Question Notes

Printed on: 1/8/2021

Learner: Lord Mvoula

Test Name Objective 26: Intrapartum Completion Date 2021-01-08T23:17:01

Fetal Surveillance (2018)
Score 8.0 of 10.0 (80.00%) Timespent 00:14:48
Result Passed

Question Result / Notes

Order Name Score Notes

1 A 33-year-old G2P1 woman at 39 weeks 1.0
gestation presents with painful contractions.
Her membranes ruptured two hours prior to
presentation. Her pregnancy has been
uncomplicated, and she has a history of a
cesarean delivery for breech presentation.
She highly desires a vaginal birth. On
admission, she is having contractions every
four minutes and fetal heart tracing is
Category I. On cervical exam, she is 5 cm
dilated, 80% effaced and the fetal vertex is
at -1 station. Four hours later, she continues
to contract every four minutes with
reassuring fetal status and her cervical
exam is unchanged. What is the next best
step in the management of this patient?
2 A 19-year-old G3P0 woman at 39 weeks 0.0
gestation with spontaneous rupture of
membranes for 13 hours presented to labor
and delivery. Her vital signs are: blood
pressure 120/70; pulse 96 beats/minute;
temperature 100.0° F (37.7° C). Fundal
height is 36 cm and her uterus is slightly
tender to palpation. Estimated fetal weight is
2700 g. Cervix is dilated to 1 cm, 50%
effaced, -2 station. Her fetal tracing is
shown below. What is the most likely
underlying etiology for these findings?
3 A 33-year-old G1P0 woman at 38 weeks 1.0
gestation with pregnancy complicated by
type 1 diabetes was admitted for induction
due to oligohydramnios. She received
Cervidil (prostaglandin E2) overnight, and
her cervix was noted to be 3 cm dilated in
the morning, so oxytocin induction was
started. After three hours of oxytocin, fetal
heart rate is noted to be in the 160s with
minimal variability and late decelerations
despite resuscitation with oxygen, fluids and
left lateral position. Thirty minutes after
discontinuing the oxytocin, she continues to
have contractions every three to four
minutes with late decelerations. Her blood
pressure is 138/88 and her pulse is 110
beats/minute. Her cervical exam is 4 cm
dilated. What is the most appropriate next
step in the management of this patient?
 Question Notes

Printed on: 1/8/2021

Order Name Score Notes

4 A 19-year-old G1P0 woman at 42 weeks 1.0
gestation presents to labor and delivery with
spontaneous rupture of membranes for 13
hours and spontaneous onset of labor. Her
vital signs are: blood pressure 120/70; pulse
72 beats/minute; afebrile; fundal height 36
cm; and estimated fetal weight of 2700 gm.
Cervix is dilated to 4 cm, 100% effaced, +1
station. Her fetal tracing is shown below.
What is the most likely underlying etiology
for these findings?
5 A 19-year-old G1P0 woman at 39 weeks 1.0
gestation presents in labor. She denies
ruptured membranes. Her prenatal course
was uncomplicated and ultrasound at 18
weeks revealed no fetal abnormalities. Her
vital signs are: blood pressure 120/70; pulse
72 beats/minute; temperature 101.0° F
(38.3° C); fundal height 36 cm; and
estimated fetal weight of 2900 gm. Cervix is
dilated to 4 cm, 100% effaced and at +1
station. She receives 10 mg of morphine
intramuscularly for pain and, soon after, has
spontaneous rupture of the membranes.
Light meconium-stained fluid was noted
and, five minutes later, the fetal heart rate
tracing revealed variable decelerations with
moderate variability. What is the most likely
cause of the findings on the tracing?
6 A 29-year-old G1P0 woman at 42 weeks 1.0
gestation presents in labor. She denies
ruptured membranes. Her prenatal course
was complicated by chronic hypertension.
Her vital signs are: blood pressure 130/80;
pulse 72 beats/minute; afebrile; fundal
height 36 cm; and estimated fetal weight of
2100 gm. Cervix is dilated to 4 cm, 100%
effaced, +1 station. The fetal heart rate
tracing is shown below. What is the most
likely diagnosis?
7 A 29-year-old G1P0 woman at 42 weeks 1.0
gestation presents in labor. She denies
ruptured membranes. Her prenatal course
was complicated by chronic hypertension.
Her vital signs are: blood pressure 130/80;
pulse 72 beats/minute; afebrile; fundal
height 38 cm; and estimated fetal weight of
3000 g. Cervix is dilated to 4 cm, 100%
effaced, -1 station and bulging membranes.
The fetal heart rate tracing reveals five
contractions in 10 minutes and repetitive
late decelerations. What is the most likely
cause of the findings on the tracing?
8 A 29-year-old G1P0 woman at 41 weeks 1.0
gestation presents to labor and delivery
because of intermittent contractions. She
denies ruptured membranes. Her prenatal
course was uncomplicated. Her vital signs
are: blood pressure 140/96; pulse 72
beats/minute; afebrile; fundal height 32 cm;
and estimated fetal weight of 2900 g. Cervix
is closed, 25% effaced, -2 station. The fetal
heart rate tracing shows occasional late
decelerations. Of the following, what is the
next best step in management?
 Question Notes

Printed on: 1/8/2021

Order Name Score Notes

9 A 29-year-old G1P0 woman at 40 weeks 0.0
gestation presents to labor and delivery
because of contractions and ruptured
membranes. Her prenatal course was
uncomplicated. Her vital signs are: blood
pressure 140/96; pulse 72 beats/minute;
afebrile; fundal height 36 cm; and estimated
fetal weight of 3300 g. Cervix is 6 cm
dilated, 100% effaced, 0 station. The fetal
heart rate tracing for the last hour has
minimal variability and no accelerations. Of
the following, what is the initial step in the
management of this patient?
10 A 29-year-old G1P0 woman at 41 weeks 1.0
gestation presents in early labor. The
prenatal course was uncomplicated.
Ultrasound at 21 weeks was consistent with
gestational age. Her vital signs reveal a
blood pressure of 128/76; pulse 74
beats/minute; and she is afebrile. Fundal
height is 36 cm with estimated fetal weight
of 2700 g. Cervix is dilated to 1 cm, 50%
effaced and the fetal vertex is at -2 station.
The nurse calls you to evaluate the fetal
tracing. Fetal tracing is shown below. What
is the most likely diagnosis?