NCC Electronic Fetal Monitoring Certification| 470
QUESTIONS| 56 PAGES| WITH COMPLETE SOLUTION
Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above Correct Answer: e. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. Correct Answer: b. Increases cardiac
output by increasing it's heart rate.
Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change Correct Answer: a. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D Correct Answer: g. C & D
The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the
FHR baseline?
a. Increases baseline
b. Decreases baseline Correct Answer: b. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. Correct Answer:
True
T/F: The parasympathetic nervous system is a cardioaccelerator. Correct Answer: False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood
pressure. Correct Answer: True
,T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the
ultrasound transducer and the fetal spiral electrode. Correct Answer: True
T/F: Variability can be determined with the fetoscope. Correct Answer: False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped
in warm water to make cleaning easier. Correct Answer: False
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
increased variability. Correct Answer: True
T/F: All fetal monitors contain a logic system designed to reject artifact. Correct Answer: True
T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. Correct Answer: True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. Correct Answer:
False
T/F: Both internal and external monitoring methods are equally accurate means of obtaining the
fetal heart rate and contraction patterns. Correct Answer: False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. Correct
Answer: True
T/F: The external toco gives measurable uterine pressure. Correct Answer: False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present.
Correct Answer: False
T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's back, as
the fetal heart is heard best there. Correct Answer: True
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. Correct Answer: False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal.
Correct Answer: False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. Correct Answer: False
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died.
Correct Answer: True
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. Correct
Answer: True
,T/F: Variability and periodic changes can be detected with both internal and external monitoring.
Correct Answer: True
T/F: Variable decelerations are a result of cord compression. Correct Answer: True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of
adequate fetal oxygenation. Correct Answer: True
T/F: Variable decelerations are a vagal response. Correct Answer: True
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are
delayed in timing with the nadir of the deceleration occurring after the peak of the contraction.
Correct Answer: True
T/F: The fetal heart rate baseline can be determined during periods of marked variability. Correct
Answer: False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through
the placenta. Correct Answer: True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in
labor. Correct Answer: True
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated.
Correct Answer: False
What is your first intervention in management of a patient experiencing variable decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion Correct Answer: b. Change maternal position
Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 Correct Answer: c. 2, 3 and 4
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
, c. Cord compression
d. Maternal position change Correct Answer: a. Utero-placental insufficiency
The most prevalent risk factor associated with fetal death before the onset of labor is:
a. Low socioeconomic status
b. Fetal malpresentation
c. Uteroplacental insufficiency
d. Uterine anomalies Correct Answer: c. Uteroplacental insufficiency
Which of the following is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels Correct Answer: d. Maternal HCG levels
Which of the following conditions is not an indication for antepartum fetal surveillance?
a. Gestational hypertension
b. Diabetes in pregnancy
c. Fetus in breech presentation
d. Decreased fetal movement Correct Answer: c. Fetus in breech presentation
Which of the following does not affect the degree of fetal activity?
a. Vibroacoustic stimulation
b. Smoking
c. Fetal position
d. Gestational age Correct Answer: a. Vibroacoustic stimulation
To be considered reactive, a nonstress test must have:
a. 4 fetal heart rate accelerations in a 20 minute window
b. 2 fetal heart rate accelerations in a 10 minute window
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window Correct Answer: d. 2 fetal heart rate
accelerations in a 20 minute window
If a nonstress test is nonreactive after 40 minutes, the next step should be:
a. Have the client go home and do fetal movement counts
b. Do a biophysical profile or contraction stress test
c. Repeat the nonstress test within a week
d. Admit the client for delivery Correct Answer: b. Do a biophysical profile or contraction stress
test
All of the following are components of a biophysical profile except:
a. Contraction stress test
b. Assessment of fetal breathing
c. Amniotic fluid volume measurement
d. Fetal movement assessment Correct Answer: a. Contraction stress test
QUESTIONS| 56 PAGES| WITH COMPLETE SOLUTION
Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above Correct Answer: e. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. Correct Answer: b. Increases cardiac
output by increasing it's heart rate.
Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change Correct Answer: a. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D Correct Answer: g. C & D
The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the
FHR baseline?
a. Increases baseline
b. Decreases baseline Correct Answer: b. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. Correct Answer:
True
T/F: The parasympathetic nervous system is a cardioaccelerator. Correct Answer: False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood
pressure. Correct Answer: True
,T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the
ultrasound transducer and the fetal spiral electrode. Correct Answer: True
T/F: Variability can be determined with the fetoscope. Correct Answer: False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped
in warm water to make cleaning easier. Correct Answer: False
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
increased variability. Correct Answer: True
T/F: All fetal monitors contain a logic system designed to reject artifact. Correct Answer: True
T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. Correct Answer: True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. Correct Answer:
False
T/F: Both internal and external monitoring methods are equally accurate means of obtaining the
fetal heart rate and contraction patterns. Correct Answer: False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. Correct
Answer: True
T/F: The external toco gives measurable uterine pressure. Correct Answer: False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present.
Correct Answer: False
T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's back, as
the fetal heart is heard best there. Correct Answer: True
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. Correct Answer: False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal.
Correct Answer: False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. Correct Answer: False
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died.
Correct Answer: True
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. Correct
Answer: True
,T/F: Variability and periodic changes can be detected with both internal and external monitoring.
Correct Answer: True
T/F: Variable decelerations are a result of cord compression. Correct Answer: True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of
adequate fetal oxygenation. Correct Answer: True
T/F: Variable decelerations are a vagal response. Correct Answer: True
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are
delayed in timing with the nadir of the deceleration occurring after the peak of the contraction.
Correct Answer: True
T/F: The fetal heart rate baseline can be determined during periods of marked variability. Correct
Answer: False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through
the placenta. Correct Answer: True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in
labor. Correct Answer: True
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated.
Correct Answer: False
What is your first intervention in management of a patient experiencing variable decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion Correct Answer: b. Change maternal position
Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 Correct Answer: c. 2, 3 and 4
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
, c. Cord compression
d. Maternal position change Correct Answer: a. Utero-placental insufficiency
The most prevalent risk factor associated with fetal death before the onset of labor is:
a. Low socioeconomic status
b. Fetal malpresentation
c. Uteroplacental insufficiency
d. Uterine anomalies Correct Answer: c. Uteroplacental insufficiency
Which of the following is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels Correct Answer: d. Maternal HCG levels
Which of the following conditions is not an indication for antepartum fetal surveillance?
a. Gestational hypertension
b. Diabetes in pregnancy
c. Fetus in breech presentation
d. Decreased fetal movement Correct Answer: c. Fetus in breech presentation
Which of the following does not affect the degree of fetal activity?
a. Vibroacoustic stimulation
b. Smoking
c. Fetal position
d. Gestational age Correct Answer: a. Vibroacoustic stimulation
To be considered reactive, a nonstress test must have:
a. 4 fetal heart rate accelerations in a 20 minute window
b. 2 fetal heart rate accelerations in a 10 minute window
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window Correct Answer: d. 2 fetal heart rate
accelerations in a 20 minute window
If a nonstress test is nonreactive after 40 minutes, the next step should be:
a. Have the client go home and do fetal movement counts
b. Do a biophysical profile or contraction stress test
c. Repeat the nonstress test within a week
d. Admit the client for delivery Correct Answer: b. Do a biophysical profile or contraction stress
test
All of the following are components of a biophysical profile except:
a. Contraction stress test
b. Assessment of fetal breathing
c. Amniotic fluid volume measurement
d. Fetal movement assessment Correct Answer: a. Contraction stress test
