EFM CERTIFICATION EXAM 3 COMPREHENSIVE
SCRIPT 2026 QUESTIONS AND SOLUTIONS
◉ Reactive NST Answer: 2 or more accelerations in 20 minute time
frame with or without mom feeling the movement *can have
variable decels however further assessment for AFI within a few
hours is warranted*
◉ 10x10 acceleration is acceptable at what gestational age? Answer:
under 32 weeks
◉ Nonreactive NST Answer: the FHR tracing does NOT demonstrate
at least 2 qualifying accelerations within a 20 minute window after
40 minutes of monitoring
◉ How must we follow up after a nonreactive NST? Answer: BPP or
CST
◉ Benefit of Vibroacoustic Stimulation Test Answer: ANTEPARTUM
test that can decrease the number of nonreactive NSTs related to
quiet fetal sleep cycles and shorten performance time *NOT a follow
up test for nonreactive NST*
◉ BPP Answer: NST/FHR reactivity
,Fetal Movement
Tone
Breathing
Amniotic fluid volume
◉ BPP = 8-10 Answer: NORMAL - routine testing schedule can be
resumed
◉ BPP = 6 Answer: SUSPICIOUS/EQUIVOCAL - testing is repeated
the next day
◉ BPP < 4 Answer: ABNORMAL - increased perinatal morbidity and
mortality and usually warrants hospitalization for further evaluation
and/or delivery
◉ What follow up test for nonreactive NST is more sensitive and
more specific than BPP? Answer: CST
◉ CST contraindications Answer: patients with preterm labor, high
risk of preterm labor, history of uterine scar or placenta previa
◉ Negative/Reassuring CST Answer: at least 3 contractions in a 10
minute period with NO late or significant variable decelerations -
routine testing can be resumed
, ◉ Positive/Non-Reassuring CST Answer: at least half of the
contractions during a 10 minute period are associated with late
decelerations - hospitalization for further evaluation and/or
delivery
◉ How long do you evaluate the FHR with Intermittent Ausculation?
Answer: 30-60 seconds after/between uterine contractions
◉ LOW RISK patient IA Answer: q30 minutes during active phase of
labor and q15 minutes during second stage of labor
◉ HIGH RISK patient IA Answer: q15 minutes during active phase of
labor and q5 minutes during second stage of labor
◉ Limitations of IA Answer: baseline variability and types of FHR
decelerations cannot be assessed; numerically defined terms like
tachycardia and bradycardia are OK
◉ FHR sound with ultrasound transducer is a result of...? Answer:
the opening and closing of the fetal heart valves, NOT the actual
blood flow
◉ EFM may 1/2 count FHR Answer: above 180-200 bpm
SCRIPT 2026 QUESTIONS AND SOLUTIONS
◉ Reactive NST Answer: 2 or more accelerations in 20 minute time
frame with or without mom feeling the movement *can have
variable decels however further assessment for AFI within a few
hours is warranted*
◉ 10x10 acceleration is acceptable at what gestational age? Answer:
under 32 weeks
◉ Nonreactive NST Answer: the FHR tracing does NOT demonstrate
at least 2 qualifying accelerations within a 20 minute window after
40 minutes of monitoring
◉ How must we follow up after a nonreactive NST? Answer: BPP or
CST
◉ Benefit of Vibroacoustic Stimulation Test Answer: ANTEPARTUM
test that can decrease the number of nonreactive NSTs related to
quiet fetal sleep cycles and shorten performance time *NOT a follow
up test for nonreactive NST*
◉ BPP Answer: NST/FHR reactivity
,Fetal Movement
Tone
Breathing
Amniotic fluid volume
◉ BPP = 8-10 Answer: NORMAL - routine testing schedule can be
resumed
◉ BPP = 6 Answer: SUSPICIOUS/EQUIVOCAL - testing is repeated
the next day
◉ BPP < 4 Answer: ABNORMAL - increased perinatal morbidity and
mortality and usually warrants hospitalization for further evaluation
and/or delivery
◉ What follow up test for nonreactive NST is more sensitive and
more specific than BPP? Answer: CST
◉ CST contraindications Answer: patients with preterm labor, high
risk of preterm labor, history of uterine scar or placenta previa
◉ Negative/Reassuring CST Answer: at least 3 contractions in a 10
minute period with NO late or significant variable decelerations -
routine testing can be resumed
, ◉ Positive/Non-Reassuring CST Answer: at least half of the
contractions during a 10 minute period are associated with late
decelerations - hospitalization for further evaluation and/or
delivery
◉ How long do you evaluate the FHR with Intermittent Ausculation?
Answer: 30-60 seconds after/between uterine contractions
◉ LOW RISK patient IA Answer: q30 minutes during active phase of
labor and q15 minutes during second stage of labor
◉ HIGH RISK patient IA Answer: q15 minutes during active phase of
labor and q5 minutes during second stage of labor
◉ Limitations of IA Answer: baseline variability and types of FHR
decelerations cannot be assessed; numerically defined terms like
tachycardia and bradycardia are OK
◉ FHR sound with ultrasound transducer is a result of...? Answer:
the opening and closing of the fetal heart valves, NOT the actual
blood flow
◉ EFM may 1/2 count FHR Answer: above 180-200 bpm
