CMA Fetal Monitoring & Assessment 2 — Questions and Answers
Question 1: Variable decelerations on a fetal monitor are most commonly associated with:
- Fetal head compression
- Uteroplacental insufficiency
- Umbilical cord compression (Correct answer)
- Maternal hypoglycemia
Correct answer: Umbilical cord compression
Variable decelerations have an abrupt onset and variable shape, classically caused by umbilical cord compression that transiently reduces fetal blood flow.
Question 2: Late decelerations are clinically significant because they indicate:
- Normal fetal response to pushing
- Umbilical cord entanglement
- Uteroplacental insufficiency (Correct answer)
- Fetal sleep cycle
Correct answer: Uteroplacental insufficiency
Late decelerations begin after the contraction peak and represent inadequate oxygen delivery due to uteroplacental insufficiency.
Question 3: What is the maximum possible score on a biophysical profile?
- 8
- 10 (Correct answer)
- 12
- 6
Correct answer: 10
The BPP has five parameters each scored 0 or 2, giving a maximum total of 10; a score of 8–10 is reassuring.
Question 4: Fetal tachycardia is defined as a baseline FHR above which value sustained for more than 10 minutes?
- 150 bpm
- 160 bpm (Correct answer)
- 170 bpm
- 180 bpm
Correct answer: 160 bpm
A baseline FHR exceeding 160 bpm for more than 10 minutes is classified as fetal tachycardia and may indicate infection, hypoxia, or medication effect.
Question 5: An amniotic fluid index (AFI) of less than 5 cm is diagnostic of:
- Polyhydramnios
- Normal fluid volume
- Oligohydramnios (Correct answer)
- Borderline low fluid
Correct answer: Oligohydramnios
An AFI below 5 cm indicates oligohydramnios, which can result from renal anomalies, prolonged pregnancy, or uteroplacental compromise.
Question 6: On electronic fetal monitoring, 'variability' reflects the integrity of which fetal system?
- Musculoskeletal system
- Autonomic nervous system (Correct answer)
- Renal system
- Pulmonary system
Correct answer: Autonomic nervous system
Baseline FHR variability — the fluctuation in heart rate between beats — is generated by the interplay of the fetal sympathetic and parasympathetic nervous systems.
Question 7: A midwife assistant notices late decelerations on the monitor. Which intervention should be AVOIDED?
- Repositioning the mother to the left lateral position
- Administering supplemental oxygen via face mask
- Increasing the oxytocin infusion rate (Correct answer)
- Notifying the supervising provider immediately
Correct answer: Increasing the oxytocin infusion rate
Increasing oxytocin would intensify contractions and worsen uteroplacental perfusion, exacerbating fetal distress; it should be decreased or stopped.
CMA Fetal Monitoring & Assessment 2
Variable decelerations on a fetal monitor are most commonly associated with: