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Fetal supraventricular tachycardia will often appear on the monitor as
A. the same rate as the maternal pulse
B. half the actual rate
C. artifact
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract NCC-Recommended Sources NCC-recommended fetal assessment texts emphasize that external Doppler ultrasound may undercount very rapid fetal arrhythmias such as fetal supraventricular tachycardia (SVT). Because Doppler detects mechanical motion rather than electrical activity, the device may record only every other cardiac contraction
, a phenomenon known as "half-counting."
Menihan's Electronic Fetal Monitoring explains that with SVT-often exceeding 200 to 260 bpm-the monitor "may display a fetal heart rate at approximately half the true atrial rate." AWHONN teaching materials affirm that rapid, regular tachyarrhythmias may appear deceptively slower on the external monitor due to Doppler under-sampling. Simpson & Creehan note that half-counting is a recognized technical limitation and may cause clinicians to miss true tachyarrhythmias if internal monitoring is not applied.
In contrast, artifact displays irregular, inconsistent, and non-physiologic deflections. Matching the maternal pulse suggests maternal heart rate misinterpretation, not SVT.
Miller's Pocket Guide also highlights that half-counting is "commonly seen in fetal SVT when using external Doppler due to failure to detect each rapid contraction." Therefore, fetal SVT most commonly appears as half the actual rate on an external fetal monitor.
References:
AWHONN - Fetal Heart Monitoring Principles & PracticesMenihan - Electronic Fetal MonitoringSimpson & Creehan - Perinatal NursingCreasy & Resnik - Maternal-Fetal MedicineMiller's Pocket Guide
NEW QUESTION # 80
A pattern of recurrent variable decelerations would move from Category II to Category III if what fetal heart rate change occurs?
A. Late decelerations
B. Absent variability
C. Tachysystole
Answer: B
NEW QUESTION # 81
When monitoring monochorionic-monoamniotic twins, which of the following fetal heart rate patterns would be anticipated?
A. Baseline tachycardia
B. Minimal variability
C. Variable decelerations
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract (NCC-Referenced Sources) Mono-mono twins share a single amniotic cavity, which significantly increases the risk of cord entanglement
, a concept highlighted in AWHONN FHM, Creasy & Resnik Maternal-Fetal Medicine, and Miller's EFM Pocket Guide.
These texts emphasize:
* "Cord entanglement is nearly universal in monoamniotic twins."
* "Variable decelerations are common due to recurrent cord compression." Baseline tachycardia or minimal variability are not expected baseline characteristics, but may appear only in pathologic circumstances.
Thus, variable decelerations are the expected and anticipated FHR pattern in mono-mono twins.
NEW QUESTION # 82
A woman who is one week past a confirmed due date has serial ultrasounds to determine:
A. Amniotic fluid volume
B. Fetal weight
C. Placental calcification
Answer: A
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Post-dates surveillance focuses on:
* Amniotic fluid volume (AFI or deepest vertical pocket)
* This is the most sensitive parameter of placental function
* Oligohydramnios is strongly associated with post-maturity and perinatal morbidity NCC and AWHONN emphasize amniotic fluid as the primary parameter for fetal well-being in post-term surveillance.
Why the incorrect answers are wrong:
* B. Fetal weight # inaccurate and not used for surveillance decisions.
* C. Placental calcification # poor predictor of fetal outcome and not used for management.
References:NCC C-EFM Candidate Guide; ACOG post-dates management (summaries); Simpson & Creehan.
NEW QUESTION # 83
A woman is admitted to labor and delivery with vaginal bleeding. This tracing is obtained. This is most consistent with:
A. Dysrhythmia
B. An indeterminate pattern
C. Normal baseline
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The tracing shows:
* Baseline approx. 120 bpm
* Minimal variability (amplitude <5 bpm) across the entire strip
* No accelerations
* No decelerations
* Contractions present but not excessive
NCC defines:
* Category I requires moderate variability # not present.
* Category III requires absent variability with recurrent decels, bradycardia, or sinusoidal pattern # not present.
* Thus this falls into Category II: "indeterminate."
Minimal variability for this length of time cannot be considered a normal baseline, especially in the setting of vaginal bleeding, which raises concern for:
* Abruption
* Maternal anemia
* Hypovolemia
* Decreased uteroplacental perfusion
There is no evidence of dysrhythmia (no irregular R-R intervals, no chaotic spikes, no sawtooth pattern).
Therefore, the correct interpretation is A. An indeterminate pattern (Category II).
References:NCC C-EFM Candidate Guide; NICHD Definitions; AWHONN Principles & Practices; Menihan; Simpson & Creehan; Creasy & Resnik.
NEW QUESTION # 84
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