AWHONN ADVANCED FETAL MONITORING PREPARATION
LATEST ACTUAL EXAM 130 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Question 1
When interpreting a fetal heart rate (FHR) tracing, which of the following
characteristics is most reassuring and indicative of adequate fetal
oxygenation?
A) Absent variability
B) Moderate variability
C) Marked variability
D) Recurrent late decelerations
E) Sustained bradycardia
Correct Answer: B) Moderate variability
Rationale: Moderate FHR variability (6-25 bpm fluctuation) is the
most important predictor of adequate fetal oxygenation and an
intact fetal neurological system. It is considered a highly reassuring
sign.
Question 2
A fetal heart rate (FHR) tracing shows a baseline FHR of 165 beats per
minute (bpm). This FHR is categorized as:
A) Normal
B) Tachycardia
C) Bradycardia
D) Sinusoidal
E) Undetermined
Correct Answer: B) Tachycardia
Rationale: Fetal tachycardia is defined as a baseline FHR greater
than 160 bpm for a duration of 10 minutes or longer.
Question 3
What is the primary maternal physiological change that commonly causes
recurrent late decelerations on a fetal heart rate (FHR) tracing?
A) Fetal head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Rapid fetal descent
E) Maternal fever
Correct Answer: C) Uteroplacental insufficiency
Rationale: Late decelerations are caused by uteroplacental
,insufficiency, where there is a decrease in blood flow and oxygen
transfer to the fetus during a contraction. This results in myocardial
depression and a delayed FHR response.
Question 4
A fetal heart rate (FHR) tracing exhibits a baseline of 130 bpm, moderate
variability, and accelerations. However, there are also recurrent variable
decelerations that drop to 70 bpm for 45 seconds. This tracing is classified
as:
A) Category I
B) Category II
C) Category III
D) Indeterminate
E) Reassuring
Correct Answer: B) Category II
Rationale: Category II tracings include all FHR tracings that do not
meet Category I or Category III criteria. Recurrent variable
decelerations are a common feature of Category II tracings,
especially when accompanied by moderate variability and
accelerations, indicating some fetal compromise but not yet severe.
Question 5
Which of the following interventions is a priority for managing recurrent
variable decelerations on a fetal heart rate (FHR) tracing?
A) Administer a tocolytic agent.
B) Place the client in a supine position.
C) Increase the rate of oxytocin infusion.
D) Reposition the client (e.g., left lateral, right lateral, hands and
knees).
E) Prepare for immediate cesarean section.
Correct Answer: D) Reposition the client (e.g., left lateral, right
lateral, hands and knees).
Rationale: Variable decelerations are typically caused by umbilical
cord compression. Repositioning the client is the first and most
effective intervention to relieve cord compression and improve fetal
circulation.
Question 6
A fetal heart rate (FHR) tracing shows a baseline of 110 bpm, absent
variability, and recurrent late decelerations. The client is experiencing
uterine tachysystole. What is the most appropriate initial intrauterine
,resuscitation action?
A) Increase intravenous fluids.
B) Administer oxygen via non-rebreather mask.
C) Perform a vaginal examination.
D) Discontinue oxytocin infusion.
E) Apply fetal scalp stimulation.
Correct Answer: D) Discontinue oxytocin infusion.
Rationale: The FHR pattern (bradycardia, absent variability,
recurrent late decelerations) combined with uterine tachysystole
indicates severe fetal compromise, likely due to inadequate
uteroplacental perfusion. Discontinuing oxytocin to resolve
tachysystole and improve perfusion is the priority.
Question 7
What is the primary cause of early decelerations on a fetal heart rate (FHR)
tracing?
A) Umbilical cord compression
B) Uteroplacental insufficiency
C) Fetal head compression
D) Maternal hypotension
E) Fetal hypoxia
Correct Answer: C) Fetal head compression
Rationale: Early decelerations are benign and typically caused by
transient fetal head compression during a uterine contraction,
resulting in a vagal response and slowing of the FHR. They mirror
the contraction.
