AWHONN ADVANCED FETAL MONITORING EXAM LATEST
ACTUAL EXAM
True or False: Moderate variability reliably predicts the absence of metabolic
acidemia at the time it is observed - ANSWER: True
Paper speed for fetal monitoring in the US is... - ANSWER: 3cm/min
Where is the baseline FHR regulated? - ANSWER: Intrinsic cardiac pacemakers, SA
node (110-160bpm) and AV node (40-60bpm)
Baseline FHR decreases with gestational age due to... - ANSWER: Increasing
parasympathetic tone
At what gestational age are FHR accelerations expected to be 15x15? - ANSWER: 32
weeks. Under 32 weeks, 10x10 is acceptable.
Risk Management is... - ANSWER: any activity, process, or policy to reduce liability
Quality assurance is... - ANSWER: activities and programs intended to improve
quality of care
A sentinel event is... - ANSWER: any unanticipated event resulting in death or serious
physical or psychological injury to a patient or patients, not related to the natural
course of the patient's illness
Nonmaleficence is... - ANSWER: the principle of not doing harm
Beneficence is... - ANSWER: an act of charity, mercy, and kindness with a strong
connotation of doing good to others, including moral obligation
Personal autonomy is... - ANSWER: the capacity to decide for oneself and pursue the
course of action in one's life, often regardless of any particular moral content
Fetal oxygenation consists of what two basic elements: - ANSWER: Transfer of
oxygen from the environment to the fetus (extrinsic factors/external environment)
and Fetal response to interruption of oxygen transfer (intrinsic factors/internal
environment)
Total amount of oxygen in arterial blood consists of two components: - ANSWER:
PaO2 and SaO2
% of PaO2, or "floating" oxygen - ANSWER: 1-2%
% of SaO2, or "bound" oxygen - ANSWER: 98-99%
,True or False: The "extra" floating oxygen that is dissolved in plasma creates an
increased "pressure" that helps bind oxygen to hemoglobin - ANSWER: True
Oxygen saturation, or SaO2 is... - ANSWER: % of oxygen carried on hemoglobin
Hemoglobin can carry a maximum of ___ molecules of oxygen - ANSWER: 4
What is the maternal oxygen pathway? - ANSWER: Environment, lungs, heart,
vasculature, uterus, placenta, umbilical cord, fetus
What occurs once maternal oxygen reaches the vasculature? - ANSWER: Oxygenated
blood travels from the lungs to the uterus via the pulmonary veins, left atrium and
ventricle, aorta, and uterine arteries
What is passive diffusion? - ANSWER: Diffusion of oxygen across the placenta that
eventually leads to the spiral arteries that infiltrate the intervillous space of the
placenta. The oxygenated blood bathes the chorionic villi on the fetal side of the
placenta.
True or False: The exchange of oxygen between the maternal and fetal circulations
occurs at the uterine level in the maternal oxygen pathway? - ANSWER: False. This
occurs at the placental level.
