Obstetric Nurse Test Obstetric Nurse Intrapartum Fetal Monitoring 3 — Questions and Answers
Question 1: A prolonged deceleration is defined as a FHR decrease of at least 15 bpm below baseline lasting:
- 30 seconds to less than 2 minutes
- 2 minutes or more but less than 10 minutes (Correct answer)
- 10 minutes or longer
- 1 minute or more but less than 5 minutes
Correct answer: 2 minutes or more but less than 10 minutes
A prolonged deceleration lasts ≥2 minutes but <10 minutes; if it lasts ≥10 minutes, it represents a baseline change.
Question 2: Which fetal heart rate characteristic is defined as fluctuations in the baseline FHR that are irregular in amplitude and frequency, measured at 2 cycles per minute?
- Accelerations
- Variability (Correct answer)
- Decelerations
- Saltatory pattern
Correct answer: Variability
Baseline FHR variability refers to the irregular fluctuations above and below the baseline, reflecting the interplay between the sympathetic and parasympathetic nervous systems.
Question 3: A patient at 38 weeks gestation is receiving oxytocin augmentation. The FHR shows moderate variability, no accelerations, and occasional mild variable decelerations. What category is this tracing?
- Category I
- Category II (Correct answer)
- Category III
- Unclassifiable — requires consultation
Correct answer: Category II
Any tracing that does not meet Category I or Category III criteria is Category II; recurrent variable decelerations with moderate variability is Category II.
Question 4: During pushing in the second stage, the nurse observes FHR decelerations that begin after the contraction peaks and have a slow return to baseline. This pattern is MOST consistent with:
- Early decelerations due to head compression
- Variable decelerations due to cord occlusion
- Late decelerations indicating uteroplacental insufficiency (Correct answer)
- Accelerations misidentified as decelerations
Correct answer: Late decelerations indicating uteroplacental insufficiency
Late decelerations that begin after the contraction peak and slowly return to baseline reflect uteroplacental insufficiency and impaired gas exchange.
Question 5: Which of the following fetal scalp electrode (FSE) placements is CONTRAINDICATED?
- When external monitoring is inadequate in active labor
- When the cervix is dilated ≥2 cm and membranes are ruptured
- When the patient is HIV-positive (Correct answer)
- When fetal presentation is vertex
Correct answer: When the patient is HIV-positive
FSE is contraindicated in patients with HIV, hepatitis B or C, or other blood-borne infections due to the risk of vertical transmission via the puncture site.
Question 6: On an EFM strip running at 3 cm/min, each small square on the horizontal axis represents how much time?
- 10 seconds (Correct answer)
- 30 seconds
- 1 minute
- 2 minutes
Correct answer: 10 seconds
At the standard US paper speed of 3 cm/min, each small square (1 mm) on the horizontal axis represents 10 seconds of time.
Question 7: A nurse notices the FHR tracing has a baseline of 130 bpm with variability that appears to be 3–4 bpm. How is this variability classified?
- Absent variability
- Minimal variability (Correct answer)
- Moderate variability
- Marked variability
Correct answer: Minimal variability
Minimal variability is defined as amplitude range greater than undetectable but ≤5 bpm, which includes a 3–4 bpm range.
Obstetric Nurse Test Obstetric Nurse Intrapartum Fetal Monitoring 3
A prolonged deceleration is defined as a FHR decrease of at least 15 bpm below baseline lasting: