RELIAS FETAL HEART MONITORING Exam
2 Practice Questions with 100% Correct Answers
Latest Versions 2025 Graded A+
Here is a fresh set of practice questions for the Relias Fetal Heart
Monitoring exam, drawn from common scenarios, case studies, and key
concepts in AWHONN/Relias materials. These include situational
questions often seen in the exam.
Question 1:** A laboring patient becomes hypotensive after receiving
epidural anesthesia. The FHR tracing shows recurrent decelerations that
mirror the contractions (starting and ending with the contraction).
What pattern is this, and what is the first intervention?
Answer Early decelerations (benign, likely due to head compression or
vagal response); first, correct maternal hypotension (e.g., IV fluid bolus
or ephedrine).
**Explanation:** Hypotension interrupts maternal circulation in the
oxygenation pathway; early decels are Category I if variability moderate.
Question 2:** Which factors negatively affect fetal oxygenation? (Select
all that apply)
Answer Maternal asthma; intrauterine growth restriction (IUGR); post-
term pregnancy (42 weeks); oligohydramnios.
,**Explanation:** Asthma (maternal oxygenation); IUGR/post-term
(placental exchange); oligohydramnios (fetal circulation/cord
compression).
Question 3:** A tracing shows a prolonged deceleration lasting 4
minutes despite repositioning and discontinuing oxytocin. Additional
appropriate interventions? (Select all that apply)
Answer Vaginal examination (rule out cord prolapse); supplemental
oxygen (8–10 L/min non-rebreather for 15–30 minutes).
**Explanation:** Avoid digital scalp stimulation during the
deceleration; focus on acute causes and improving oxygenation.
Question 4:** Fetal heart rate bradycardia associated with umbilical
cord prolapse most likely results in which acid-base status?
Answer Mixed acidosis.
**Explanation:** Acute severe hypoxia causes initial respiratory
acidosis (CO₂ buildup) followed by metabolic (lactic acid).
Question 5:** Which statements are true regarding FHR monitoring
instrumentation? (Select 2)
Answer A fetal spiral electrode can accurately detect FHRs >240 bpm; a
fetal spiral electrode can record the maternal heart rate in cases of fetal
demise.
,**Explanation:** Internal FSE is direct and precise; external may be
unreliable in high rates or demise.
Question 6:** A patient has recurrent late decelerations with moderate
variability. After interventions, the pattern resolves to moderate
variability with accelerations. What is the new category?
Answer Category I (normal).
**Explanation:** Resolution of non-reassuring features with reassuring
variability returns to normal.
Question 7:** In a patient with placental abruption, what FHR pattern is
most commonly seen?
Answer Recurrent late decelerations, prolonged decelerations, or
bradycardia with decreased variability.
**Explanation:** Abruption interrupts placental exchange, causing
uteroplacental insufficiency.
Question 8:** Scalp stimulation at baseline elicits an acceleration. What
does this indicate?
Answer Reassurance of no current acidemia.
**Explanation:** Sympathetic response shows intact neurologic
function and oxygenation.
, Question 9:** Tachysystole is defined as >5 contractions in 10 minutes.
Priority intervention?
Answer Discontinue/reduce oxytocin; lateral repositioning; consider
terbutaline.
**Explanation:** Reduces uterine activity to restore placental
perfusion.
Question 10:** A tracing shows absent variability with a sinusoidal
pattern. What category and likely cause?
Answer Category III; severe fetal anemia (e.g., isoimmunization).
**Explanation:** Predictive of abnormal acid-base; expedited delivery
needed.
Question 11:** Supplemental oxygen is indicated for?
Answer Non-reassuring patterns (recurrent lates/variables/prolongeds);
short-term (15–30 minutes).
**Explanation:** Increases maternal-fetal O₂ gradient; avoid prolonged
use due to free radical risk.
Question 12:** In second-stage labor, recurrent variable decelerations
with moderate variability are common due to?
Answer Head and cord compression during pushing.