Oxygen affinity is... - ANSWER: The ability of hemoglobin to acquire and release
oxygen molecules. "attraction"
True or False: Higher PaO2 levels in the lungs decrease the hemoglobin's affinity for
oxygen - ANSWER: False. It increases the affinity
True or False: Lower PaO2 levels in the body tissues allows oxygen to be readily
released from the hemoglobin - ANSWER: True
PCR of ____, along with elevated BP is a sign of pre-e - ANSWER: >/= 0.3
In pre-term labor, magnesium may be given for... - ANSWER: Neuro protection
Factors that increase oxygen delivery to the tissues include: - ANSWER: Exercise,
uterine contractions (labor), increased metabolism, certain medications, transfusing
PRBC
Factors that decrease oxygen delivery to the tissues include: - ANSWER:
Hypovolemia, hypoxemia, anemia (mother needs to retain)
Maternal cardiac output increases ___ by the third trimester and increases an
additional ___ in labor - ANSWER: 50% and 20%
, True or False: Maternal spiral arteries have increased ability to constrict or "auto-
regulate" - ANSWER: False
Fetal Reserve is... - ANSWER: A fetus's ability to tolerate temporary interruptions in
oxygenation
When the fetal reserve is at 100% the fetus has approximately _____ the amount of
resources needed for growth and oxygenation - ANSWER: Twice
When the fetal reserve is at ___, fetal resources are _______ and
________________________ may develop - ANSWER: 75%. Limited. Fetal Growth
Restriction (FGR)
Oxygen and carbon dioxide transfer decreases and the fetus can become
compromised when the fetal reserve is at ____? - ANSWER: 50%
The body normally consumes approximately ___ of the total oxygen available. -
ANSWER: 25%
Conditions that increase oxygen consumption include: - ANSWER: Exercise, stress,
fever, tissue healing, pregnancy, and labor
Oxygen consumption increases: ___ during pregnancy, another ___ in a twin
gestation, and another _______ during labor - ANSWER: 20%. 10%, 40%-60%.
True or False: Oxygen delivery is increased in pregnancy and labor because oxygen
consumption is also increased. - ANSWER: True
True or False: Oxygen transfer across the placental blood-blood barrier occurs faster
than carbon dioxide. - ANSWER: False. It occurs slower, therefor interruption in the
blood flow affects oxygen transfer greater than carbon dioxide transfer
Maternal chronic disease processes that decrease the size of the placenta will
decrease the exchange of gases and other substances. This may result in... -
ANSWER: FGR and fetal metabolic acidemia
What are the components of the umbilical cord? - ANSWER: 1 vein, 2 arteries, and
Wharton's jelly
The umbilical vein carries... - ANSWER: oxygen rich blood from the placenta to the
fetus
The umbilical arteries carry... - ANSWER: deoxygenated blood from the fetus to the
placenta
Wharton's Jelly is responsible for... - ANSWER: protecting the umbilical cord from
compression
ACTUAL EXAM
True or False: Moderate variability reliably predicts the absence of metabolic
acidemia at the time it is observed - ANSWER: True
Paper speed for fetal monitoring in the US is... - ANSWER: 3cm/min
Where is the baseline FHR regulated? - ANSWER: Intrinsic cardiac pacemakers, SA
node (110-160bpm) and AV node (40-60bpm)
Baseline FHR decreases with gestational age due to... - ANSWER: Increasing
parasympathetic tone
At what gestational age are FHR accelerations expected to be 15x15? - ANSWER: 32
weeks. Under 32 weeks, 10x10 is acceptable.
Risk Management is... - ANSWER: any activity, process, or policy to reduce liability
Quality assurance is... - ANSWER: activities and programs intended to improve
quality of care
A sentinel event is... - ANSWER: any unanticipated event resulting in death or serious
physical or psychological injury to a patient or patients, not related to the natural
course of the patient's illness
Nonmaleficence is... - ANSWER: the principle of not doing harm
Beneficence is... - ANSWER: an act of charity, mercy, and kindness with a strong
connotation of doing good to others, including moral obligation
Personal autonomy is... - ANSWER: the capacity to decide for oneself and pursue the
course of action in one's life, often regardless of any particular moral content
Fetal oxygenation consists of what two basic elements: - ANSWER: Transfer of
oxygen from the environment to the fetus (extrinsic factors/external environment)
and Fetal response to interruption of oxygen transfer (intrinsic factors/internal
environment)
Total amount of oxygen in arterial blood consists of two components: - ANSWER:
PaO2 and SaO2
% of PaO2, or "floating" oxygen - ANSWER: 1-2%
% of SaO2, or "bound" oxygen - ANSWER: 98-99%
,True or False: The "extra" floating oxygen that is dissolved in plasma creates an
increased "pressure" that helps bind oxygen to hemoglobin - ANSWER: True
Oxygen saturation, or SaO2 is... - ANSWER: % of oxygen carried on hemoglobin
Hemoglobin can carry a maximum of ___ molecules of oxygen - ANSWER: 4
What is the maternal oxygen pathway? - ANSWER: Environment, lungs, heart,
vasculature, uterus, placenta, umbilical cord, fetus
What occurs once maternal oxygen reaches the vasculature? - ANSWER: Oxygenated
blood travels from the lungs to the uterus via the pulmonary veins, left atrium and
ventricle, aorta, and uterine arteries
What is passive diffusion? - ANSWER: Diffusion of oxygen across the placenta that
eventually leads to the spiral arteries that infiltrate the intervillous space of the
placenta. The oxygenated blood bathes the chorionic villi on the fetal side of the
placenta.
