Fetal Monitoring Review
Questions
Ana Corona
2009
Variable decelerations in FHR during labor
are severe dips occurring at the peak of
contraction. This FHR problem is associated
with which one of the following conditions?
1.
2.
3.
4.
Utero-placental insufficiency
Fetal head compression
Uterine insufficiency
Pressure on the umbilical cord
Answer is 4
• These decelerations are common during
labor.
• The FHR drops during the contraction
resulting from stimulation from
chemoreceptors and baroreceptors as the
cord is compressed.
• The nurse should recognize these
readings on the fetal monitor as normal.
A nurse is caring for a client in labor and is
monitoring the FHR patterns. The nurse notes
the presence of episodic accelerations on the
electronic fetal monitor tracing. Which of the
following actions is most appropriate?
1. Document the findings and tell the mother
that the monitor indicates fetal well-being
2. Take the mothers vital signs and tell the
mother that bed rest is required to
conserve oxygen.
3. Notify the physician of the findings.
4. Reposition the mother and check the
monitor for changes in the fetal tracing
Answer is 1
• Accelerations are transient increases in
the fetal heart rate that often accompany
contractions or are caused by fetal
movement.
• Episodic accelerations are thought to be a
sign of fetal-well being and adequate
oxygen reserve.
A nurse is admitting a pregnant client to the
labor room and attaches an external
electronic fetal monitor to the client’s
abdomen. After attachment of the monitor, the
initial nursing assessment is which of the
following?
1. Identifying the types of accelerations
2. Assessing the baseline fetal heart rate
3. Determining the frequency of the
contractions
4. Determining the intensity of the
contractions
Answer is 2
• Assessing the baseline fetal heart rate is
important so that abnormal variations of
the baseline rate will be identified if they
occur.
• Options 1 and 3 are important to assess,
but not as the first priority.
A nurse is monitoring a client in labor. The
nurse suspects umbilical cord compression if
which of the following is noted on the external
monitor tracing during a contraction?
1.
2.
3.
4.
Early decelerations
Variable decelerations
Late decelerations
Short-term variability
Answer is 2
• Variable decelerations occur if the umbilical
cord becomes compressed, thus reducing
blood flow between the placenta and the
fetus.
• Early decelerations result from pressure on
the fetal head during a contraction.
• Late decelerations are an suggests uteroplacental insufficiency during a contraction.
• Short-term variability refers to the beat-tobeat range in the fetal heart rate.
The physician asks the nurse the frequency of
a laboring client’s contractions. The nurse
assesses the client’s contractions by timing
from the beginning of one contraction:
1.
2.
3.
4.
Until the time it is completely over
To the end of a second contraction
To the beginning of the next contraction
Until the time that the uterus becomes
very firm
Answer is 3
• This is the way to determine the frequency
of the contractions
When monitoring the FHR of a client in labor,
the nurse identifies an elevation of 15 beats
above the baseline rate of 135 beats per
minute lasting for 15 seconds. This should be
documented as:
1.
2.
3.
4.
An acceleration
An early elevation
A sonographic motion
A tachycardic heart rate
Answer is 1
• An acceleration is an abrupt elevation
above the baseline of 15 beats per minute
for 15 seconds; if the acceleration persists
for more than 10 minutes it is considered a
change in baseline rate.
• A tachycardic FHR is above 160 beats per
minute.
Which of the following findings meets
the criteria of a reassuring FHR
pattern?
1. FHR does not change as a result of fetal
activity
2. Average baseline rate ranges between
100 - 140 BPM
3. Mild late deceleration patterns occur with
some contractions
4. Variability averages between 6 - 10 BPM
Answer is 4
• Variability indicates a well oxygenated fetus
with a functioning autonomic nervous
system.
• FHR should accelerate with fetal movement.
• Baseline range for the FHR is 120 to 160
beats per minute.
• Late deceleration patterns are never
reassuring, though early and mild variable
decelerations are expected, reassuring
findings.