EFM EFM - Electronic Fetal Monitoring Documentation and Communication Questions and Answers 1 — Questions and Answers
Question 1: Which communication framework is most recommended for reporting concerning fetal heart rate patterns to a provider in the US?
- SBAR (Situation, Background, Assessment, Recommendation) (Correct answer)
- SOAP (Subjective, Objective, Assessment, Plan)
- CHART (Complaint, History, Assessment, Rx, Treatment)
- PACE (Patient, Assessment, Complication, Evaluation)
Correct answer: SBAR (Situation, Background, Assessment, Recommendation)
SBAR is the standard structured communication tool recommended for reporting FHR concerns because it ensures complete, organized information transfer.
Question 2: When documenting a category II fetal heart rate tracing, what is the MOST important element to record?
- Interventions performed and fetal response (Correct answer)
- Only the strip interpretation label
- The nurse's personal opinion of fetal status
- The number of visitors in the room
Correct answer: Interventions performed and fetal response
Documenting the interventions performed and the fetal response demonstrates clinical action taken and establishes a clear record for continuity of care.
Question 3: How frequently should EFM strip assessments be documented during active labor in a low-risk patient per AWHONN guidelines?
- Every 15 minutes (Correct answer)
- Every 5 minutes
- Every 30 minutes
- Every hour
Correct answer: Every 15 minutes
AWHONN recommends documenting EFM assessments every 15 minutes during active labor for low-risk patients to ensure timely identification of changes.
Question 4: Which term should be used in documentation when describing a fetal heart rate pattern that cannot be categorized as Category I or Category III?
- Category II (Correct answer)
- Indeterminate
- Suspicious
- Non-reassuring
Correct answer: Category II
The NICHD three-tier classification system uses 'Category II' for tracings that are neither normal (Category I) nor abnormal (Category III).
Question 5: What is the primary purpose of the 'chain of command' in EFM-related clinical communication?
- To escalate patient safety concerns when a provider does not respond appropriately (Correct answer)
- To document the hierarchy of nursing staff on the unit
- To assign responsibility for charting the EFM strip
- To determine who places the external monitor
Correct answer: To escalate patient safety concerns when a provider does not respond appropriately
The chain of command exists to ensure patient safety by providing nurses a formal pathway to escalate concerns when initial communication with a provider is inadequate.
Question 6: When documenting fetal heart rate accelerations, which detail is required to meet the standard NICHD definition in a term fetus?
- Peak ≥15 bpm above baseline lasting ≥15 seconds (Correct answer)
- Peak ≥10 bpm above baseline lasting ≥10 seconds
- Peak ≥20 bpm above baseline lasting ≥30 seconds
- Any visible increase in FHR above the baseline
Correct answer: Peak ≥15 bpm above baseline lasting ≥15 seconds
In a term fetus, an acceleration is defined by NICHD as a peak of at least 15 bpm above baseline with a duration of at least 15 seconds.
EFM EFM - Electronic Fetal Monitoring Documentation and Communication Questions and Answers 1
Which communication framework is most recommended for reporting concerning fetal heart rate patterns to a provider in the US?