NCC EFM Certification EXAM QUESTIONS AND ANSWERS (VERIFIED
NCC EFM Certification
AND WELL DETAILED ANSWERS) LATEST UPDATE 2025/2026
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1. Which of the following factors can have a negative e. All of the above
effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above
2. How does the fetus compensate for decreased mater- b. Increases cardiac out-
nal circulating volume? put by increasing it's heart
a. Increases cardiac output by increasing stroke vol- rate.
ume.
b. Increases cardiac output by increasing it's heart
rate.
c. Increases cardiac output by increasing fetal move-
ment.
3. Stimulating the vagus nerve typically produces: a. A decrease in the heart
a. A decrease in the heart rate rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change
4. What initially causes a chemoreceptor response? g. C & D
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D
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5. The vagus nerve begins maturation 26 to 28 weeks. Its b. Decreases baseline
dominance results in what effect to the FHR baseline?
a. Increases baseline
b. Decreases baseline
6. T/F: Oxygen exchange in the placenta takes place in True
the intervillous space.
7. T/F: The parasympathetic nervous system is a car- False
dioaccelerator.
8. T/F: Baroreceptors are stretch receptors which re- True
spond to increases or decreases in blood pressure.
9. T/F: There are two electronic fetal monitoring meth- True
ods of obtaining the fetal heart rate: the ultrasound
transducer and the fetal spiral electrode.
10. T/F: Variability can be determined with the fetoscope. False
11. T/F: Because the ultrasound transducer and toco False
transducer are sealed units, they can be dipped in
warm water to make cleaning easier.
12. T/F: The most common artifact with the ultrasound True
transducer system for fetal heart rate is increased
variability.
13. T/F: All fetal monitors contain a logic system designed True
to reject artifact.
14. T/F: The monitor should always be tested before start- True
ing a tracing, either external or internal mode and
labeled a test.
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15. T/F: The paper speed on the fetal monitor should al- False
ways be set at 1cm/min.
16. T/F: Both internal and external monitoring methods False
are equally accurate means of obtaining the fetal
heart rate and contraction patterns.
17. T/F: The external toco is usually placed over the uter- True
ine fundus to pick up contractions.
18. T/F: The external toco gives measurable uterine pres- False
sure.
19. T/F: The fetal spiral electrode can be placed when False
vaginal bleeding of unknown origin is present.
20. T/F: The ultrasound transducer is usually placed on True
the side of the uterus over the baby's back, as the fetal
heart is heard best there.
21. T/F: The spiral electrode is used to more accurately False
determine the frequency, duration, and intensity of
uterine contractions.
22. T/F: The heart rate from a well-applied fetal spiral False
electrode can only be fetal, not maternal.
23. T/F: The intrauterine catheter is used to pick up the False
fetal heart rate.
24. T/F: The internal spiral electrode may pick up the ma- True
ternal heart rate if the baby has died.
, NCC EFM Certification
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25. T/F: Fetal arrhythmias can be seen on both internal True
and external monitor tracings.
26. T/F: Variability and periodic changes can be detected True
with both internal and external monitoring.
27. T/F: Variable decelerations are a result of cord com- True
pression.
28. T/F: The presence of FHR accelerations in the intra- True
partum and antepartum periods is a sign of adequate
fetal oxygenation.
29. T/F: Variable decelerations are a vagal response. True
30. T/F: Late decelerations have a gradual decrease in FHR True
(onset to nadir 30 seconds) and are delayed in timing
with the nadir of the deceleration occurring after the
peak of the contraction.
31. T/F: The fetal heart rate baseline can be determined False
during periods of marked variability.
32. T/F: Anything that affects maternal blood flow (cardiac True
output) can affect the blood flow through the placen-
ta.
33. T/F: Variable decelerations are the most frequently True
seen fetal heart rate deceleration pattern in labor.
34. T/F: Minimal variability is always an indicator of hypox- False
ia and a Cesarean section is indicated.
35.
