EFM - Electronic Fetal Monitoring Periodic and Episodic Changes Questions and Answers

Question 1

A fetal heart rate tracing shows recurrent decelerations where the onset, nadir, and recovery are delayed relative to the beginning, peak, and end of the uterine contractions.
This pattern is most indicative of which underlying condition?

Accepted Answer

Uteroplacental insufficiency

Answer

Umbilical cord compression

Answer

Fetal head compression

Answer

Maternal supine position

Question 2

According to the 2008 NICHD guidelines, which of the following defines a fetal heart rate acceleration for a fetus at 34 weeks gestation?

Accepted Answer

An abrupt increase of at least 15 bpm above baseline, lasting at least 15 seconds but less than 2 minutes.

Answer

An abrupt increase of at least 10 bpm above baseline, lasting at least 10 seconds.

Answer

A gradual increase of at least 15 bpm above baseline, lasting at least 15 seconds.

Answer

Any increase above baseline that lasts for more than 2 minutes.

Question 3

A laboring patient's EFM tracing shows an abrupt FHR decrease from a baseline of 145 bpm to a nadir of 90 bpm. The onset of the deceleration to the nadir is less than 30 seconds. This change is best described as a:

Accepted Answer

Variable deceleration

Answer

Late deceleration

Answer

Early deceleration

Answer

Prolonged deceleration

Question 4

A clinician notes a visually apparent, smooth, sine wave-like undulating pattern in the FHR baseline with a frequency of 3-5 cycles per minute that persists for 25 minutes. This pattern is defined as a sinusoidal pattern and is a Category III tracing, often associated with which condition?

Accepted Answer

Severe fetal anemia

Answer

Maternal fever

Answer

Fetal sleep cycle

Answer

Use of epidural analgesia

Question 5

A fetal heart rate deceleration begins at a baseline of 130 bpm, drops to 80 bpm, and lasts for 4 minutes before returning to the previous baseline. According to NICHD guidelines, how should this event be classified?

Accepted Answer

A prolonged deceleration

Answer

A new baseline of bradycardia

Answer

A recurrent late deceleration

Answer

A severe variable deceleration

Question 6

A series of accelerations are observed on a fetal monitoring strip that do not occur in conjunction with uterine contractions. These changes are best described as:

Accepted Answer

Episodic

Answer

Periodic

Answer

Cyclical

Answer

Reactive