AWHONN Advanced FHM Course Exam Answers Newest 2025 Rated A+

AWHONN Advanced FHM Course Exam
Answers Newest 2025 Rated A+
CASE STUDY A) SILVIA. Silvia, a 28-year-old G1P0000 at 39 1/7 weeks by sonogram, and
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her partner arrived on the labor unit at 0730 for scheduled induction for IUGR/FGR. Silvia's
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family history is negative for medical problems with the exception of her mother's long-term
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history of diabetes. Silvia has no history of medical problems and she has never had any
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surgeries. She developed gestational diabetes with this pregnancy, but her other prenatal
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labs were all normal. During one of the ultrasound examinations performed to evaluate the
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IUGR/FGR, a single umbilical artery was noted. On her most recent biophysical profile
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(BPP), the amniotic fluid index (AFI) was 11 cm (AFI less than 5 cm is defined as
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oligohydramnios) and the estimated fetal weight (EFW) was 2524 grams (7th percentile).
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WHAT FETAL HEART RATE DECELERATION IS MORE LIKELY TO OCCUR IN THE
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PRESENCE OF SILVIA'S SINGLE UMBILICAL ARTERY? - Correct Answers Variable
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decelerations
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The single umbilical artery impacts which component of the oxygen transfer system? -
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Correct Answers Oxygen delivery
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Which of Silvia's findings indicates a potential for chronic fetal hypoxemia? - Correct
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Answers Intrauterine growth restriction (IUGR)
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With the finding of a single umbilical artery, what would you expect to occur with fetal
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perfusion? - Correct Answers Decreased blood perfusion from the fetus to the placenta
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Silvia's admission vital signs were BP 109/60, pulse 83 bpm, respirations 18/minute,
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temperature 97F (36.6C). Vaginal examination findings were 2-3 cm dilated, 50% effaced, -
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1 station, membranes intact, and cephalic presentation. External electronic fetal monitor
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devices were placed (ultrasound and tocodynamometer). She denied having contractions,
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vaginal leaking or bleeding. Following this admission tracing, oxytocin was ordered and
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initiated at 2 mU/min. Within an hour, the rate was increased to 5 mU/min. PRIMARY
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BENEFITS ASSOCIATED WITH THE USE OF STANDARDIZED TERMINOLOGY FOR
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FHM INTERPRETATION IN THE CLINICAL SETTING INCLUDE: - Correct Answers
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Enhanced communication among health care providers and promotion of patient safety
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Refer to tracing A-1. Which is the correct assessment of the admission tracing? - Correct
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Answers Moderate variability
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Refer to tracing A-1. Based on this tracing, a necessary intervention would be to: - Correct
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Answers Readjust the toco
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, Refer to tracing A-2. Oxytocin was infusing at 5 mU/min when the provider arrived and
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ordered the oxytocin increased to 8 mU/min. A CORRECT INTERPRETATION OF THIS
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TRACING IS: - Correct Answers An oxygenated, neurologically intact fetus
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Refer to tracing A-2. A high-priority intervention at this time is to: - Correct Answers
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Readjust the toco
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One hour later, the nurse observed two 3 cm sized, thick dark blood clots on the under pad.
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Silvia denied pain and her abdomen was soft to palpation. Which component of oxygen
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transport to the fetus could potentially be compromised by this bleeding? - Correct Answers
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Delivery
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Refer to tracing A-3. Silvia's vital signs were BP 123/70, pulse 86 bpm, respirations
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18/minute. The oxytocin was infusing at 11 mU/min and VE findings were 3-4 cm, 80%
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effaced, -2 station, membranes intact and cephalic presentation, with a moderate amount of
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blood on vaginal exam. WHICH OF THE FOLLOWING IS AN APPROPRIATE
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PHYSIOLOGIC GOAL BASED ON TRACING A-3? - Correct Answers Maximize utero-
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placental circulation I




Refer to tracing A-3. The correct assessment of this tracing includes: - Correct Answers
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Sinusoidal pattern
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Refer to tracing A-4. At the time of tracing 4, the resident performed an AROM and fluid was
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clear. A vaginal exam indicated the cervix was unchanged. The resident placed a fetal spiral
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electrode and had difficulty placing an IUPC. The nurse could palpate contractions but could
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not determine the frequency and duration by palpation. The oxytocin was discontinued, an
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intravenous fluid bolus was administered, and Silvia was repositioned. WHAT FHR
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CHARACTERISTICS SHOULD THE NURSE REPORT TO THE PROVIDER? - Correct
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Answers Recurrent decelerations
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Refer to tracing A-4. The correct physiologic interpretation of this tracing is: - Correct
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Answers Fetal hypoxemia may be present
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Refer to tracing A-5. At 1332, the resident successfully placed the IUPC and an
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amnioinfusion was initiated at 1430. The resident telephoned the provider to report the
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initiation of the amnioinfusion. WHICH INTRINSIC HOMEOSTATIC RESPONSE IS THE
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FETUS DEMONSTRATING? - Correct Answers Baroreceptor
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Refer to tracing A-5. An amnioinfusion is intended to relieve which extrinsic factor that
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compromises oxygen transport? - Correct Answers Umbilical cord compression
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At 1410, the nurse again telephoned the provider to report Silvia's status, including two
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more dark red blood clots and absent variability with recurrent decelerations, and asked the
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provider to come to the bedside for evaluation. The provider indicated she was "on the way
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to the hospital" and ordered an emergency cesarean to be started by the senior resident.
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Silvia was prepped for cesarean birth. The nurse is planning to document her telephone
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