia. - Answer️False T/F: Use of a fetoscope for intermittent auscultation of the fetal heart rate may be used to detect accelerations and decelerations from the baseline, and can clarify double-counting of half-counting of baseline rate. - Answer️True T/F: Auscultation may be used to detect baseline variability and discriminate FHR deceleration patterns. - Answer️False _______ represents increased sympathetic or decreased parasympathetic autonomic tone. A. Bradycardia B. Tachycardia - Answer️B. Tachycardia T/F: In the context of moderate variability, late decelerations are considered neurogenic in origin and are typically amenable to intrauterine resuscitation techniques directed towards maximizing uterine blood flow. - Answer️True When coupling or tripling is apparent on the uterine activity tracing, this may be indicative of a dysfunctional labor process and saturation (down regulation) of uterine oxytocin receptor sites in response to excess exposure to oxytocin. Which of the following interventions would be most appropriate? A. Normal response; continue to increase oxytocin titration B. Turn patient on side C. Decrease or discontinue oxytocin infusion - Answer️C. Decrease or discontinue oxytocin infusion The most common tachyarrhythmia in fetuses, supraventricular tachycardia, typically occurs at a rate of _____ to _____ bpm with minimal or absent variability. A. 160-200 B. 200-240 C. 240-260 - Answer️C. 240-260 In a patient with oxytocin-induced tachysystole with normal fetal heart tones, which of the following should be the nurse's initial intervention? A. Assist the patient to lateral position B. Discontinue Pitocin C. Administer IV fluid bolus - Answer️A. Assist the patient to lateral position In a patient with oxytocin-induced tachysystole with indeterminate or abnormal fetal heart tones, which of the following should be the nurse's initial intervention? A. Assist the patient to lateral position B. Discontinue Pitocin C. Administer IV fluid bolus - Answer️B. Discontinue Pitocin Fetal hypoxia and acidemia are demonstrated by pH _____ and base excess _____. - Answer️ 7.15; -8 T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns of moderate to severe late decelerations. - Answer️False T/F: Amnioinfusion is an appropriate intervention to attempt to resolve patterns with absent variability. - Answer️False T/F: Amnioinfusion may be an appropriate intervention for patients with oligohydramnios in the prevention of the development of variable decelerations. - Answer️False Not for prevention T/F: Meconium-stained amniotic fluid is an indication for amnioinfusion. - Answer️False T/F: Uterine resting tone may appear higher (25 to 40 mmHg) during amnioinfusion. - Answer️True _______ denotes a decrease in oxygenation of the fetal tissues. A. Hypercapnia B. Hypoxia C. Hypoxemia - Answer️B. Hypoxia _______ denotes a decrease in oxygen content of the fetal blood. A. Hypercapnia B. Hypoxia C. Hypoxemia - Answer️C. Hypoxemia _______ denotes an increase in carbon dioxide in the fetal blood. A. Hypercapnia B. Hypoxia C. Hypoxemia - Answer️A. Hypercapnia _______ denotes an increase in hydrogen ions in the fetal blood. A. Acidosis B. Acidemia C. Hypercapnia - Answer️B. Acidemia _______ denotes an increase in hydrogen ions in the fetal tissues. A. Acidosis B. Acidemia C. Hypercapnia - Answer️A. Acidosis _______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon dioxide (PCO2) values. A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis - Answer️A. Metabolic acidosis _______ _______ occurs when there is high PCO2 with normal bicarbonate levels. A. Metabolic acidosis B. Respiratory acidosis C. Metabolic alkalosis - Answer️B. Respiratory acidosis _______ _______ occurs when the HCO3 concentration is lower than normal. A. Base deficit B. Base excess C. Metabolic acidosis - Answer️A. Base deficit _______ _______ occurs when the HCO3 concentration is higher than normal. A. Base deficit B. Base excess C. Metabolic acidosis - Answer️B. Base excess _______ is defined as the energy-consuming process of metabolism. - Answer️Anabolism _______ is defined as the energy-releasing process of metabolism. - Answer️Catabolism T/F: It is an appropriate intervention to perform fetal scalp stimulation during a deceleration. - Answer️False Normal oxygen saturation for the fetus in labor is ___% to ___%. - Answer️30% to 65% The normal mean value range for arterial pH is A. 7.0-7.20 B. 7.20-7.29 C. 7.29-7.39 - Answer️B. 7.20-7.29 The normal mean value range for arterial PCO2 is A. 22-24 B. 35-40 C. 49-56 - Answer️C. 49-56 The normal mean value range for arterial bicarbonate (HCO3) is A. 22-24 B. 35-40 C. 49-56 - Answer️A. 22-24 The normal mean value range for arterial base deficit is A. 2.7-8.3 B. -3.0-2.5 C. 4.2-12.9 - Answer️A. 2.7-8.3 The normal mean value range for arterial PO2 is A. 22-24 B. 15-24 C. 49-56 - Answer️B. 15-24 pH 7.05 PO2 21 PCO2 72 HCO3 24 Base excess -12 A. Metabolic acidosis B. Respiratory acidosis C. Mixed acidosis - Answer️B. Respiratory acidosis pH 7.0 PO2 18 PCO2 54 HCO3 20 Base deficit 14 A. Metabolic acidosis B. Respiratory acidosis C. Mixed acidosis - Answer️A. Metabolic acidosis pH 7.02 PO2 17 PCO2 72 HCO3 19 Base deficit 16 A. Metabolic acidosis B. Respiratory acidosis C. Mixed acidosis - Answer️C. Mixed acidosis Which is a correct description of daily fetal movement counting? A. Counting should not be started by low-risk mothers until 38 weeks of gestation B. Fetal movement counting is not reliable because the methods of counting vary C. The mother counts the number of movements over a specified length of time - Answer️C. The mother counts the number of movements over a specified length of time The BPP includes the assessment of FHR along with what other four components? A. Amniotic fluid, fetal breathing, fetal movement, fetal tone B. Amniotic fluid, fetal anomalies, fetal breathing, fetal movement C. Estimated fetal weight, fetal breathing, fetal movement, placental grading - Answer️A. Amniotic fluid, fetal breathing, fetal movement, fetal tone Which of the following might indicate a potential for chronic fetal hypoxemia? A. Decreased amniotic fluid volume B. Increased amniotic fluid volume C. Intrauterine growth restriction - Answer️C. Intrauterine growth restriction With the finding of a single umbilical artery, what would you expect to observe with Doppler flow studies? A. Decreased blood perfusion from the fetus to the placenta B. Decreased blood perfusion from the placenta to the fetus C. Homeostatic dilation of the umbilical artery - Answer️A. Decreased blood perfusion from the fetus to the placenta Two umbilical arteries flow from the fetus to the placenta Primary benefits associated with the use of standardized terminology for fetal heart monitoring interpretation include A. Enhanced communication among health care providers and promotion of patient safety B. Increased nursing time at the bedside and enhanced patient satisfaction C. Increased likelihood of correctly diagnosing fetal acidosis during labor - Answer️A. Enhanced communication among health care providers and promotion of patient safety A patient presents with a small amount of thick dark blood clots who denies pain and whose abdomen is soft to the touch. Which component of oxygen transport to the fetus could potentially be compromised by this bleeding? A. Affinity B. Saturation C. Delivery - Answer️C. Delivery What is the most appropriate physiologic goal for a patient whose tracing reveals a sinusoidal baseline? A. Maximize umbilical circulation B. Maximize uteroplacental circulation C. Reduce uterine activity - Answer️B. Maximize uteroplacental circulation Compromised oxygenation - maximize uteroplacental circulation to promote perfusion and oxygenation When recurrent late decelerations are occurring, the correct physiologic interpretation of this event is A. Fetal myocardial acidosis is occurring B. Fetal hypoxemia may be present C. The fetus has oxygen reserves - Answer️B. Fetal hypoxemia may be present Which intrinsic homeostatic response is the fetus demonstrating when abrupt variable decelerations are present? A. Baroreceptor B. Catecholamine C. Sympathetic - Answer️A. Baroreceptor An amnioinfusion is intended to relieve which extrinsic factor that compromises oxygen transport? A. Excessive uterine compression B. Structural abnormalities of the placenta C. Umbilical cord compression - Answer️C. Umbilical cord compression The nurse wants to document her conversation with the attending physician during an emergent situation. The best approach to documentation would be to A. Continue providing care for the patient and write a late entry summarizing the conversation after the cesarean is completed B. Enter an objective transcription of the conversation in the electronic record while colleagues are preparing the patient for surgery C. Report the conversation to the charge nurse, who can make an entry in the medical r - Answer️A. Continue providing care for the patient and write a late entry summarizing the conversation after the cesarean is completed An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. Which interpretation of these umbilical cord and initial neonatal blood results is correct? A. Base buffers have