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Advanced Fetal Monitoring Exam Questions
With Verified Answers.
True or False: Moderate variability reliably predicts the absence of metabolic acidemia at the
time it is observed - answer✔True
Paper speed for fetal monitoring in the US is... - answer✔3cm/min
Where is the baseline FHR regulated? - answer✔Intrinsic cardiac pacemakers, SA node (110-
160bpm) and AV node (40-60bpm)
Baseline FHR decreases with gestational age due to... - answer✔Increasing parasympathetic tone
At what gestational age are FHR accelerations expected to be 15x15? - answer✔32 weeks. Under
32 weeks, 10x10 is acceptable.
Risk Management is... - answer✔any activity, process, or policy to reduce liability
Quality assurance is... - answer✔activities and programs intended to improve quality of care
A sentinel event is... - answer✔any unanticipated event resulting in death or serious physical or
psychological injury to a patient or patients, not related to the natural course of the patient's
illness
Nonmaleficence is... - answer✔the principle of not doing harm
Beneficence is... - answer✔an act of charity, mercy, and kindness with a strong connotation of
doing good to others, including moral obligation
Personal autonomy is... - answer✔the capacity to decide for oneself and pursue the course of
action in one's life, often regardless of any particular moral content
Fetal oxygenation consists of what two basic elements: - answer✔Transfer of oxygen from the
environment to the fetus (extrinsic factors/external environment) and Fetal response to
interruption of oxygen transfer (intrinsic factors/internal environment)
Total amount of oxygen in arterial blood consists of two components: - answer✔PaO2 and SaO2
% of PaO2, or "floating" oxygen - answer✔1-2%
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% of SaO2, or "bound" oxygen - answer✔98-99%
True or False: The "extra" floating oxygen that is dissolved in plasma creates an increased
"pressure" that helps bind oxygen to hemoglobin - answer✔True
Oxygen saturation, or SaO2 is... - answer✔% of oxygen carried on hemoglobin
Hemoglobin can carry a maximum of ___ molecules of oxygen - answer✔4
What is the maternal oxygen pathway? - answer✔Environment, lungs, heart, vasculature, uterus,
placenta, umbilical cord, fetus
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
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%
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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
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)
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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
Fetal circulation preferentially shifts higher concentrations of oxygen to organs that consume the
most, like the... - answer✔Heart, brain, and adrenals
The fetus has a higher _________ and ______________ relative to its body size compared to the
adult - answer✔heart rate and cardiac output
Aerobic metabolism is maintained until... - answer✔The available oxygen in the intervillous
space decreases to 50% of normal levels
True or False: With transient hypoxemia, the normoxic fetus can compensate by redistributing
blood flow to the vital organs and the FHR will slow to consume less oxygen - answer✔True
Baroreceptors ("stretch receptors").... - answer✔Sense pressure changes in the BP
When fetal BP increases, baroreceptor stimulation results in parasympathetic stimulation
which.... - answer✔Slow the FHR
True or False: Baroreceptor stimulation causes vagal stimulation, a reflex bradycardia and
vasodilation that is nearly instantaneous - answer✔True
What is placental reserve? - answer✔Oxygen that is in the placenta during a contraction when no
other blood flow is entering the placenta
Compensatory mechanisms in the hypoxic fetus: - answer✔Redistribution of blood flow to
maintain O2 to vital organs (redistribution decreases oxygen consumption)
The Cental Nervous System is made of the Autonomic and Voluntary systems. Which is divided
into Sympathetic and Parasympathetic systems? - answer✔Autonomic
