NCC EFM EXAM PRACTICE 130
QUESTIONS WITH DETAILED
VERIFIED ANSWERS 100%
CORRECT ALREADY GRADED A+
BRAND NEW!!
"Sinusoidal pattern - CORRECT ANSWER=> Visually apparent, smooth, sine wave-like pattern in
FHR lasting ≥20 minutes
-oscillation frequency: 3-5 cycles/min
-no variability classification or reactivity
-r/t severe anemia: previa, hemorrhage, abruption, RH isoimmunization, asphyxia, infection,
cardiac anomaly, twin to twin transfusion, gastroschesis
-Transient if <20min, can be r/t thumb sucking or opioids (stadol, fentanyl)"
"Interventions - CORRECT ANSWER=> -Position change: off of vena cava & aorta, least invasive,
1st line of treatment
-Fluid bolus
-Amnioinfusion (for variables)
-Tocolytics (terb)
-Ephedrine to ↑ BP
-Supplemental O2: not used w O2 >95%, can cause vasoconstriction, free radical formation,
ocular toxicity if used limit to 15-30min"
"Category I tracing - CORRECT ANSWER=> Normal acid base balance
-Baseline between 110 to 160
-Moderate variability
-No late, variable, or prolonged decels
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,-May have early decels
-May or may not have accels"
"Category II tracing - CORRECT ANSWER=> Indeterminate acid base balance
-Minimal variability
-Marked variability
-Late or variable decels
-Bradycardia with variability
-Tachycardia
-Prolonged decels
-Absent variability w NO decels
-Absence of induced acccel WITH fetal stimulation"
"Category III tracing - CORRECT ANSWER=> Predictive of abnormal acid base balance at that
moment
-Sinusoidal rhythm: has to last ≥20min, r/t anemia (previa, bleeding, abruption)
-Absent variability WITH one of the following: bradycardia, recurrent late or recurrent variable
decels
-Decide for c/s within 30min"
"Normal uterine activity - CORRECT ANSWER=> ≤5 contractions in 10 mins averaging over 30 min
window
-adequate contractions: q2-3 lasting 80-90s
-intensity: 25-75 mmhg
-resting tone: 10-15 mmhg
-MVU: 200-220 in 10 mins
-intercontraction interval (relaxation time) should be 45-60sec"
"Tachysystole - CORRECT ANSWER=> >5 contractions in 10 mins averaged over 30 min window
-tetanic contractions: >90 secs
-position change
-500 LR to dilute uterotonic
-↓ pitocin (see protocol)
-tocolytic (terbutaline)
-O2 if decel"
"Tachysystole & pitocin - CORRECT ANSWER=> With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
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, -If not resolved in another 15min, pause pit
-If pit's off for <30 min, resume pit at 1/2 of current dose
-If off for >30 min, start @ initial order dose
With fetal intolerance: pit off immediately"
"Hypertonous labor - CORRECT ANSWER=> Frequent & painful but poor quality contractions
occurring in latent labor
-despite increased tone, not enough pressure to cause cx change
-indicative of CPD or malpresentation
-tx: comfort care, pitocin, AROM"
"Hypotonic labor - CORRECT ANSWER=> Weak & insufficient labor occurring during the active
phase
-inadequate, infrequent, & less intense contractions don't dilate or efface cx
-caused by tired uterus or overdistention (poly, multiple gestation, LGA)"
"Arrest of labor - CORRECT ANSWER=> >6cm dilated w/ ROM & one of the following w no cx
change:
-4 hrs of adequate contractions (>200 MVUs)
-6 hrs of inadequate contractions"
"Fetal dysrhythmias - CORRECT ANSWER=> 1) SVT: 210-300 bpm
-tx w digoxin (↑ dose to cross placenta)
-concern w hydrops, CHF (heart stress), ↑ O2 demand & use, ↓ stroke volume, demise
2) Congenital heart block (<60 bpm): 3rd degree → concern w hydrops, lupus, CHF
3) Ectopic beats: extra beats heard, benign, may be transient"
"Lupus (SLE) - CORRECT ANSWER=> Can cause congenital 3rd degree heart block
-bradycardia
-autoimmune → inflammatory response → overgrowth of collagen in heart muscle
-damages fetal conduction system of the heart, attacks fetal tissue
-usually diagnosed in 2nd trimester"
"Preterm labor - CORRECT ANSWER=> Cx dilation bw 20-36.6 wks
-late preterm: 34-36.6 wks
-common risk factors: multiples, previous PTD (greatest), uterine or cx abnormalities, infection,
<18 months bw pregnancies, IUGR
-↓ reserve & ↓ parasympathetic maturity
Page | 3
QUESTIONS WITH DETAILED
VERIFIED ANSWERS 100%
CORRECT ALREADY GRADED A+
BRAND NEW!!