been used to maintain oxygenation B. The mother was probably hypoglycemic C. The neonate is anemic - Answer️C. The neonate is anemic An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. These umbilical cord blood gases indicate A. Asphyxia related to umbilical and placental abnormalities B. Hypoxia related to neurological damage C. Mixed acidosis - Answer️C. Mixed acidosis An infant was delivered via cesarean. Umbilical cord blood gases were: pH 6.88, PCO2 114, PO2 10, bicarbonate 15, base excess (-) 20. The initial neonatal hemocrit was 20% and the hemoglobin was 8. Which phrase best describes acidemia? A. A decrease of oxygen concentration in the blood B. An increase in hydrogen ions in the blood C. An increase of hydrogen ions in the tissues - Answer️B. An increase in hydrogen ions in the blood Which compromise in fetal oxygenation could be a result of a post-date pregnancy? A. Increased saturation capacity B. Increased fetal oxygen affinity C. Decreased placental perfusion - Answer️C. Decreased placental perfusion What are the possible implications of an AFI of 3 cm for labor? A. An amnioinfusion will be needed B. Increased risk of uterine hyperstimulation C. Potential umbilical cord compression - Answer️C. Potential umbilical cord compression Which is a characteristic of a negative CST? A. Absence of late decelerations B. Recurrent late decelerations C. Reactive FHR tracing - Answer️A. Absence of late decelerations Which FHR tracing features must be assessed to distinguish arrhythmias from artifact? A. Shape and regularity of the spikes B. Spikes and variability C. Spikes and baseline - Answer️A. Shape and regularity of the spikes How might a fetal arrhythmia affect fetal oxygenation? A. By increasing fetal oxygen affinity B. By increasing sympathetic response C. By reducing fetal perfusion - Answer️C. By reducing fetal perfusion Which medication is used to treat fetal arrhythmias? A. Digoxin B. Labetolol C. Nifedipine - Answer️A. Digoxin Inotropic - promotes regular and effective cardiac contraction Fetal hydrops may present on ultrasound as fetal scalp edema and increased abdominal fluid as a results of A. An increase in gestational age B. Congestive heart failure C. Sustained oligohydramnios - Answer️B. Congestive heart failure What might increase fetal oxygen consumption? A. Hyperthermia B. Umbilical cord compression C. Uterine tachysystole - Answer️A. Hyperthermia Increases metabolism and oxygen consumption T/F: Adequacy of uterine resting tone measured by an IUPC should be validated by palpation. - Answer️True Which assessment or intervention would be least appropriate in a patient whose FHR tracing revealed tachycardia and a prolonged deceleration? A. Change maternal position to right lateral B. Further assess fetal oxygenation with scalp stimulation C. Perform a vaginal exam to assess fetal descent - Answer️B. Further assess fetal oxygenation with scalp stimulation Only used with normal baseline rate and never during decels; not an intervention Which of the following pieces of information would be of highest priority to relay to the neonatal team as they prepare for an emergency cesarean delivery? A. FHR arrhythmia, meconium, length of labor B. Gestational age, meconium, arrhythmia C. Gravidity & parity, gestational age, maternal temperature - Answer️B. Gestational age, meconium, arrhythmia What characteristics are necessary for a reactive NST in a G3P0 patient who is 25 6/7 weeks' gestation? A. Accelerations of 15bpm above the baseline lasting at least 15 seconds above the baseline B. Accelerations of 10bpm above the baseline lasting at least 10 seconds above the baseline C. Any acceleration greater than 10bpm above the baseline - Answer️B. Accelerations of 10bpm above the baseline lasting at least 10 seconds above the baseline How long may a standard NST be extended in a term gestation if reactivity is not initially demonstrated? A. From the initial 20 min to 40 min B. From the initial 20 min to 60 min C. From the initial 30 min to 60 min - Answer️A. From the initial 20 min to 40 min Accounts for fetal sleep Which is the most appropriate application of vibroacoustic stimulation (fetal acoustic stimulation) in a standard NST? A. The device is placed at the top of the maternal fundus B. The mother uses a marker button to document the fetal movement response C. The stimulation is applied after a baseline is established - Answer️C. The stimulation is applied after a baseline is established Which of the following characteristics are most common in the preterm fetus? A. Increased baseline rate and prolonged accelerations B. Increased