Question 8
A fetal heart rate (FHR) tracing shows a baseline FHR of 95 bpm for 7
minutes. This FHR is categorized as:
A) Normal
B) Tachycardia
C) Bradycardia
D) Sinusoidal
E) Prolonged deceleration
Correct Answer: C) Bradycardia
Rationale: Fetal bradycardia is defined as a baseline FHR less than
110 bpm for a duration of 10 minutes or longer. A rate of 95 bpm for
7 minutes constitutes a baseline bradycardia.
, Question 9
What does "uterine tachysystole" refer to in fetal monitoring?
A) Less than 5 contractions in 10 minutes, averaged over 30 minutes.
B) More than 5 contractions in 10 minutes, averaged over a 30-
minute window.
C) Contractions lasting less than 60 seconds.
D) Contractions with a resting tone of 25 mmHg.
E) Absence of uterine contractions.
Correct Answer: B) More than 5 contractions in 10 minutes,
averaged over a 30-minute window.
Rationale: Uterine tachysystole is excessive uterine activity, defined
as more than 5 contractions in 10 minutes, averaged over a 30-
minute window. It can lead to uteroplacental insufficiency and fetal
compromise.
Question 10
Which FHR pattern is characterized by a smooth, sine-wave-like undulating
pattern with a frequency of 3-5 cycles per minute for at least 20 minutes?
A) Minimal variability
B) Marked variability
C) Sinusoidal pattern
D) Early decelerations
E) Prolonged accelerations
Correct Answer: C) Sinusoidal pattern
Rationale: A sinusoidal FHR pattern is a rare and ominous finding,
often associated with severe fetal anemia, hypoxemia, or acidemia,
and is classified as Category III.
Question 11
The nurse notes recurrent late decelerations on the FHR tracing. The client's
blood pressure is 90/50 mmHg. What is the first intervention?
A) Discontinue oxytocin.
B) Increase intravenous fluids (IV bolus).
C) Reposition the client to lateral recumbent.
D) Administer oxygen via non-rebreather mask.
E) Call for immediate provider evaluation.
Correct Answer: B) Increase intravenous fluids (IV bolus).
Rationale: Late decelerations are caused by uteroplacental
insufficiency. If maternal hypotension is identified, an IV fluid bolus
is the priority to improve maternal blood volume and placental
LATEST ACTUAL EXAM 130 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES (VERIFIED
ANSWERS) |ALREADY GRADED A+
Question 1
When interpreting a fetal heart rate (FHR) tracing, which of the following
characteristics is most reassuring and indicative of adequate fetal
oxygenation?
A) Absent variability
B) Moderate variability
C) Marked variability
D) Recurrent late decelerations
E) Sustained bradycardia
Correct Answer: B) Moderate variability
Rationale: Moderate FHR variability (6-25 bpm fluctuation) is the
most important predictor of adequate fetal oxygenation and an
intact fetal neurological system. It is considered a highly reassuring
sign.
Question 2
A fetal heart rate (FHR) tracing shows a baseline FHR of 165 beats per
minute (bpm). This FHR is categorized as:
A) Normal
B) Tachycardia
C) Bradycardia
D) Sinusoidal
E) Undetermined
Correct Answer: B) Tachycardia
Rationale: Fetal tachycardia is defined as a baseline FHR greater
than 160 bpm for a duration of 10 minutes or longer.
Question 3
What is the primary maternal physiological change that commonly causes
recurrent late decelerations on a fetal heart rate (FHR) tracing?
A) Fetal head compression
B) Umbilical cord compression
C) Uteroplacental insufficiency
D) Rapid fetal descent
E) Maternal fever
Correct Answer: C) Uteroplacental insufficiency
Rationale: Late decelerations are caused by uteroplacental
,insufficiency, where there is a decrease in blood flow and oxygen
transfer to the fetus during a contraction. This results in myocardial
depression and a delayed FHR response.
Question 4
A fetal heart rate (FHR) tracing exhibits a baseline of 130 bpm, moderate
variability, and accelerations. However, there are also recurrent variable
decelerations that drop to 70 bpm for 45 seconds. This tracing is classified
as:
A) Category I
B) Category II
C) Category III
D) Indeterminate
E) Reassuring
Correct Answer: B) Category II
Rationale: Category II tracings include all FHR tracings that do not
meet Category I or Category III criteria. Recurrent variable
decelerations are a common feature of Category II tracings,
especially when accompanied by moderate variability and
accelerations, indicating some fetal compromise but not yet severe.