True or False: The exchange of oxygen between the maternal and fetal circulations
occurs at the uterine level in the maternal oxygen pathway? - ANSWER: False. This
occurs at the placental level.
Oxygen affinity is... - ANSWER: The ability of hemoglobin to acquire and release
oxygen molecules. "attraction"
True or False: Higher PaO2 levels in the lungs decrease the hemoglobin's affinity for
oxygen - ANSWER: False. It increases the affinity
True or False: Lower PaO2 levels in the body tissues allows oxygen to be readily
released from the hemoglobin - ANSWER: True
PCR of ____, along with elevated BP is a sign of pre-e - ANSWER: >/= 0.3
In pre-term labor, magnesium may be given for... - ANSWER: Neuro protection
Factors that increase oxygen delivery to the tissues include: - ANSWER: Exercise,
uterine contractions (labor), increased metabolism, certain medications, transfusing
PRBC
Factors that decrease oxygen delivery to the tissues include: - ANSWER:
Hypovolemia, hypoxemia, anemia (mother needs to retain)
Maternal cardiac output increases ___ by the third trimester and increases an
additional ___ in labor - ANSWER: 50% and 20%
, True or False: Maternal spiral arteries have increased ability to constrict or "auto-
regulate" - ANSWER: False
Fetal Reserve is... - ANSWER: A fetus's ability to tolerate temporary interruptions in
oxygenation
When the fetal reserve is at 100% the fetus has approximately _____ the amount of
resources needed for growth and oxygenation - ANSWER: Twice
When the fetal reserve is at ___, fetal resources are _______ and
________________________ may develop - ANSWER: 75%. Limited. Fetal Growth
Restriction (FGR)
Oxygen and carbon dioxide transfer decreases and the fetus can become
compromised when the fetal reserve is at ____? - ANSWER: 50%
The body normally consumes approximately ___ of the total oxygen available. -
ANSWER: 25%
Conditions that increase oxygen consumption include: - ANSWER: Exercise, stress,
fever, tissue healing, pregnancy, and labor
Oxygen consumption increases: ___ during pregnancy, another ___ in a twin
gestation, and another _______ during labor - ANSWER: 20%. 10%, 40%-60%.
True or False: Oxygen delivery is increased in pregnancy and labor because oxygen
consumption is also increased. - ANSWER: True
True or False: Oxygen transfer across the placental blood-blood barrier occurs faster
than carbon dioxide. - ANSWER: False. It occurs slower, therefor interruption in the
blood flow affects oxygen transfer greater than carbon dioxide transfer
Maternal chronic disease processes that decrease the size of the placenta will
decrease the exchange of gases and other substances. This may result in... -
ANSWER: FGR and fetal metabolic acidemia
What are the components of the umbilical cord? - ANSWER: 1 vein, 2 arteries, and
Wharton's jelly
The umbilical vein carries... - ANSWER: oxygen rich blood from the placenta to the
fetus
The umbilical arteries carry... - ANSWER: deoxygenated blood from the fetus to the
placenta
Wharton's Jelly is responsible for... - ANSWER: protecting the umbilical cord from
compression
