NCC ELECTRONIC FETAL
MONITORING CERTIFICATION
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which of the following describes a fetal heart rate (FHR) characteristic that is most
representative of a metabolic acidemia?
A. Presence of moderate variability with recurrent late decelerations
B. Minimal variability with no accelerations or decelerations
C. Absent variability with recurrent late decelerations
D. Marked variability during a second-stage pushing effort
Answer: C
Conceptual Explanation: Absent variability in the presence of recurrent late or variable
decelerations, or bradycardia, is highly predictive of fetal acid-base imbalance and
potential metabolic acidemia.
2. A patient at 38 weeks gestation has a FHR baseline of 145 bpm, moderate variability, and
intermittent variable decelerations. What is the NICHD category for this strip?
A. Category I
,B. Category II
C. Category III
D. Category IV
Answer: B
Conceptual Explanation: Category II includes all tracings not categorized as Category I or
III. Variable decelerations accompanied by moderate variability do not meet Category I
criteria but are not Category III.
3. What is the primary physiological mechanism behind a late deceleration?
A. Transient fetal baroreceptor response to cord occlusion
B. Vagal response to fetal head compression
C. Chemoreceptor response to decreased PO2 during a contraction
D. Sympathetic nervous system surge due to fetal movement
Answer: C
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency,
where a contraction further decreases oxygen delivery to the fetus, triggering
chemoreceptors and a subsequent reflex slowing of the heart.
4. During an amnioinfusion for recurrent variable decelerations, the resting tone rises from 10
mmHg to 35 mmHg. The priority nursing action is to:
A. Continue the infusion at a slower rate
, B. Perform a sterile vaginal exam
C. Reposition the patient to a lateral side
D. Discontinue the amnioinfusion immediately
Answer: D
Conceptual Explanation: An elevated resting tone during amnioinfusion suggests fluid
accumulation or uterine overdistension, requiring immediate cessation of the infusion to
prevent uterine rupture or decreased perfusion.
5. The definition of uterine tachysystole is based on a 10-minute window averaged over 30
minutes, exceeding how many contractions?
A. More than 3 contractions
B. More than 5 contractions
C. More than 4 contractions
D. More than 6 contractions
Answer: B
Conceptual Explanation: Tachysystole is defined as more than 5 contractions in a 10-
minute window, averaged over a 30-minute period.
6. Fetal tachycardia is defined as a baseline heart rate greater than 160 bpm for at least how
many minutes?
A. 2 minutes
MONITORING CERTIFICATION
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which of the following describes a fetal heart rate (FHR) characteristic that is most
representative of a metabolic acidemia?
A. Presence of moderate variability with recurrent late decelerations
B. Minimal variability with no accelerations or decelerations
C. Absent variability with recurrent late decelerations
D. Marked variability during a second-stage pushing effort
Answer: C
Conceptual Explanation: Absent variability in the presence of recurrent late or variable
decelerations, or bradycardia, is highly predictive of fetal acid-base imbalance and
potential metabolic acidemia.
2. A patient at 38 weeks gestation has a FHR baseline of 145 bpm, moderate variability, and
intermittent variable decelerations. What is the NICHD category for this strip?
A. Category I
,B. Category II
C. Category III
D. Category IV
Answer: B
Conceptual Explanation: Category II includes all tracings not categorized as Category I or
III. Variable decelerations accompanied by moderate variability do not meet Category I
criteria but are not Category III.
3. What is the primary physiological mechanism behind a late deceleration?
A. Transient fetal baroreceptor response to cord occlusion
B. Vagal response to fetal head compression
C. Chemoreceptor response to decreased PO2 during a contraction
D. Sympathetic nervous system surge due to fetal movement
Answer: C
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency,
where a contraction further decreases oxygen delivery to the fetus, triggering
chemoreceptors and a subsequent reflex slowing of the heart.
4. During an amnioinfusion for recurrent variable decelerations, the resting tone rises from 10
mmHg to 35 mmHg. The priority nursing action is to:
A. Continue the infusion at a slower rate
, B. Perform a sterile vaginal exam
C. Reposition the patient to a lateral side
D. Discontinue the amnioinfusion immediately
Answer: D
Conceptual Explanation: An elevated resting tone during amnioinfusion suggests fluid
accumulation or uterine overdistension, requiring immediate cessation of the infusion to
prevent uterine rupture or decreased perfusion.
5. The definition of uterine tachysystole is based on a 10-minute window averaged over 30
minutes, exceeding how many contractions?
A. More than 3 contractions
B. More than 5 contractions
C. More than 4 contractions
D. More than 6 contractions
Answer: B
Conceptual Explanation: Tachysystole is defined as more than 5 contractions in a 10-
minute window, averaged over a 30-minute period.
6. Fetal tachycardia is defined as a baseline heart rate greater than 160 bpm for at least how
many minutes?
A. 2 minutes
