NCC EFM Certification Exam – Electronic Fetal
Monitoring
Verified Questions and ANSWER>-s &
Rationales Graded A+ 100% Pass Guarantee
Question 1
All of the following are disadvantages of the ultrasound transducer for monitoring the FHR except:
A. It is noninvasive
B. It may half or double the actual FHR
C. It restricts patient movement
Correct ANSWER>✔-: A. It is noninvasive
Rationale: The ultrasound transducer is a noninvasive method of monitoring fetal heart rate, which is
actually an advantage, not a disadvantage. Options B and C are both disadvantages of the ultrasound
transducer. The transducer can sometimes double or halve the actual FHR due to artifact, and it does
restrict patient movement as it must remain in a fixed position on the maternal abdomen to maintain
adequate signal.
Question 2
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through the
placenta.
Correct ANSWER>✔-: True
,Rationale: This statement is true because placental perfusion is directly dependent on maternal cardiac
output and blood flow. Any condition that decreases maternal cardiac output (such as hypotension,
dehydration, hemorrhage, or certain medications) will reduce blood flow to the placenta, potentially
compromising fetal oxygenation and nutrient delivery.
Question 3
Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal:
A. Hypoxemia
B. Rotation
C. Vagal stimulation
Correct ANSWER>✔-: C. Vagal stimulation
Rationale: During the second stage of labor, as the fetus descends through the birth canal, pressure on
the fetal head can stimulate the vagus nerve, leading to a vagal response that causes bradycardia. This is
typically a benign, transient finding. While hypoxemia can cause bradycardia, it is less likely when the
tracing was previously normal. Rotation itself does not directly cause bradycardia.
Question 4
All of the following might indicate a pseudosinusoidal pattern as opposed to a sinusoidal pattern,
except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min
Correct ANSWER>✔-: D. Frequency of oscillations of two to five cycles/min
,Rationale: A frequency of oscillations of two to five cycles per minute is characteristic of a true
sinusoidal pattern, not a pseudosinusoidal pattern. Pseudosinusoidal patterns are typically associated
with recent narcotic administration to the mother, the presence of accelerations in the FHR, and
moderate variability. A true sinusoidal pattern is smooth, regular, and lacks variability or accelerations.
Question 5
The BPP includes the assessment of FHR along with what other four components?
A. Amniotic fluid, fetal breathing, fetal movement, fetal tone
B. Amniotic fluid, fetal anomalies, fetal breathing, fetal movement
C. Estimated fetal weight, fetal breathing, fetal movement, placental grading
Correct ANSWER>✔-: A. Amniotic fluid, fetal breathing, fetal movement, fetal tone
Rationale: The Biophysical Profile (BPP) consists of five components: fetal heart rate (assessed via NST),
amniotic fluid volume, fetal breathing movements, fetal gross body movements, and fetal tone. Each of
the four ultrasound components receives a score of 0 or 2, and the NST receives a score of 0 or 2, for a
maximum total score of 10.
Question 6
FHR decelerations that are benign and do not require intervention are:
A. Early
B. Late
C. Variable
Correct ANSWER>✔-: A. Early
Rationale: Early decelerations are benign, mirror images of uterine contractions that are caused by fetal
head compression during contractions. They are generally considered a normal physiological response
and do not require intervention as they are not associated with fetal hypoxia or acidosis. Late
, decelerations indicate uteroplacental insufficiency and require intervention, while variable decelerations
may or may not require intervention depending on their characteristics.
Question 7
Which of the following is considered using the chain of command?
A. Asking the patient to talk with the provider directly
B. Notifying the charge nurse
C. Writing a variance report
Correct ANSWER>✔-: B. Notifying the charge nurse
Rationale: The chain of command in a healthcare setting involves following the established hierarchy of
authority to communicate concerns or issues. Notifying the charge nurse is a key step in the chain of
command process. Asking the patient to talk with the provider directly bypasses proper channels and is
not appropriate. Writing a variance report is documentation that may occur after an event but is not
itself considered using the chain of command.
Question 8
What is the normal baseline FHR range for a term fetus?
