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Quizzes > Health & Medicine > Human Anatomy & Medicine

Ready to Master Fetal Monitoring Strips? Start the Quiz

Join the fetal monitoring strips practice quiz and sharpen your fetal heart rate monitoring practice with real examples!

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art illustration for fetal monitoring strips quiz on a coral background

Use this fetal monitoring strips practice quiz to read strips, spot fetal heart rate patterns, and choose the right action in realistic cases. You'll sharpen bedside judgment and check gaps before an exam or shift; warm up with EKG practice or review rhythms in the ACLS guide .

What is the normal baseline fetal heart rate as seen on a monitoring strip?
160-180 bpm
110-160 bpm
80-100 bpm
90-110 bpm
The normal baseline fetal heart rate ranges from 110 to 160 beats per minute, reflecting adequate autonomic control. Values below 110 bpm indicate bradycardia, while those above 160 bpm suggest tachycardia. Accurate baseline assessment is essential for categorizing the tracing and determining fetal well-being.
Moderate variability in fetal heart rate is defined as fluctuations of how many beats per minute?
1 - 5 bpm
0 bpm (absent)
6 - 25 bpm
26 - 40 bpm
Moderate variability, defined as 6 to 25 bpm fluctuations, is reassuring and indicates an intact central nervous system and adequate oxygenation. Minimal variability is 1 - 5 bpm, and marked variability exceeds 25 bpm. Variability is a key component in tracing classification.
Which of the following best describes a reactive nonstress test in a term fetus?
One acceleration of ?10 bpm lasting ?10 seconds within 10 minutes
Two accelerations of ?15 bpm lasting ?15 seconds within 20 minutes
A baseline of 170 bpm with minimal variability
Three decelerations following uterine contractions
A reactive NST requires at least two accelerations of the fetal heart rate of 15 bpm above baseline, each lasting 15 seconds, within a 20-minute window. This indicates fetal well-being. Variations in criteria apply to preterm fetuses.
Early decelerations on a fetal monitor are typically caused by which of the following?
Fetal hypoxia
Head compression
Umbilical cord compression
Uteroplacental insufficiency
Early decelerations are a result of vagal response to fetal head compression during contractions. They mirror the contraction, with onset, nadir, and recovery corresponding to contraction phases. They are considered benign.
How many contractions in a 10-minute window is considered normal in active labor?
More than 12 contractions
2 - 5 contractions
9 - 12 contractions
6 - 8 contractions
A normal contraction frequency is 2 - 5 in a 10-minute interval, averaged over 30 minutes. More frequent contractions may indicate tachysystole, increasing risk of fetal distress. Monitoring frequency ensures adequate uterine rest.
A variable deceleration is characterized by which of the following shapes on the tracing?
Late onset after contraction peak
Smooth, undulating sine wave pattern
Abrupt onset with a V-, U-, or W-shape
Gradual onset that mirrors contraction
Variable decelerations have an abrupt decrease in fetal heart rate, dropping at least 15 bpm below baseline, forming a V-, U-, or W-shaped pattern. They are due to cord compression. Their timing relative to contractions varies.
What term describes fetal heart rate variability of less than 5 bpm?
Minimal variability
Moderate variability
Absent variability
Marked variability
Minimal variability is defined as fluctuations of less than 5 bpm, reflecting decreased fetal autonomic regulation. Moderate variability (6 - 25 bpm) is reassuring. Absent variability is no detectable change.
An acceleration in a term fetus is defined as an increase in heart rate of how much and lasting for how long?
?10 bpm above baseline for ?30 seconds
?10 bpm above baseline for ?10 seconds
?20 bpm above baseline for ?20 seconds
?15 bpm above baseline for ?15 seconds
In term fetuses, accelerations must be at least 15 bpm above the baseline and last at least 15 seconds to be considered reactive and reassuring. Preterm criteria differ. Accelerations indicate fetal movement and oxygenation.
Which combination of features defines a Category I fetal heart rate tracing?
Baseline <110 bpm, absent variability, recurrent late decelerations
Baseline 100 - 120 bpm, minimal variability, early decelerations
Baseline 160 - 180 bpm, marked variability, variable decelerations
Baseline 110 - 160 bpm, moderate variability, no late or variable decelerations
Category I tracings have a normal baseline (110 - 160 bpm), moderate variability, possible accelerations or early decelerations, and no late or variable decelerations. This category indicates fetal well-being and requires routine care.
Late decelerations are most indicative of which underlying condition?
Uteroplacental insufficiency
Umbilical cord prolapse
Fetal head compression
Maternal hypotension excluding uteroplacental causes
Late decelerations begin after the peak of a contraction and return to baseline after the contraction ends, indicating uteroplacental insufficiency and potential fetal hypoxia. They are uniform, gradual, and concerning.
What is the first recommended intervention when recurrent late decelerations are detected?
Prepare for immediate cesarean delivery
Increase oxytocin infusion
Reposition the mother to left lateral decubitus
Administer a tocolytic immediately
Repositioning to the left lateral position improves uteroplacental blood flow, alleviating reversible causes of late decelerations. Additional measures include IV fluids and oxygen. If persistent, further action is needed.
How is contraction duration measured on a fetal monitoring strip?
