NCC EFM practice Exam Complete Guide Solution

NCC EFM practice Exam Complete Guide 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 Ans- e. All of the above 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 Ans- a. A decrease in the heart rate 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 Ans- b. Decreases baseline T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased variability. Ans- True T/F: All fetal monitors contain a logic system designed to reject artifact. Ans- True T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. Ans- True T/F: Variability and periodic changes can be detected with both internal and external monitoring. AnsTrue T/F: Variable decelerations are a vagal response. Ans- True T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. Ans- True 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 Ans- c. 2, 3 and 4 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 Ans- c. Uteroplacental insufficiency 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 Ans- 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 Ans- a. Vibroacoustic stimulation T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas, and number of umbilical vessels. Ans- True T/F: Low amplitude contractions are not an early sign of preterm labor. Ans- False T/F: Corticosteroid administration may cause an increase in FHR accelerations. Ans- False T/F: Corticosteroid administration may cause an increase in FHR. Ans- True T/F: Contractions cause an increase in uterine venous pressure and a decrease in uterine artery perfusion. Ans- 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 Ans- B. Increase BP and decrease HR 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 Ans- 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 Ans- D. Maternal fever 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 Ans- 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 Ans- B. 200 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 Ans- A. 7.10 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 Ans- 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 Ans- C. 10 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 Ans- B. Perform vaginal exam Scalp stimulation The FHR is controlled by the A. Sympathetic nervous system B. Sinoatrial node C. Atrioventricular node D. Parasympathetic nervous system Ans- B. Sinoatrial node T/F: Fetal tachycardia is a normal compensatory response to transient fetal hypoxemia. Ans- True At how many weeks gestation should FHR variability be normal in manner? A. 24 weeks B. 28 weeks C. 32 weeks D. 36 weeks Ans- B. 28 weeks Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leads first to _______ _______, then _______ _______. A. Respiratory alkalosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis C. Respiratory alkalosis; metabolic alkalosis D. Respiratory acidosis; metabolic acidosis Ans- B. Respiratory acidosis; metabolic acidosis Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is typically present in _______. A. Variable decelerations B. Late decelerations C. Early decelerations D. Accelerations Ans- B. Late decelerations Place the following interventions for a sinusoidal FHR in the correct order: 1. Prepare for cesarean delivery 2. Place patient in lateral position 3. Determine if pattern is related to narcotic analgesic administration 4. Provide oxygen via face mask A. 4, 2, 3, 1 B. 3, 1, 2, 4 C. 4, 3, 2, 1 D. 3, 2, 4, 1 Ans- D. 3, 2, 4, 1 FHTs with accelerations, no decelerations, and minimal variability would be categorized as A. Category I B. Category II C. Category III Ans- B. Category II FHTs with minimal variability, absent accelerations, and a 3-minute prolonged deceleration would be categorized as A. Category I B. Category II C. Category III Ans- B. Category II Which of the following is not a likely cause of a sinusoidal FHR pattern? A. Chronic fetal bleeding B. Fetal hypoxia or anemia C. Triple screen positive for Trisomy 21 D. Fetal isoimmunization Ans- C. Triple screen positive for Trisomy 21 Which of the following factors is not likely to cause uteroplacental insufficiency? A. Late-term gestation B. Preeclampsia C. Gestational diabetes D. Polyhydramnios E. Maternal smoking or drug use Ans- D. Polyhydramnios The normal FHR baseline A. Decreases during labor B. Fluctuates during labor C. Increases during labor Ans- B. Fluctuates during labor Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal A. Hypoxemia B. Rotation C. Vagal stimulation Ans- C. Vagal stimulatio