NCC EFM Certification Exam – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A nurse is reviewing a fetal heart rate (FHR) tracing and notes a baseline rate of 165 beats per minute
that has persisted for the past 45 minutes. The client is afebrile and denies any recent medication
administration. Which of the following should the nurse identify as the most likely underlying cause of
this tachycardia?
A. Maternal supine hypotension
B. Fetal anemia
C. Maternal dehydration
D. Fetal sleep cycle
Correct Answer: C. Maternal dehydration
,Rationale: Maternal dehydration is a common cause of fetal tachycardia as it can lead to decreased maternal
circulating volume and a compensatory increase in fetal heart rate to maintain cardiac output. Supine
hypotension (A) typically causes variable decelerations, not persistent tachycardia. Fetal anemia (B) is
associated with a sinusoidal pattern, not isolated tachycardia. Fetal sleep cycles (D) are characterized by
decreased variability and a stable, normal baseline rate, not tachycardia.
2. A client at 38 weeks gestation is undergoing a contraction stress test (CST). The nurse observes three
uterine contractions in a 10-minute window, and there are no late decelerations noted with any of the
contractions. How should the nurse interpret this finding?
A. Positive CST
B. Negative CST
C. Equivocal CST
D. Unsatisfactory CST
Correct Answer: B. Negative CST
Rationale: A negative CST is a reassuring finding. It requires a minimum of three contractions in a 10-minute
window with no late decelerations or significant variable decelerations. A positive CST (A) is characterized by
late decelerations with 50% or more of contractions. An equivocal CST (C) indicates intermittent late or variable
decelerations. An unsatisfactory CST (D) occurs when adequate uterine activity cannot be achieved .
,3. The nurse is caring for a client in active labor. The FHR tracing reveals recurrent variable decelerations
that decrease at least 15 beats per minute and last at least 15 seconds. The nurse's priority intervention
should be to:
A. Administer oxygen via non-rebreather mask
B. Change the maternal position
C. Discontinue oxytocin infusion
D. Prepare for immediate delivery
Correct Answer: B. Change the maternal position
Rationale: Variable decelerations are most commonly caused by umbilical cord compression. The initial
intervention is to change the maternal position to relieve pressure on the cord. This can be accomplished by
moving the client to a side-lying position or knee-chest position. Administering oxygen (A), discontinuing
oxytocin (C), and preparing for delivery (D) may be necessary if the decelerations persist or worsen, but position
change is the first-line intervention .
4. A nurse is interpreting an FHR tracing and notes a smooth, sine wave-like undulating pattern with a
frequency of 3-5 cycles per minute. This pattern is most concerning for which of the following conditions?
, A. Fetal sleep state
B. Severe fetal anemia
C. Maternal narcotic administration
D. Umbilical cord compression
Correct Answer: B. Severe fetal anemia
Rationale: A sinusoidal pattern is characterized by a smooth, sine wave-like undulation of the FHR baseline
with a frequency of 2-5 cycles per minute and an amplitude of 5-15 beats per minute. This pattern is associated
with severe fetal anemia, isoimmunization, or fetal hypoxia. A fetal sleep state (A) would present with a stable
baseline and decreased variability. Narcotic administration (C) can cause a pseudo-sinusoidal pattern but is
typically not this pronounced .
5. The nurse is assessing a fetal heart rate tracing and notes that the baseline variability is absent. The
nurse should first:
A. Document the finding and continue to monitor
B. Administer oxygen and reposition the client
C. Prepare the client for an emergency cesarean section
D. Notify the healthcare provider immediately
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES |
GUARANTEED PASS | 2026/27 LATEST UPDATE | EXAM PREP |
STUDY GUIDE | PRACTICE TEST
SECTION ONE: QUESTIONS 1-50
1. A nurse is reviewing a fetal heart rate (FHR) tracing and notes a baseline rate of 165 beats per minute
that has persisted for the past 45 minutes. The client is afebrile and denies any recent medication
administration. Which of the following should the nurse identify as the most likely underlying cause of
this tachycardia?
A. Maternal supine hypotension
B. Fetal anemia
C. Maternal dehydration
D. Fetal sleep cycle
Correct Answer: C. Maternal dehydration
,Rationale: Maternal dehydration is a common cause of fetal tachycardia as it can lead to decreased maternal
circulating volume and a compensatory increase in fetal heart rate to maintain cardiac output. Supine
hypotension (A) typically causes variable decelerations, not persistent tachycardia. Fetal anemia (B) is
associated with a sinusoidal pattern, not isolated tachycardia. Fetal sleep cycles (D) are characterized by
decreased variability and a stable, normal baseline rate, not tachycardia.
2. A client at 38 weeks gestation is undergoing a contraction stress test (CST). The nurse observes three
uterine contractions in a 10-minute window, and there are no late decelerations noted with any of the
contractions. How should the nurse interpret this finding?
A. Positive CST
B. Negative CST
C. Equivocal CST
D. Unsatisfactory CST
Correct Answer: B. Negative CST
Rationale: A negative CST is a reassuring finding. It requires a minimum of three contractions in a 10-minute
window with no late decelerations or significant variable decelerations. A positive CST (A) is characterized by
late decelerations with 50% or more of contractions. An equivocal CST (C) indicates intermittent late or variable
decelerations. An unsatisfactory CST (D) occurs when adequate uterine activity cannot be achieved .
,3. The nurse is caring for a client in active labor. The FHR tracing reveals recurrent variable decelerations
that decrease at least 15 beats per minute and last at least 15 seconds. The nurse's priority intervention
should be to:
A. Administer oxygen via non-rebreather mask
B. Change the maternal position
C. Discontinue oxytocin infusion
D. Prepare for immediate delivery
Correct Answer: B. Change the maternal position
Rationale: Variable decelerations are most commonly caused by umbilical cord compression. The initial
intervention is to change the maternal position to relieve pressure on the cord. This can be accomplished by
moving the client to a side-lying position or knee-chest position. Administering oxygen (A), discontinuing
oxytocin (C), and preparing for delivery (D) may be necessary if the decelerations persist or worsen, but position
change is the first-line intervention .
4. A nurse is interpreting an FHR tracing and notes a smooth, sine wave-like undulating pattern with a
frequency of 3-5 cycles per minute. This pattern is most concerning for which of the following conditions?
, A. Fetal sleep state
B. Severe fetal anemia
C. Maternal narcotic administration
D. Umbilical cord compression
Correct Answer: B. Severe fetal anemia
Rationale: A sinusoidal pattern is characterized by a smooth, sine wave-like undulation of the FHR baseline
with a frequency of 2-5 cycles per minute and an amplitude of 5-15 beats per minute. This pattern is associated
with severe fetal anemia, isoimmunization, or fetal hypoxia. A fetal sleep state (A) would present with a stable
baseline and decreased variability. Narcotic administration (C) can cause a pseudo-sinusoidal pattern but is
typically not this pronounced .
5. The nurse is assessing a fetal heart rate tracing and notes that the baseline variability is absent. The
nurse should first:
A. Document the finding and continue to monitor
B. Administer oxygen and reposition the client
C. Prepare the client for an emergency cesarean section
D. Notify the healthcare provider immediately
