hich of the following factors can have a negative effect on uterine blood flow? a. Hypertension b. Epidural c. Hemorrhage d. Diabetes e. All of the above - e. All of the above 2. How does the fetus compensate for decreased maternal circulating volume? a. Increases cardiac output by increasing stroke volume. b. Increases cardiac output by increasing it's heart rate. c. Increases cardiac output by increasing fetal movement. - b. Increases cardiac output by increasing it's heart rate. 3. Stimulating the vagus nerve typically produces: a. A decrease in the heart rate b. An increase in the heart rate c. An increase in stroke volume d. No change - a. A decrease in the heart rate 4. What initially causes a chemoreceptor response? a. Epidurals b. Supine maternal position c. Increased CO2 levels d. Decreased O2 levels e. A & C f. A & B g. C & D - g. C & D 5. The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the FHR baseline? a. Increases baseline b. Decreases baseline - b. Decreases baseline 6. T/F: Oxygen exchange in the placenta takes place in the intervillous space. - True 7. T/F: The parasympathetic nervous system is a cardioaccelerator. - False 8. T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood pressure. - True 9. T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound transducer and the fetal spiral electrode. - True 10.T/F: Variability can be determined with the fetoscope. - False 11.T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped in warm water to make cleaning easier. - False 12.T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased variability. - True 13.T/F: All fetal monitors contain a logic system designed to reject artifact. - True 14.T/F: The monitor should always be tested before starting a tracing, either external or internal mode and labeled a test. - True 15.T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - False 16.T/F: Both internal and external monitoring methods are equally accurate means of obtaining the fetal heart rate and contraction patterns. - False 17.T/F: The external toco is usually placed over the uterine fundus to pick up contractions. - True 18.T/F: The external toco gives measurable uterine pressure. - False 19.T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present. - False 20.T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's back, as the fetal heart is heard best there. - True 21.T/F: The spiral electrode is used to more accurately determine the frequency, duration, and intensity of uterine contractions. - False 22.T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. - False 23.T/F: The intrauterine catheter is used to pick up the fetal heart rate. - False 24.T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. - True 25.T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. - True 26.T/F: Variability and periodic changes can be detected with both internal and external monitoring. - True 27.T/F: Variable decelerations are a result of cord compression. - True 28.T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of adequate fetal oxygenation. - True 29.T/F: Variable decelerations are a vagal response. - True 30.T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are delayed in timing with the nadir of the deceleration occurring after the peak of the contraction. - True 31.T/F: The fetal heart rate baseline can be determined during periods of marked variability. - False 32.T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through the placenta. - True 33.T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. - True 34.T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated. - False 35.What is your first intervention in management of a patient experiencing variable decelerations? a. Immediate delivery b. Change maternal position c. No treatment indicated d. Oxygen e. Stop oxytocin infusion - b. Change maternal position 36.Etiology of a baseline FHR of 165bpm occurring for the last hour can be: 1. Maternal supine hypotension 2. Maternal fever 3. Maternal dehydration 4. Unknown a. 1 and 2 b. 1, 2 and 3 c. 2, 3 and 4 - c. 2, 3 and 4 37.What is the most probable cause of recurrent late decelerations? a. Utero-placental insufficiency b. Head compression c. Cord compression d. Maternal position change - a. Utero-placental insufficiency 38.The most prevalent risk factor associated with fetal death before the onset of labor is: a. Low socioeconomic status b. Fetal malpresentation c. Uteroplacental insufficiency d. Uterine anomalies - c. Uteroplacental insufficiency 39.Which of the following is NOT used for antepartum fetal surveillance? a. Fetal movement counting b. Antepartum fetal heart rate testing c. Biophysical profile testing d. Maternal HCG levels - d. Maternal HCG levels 40.Which of the following conditions is not an indication for antepartum fetal surveillance? a. Gestational hypertension b. Diabetes in pregnancy c. Fetus in breech presentation d. Decreased fetal movement - c. Fetus in breech presentation 41.Which of the following does not affect the degree of fetal activity? a. Vibroacoustic stimulation b. Smoking c. Fetal position d. Gestational age - a. Vibroacoustic stimulation 42.To be considered reactive, a nonstress test must have: a. 4 fetal heart rate accelerations in a 20 minute window b. 2 fetal heart rate accelerations in a 10 minute window c. 4 fetal heart rate accelerations in a 40 minute window d. 2 fetal heart rate accelerations in a 20 minute window - d. 2 fetal heart rate accelerations in a 20 minute window 43.If a nonstress test is nonreactive after 40 minutes, the next step should be: a. Have the client go home and do fetal movement counts b. Do a biophysical profile or contraction stress test c. Repeat the nonstress test within a week d. Admit the client for delivery - b. Do a biophysical profile or contraction stress test 44.All of the following are components of a biophysical profile except: a. Contraction stress test b. Assessment of fetal breathing c. Amniotic fluid volume measurement d. Fetal movement assessment - a. Contraction stress test 45.A modified biophysical profile includes a nonstress test and: a. Contraction stress test b. Ultrasound assessment of fetal movement c. Ultrasound assessment of amniotic fluid volume d. Fetal movement counts - c. Ultrasound assessment of amniotic fluid volume 46.For a contraction stress test to be interpretable, you must have a minimum of: a. 5 contractions in a 10-minute window b. 3 contractions in a 10-minute window c. 4 contractions in a 10-minute window d. 2 contractions in a 10-minute window - b. 3 contractions in a 10 minute window 47.A negative contraction stress test is one in which: a. No contractions are seen b. There are late decelerations with > 50% of the contractions seen c. There are no fetal heart rate late decelerations with the contractions d. There is one fetal heart rate deceleration seen - c. There are no fetal heart rate late decelerations with the contractions 48.According to AWHONN, the normal baseline Fetal Heart Rate (FHR) is A. 90-150 bpm B. 100-170 bpm C. 110-160 bpm D. 120-140 bpm - C. 110-160 bpm 49.What are the two most important characteristics of the FHR? A. Rate and decelerations B. Variability and accelerations C. Variability and decelerations D. Rate and variability - B. Variability and accelerations 50.You recognize that an FHR tracing has been showing a decrease in variability for the last 45 minutes. Your first intervention should be to A. Encourage ambulation B. Administer oxygen C. Discontinue IV fluids D. Increase Pitocin rate - B. Administer oxygen