"Sinusoidal pattern - CORRECT ANSWER=> Visually apparent, smooth, sine wave-like pattern in
FHR lasting ≥20 minutes
-oscillation frequency: 3-5 cycles/min
-no variability classification or reactivity
-r/t severe anemia: previa, hemorrhage, abruption, RH isoimmunization, asphyxia, infection,
cardiac anomaly, twin to twin transfusion, gastroschesis
-Transient if <20min, can be r/t thumb sucking or opioids (stadol, fentanyl)"
"Interventions - CORRECT ANSWER=> -Position change: off of vena cava & aorta, least invasive,
1st line of treatment
-Fluid bolus
-Amnioinfusion (for variables)
-Tocolytics (terb)
-Ephedrine to ↑ BP
-Supplemental O2: not used w O2 >95%, can cause vasoconstriction, free radical formation,
ocular toxicity if used limit to 15-30min"
"Category I tracing - CORRECT ANSWER=> Normal acid base balance
-Baseline between 110 to 160
-Moderate variability
-No late, variable, or prolonged decels
Page | 1
,-May have early decels
-May or may not have accels"
"Category II tracing - CORRECT ANSWER=> Indeterminate acid base balance
-Minimal variability
-Marked variability
-Late or variable decels
-Bradycardia with variability
-Tachycardia
-Prolonged decels
-Absent variability w NO decels
-Absence of induced acccel WITH fetal stimulation"
"Category III tracing - CORRECT ANSWER=> Predictive of abnormal acid base balance at that
moment
-Sinusoidal rhythm: has to last ≥20min, r/t anemia (previa, bleeding, abruption)
-Absent variability WITH one of the following: bradycardia, recurrent late or recurrent variable
decels
-Decide for c/s within 30min"
"Normal uterine activity - CORRECT ANSWER=> ≤5 contractions in 10 mins averaging over 30 min
window
-adequate contractions: q2-3 lasting 80-90s
-intensity: 25-75 mmhg
-resting tone: 10-15 mmhg
-MVU: 200-220 in 10 mins
-intercontraction interval (relaxation time) should be 45-60sec"
"Tachysystole - CORRECT ANSWER=> >5 contractions in 10 mins averaged over 30 min window
-tetanic contractions: >90 secs
-position change
-500 LR to dilute uterotonic
-↓ pitocin (see protocol)
-tocolytic (terbutaline)
-O2 if decel"
"Tachysystole & pitocin - CORRECT ANSWER=> With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
Page | 2
, -If not resolved in another 15min, pause pit
-If pit's off for <30 min, resume pit at 1/2 of current dose
-If off for >30 min, start @ initial order dose
With fetal intolerance: pit off immediately"
"Hypertonous labor - CORRECT ANSWER=> Frequent & painful but poor quality contractions
occurring in latent labor
-despite increased tone, not enough pressure to cause cx change
-indicative of CPD or malpresentation
-tx: comfort care, pitocin, AROM"
"Hypotonic labor - CORRECT ANSWER=> Weak & insufficient labor occurring during the active
phase
-inadequate, infrequent, & less intense contractions don't dilate or efface cx
-caused by tired uterus or overdistention (poly, multiple gestation, LGA)"
"Arrest of labor - CORRECT ANSWER=> >6cm dilated w/ ROM & one of the following w no cx
change:
-4 hrs of adequate contractions (>200 MVUs)
-6 hrs of inadequate contractions"
"Fetal dysrhythmias - CORRECT ANSWER=> 1) SVT: 210-300 bpm
-tx w digoxin (↑ dose to cross placenta)
-concern w hydrops, CHF (heart stress), ↑ O2 demand & use, ↓ stroke volume, demise
2) Congenital heart block (<60 bpm): 3rd degree → concern w hydrops, lupus, CHF
3) Ectopic beats: extra beats heard, benign, may be transient"
"Lupus (SLE) - CORRECT ANSWER=> Can cause congenital 3rd degree heart block
-bradycardia
-autoimmune → inflammatory response → overgrowth of collagen in heart muscle
-damages fetal conduction system of the heart, attacks fetal tissue
-usually diagnosed in 2nd trimester"
"Preterm labor - CORRECT ANSWER=> Cx dilation bw 20-36.6 wks
-late preterm: 34-36.6 wks
-common risk factors: multiples, previous PTD (greatest), uterine or cx abnormalities, infection,
<18 months bw pregnancies, IUGR
-↓ reserve & ↓ parasympathetic maturity
Page | 3
