NCC EFM Certification Exam 2026 –
Electronic Fetal Monitoring Actual Test
Bank with Verified Questions and
Rationales | Graded A | 100% Pass
Guarantee
Section 1: Fetal Heart Rate Baseline (Questions 1-15)
1. According to NICHD guidelines, the normal fetal heart rate baseline range
is:
A) 90–150 bpm
B) 100–160 bpm
C) 110–160 bpm
D) 120–180 bpm
Rationale: The NICHD consensus defines a normal fetal heart rate baseline as
between 110 and 160 beats per minute (bpm), sustained for at least 10 minutes.
Rates below 110 bpm indicate bradycardia; rates above 160 bpm indicate
tachycardia.
2. The baseline fetal heart rate is defined as the approximate mean rate
determined over a:
,A) 5-minute window
B) 10-minute window (excluding accelerations, decelerations, and marked
variability)
C) 15-minute window
D) 20-minute window
Rationale: The baseline is the approximate mean FHR rounded to increments of 5
bpm during a 10-minute window, excluding accelerations, decelerations, and
periods of marked variability. A minimum baseline segment must last at least 2
minutes.
3. The baseline fetal heart rate is determined as the approximate mean rate
rounded to increments of:
A) 1 bpm
B) 5 bpm
C) 10 bpm
D) 15 bpm
Rationale: NICHD guidelines specify rounding to the nearest 5 bpm (e.g., 152
bpm = 150 bpm; 158 bpm = 160 bpm). This standardization ensures consistency in
clinical communication and documentation.
4. A sustained baseline fetal heart rate of 165 bpm for 20 minutes in a term
fetus should prompt the nurse to:
A) Evaluate for potential causes: maternal fever, dehydration,
chorioamnionitis
,B) Document as a normal variant
C) Prepare for immediate cesarean section
D) Apply internal monitoring
Rationale: Persistent tachycardia requires assessment of maternal and fetal status.
The nurse should check maternal temperature, hydration status, and signs of
chorioamnionitis.
5. A common cause of fetal tachycardia (baseline >160 bpm) is:
A) Maternal fever
B) Chorioamnionitis
C) Fetal hypoxia (early sign)
D) All of the above
Rationale: Tachycardia can be caused by maternal fever, chorioamnionitis,
dehydration, hyperthyroidism, medications (e.g., terbutaline), or early fetal
hypoxia. Isolated tachycardia without other abnormalities may be benign.
6. A patient at 38 weeks gestation has a fetal heart rate baseline of 90 bpm
sustained for 12 minutes. The most appropriate initial nursing action is to:
A) Notify the provider immediately
B) Continue monitoring and reassess in 30 minutes
C) Apply a fetal scalp electrode
D) Administer oxygen via face mask
, Rationale: Prolonged bradycardia (<110 bpm for ≥10 minutes) is concerning and
warrants immediate provider notification. Further evaluation for possible causes
(cord prolapse, uterine rupture, maternal hypotension) should be initiated.
7. A baseline fetal heart rate of 175 bpm for 15 minutes is classified as:
A) Marked tachycardia
B) Tachycardia
C) Normal baseline
D) Severe tachycardia
Rationale: NICHD defines tachycardia as baseline >160 bpm for ≥10 minutes.
There is no official subclassification of "marked" or "severe" tachycardia, though
clinical significance varies with etiology.
8. Which of the following is NOT a known cause of fetal tachycardia?
A) Maternal fever
B) Beta-adrenergic agonists (e.g., terbutaline)
C) Maternal opioid administration
D) Chorioamnionitis
Rationale: Maternal opioids (e.g., morphine, fentanyl) typically cause fetal
bradycardia, not tachycardia. Beta-adrenergic agonists can cause tachycardia; fever
and chorioamnionitis are common causes of fetal tachycardia.
Electronic Fetal Monitoring Actual Test
Bank with Verified Questions and
Rationales | Graded A | 100% Pass
Guarantee
Section 1: Fetal Heart Rate Baseline (Questions 1-15)
1. According to NICHD guidelines, the normal fetal heart rate baseline range
is:
A) 90–150 bpm
B) 100–160 bpm
C) 110–160 bpm
D) 120–180 bpm
Rationale: The NICHD consensus defines a normal fetal heart rate baseline as
between 110 and 160 beats per minute (bpm), sustained for at least 10 minutes.
Rates below 110 bpm indicate bradycardia; rates above 160 bpm indicate
tachycardia.
2. The baseline fetal heart rate is defined as the approximate mean rate
determined over a:
,A) 5-minute window
B) 10-minute window (excluding accelerations, decelerations, and marked
variability)
C) 15-minute window
D) 20-minute window
Rationale: The baseline is the approximate mean FHR rounded to increments of 5
bpm during a 10-minute window, excluding accelerations, decelerations, and
periods of marked variability. A minimum baseline segment must last at least 2
minutes.
3. The baseline fetal heart rate is determined as the approximate mean rate
rounded to increments of:
A) 1 bpm
B) 5 bpm
C) 10 bpm
D) 15 bpm
Rationale: NICHD guidelines specify rounding to the nearest 5 bpm (e.g., 152
bpm = 150 bpm; 158 bpm = 160 bpm). This standardization ensures consistency in
clinical communication and documentation.
4. A sustained baseline fetal heart rate of 165 bpm for 20 minutes in a term
fetus should prompt the nurse to:
A) Evaluate for potential causes: maternal fever, dehydration,
chorioamnionitis
,B) Document as a normal variant
C) Prepare for immediate cesarean section
D) Apply internal monitoring
Rationale: Persistent tachycardia requires assessment of maternal and fetal status.
The nurse should check maternal temperature, hydration status, and signs of
chorioamnionitis.
5. A common cause of fetal tachycardia (baseline >160 bpm) is:
A) Maternal fever
B) Chorioamnionitis
C) Fetal hypoxia (early sign)
D) All of the above
Rationale: Tachycardia can be caused by maternal fever, chorioamnionitis,
dehydration, hyperthyroidism, medications (e.g., terbutaline), or early fetal
hypoxia. Isolated tachycardia without other abnormalities may be benign.
6. A patient at 38 weeks gestation has a fetal heart rate baseline of 90 bpm
sustained for 12 minutes. The most appropriate initial nursing action is to:
A) Notify the provider immediately
B) Continue monitoring and reassess in 30 minutes
C) Apply a fetal scalp electrode
D) Administer oxygen via face mask
, Rationale: Prolonged bradycardia (<110 bpm for ≥10 minutes) is concerning and
warrants immediate provider notification. Further evaluation for possible causes
(cord prolapse, uterine rupture, maternal hypotension) should be initiated.
7. A baseline fetal heart rate of 175 bpm for 15 minutes is classified as:
A) Marked tachycardia
B) Tachycardia
C) Normal baseline
D) Severe tachycardia
Rationale: NICHD defines tachycardia as baseline >160 bpm for ≥10 minutes.
There is no official subclassification of "marked" or "severe" tachycardia, though
clinical significance varies with etiology.
8. Which of the following is NOT a known cause of fetal tachycardia?
A) Maternal fever
B) Beta-adrenergic agonists (e.g., terbutaline)
C) Maternal opioid administration
D) Chorioamnionitis
Rationale: Maternal opioids (e.g., morphine, fentanyl) typically cause fetal
bradycardia, not tachycardia. Beta-adrenergic agonists can cause tachycardia; fever
and chorioamnionitis are common causes of fetal tachycardia.
