EFM - Electronic Fetal Monitoring Fetal Heart Rate Variability Questions and Answers

Question 1

A nurse is evaluating an electronic fetal monitoring (EFM) strip and notes the variability is consistently greater than 25 beats per minute (bpm) from the baseline.
According to NICHD guidelines, how should this fetal heart rate variability be classified?

Accepted Answer

Marked

Answer

Moderate

Answer

Minimal

Answer

Absent

Question 2

An EFM tracing shows a baseline fetal heart rate of 140 bpm with an amplitude range of 2-3 bpm for the past 40 minutes. The patient denies receiving any recent medications. Which of the following is the most likely cause for this pattern?

Accepted Answer

Fetal sleep cycle

Answer

Maternal fever

Answer

Umbilical cord compression

Answer

Uteroplacental insufficiency

Question 3

Which of the following is the single most important characteristic of the fetal heart rate that reliably predicts the absence of fetal metabolic acidemia at the time of observation?

Accepted Answer

Presence of moderate variability

Answer

Presence of accelerations

Answer

A baseline rate of 110-160 bpm

Answer

Absence of decelerations

Question 4

A laboring patient's EFM tracing displays an undulating, smooth, sine wave-like pattern with a frequency of 3-5 cycles per minute and an amplitude of 5-15 bpm that has persisted for 20 minutes. What condition is most commonly associated with this ominous pattern?

Accepted Answer

Severe fetal anemia

Answer

Maternal sedation

Answer

Fetal cardiac arrhythmia

Answer

Fetal hiccups

Question 5

A nurse observes a change in the fetal heart rate variability from moderate to absent on the EFM tracing, which persists despite intrauterine resuscitation measures. This change is most concerning for the development of which fetal condition?

Accepted Answer

Fetal metabolic acidemia

Answer

Fetal metabolic alkalosis

Answer

Transient fetal hypoxemia

Answer

Compensated respiratory acidemia

Question 6

Which of the following interventions or conditions is LEAST likely to cause a decrease in or absence of fetal heart rate variability?

Accepted Answer

Fetal acoustic stimulation

Answer

Administration of magnesium sulfate

Answer

Fetal sleep state

Answer

Administration of narcotic analgesics