Practice Quiz

CPM Certified Professional Midwife

Category - Prenatal

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A 28 - year - old client at 29 weeks’ gestation comes to clinic due to decreased fetal movements. The midwife instructs the client to focus on the fetal activity for an hour. After the specified time period, the client reports two fetal movements. The midwife orders a non - stress test. The NST records an increase in fetal heart rate by 15 beats per minute, lasting for 15 minutes, after each fetal movement. This finding is recorded thrice in a period of 20 minutes. Based on the NST result, the next action of the midwife is to:
  1. Reinforce fetal movement counting.
  2. Perform contraction stress testing.
  3. Order for a serial fetal assessment.
  4. Refer to physician immediately.
Explanation
Answer: A - The next action of the midwife is to reinforce fetal movement counting. The NST is reactive because more than two accelerations were recorded in a period of 20 minutes. Acceleration is the increase of the fetal heart rate by 15 beats per minute, lasting for 15 minutes, after each fetal movement. A reactive NST indicates fetal well - being. A contraction stress test, an order for serial fetal assessment and referral to a physician are not indicated because the NST is reactive.
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