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NCC EFM ACTUAL EXAM
[LATEST UPDATED VERSION]
Increases metabolism and oxygen consumption
Which assessment or intervention would be least appropriate in a patient whose
FHR tracing revealed tachycardia and a prolonged deceleration?
A. Change maternal position to right lateral
B. Further assess fetal oxygenation with scalp stimulation
C. Perform a vaginal exam to assess fetal descent - B. Further assess fetal
oxygenation with scalp stimulation
Only used with normal baseline rate and never during decels; not an intervention
Which of the following pieces of information would be of highest priority to relay
to the neonatal team as they prepare for an emergency cesarean delivery?
A. FHR arrhythmia, meconium, length of labor
B. Gestational age, meconium, arrhythmia
C. Gravidity & parity, gestational age, maternal temperature - B. Gestational age,
meconium, arrhythmia
Which medications used with preterm labor can affect the FHR characteristics?
A. Terbutaline and antibiotics
B. Betamethasone and terbutaline
C. Antibiotics and narcotics - B. Betamethasone and terbutaline
What characterizes a preterm fetal response to stress?
A. More frequently occurring late decelerations
B. More frequently occurring prolonged decelerations
C. More rapid deterioration from Category I to Category II or III - C. More rapid
deterioration from Category I to Category II or III
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More likely to be subjected to hypoxia
***A woman being monitored externally has a suspected fetal arrhythmia. The
most appropriate action is to
A. Insert a spiral electrode and turn off the logic
B. Turn the logic on if an external monitor is in place
C. Use a Doppler to listen to the ventricular rate - A. Insert a spiral electrode and
turn off the logic
*** The fetus responds to a significant drop of PO2 by
A. Increasing O2 consumption
B. Reducing lactic acid production
C. Shifting blood to vital organs - C. Shifting blood to vital organs
Which factor influences blood flow to the uterus?
A. Fetal arterial pressure
B. Intervillous space flow
C. Maternal arterial vasoconstriction - C. Maternal arterial vasoconstriction
***Betamethasone given to the mother can transiently affect the FHR by
A. Decreasing variability
B. Increasing variability
C. Lowering the baseline - A. Decreasing variability
In a fetal heart rate tracing with marked variability, which of the following is likely
the cause?
A. Recent ephedrine administration
B. Recent epidural placement
C. Fetal acidemia - A. Recent ephedrine administration
A fetal heart rate change that can be seen after administration of butorphanol
(Stadol) is
A. Bradycardia
B. Marked variability
C. Sinusoidal-appearing - C. Sinusoidal-appearing
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The FHR pattern that is likely to be seen with maternal hypothermia is
A. Bradycardia
B. Marked variability
C. Tachycardia - A. Bradycardia
*** Baseline FHR variability is determined in what amount of time, excluding
accelerations and decelerations?
A. 10 min
B. 20 min
C. 30 min - A. 10 min
Which of the following tachyarrhythmias can result in fetal hydrops?
A. Persistent supraventricular tachycardia
B. Premature atrial contractions
C. Sinus tachycardia - A. Persistent supraventricular tachycardia
*** A preterm fetus with persistent supraventricular tachycardia that is not
hydropic is best treated with maternal administration of
A. Digoxin
B. Phenobarbital
C. Terbutaline - A. Digoxin
The initial response in treating a primigravida being induced for preeclampsia who
has a seizure is
A. Administer terbutaline to slow down uterine activity
B. Initiate magnesium sulfate
C. Perform an immediate cesarean delivery - B. Initiate magnesium sulfate
Which FHR sounds are counted with a stethoscope and a fetoscope?
A. Atrial
B. Atrial and ventricular
C. Ventricular - C. Ventricular
*** When using auscultation to determine FHR baseline, the FHR should be
counted after the contractions for
A. 5-10 sec
B. 15-30 sec
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C. 30-60 sec - C. 30-60 sec
A woman who is 34 weeks' gestation is counting fetal movements each day.
Today she counted eight fetal movements in a two-hour period. Based on her kick
counts, this woman should
A. Continue counting for one more hour
B. Discontinue counting until tomorrow
C. Notify her provider for further evaluation - C. Notify her provider for further
evaluation
A BPP score of 6 is considered
A. Abnormal
B. Normal
C. Equivocal - C. Equivocal
*** As fetal hypoxia (asphyxia) worsens, the last component of the BPP to
disappear is fetal
A. Breathing
B. Movement
C. Tone - C. Tone
The legal term that describes a failure to meet the required standard of care is
A. Breach of duty
B. Negligence
C. Proximate cause - A. Breach of duty
*** Regarding the reliability of EFM, there is
A. Good interobserver reliability
B. Good intraobserver reliability
C. Poor interobserver and intraobserver reliability - C. Poor interobserver and
intraobserver reliability
The objective of intrapartum FHR monitoring is to assess for fetal
A. Acidemia
B. Oxygenation
C. Well-being - B. Oxygenation
NCC EFM ACTUAL EXAM
[LATEST UPDATED VERSION]
Increases metabolism and oxygen consumption
Which assessment or intervention would be least appropriate in a patient whose
FHR tracing revealed tachycardia and a prolonged deceleration?