baseline rate and variable decelerations C. Prolonged accelerations and variable decelerations - Answer️B. Increased baseline rate and variable decelerations As well as decreased variability What typical characteristics of preterm uterine activity may be present in a patient experiencing preterm labor? A. An irritable uterus with wandering hypertonus B. Low-amplitude high-frequency contractions C. Tetanic contractions - Answer️B. Low amplitude high-frequency contractions Which medications used with preterm labor can affect the FHR characteristics? A. Terbutaline and antibiotics B. Betamethasone and terbutaline C. Antibiotics and narcotics - Answer️B. Betamethasone and terbutaline What characterizes a preterm fetal response to stress? A. More frequently occurring late decelerations B. More frequently occurring prolonged decelerations C. More rapid deterioration from Category I to Category II or III - Answer️C. More rapid deterioration from Category I to Category II or III More likely to be subjected to hypoxia Clinical decision-making at the bedside should include: A. Communication with the primary care provider only during a crisis B. Integration of physiologic concepts with maternal-fetal assessment findings C. Reliance primarily on technology over bedside assessments - Answer️B. Integration of physiologic concepts with maternal-fetal assessment findings In the United States, the paper speed on the monitor is set at A. 1 cm/min B. 2 cm/min C. 3 cm/min - Answer️C. 3 cm/min A woman being monitored externally has a suspected fetal arrhythmia. The most appropriate action is to A. Insert a spiral electrode and turn off the logic B. Turn the logic on if an external monitor is in place C. Use a Doppler to listen to the ventricular rate - Answer️A. Insert a spiral electrode and turn off the logic The ultrasound transducer on the electronic fetal monitor measures the A. Electrical signal of the fetal heart B. Mechanical movements of the fetal heart reflected off of sound waves C. R-to-R intervals of the fetal heart - Answer️B. Mechanical movements of the fetal heart reflected off of sound waves The purpose of autocorrelation in external monitoring is to A. Compare incoming waveforms for comparison B. Decrease signal to noise levels C. Distinguish fetal from maternal HR - Answer️A. Compare incoming waveforms for comparison The area of maximum intensity of the FHR is usually the fetal A. Back B. Chest C. Umbilicus - Answer️A. Back Palpating the uterus is best performed by using the A. Back of the hand B. Fingertips C. Palm - Answer️B. Fingertips What is the most sensitive method of assessing uterine activity? A. IUPC B. Manual palpation C. Maternal perception - Answer️A. IUPC In comparison to maternal blood, the affinity of fetal blood for oxygen is A. Higher B. Lower C. The same - Answer️A. Higher The process that requires energy to accomplish the passage of substances within the intervillous space is A. Active transport B. Diffusion C. Facilitated diffusion - Answer️A. Active transport The umbilical vein carries A. Carbon dioxide from the fetus back to the placenta B. Deoxygenated blood from the fetus to the placenta C. Oxygenated blood from the placenta to the fetus - Answer️C. Oxygenated blood from the placenta to the fetus Fetal hypoxia is best described as a condition of A. Decreased oxygen in the blood B. Decreased oxygen in the tissue C. Increased hydrogen ions in the blood - Answer️B. Decreased oxygen in the tissue Stimulation of the parasympathetic nervous system causes the FHR to A. Decrease B. Increase C. Remain the same - Answer️A. Decrease Chemoreceptors respond mainly to changes in A. Blood pressure B. Hormonal levels C. Oxygen and carbon dioxide levels - Answer️C. Oxygen and carbon dioxide levels The fetus responds to a significant drop of PO2 by A. Increasing O2 consumption B. Reducing lactic acid production C. Shifting blood to vital organs - Answer️C. Shifting blood to vital organs Activation of fetal chemoreceptors results in which FHR change? A. Decrease B. Increase C. No change - Answer️A. Decrease Tachycardia is associated with increased A. Parasympathetic tone B. Sympathetic tone C. Vagal response - Answer️B. Sympathetic tone A patient receiving oxytocin has 17 contractions in 30 minutes. According to the NICHD guidelines, this is called A. Hyperstimulation B. Hypertonus C. Tachysystole - Answer️C. Tachysystole Maternal supine hypotension is caused mainly by compression of the A. Inferior vena cava B. Spiral arteries C. Uterine vessels - Answer️A. Inferior vena cava Which factor influences blood flow to the uterus? A. Fetal arterial pressu