NCC EFM Certification
AND WELL DETAILED ANSWERS) LATEST UPDATE 2025/2026
Study online at https://quizlet.com/_f9u758
1. Which of the following factors can have a negative e. All of the above
effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above
2. How does the fetus compensate for decreased mater- b. Increases cardiac out-
nal circulating volume? put by increasing it's heart
a. Increases cardiac output by increasing stroke vol- rate.
ume.
b. Increases cardiac output by increasing it's heart
rate.
c. Increases cardiac output by increasing fetal move-
ment.
3. Stimulating the vagus nerve typically produces: a. A decrease in the heart
a. A decrease in the heart rate rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change
4. What initially causes a chemoreceptor response? g. C & D
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D
, NCC EFM Certification
Study online at https://quizlet.com/_f9u758
5. The vagus nerve begins maturation 26 to 28 weeks. Its b. Decreases baseline
dominance results in what effect to the FHR baseline?
a. Increases baseline
b. Decreases baseline
6. T/F: Oxygen exchange in the placenta takes place in True
the intervillous space.
7. T/F: The parasympathetic nervous system is a car- False
dioaccelerator.
8. T/F: Baroreceptors are stretch receptors which re- True
spond to increases or decreases in blood pressure.
9. T/F: There are two electronic fetal monitoring meth- True
ods of obtaining the fetal heart rate: the ultrasound
transducer and the fetal spiral electrode.
10. T/F: Variability can be determined with the fetoscope. False
11. T/F: Because the ultrasound transducer and toco False
transducer are sealed units, they can be dipped in
warm water to make cleaning easier.
12. T/F: The most common artifact with the ultrasound True
transducer system for fetal heart rate is increased
variability.
13. T/F: All fetal monitors contain a logic system designed True
to reject artifact.
14. T/F: The monitor should always be tested before start- True
ing a tracing, either external or internal mode and
labeled a test.
, NCC EFM Certification
Study online at https://quizlet.com/_f9u758
15. T/F: The paper speed on the fetal monitor should al- False
ways be set at 1cm/min.
16. T/F: Both internal and external monitoring methods False
are equally accurate means of obtaining the fetal
heart rate and contraction patterns.
17. T/F: The external toco is usually placed over the uter- True
ine fundus to pick up contractions.
18. T/F: The external toco gives measurable uterine pres- False
sure.
19. T/F: The fetal spiral electrode can be placed when False
vaginal bleeding of unknown origin is present.
20. T/F: The ultrasound transducer is usually placed on True
the side of the uterus over the baby's back, as the fetal
heart is heard best there.
21. T/F: The spiral electrode is used to more accurately False
determine the frequency, duration, and intensity of
uterine contractions.
22. T/F: The heart rate from a well-applied fetal spiral False
electrode can only be fetal, not maternal.
23. T/F: The intrauterine catheter is used to pick up the False
fetal heart rate.
24. T/F: The internal spiral electrode may pick up the ma- True
ternal heart rate if the baby has died.
, NCC EFM Certification
Study online at https://quizlet.com/_f9u758
25. T/F: Fetal arrhythmias can be seen on both internal True
and external monitor tracings.
26. T/F: Variability and periodic changes can be detected True
with both internal and external monitoring.
27. T/F: Variable decelerations are a result of cord com- True
pression.
28. T/F: The presence of FHR accelerations in the intra- True
partum and antepartum periods is a sign of adequate
fetal oxygenation.
29. T/F: Variable decelerations are a vagal response. True
30. T/F: Late decelerations have a gradual decrease in FHR True
(onset to nadir 30 seconds) and are delayed in timing
with the nadir of the deceleration occurring after the
peak of the contraction.
31. T/F: The fetal heart rate baseline can be determined False
during periods of marked variability.
32. T/F: Anything that affects maternal blood flow (cardiac True
output) can affect the blood flow through the placen-
ta.
33. T/F: Variable decelerations are the most frequently True
seen fetal heart rate deceleration pattern in labor.
34. T/F: Minimal variability is always an indicator of hypox- False
ia and a Cesarean section is indicated.
35.
