NCC EFM fetal monitoring practice quizzes part 1, With complete verified solution 100%

NCC EFM fetal monitoring practice quizzes part 1, With complete verified solution 100% 1. A woman in the first stage of labor is to have a direct fetal scalp electrode placed. The fetal presenting part is not engaged but membranes have been ruptured. Placement of the fetal scalp electrode increases the risk of a. cord prolapse b. prolonged labor c neonatal hematoma a 2. When variable decelerations persist despite intrauterine resuscitation, a factor that would lead to consideration of letting labor continue to delivery is a. acceleration after vibroacoustion b. regular fetal breathing motions c. no tachysystole a A characteristic of a sinusoidal heart rate pattern is a. amplitude of 5 to 15 beats/min above and below the baseline b. a fixed baseline variability range for 10 or more minutes c. bradycardia with regular oscillation pattern a Since the introduction of electronic fetal monitoring, what effects have occurred? a. Better early detection of hypoxic ischemic encephalopathy b. Decreased incidence of cerebral palsy c. Increased incidence of cesarean delivery c. Increased incidence of cesarean delivery Oligohydramnios is defined on the biophysical profile as a. amniotic fluid index falling below the threshold of 5 cm b. no single measurable vertical pocket of fluid greater than 2 cm c. all four quadrant pockets of fluid being less than 6 cm b. no single measurable vertical pocket of fluid greater than 2 cm The optimal antepartum fetal testing strategy would identify an at risk fetus prior to an irreversible event while a. cinfirming fetal viability b. minimizing iatrogenic prematurity c. preventing progression of fetal complications b. minimizing iatrogenic prematurity Accelerations on the electronic fetal monitoring in the intrapartum period a. are not required for the tracing to be considered normal b. must show 15 beats x 15 seconds acceleration to be categorized as such c. normal EFM tracings without accelerations are assigned a category II designation a. are not required for the tracing to be considered normal Myometrial compression of the spiral arteries is the underlying cause of a. late decelerations b. sinusoidal pattern c. variable decelerations a. late decelerations The physiologic basis of the biophysical profile is that fetal movement decreases with a. depressed central nervous system b. increasing hypoxia c. reduced cardiac function b. increasing hypoxia There are different criteria for nonstress test evaluation between preterm and term fetuses because in the preterm fetus a. heart rate is often increased b. magnitude of accelerations can vary over time c. fetal heart rate variability is more sensitive to uterine b. magnitude of accelerations can vary over time The minimal baseline duration on an electronic fetal monitor must be at least 2 minutes in any given window for how many minutes? a. 5 b. 10 c. 20 b. 10 To determine if a fetal heart rate tracing should be assigned a category III designation absent variability, which of the following should be present? a. bradycardia b. tachycardia c. prolonged deceleration a. bradycardia Category III FHR tracings include either - Absent baseline FHR variability and any of the following: recurrent late decelerations Recurrent variable decelerations Bradycardia - Sinusoidal pattern There are often small increases in fetal heart rate that precede and follow variable decelerations because the compression of umbilical vein can cause tachycardia secondary to decreased a. myocardial response b. preload c. systemic vascular resistance b. preload The fetal heart rate (FHR) is controlled by the fetal central nervous system and mediated by sympathetic or parasympathetic nerve impulses originating in the fetal a. brain stem b. cerebral cortex c. hypothalamus a. brain stem A reactive nonstress test is one in which of the following occurs? a. an acceleration sustains its peak acceleration for 15 seconds b. At least one acceleration in first 10 minutes and 2 or more in the first 20 minutes c. There are at least two accelerations that peak at 15 beats above baseline and are sustained for at 15 seconds c. There are at least two accelerations that peak at 15 beats above baseline and are sustained for at 15 seconds A woman at 38 weeks gestation is evaluated for decreased fetal movement with a nonstress test. The test is reactive. The next step in management is to a. allow pregnancy to continue to term with no further testing b. continue nonstress testing each week for remainder of the pregnancy a. allow pregnancy to continue to term with no further testing To defferentiate respiratory from metabolic acidosis, the indicative measure is a. higher base deficit b. reduced oxygen saturation c. low pH a. higher base deficit BD12 or higher? No- respiratory acidemia Yes - (a) if pCO2 elevated = yes 60 Mixed acidemia (b) No 60 = Metabolic acidemia When oligohydramnios is diagnosed on biophysical profile, the first step in management is to a. deliver if pregnancy is beyond 37 weeks gestation b. perform an amnioinfusion and observe c. rule out membrane rupture and congenital anomalies c. rule out membrane rupture and congenital anomalies Category 1 tracings are strongly predictive of normal a. cardiac anatomy and physiology b. cerebral cortex activity c. fetal acid-based status c. fetal acid-based status The presence of intermittent FHR accelerations associated with fetal movement is believed to be an indicator of a. adequate uteroplacental circulation b. intact fetal autonomic system c. functional cerebral cortex b. intact fetal autonomic system The criteria for a negative contraction stress test is a. 3 contractions lasting 40 seconds within 10 minutes b. detection of any decelerations occurring with uterine contractions c. the same as for a reactive nonstress test a. 3 contractions lasting 40 seconds within 10 minutes The magnitude of vagal nerve stimulation correlates with the magnitude of pressure applied against the fetal heart resulting in decelerations that a. mirror the image of contraction b. occur prior to the peak of the contraction c. show profoyund depth but quick return a. mirror the image of contraction Early decelerations indicative of intact central nervous system: representing vagal response to the compression of the fetal head pressure on fetal head stimulates vagus nerve, which will decrease HR. Abnormal umbilical artery Doppler S/D ratios imply a pathology of a. cephalization b. fetal cardiac anatomy or physiology c. placental vasculature c. placental vasculature In a fetus under 32 weeks, the nonstress test shows an acceleration 15 x 15 at minute 6 and 10x10 by minute 12. There are no further accelerations in the remainder of the 20 minute testing window. The best interpretation is