From the start of rise to return to baseline
From peak to return to baseline
From one peak to the next peak
From baseline to the peak
Contraction duration is calculated by measuring from the initial rise of the contraction waveform to its return to baseline. Frequency is measured from peak to peak over time. Accurate measurement guides management.
Which statement best differentiates a true sinusoidal pattern from a pseudo-sinusoidal pattern?
True sinusoidal is continuous for >20 minutes; pseudo is intermittent
True sinusoidal has sharp peaks; pseudo has smooth undulations
True sinusoidal is due to anesthesia; pseudo from fetal anemia
There is no difference - they are identical patterns
A true sinusoidal pattern is a smooth, wave-like oscillation of 3 - 5 cycles per minute lasting over 20 minutes and indicates severe fetal anemia or hypoxia. A pseudo-sinusoidal pattern is shorter and often related to opioid administration.
What is the primary management step for a Category II fetal heart rate tracing?
Implement intrauterine resuscitation measures
Increase oxytocin infusion
Immediate operative delivery
No intervention is needed
Category II tracings require evaluation and interventions such as maternal repositioning, oxygen, IV fluids, and stopping oxytocin to optimize fetal oxygenation. Continuous monitoring and potential escalation are necessary.
Fetal bradycardia is defined as a baseline heart rate below what threshold?
<120 bpm
<90 bpm
<100 bpm
<110 bpm
Bradycardia in the fetus is defined as a baseline heart rate under 110 bpm for at least 10 minutes. It can indicate hypoxia, cord compression, or maternal hypotension. Immediate assessment and intervention are required.
Variable decelerations result primarily from which mechanism?
Uterine hyperstimulation
Umbilical cord compression causing vagal stimulation
Placental insufficiency
Fetal head compression
Variable decelerations occur when the umbilical cord is compressed, triggering baroreceptor-mediated vagal bradycardia. They are abrupt and vary in timing relative to contractions. Persistent severe variables may require intervention.
An acceleration of 15 bpm lasting 15 seconds indicates what about fetal status?
Severe fetal anemia
Uteroplacental insufficiency
Fetal hypoxia
Reassuring fetal oxygenation and CNS integrity
An acceleration of ?15 bpm for ?15 seconds is a reassuring sign of adequate fetal oxygenation and intact central nervous system function. It is a key criterion for a reactive NST.
A deceleration that lasts more than 2 minutes but less than 10 minutes is termed:
Variable deceleration
Late deceleration
Prolonged deceleration
Early deceleration
A deceleration lasting 2 - 10 minutes is classified as a prolonged deceleration. It reflects significant but transient fetal compromise. Duration over 10 minutes is a baseline change.
A true sinusoidal pattern observed for over 20 minutes is classified as which category?
Category 0
Category III
Category I
Category II
A persistent true sinusoidal pattern lasting over 20 minutes is an ominous sign classified as Category III, requiring immediate evaluation and likely delivery. It is associated with severe fetal anemia or hypoxia.
What is the basis of the fetal scalp stimulation test?
Measuring fetal blood pH directly
Causing a late deceleration to assess reserve
Provoking an acceleration via gentle scalp pressure
Inducing variable decelerations with pressure
The fetal scalp stimulation test applies gentle pressure to the fetal scalp through the cervix to elicit an acceleration, indicating fetal well-being and avoiding invasive blood sampling. Lack of response suggests acidosis.
Uterine tachysystole is defined as:
Contractions every 5 - 7 minutes
More than five contractions in 10 minutes
Single contraction lasting over 2 minutes
Three contractions in 10 minutes
Tachysystole refers to more than five contractions in a 10-minute window, averaged over 30 minutes, which may compromise fetal oxygenation. A single contraction over 2 minutes is hypertonus.
How is uterine resting tone assessed when using an intrauterine pressure catheter?
Number of contractions per 10 minutes
Baseline fetal heart rate
Peak pressure during contraction (30 - 50 mmHg)
Measurement between contractions (5 - 15 mmHg)
Resting tone is measured between contractions with an IUPC and normally ranges from 5 to 15 mmHg. Elevated resting tone can reduce placental perfusion. Accurate assessment guides management.
In a Category III tracing with recurrent late decelerations and minimal variability, the most appropriate next step is:
Increase oxytocin infusion
Administer tocolytics and wait 30 minutes
Prepare for immediate cesarean delivery
Continue monitoring without change
Recurrent late decelerations with minimal variability denote a Category III tracing and potential fetal compromise, necessitating urgent delivery, often via cesarean. Intrauterine resuscitation alone is insufficient.
A fetal scalp blood pH of which value indicates significant acidosis?
7.25
>7.40
>7.30
<7.20
A fetal scalp pH under 7.20 suggests metabolic acidosis and compromised fetal status, often prompting operative delivery. Values above 7.25 are generally reassuring.
An atypical variable deceleration with a slow return to baseline (>60 seconds) and nadir <60 bpm requires which action?
Administer oxytocin bolus
No intervention is required
Increase maternal pushing efforts
Intrauterine resuscitation and consider expedited delivery
Atypical variables with a slow return and deep nadir indicate significant cord compression and fetal compromise. Immediate intrauterine resuscitation (repositioning, oxygen, IV fluids) and preparation for expedited delivery are warranted.
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Study Outcomes

