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2025 AWHONN ADVANCED FETAL MONITORING EXAM WITH
ACCURATE AND VERIFIED QUESTIONS COVERING FETAL HEART
RATE INTERPRETATION, INTRAUTERINE RESUSCITATION,
DOCUMENTATION, AND CLINICAL DECISION-MAKING.
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
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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
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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
Fetal response to hypoxemia (hint: think about cord gas content) - ANSWER-Decreased O2
content in blood, umbilical artery PaO2 goes below 15-25mmHg
Maternal hypoxemia (decreased O2 content in blood) may lead to... - ANSWER-Fetal hypoxia
(caused by decreased O2 in the tissues)
, 4|Page
Fetal hypoxia, caused by decreased O2 to the tissues due to maternal hypoxemia, may lead to....
- ANSWER-Fetal metabolic acidosis
Fetal metabolic acidosis is the result of what in the tissues? - ANSWER-Increased lactic acid
A decrease in pH and buffers... - ANSWER-Metabolic acidemia
True or False: Metabolic acidemia may lead to fetal hypertension - ANSWER-False, it may lead to
fetal hypotension
Normal fetal PaO2 is... - ANSWER-30mmHg
Normal hemoglobin saturation is... - ANSWER-50-70%
True or False: fetal blood has a higher concentration of hemoglobin and higher affinity than
maternal blood - ANSWER-True
If fetal arterial pressure begins to fall below normal levels: - ANSWER-A. BARORECEPTORS
CAUSE VASOCONSTRICTION AND INCREASE THE FHR
An increase in arterial blood pressure produces vessel distension and causes arterial
baroreceptors to send neuronal messages to the cardioinhibitory center, which in turn causes
rapid slowing of the fetal heart rate via the parasympathetic vagus nerve. A decrease in arterial
pressure results in an increased heart rate.
Source: https://perigen.com/what-regulates-fetal-heart-rate/
Which of the following is an extrinsic influence on the FHR? - ANSWER-Fetal-placental
circulation
2025 AWHONN ADVANCED FETAL MONITORING EXAM WITH
ACCURATE AND VERIFIED QUESTIONS COVERING FETAL HEART
RATE INTERPRETATION, INTRAUTERINE RESUSCITATION,
DOCUMENTATION, AND CLINICAL DECISION-MAKING.
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
,2|Page
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
,3|Page
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
Fetal response to hypoxemia (hint: think about cord gas content) - ANSWER-Decreased O2
content in blood, umbilical artery PaO2 goes below 15-25mmHg
Maternal hypoxemia (decreased O2 content in blood) may lead to... - ANSWER-Fetal hypoxia
(caused by decreased O2 in the tissues)
, 4|Page
Fetal hypoxia, caused by decreased O2 to the tissues due to maternal hypoxemia, may lead to....
- ANSWER-Fetal metabolic acidosis
Fetal metabolic acidosis is the result of what in the tissues? - ANSWER-Increased lactic acid
A decrease in pH and buffers... - ANSWER-Metabolic acidemia
True or False: Metabolic acidemia may lead to fetal hypertension - ANSWER-False, it may lead to
fetal hypotension
Normal fetal PaO2 is... - ANSWER-30mmHg
Normal hemoglobin saturation is... - ANSWER-50-70%
True or False: fetal blood has a higher concentration of hemoglobin and higher affinity than
maternal blood - ANSWER-True
If fetal arterial pressure begins to fall below normal levels: - ANSWER-A. BARORECEPTORS
CAUSE VASOCONSTRICTION AND INCREASE THE FHR
An increase in arterial blood pressure produces vessel distension and causes arterial
baroreceptors to send neuronal messages to the cardioinhibitory center, which in turn causes
rapid slowing of the fetal heart rate via the parasympathetic vagus nerve. A decrease in arterial
pressure results in an increased heart rate.
Source: https://perigen.com/what-regulates-fetal-heart-rate/
Which of the following is an extrinsic influence on the FHR? - ANSWER-Fetal-placental
circulation