Question 5
Which of the following interventions is a priority for managing recurrent
variable decelerations on a fetal heart rate (FHR) tracing?
A) Administer a tocolytic agent.
B) Place the client in a supine position.
C) Increase the rate of oxytocin infusion.
D) Reposition the client (e.g., left lateral, right lateral, hands and
knees).
E) Prepare for immediate cesarean section.
Correct Answer: D) Reposition the client (e.g., left lateral, right
lateral, hands and knees).
Rationale: Variable decelerations are typically caused by umbilical
cord compression. Repositioning the client is the first and most
effective intervention to relieve cord compression and improve fetal
circulation.
Question 6
A fetal heart rate (FHR) tracing shows a baseline of 110 bpm, absent
variability, and recurrent late decelerations. The client is experiencing
uterine tachysystole. What is the most appropriate initial intrauterine
,resuscitation action?
A) Increase intravenous fluids.
B) Administer oxygen via non-rebreather mask.
C) Perform a vaginal examination.
D) Discontinue oxytocin infusion.
E) Apply fetal scalp stimulation.
Correct Answer: D) Discontinue oxytocin infusion.
Rationale: The FHR pattern (bradycardia, absent variability,
recurrent late decelerations) combined with uterine tachysystole
indicates severe fetal compromise, likely due to inadequate
uteroplacental perfusion. Discontinuing oxytocin to resolve
tachysystole and improve perfusion is the priority.
Question 7
What is the primary cause of early decelerations on a fetal heart rate (FHR)
tracing?
A) Umbilical cord compression
B) Uteroplacental insufficiency
C) Fetal head compression
D) Maternal hypotension
E) Fetal hypoxia
Correct Answer: C) Fetal head compression
Rationale: Early decelerations are benign and typically caused by
transient fetal head compression during a uterine contraction,
resulting in a vagal response and slowing of the FHR. They mirror
the contraction.
Question 8
A fetal heart rate (FHR) tracing shows a baseline FHR of 95 bpm for 7
minutes. This FHR is categorized as:
A) Normal
B) Tachycardia
C) Bradycardia
D) Sinusoidal
E) Prolonged deceleration
Correct Answer: C) Bradycardia
Rationale: Fetal bradycardia is defined as a baseline FHR less than
110 bpm for a duration of 10 minutes or longer. A rate of 95 bpm for
7 minutes constitutes a baseline bradycardia.
, Question 9
What does "uterine tachysystole" refer to in fetal monitoring?
A) Less than 5 contractions in 10 minutes, averaged over 30 minutes.
B) More than 5 contractions in 10 minutes, averaged over a 30-
minute window.
C) Contractions lasting less than 60 seconds.
D) Contractions with a resting tone of 25 mmHg.
E) Absence of uterine contractions.
Correct Answer: B) More than 5 contractions in 10 minutes,
averaged over a 30-minute window.
Rationale: Uterine tachysystole is excessive uterine activity, defined
as more than 5 contractions in 10 minutes, averaged over a 30-
minute window. It can lead to uteroplacental insufficiency and fetal
compromise.
Question 10
Which FHR pattern is characterized by a smooth, sine-wave-like undulating
pattern with a frequency of 3-5 cycles per minute for at least 20 minutes?
A) Minimal variability
B) Marked variability
C) Sinusoidal pattern
D) Early decelerations
E) Prolonged accelerations
Correct Answer: C) Sinusoidal pattern
Rationale: A sinusoidal FHR pattern is a rare and ominous finding,
often associated with severe fetal anemia, hypoxemia, or acidemia,
and is classified as Category III.
Question 11
The nurse notes recurrent late decelerations on the FHR tracing. The client's
blood pressure is 90/50 mmHg. What is the first intervention?
A) Discontinue oxytocin.
B) Increase intravenous fluids (IV bolus).
C) Reposition the client to lateral recumbent.
D) Administer oxygen via non-rebreather mask.
E) Call for immediate provider evaluation.
Correct Answer: B) Increase intravenous fluids (IV bolus).
Rationale: Late decelerations are caused by uteroplacental
insufficiency. If maternal hypotension is identified, an IV fluid bolus
is the priority to improve maternal blood volume and placental