  1. Analyze baseline fetal heart rate and variability -

    Interpret baseline rate, variability, and rhythm on fetal monitoring strips practice scenarios to distinguish between normal and abnormal patterns.

  2. Identify accelerations and decelerations -

    Recognize and classify various deceleration types, including early, variable, and late patterns, on fetal monitor strips and understand their clinical relevance.

  3. Interpret examples of fetal monitoring strips -

    Assess real-world strip examples of fetal monitoring strips to evaluate fetal well-being and guide evidence-based clinical decisions during labor.

  4. Differentiate deceleration categories -

    Apply fetal heart rate monitoring practice skills to distinguish early, variable, and late decelerations based on clinical guidelines.

  5. Apply clinical guidelines to strip interpretation -

    Use established protocols and guidelines to accurately practice fetal monitoring strips interpretation in simulated clinical cases.

  6. Evaluate performance and track progress -

    Review instant feedback from the quiz to identify strengths and areas for improvement in your fetal monitoring strips practice.

Cheat Sheet

  1. Baseline Fetal Heart Rate Determination -

    Reviewing fetal monitor strips always starts with establishing the baseline heart rate, typically between 110 and 160 bpm over a 10-minute window. Use the "6-seconds × 10" method - count beats in a 6-second span and multiply by 10 - to ensure accurate readings. Mastering this step builds confidence in all your fetal monitoring strips practice sessions.

  2. Variability Assessment -

    Understand variability - absent, minimal, moderate, or marked - which reflects fetal autonomic regulation (source: ACOG). Moderate variability (6 - 25 bpm) is a reassuring sign, while absent or minimal variability may require further assessment. Remember the mnemonic "Variably Moves" to recall moderate variability means healthy movement and oxygenation during fetal heart rate monitoring practice.

  3. Recognizing Accelerations -

    Accelerations are defined as transient increases in FHR ≥15 bpm above baseline lasting ≥15 seconds on term strips. These "A-Okay" signals indicate good fetal oxygenation (source: NICE guidelines). In examples of fetal monitoring strips, look for these positive blips to confirm a reactive non-stress test.

  4. Deceleration Patterns with VEAL CHOP -

    Differentiate early, variable, and late decelerations using the VEAL CHOP mnemonic - Variable: Cord compression; Early: Head compression; Acceleration: Okay; Late: Placental insufficiency (source: AWHONN). Recognizing these patterns on practice fetal monitoring strips helps you anticipate necessary interventions. Practice labeling real strip examples to reinforce this key concept.

  5. ACOG Category System Interpretation -

    Familiarize yourself with the ACOG three-tiered category system (I, II, III) for fetal heart rate monitoring practice. Category I is normal, Category II is indeterminate, and Category III is abnormal, requiring prompt intervention like repositioning, IV fluids, and oxygen. Using this classification on simulated fetal monitor strips ensures you're ready for clinical rotations.

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