**Explanation:** Often benign; intervene if variability decreases.
2 Practice Questions with 100% Correct Answers
Latest Versions 2025 Graded A+
Here is a fresh set of practice questions for the Relias Fetal Heart
Monitoring exam, drawn from common scenarios, case studies, and key
concepts in AWHONN/Relias materials. These include situational
questions often seen in the exam.
Question 1:** A laboring patient becomes hypotensive after receiving
epidural anesthesia. The FHR tracing shows recurrent decelerations that
mirror the contractions (starting and ending with the contraction).
What pattern is this, and what is the first intervention?
Answer Early decelerations (benign, likely due to head compression or
vagal response); first, correct maternal hypotension (e.g., IV fluid bolus
or ephedrine).
**Explanation:** Hypotension interrupts maternal circulation in the
oxygenation pathway; early decels are Category I if variability moderate.
Question 2:** Which factors negatively affect fetal oxygenation? (Select
all that apply)
Answer Maternal asthma; intrauterine growth restriction (IUGR); post-
term pregnancy (42 weeks); oligohydramnios.
,**Explanation:** Asthma (maternal oxygenation); IUGR/post-term
(placental exchange); oligohydramnios (fetal circulation/cord
compression).
Question 3:** A tracing shows a prolonged deceleration lasting 4
minutes despite repositioning and discontinuing oxytocin. Additional
appropriate interventions? (Select all that apply)
Answer Vaginal examination (rule out cord prolapse); supplemental
oxygen (8–10 L/min non-rebreather for 15–30 minutes).
**Explanation:** Avoid digital scalp stimulation during the
deceleration; focus on acute causes and improving oxygenation.
Question 4:** Fetal heart rate bradycardia associated with umbilical
cord prolapse most likely results in which acid-base status?
Answer Mixed acidosis.
**Explanation:** Acute severe hypoxia causes initial respiratory
acidosis (CO₂ buildup) followed by metabolic (lactic acid).
Question 5:** Which statements are true regarding FHR monitoring
instrumentation? (Select 2)
Answer A fetal spiral electrode can accurately detect FHRs >240 bpm; a
fetal spiral electrode can record the maternal heart rate in cases of fetal
demise.
,**Explanation:** Internal FSE is direct and precise; external may be
unreliable in high rates or demise.
Question 6:** A patient has recurrent late decelerations with moderate
variability. After interventions, the pattern resolves to moderate
variability with accelerations. What is the new category?
Answer Category I (normal).
**Explanation:** Resolution of non-reassuring features with reassuring
variability returns to normal.
Question 7:** In a patient with placental abruption, what FHR pattern is
most commonly seen?
Answer Recurrent late decelerations, prolonged decelerations, or
bradycardia with decreased variability.
**Explanation:** Abruption interrupts placental exchange, causing
uteroplacental insufficiency.
Question 8:** Scalp stimulation at baseline elicits an acceleration. What
does this indicate?
Answer Reassurance of no current acidemia.
**Explanation:** Sympathetic response shows intact neurologic
function and oxygenation.
, Question 9:** Tachysystole is defined as >5 contractions in 10 minutes.
Priority intervention?
Answer Discontinue/reduce oxytocin; lateral repositioning; consider
terbutaline.
**Explanation:** Reduces uterine activity to restore placental
perfusion.
Question 10:** A tracing shows absent variability with a sinusoidal
pattern. What category and likely cause?
Answer Category III; severe fetal anemia (e.g., isoimmunization).
**Explanation:** Predictive of abnormal acid-base; expedited delivery
needed.
Question 11:** Supplemental oxygen is indicated for?
Answer Non-reassuring patterns (recurrent lates/variables/prolongeds);
short-term (15–30 minutes).
**Explanation:** Increases maternal-fetal O₂ gradient; avoid prolonged
use due to free radical risk.
Question 12:** In second-stage labor, recurrent variable decelerations
with moderate variability are common due to?
Answer Head and cord compression during pushing.
**Explanation:** Often benign; intervene if variability decreases.