A. 100-150 beats per minute
B. 110-160 beats per minute
C. 120-170 beats per minute
D. 90-140 beats per minute
Correct ANSWER>✔-: B. 110-160 beats per minute
Rationale: The normal baseline FHR for a term fetus is 110-160 beats per minute. A baseline outside this
range may indicate fetal distress, maternal fever, infection, or other complications. Bradycardia is
Monitoring
Verified Questions and ANSWER>-s &
Rationales Graded A+ 100% Pass Guarantee
Question 1
All of the following are disadvantages of the ultrasound transducer for monitoring the FHR except:
A. It is noninvasive
B. It may half or double the actual FHR
C. It restricts patient movement
Correct ANSWER>✔-: A. It is noninvasive
Rationale: The ultrasound transducer is a noninvasive method of monitoring fetal heart rate, which is
actually an advantage, not a disadvantage. Options B and C are both disadvantages of the ultrasound
transducer. The transducer can sometimes double or halve the actual FHR due to artifact, and it does
restrict patient movement as it must remain in a fixed position on the maternal abdomen to maintain
adequate signal.
Question 2
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through the
placenta.
Correct ANSWER>✔-: True
,Rationale: This statement is true because placental perfusion is directly dependent on maternal cardiac
output and blood flow. Any condition that decreases maternal cardiac output (such as hypotension,
dehydration, hemorrhage, or certain medications) will reduce blood flow to the placenta, potentially
compromising fetal oxygenation and nutrient delivery.
Question 3
Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal:
A. Hypoxemia
B. Rotation
C. Vagal stimulation
Correct ANSWER>✔-: C. Vagal stimulation
Rationale: During the second stage of labor, as the fetus descends through the birth canal, pressure on
the fetal head can stimulate the vagus nerve, leading to a vagal response that causes bradycardia. This is
typically a benign, transient finding. While hypoxemia can cause bradycardia, it is less likely when the
tracing was previously normal. Rotation itself does not directly cause bradycardia.
Question 4
All of the following might indicate a pseudosinusoidal pattern as opposed to a sinusoidal pattern,
except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min
Correct ANSWER>✔-: D. Frequency of oscillations of two to five cycles/min
,Rationale: A frequency of oscillations of two to five cycles per minute is characteristic of a true
sinusoidal pattern, not a pseudosinusoidal pattern. Pseudosinusoidal patterns are typically associated
with recent narcotic administration to the mother, the presence of accelerations in the FHR, and
moderate variability. A true sinusoidal pattern is smooth, regular, and lacks variability or accelerations.
Question 5
The BPP includes the assessment of FHR along with what other four components?
A. Amniotic fluid, fetal breathing, fetal movement, fetal tone
B. Amniotic fluid, fetal anomalies, fetal breathing, fetal movement
C. Estimated fetal weight, fetal breathing, fetal movement, placental grading
Correct ANSWER>✔-: A. Amniotic fluid, fetal breathing, fetal movement, fetal tone
Rationale: The Biophysical Profile (BPP) consists of five components: fetal heart rate (assessed via NST),
amniotic fluid volume, fetal breathing movements, fetal gross body movements, and fetal tone. Each of
the four ultrasound components receives a score of 0 or 2, and the NST receives a score of 0 or 2, for a
maximum total score of 10.
Question 6
FHR decelerations that are benign and do not require intervention are:
A. Early
B. Late
C. Variable
Correct ANSWER>✔-: A. Early
Rationale: Early decelerations are benign, mirror images of uterine contractions that are caused by fetal
head compression during contractions. They are generally considered a normal physiological response
and do not require intervention as they are not associated with fetal hypoxia or acidosis. Late
, decelerations indicate uteroplacental insufficiency and require intervention, while variable decelerations
may or may not require intervention depending on their characteristics.
Question 7
Which of the following is considered using the chain of command?
A. Asking the patient to talk with the provider directly
B. Notifying the charge nurse
C. Writing a variance report
Correct ANSWER>✔-: B. Notifying the charge nurse
Rationale: The chain of command in a healthcare setting involves following the established hierarchy of
authority to communicate concerns or issues. Notifying the charge nurse is a key step in the chain of
command process. Asking the patient to talk with the provider directly bypasses proper channels and is
not appropriate. Writing a variance report is documentation that may occur after an event but is not
itself considered using the chain of command.
Question 8
What is the normal baseline FHR range for a term fetus?
A. 100-150 beats per minute
B. 110-160 beats per minute
C. 120-170 beats per minute
D. 90-140 beats per minute
Correct ANSWER>✔-: B. 110-160 beats per minute
Rationale: The normal baseline FHR for a term fetus is 110-160 beats per minute. A baseline outside this
range may indicate fetal distress, maternal fever, infection, or other complications. Bradycardia is
