NCC EFM Certification
Which 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 - ANS e. All of the above
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. - ANS b. Increases cardiac output by
increasing it's heart rate.
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 - ANS a. A decrease in the heart rate
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 - ANS g. C & D
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 - ANS b. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. - ANS True
T/F: The parasympathetic nervous system is a cardioaccelerator. - ANS False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood pressure. -
ANS True
T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the ultrasound
transducer and the fetal spiral electrode. - ANS True
T/F: Variability can be determined with the fetoscope. - ANS False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped in
warm water to make cleaning easier. - ANS False
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is increased
variability. - ANS True
,T/F: All fetal monitors contain a logic system designed to reject artifact. - ANS True
T/F: The monitor should always be tested before starting a tracing, either external or internal mode and
labeled a test. - ANS True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - ANS False
T/F: Both internal and external monitoring methods are equally accurate means of obtaining the fetal
heart rate and contraction patterns. - ANS False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. - ANS True
T/F: The external toco gives measurable uterine pressure. - ANS False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present. - ANS
False
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. - ANS True
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and intensity of
uterine contractions. - ANS False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. - ANS False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ANS False
, T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. - ANS True
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. - ANS True
T/F: Variability and periodic changes can be detected with both internal and external monitoring. - ANS
True
T/F: Variable decelerations are a result of cord compression. - ANS True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of adequate
fetal oxygenation. - ANS True
T/F: Variable decelerations are a vagal response. - ANS True
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. - ANS True
T/F: The fetal heart rate baseline can be determined during periods of marked variability. - ANS False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through the
placenta. - ANS True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in labor. -
ANS True
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated. - ANS False
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