A. Change maternal position to right lateral
B. Further assess fetal oxygenation with scalp stimulation
C. Perform a vaginal exam to assess fetal descent - B. Further assess fetal
oxygenation with scalp stimulation
Only used with normal baseline rate and never during decels; not an intervention
Which of the following pieces of information would be of highest priority to relay
to the neonatal team as they prepare for an emergency cesarean delivery?
A. FHR arrhythmia, meconium, length of labor
B. Gestational age, meconium, arrhythmia
C. Gravidity & parity, gestational age, maternal temperature - B. Gestational age,
meconium, arrhythmia
Which medications used with preterm labor can affect the FHR characteristics?
A. Terbutaline and antibiotics
B. Betamethasone and terbutaline
C. Antibiotics and narcotics - B. Betamethasone and terbutaline
What characterizes a preterm fetal response to stress?
A. More frequently occurring late decelerations
B. More frequently occurring prolonged decelerations
C. More rapid deterioration from Category I to Category II or III - C. More rapid
deterioration from Category I to Category II or III
,2|Page
More likely to be subjected to hypoxia
***A woman being monitored externally has a suspected fetal arrhythmia. The
most appropriate action is to
A. Insert a spiral electrode and turn off the logic
B. Turn the logic on if an external monitor is in place
C. Use a Doppler to listen to the ventricular rate - A. Insert a spiral electrode and
turn off the logic
*** The fetus responds to a significant drop of PO2 by
A. Increasing O2 consumption
B. Reducing lactic acid production
C. Shifting blood to vital organs - C. Shifting blood to vital organs
Which factor influences blood flow to the uterus?
A. Fetal arterial pressure
B. Intervillous space flow
C. Maternal arterial vasoconstriction - C. Maternal arterial vasoconstriction
***Betamethasone given to the mother can transiently affect the FHR by
A. Decreasing variability
B. Increasing variability
C. Lowering the baseline - A. Decreasing variability
In a fetal heart rate tracing with marked variability, which of the following is likely
the cause?
A. Recent ephedrine administration
B. Recent epidural placement
C. Fetal acidemia - A. Recent ephedrine administration
A fetal heart rate change that can be seen after administration of butorphanol
(Stadol) is
A. Bradycardia
B. Marked variability
C. Sinusoidal-appearing - C. Sinusoidal-appearing
,3|Page
The FHR pattern that is likely to be seen with maternal hypothermia is
A. Bradycardia
B. Marked variability
C. Tachycardia - A. Bradycardia
*** Baseline FHR variability is determined in what amount of time, excluding
accelerations and decelerations?
A. 10 min
B. 20 min
C. 30 min - A. 10 min
Which of the following tachyarrhythmias can result in fetal hydrops?
A. Persistent supraventricular tachycardia
B. Premature atrial contractions
C. Sinus tachycardia - A. Persistent supraventricular tachycardia
*** A preterm fetus with persistent supraventricular tachycardia that is not
hydropic is best treated with maternal administration of
A. Digoxin
B. Phenobarbital
C. Terbutaline - A. Digoxin
The initial response in treating a primigravida being induced for preeclampsia who
has a seizure is
A. Administer terbutaline to slow down uterine activity
B. Initiate magnesium sulfate
C. Perform an immediate cesarean delivery - B. Initiate magnesium sulfate
Which FHR sounds are counted with a stethoscope and a fetoscope?
A. Atrial
B. Atrial and ventricular
C. Ventricular - C. Ventricular
*** When using auscultation to determine FHR baseline, the FHR should be
counted after the contractions for
A. 5-10 sec
B. 15-30 sec
, 4|Page
C. 30-60 sec - C. 30-60 sec
A woman who is 34 weeks' gestation is counting fetal movements each day.
Today she counted eight fetal movements in a two-hour period. Based on her kick
counts, this woman should
A. Continue counting for one more hour
B. Discontinue counting until tomorrow
C. Notify her provider for further evaluation - C. Notify her provider for further
evaluation
A BPP score of 6 is considered
A. Abnormal
B. Normal
C. Equivocal - C. Equivocal
*** As fetal hypoxia (asphyxia) worsens, the last component of the BPP to
disappear is fetal
A. Breathing
B. Movement
C. Tone - C. Tone
The legal term that describes a failure to meet the required standard of care is
A. Breach of duty
B. Negligence
C. Proximate cause - A. Breach of duty
*** Regarding the reliability of EFM, there is
A. Good interobserver reliability
B. Good intraobserver reliability
C. Poor interobserver and intraobserver reliability - C. Poor interobserver and
intraobserver reliability
The objective of intrapartum FHR monitoring is to assess for fetal
A. Acidemia
B. Oxygenation
C. Well-being - B. Oxygenation
