NCC ELECTRONIC FETAL
MONITORING CERTIFICATION EXAM
QUESTIONS AND ANSWERS
1. According to NICHD nomenclature, what is the definition of moderate baseline variability?
A. Amplitude range of 1 to 5 bpm
B. Amplitude range of > 25 bpm
C. Amplitude range of 6 to 25 bpm
D. Amplitude range that is undetectable
Answer: C
Conceptual Explanation: Moderate variability is defined as an amplitude range of 6 to 25
bpm and is highly predictive of the absence of fetal acidemia.
2. Which physiological mechanism is primarily responsible for the occurrence of late
decelerations?
A. Vagal stimulation due to head compression
B. Baroreceptor response to umbilical cord occlusion
C. Sympathetic surge due to fetal movement
,D. Chemoreceptor response to fetal hypoxemia
Answer: D
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency,
which leads to fetal hypoxemia, triggering chemoreceptors and a subsequent mediated
reflex.
3. What is the criteria for uterine tachysystole?
A. More than 5 contractions in 10 minutes, averaged over 30 minutes
B. More than 3 contractions in 10 minutes, averaged over 20 minutes
C. Contractions lasting longer than 120 seconds
D. A resting tone greater than 25 mmHg via IUPC
Answer: A
Conceptual Explanation: Tachysystole is defined as more than five contractions in 10
minutes, averaged over a 30-minute window, regardless of the presence of decelerations.
4. A fetal heart rate pattern shows absent variability and recurrent late decelerations. Which
NICHD category does this fall into?
A. Category I
B. Category III
C. Category II
D. Category IV
, Answer: B
Conceptual Explanation: Category III patterns are abnormal and include absent
variability with recurrent late decelerations, recurrent variable decelerations, or
bradycardia.
5. What is the primary goal of performing fetal scalp stimulation?
A. To induce a deceleration to check for cord reserve
B. To resolve a sinusoidal pattern
C. To increase the fetal heart rate baseline
D. To assess the fetal acid-base status through the presence of an acceleration
Answer: D
Conceptual Explanation: The presence of an acceleration following scalp stimulation is
highly predictive of a fetal scalp pH of 7.20 or greater, indicating the absence of metabolic
acidemia.
6. Which umbilical cord gas value is the most specific indicator of metabolic acidemia?
A. Base deficit 14 mmol/L
B. pCO2 50 mmHg
C. pH 7.25
D. pO2 20 mmHg
Answer: A
MONITORING CERTIFICATION EXAM
QUESTIONS AND ANSWERS
1. According to NICHD nomenclature, what is the definition of moderate baseline variability?
A. Amplitude range of 1 to 5 bpm
B. Amplitude range of > 25 bpm
C. Amplitude range of 6 to 25 bpm
D. Amplitude range that is undetectable
Answer: C
Conceptual Explanation: Moderate variability is defined as an amplitude range of 6 to 25
bpm and is highly predictive of the absence of fetal acidemia.
2. Which physiological mechanism is primarily responsible for the occurrence of late
decelerations?
A. Vagal stimulation due to head compression
B. Baroreceptor response to umbilical cord occlusion
C. Sympathetic surge due to fetal movement
,D. Chemoreceptor response to fetal hypoxemia
Answer: D
Conceptual Explanation: Late decelerations are caused by uteroplacental insufficiency,
which leads to fetal hypoxemia, triggering chemoreceptors and a subsequent mediated
reflex.
3. What is the criteria for uterine tachysystole?
A. More than 5 contractions in 10 minutes, averaged over 30 minutes
B. More than 3 contractions in 10 minutes, averaged over 20 minutes
C. Contractions lasting longer than 120 seconds
D. A resting tone greater than 25 mmHg via IUPC
Answer: A
Conceptual Explanation: Tachysystole is defined as more than five contractions in 10
minutes, averaged over a 30-minute window, regardless of the presence of decelerations.
4. A fetal heart rate pattern shows absent variability and recurrent late decelerations. Which
NICHD category does this fall into?
A. Category I
B. Category III
C. Category II
D. Category IV
, Answer: B
Conceptual Explanation: Category III patterns are abnormal and include absent
variability with recurrent late decelerations, recurrent variable decelerations, or
bradycardia.
5. What is the primary goal of performing fetal scalp stimulation?
A. To induce a deceleration to check for cord reserve
B. To resolve a sinusoidal pattern
C. To increase the fetal heart rate baseline
D. To assess the fetal acid-base status through the presence of an acceleration
Answer: D
Conceptual Explanation: The presence of an acceleration following scalp stimulation is
highly predictive of a fetal scalp pH of 7.20 or greater, indicating the absence of metabolic
acidemia.
6. Which umbilical cord gas value is the most specific indicator of metabolic acidemia?
A. Base deficit 14 mmol/L
B. pCO2 50 mmHg
C. pH 7.25
D. pO2 20 mmHg
Answer: A
