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NCC EFM Practice Exam | Complete 2025–2026 Electronic Fetal Monitoring Certification Practice Test with Verified Questions and Answers

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Download the 2025–2026 NCC Electronic Fetal Monitoring (EFM) Practice Exam (PDF). Includes verified EFM certification questions, detailed answers, and rationales to help prepare for the NCC fetal monitoring exam.

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NCC EFM practice EXAM

Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above - CORRECT ANSWER e. All of the above

Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change - CORRECT ANSWER a. A decrease in the heart rate

The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect
to the FHR baseline?
a. Increases baseline
b. Decreases baseline - CORRECT ANSWER b. Decreases baseline

T/F: The most common artifact with the ultrasound transducer system for fetal heart rate
is increased variability. - CORRECT ANSWER True

T/F: All fetal monitors contain a logic system designed to reject artifact. - CORRECT
ANSWER True

T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. -
CORRECT ANSWER True

T/F: Variability and periodic changes can be detected with both internal and external
monitoring. - CORRECT ANSWER True

T/F: Variable decelerations are a vagal response. - CORRECT ANSWER True

T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration
pattern in labor. - CORRECT ANSWER True

Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown

,a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 - CORRECT ANSWER c. 2, 3 and 4

The most prevalent risk factor associated with fetal death before the onset of labor is:
a. Low socioeconomic status
b. Fetal malpresentation
c. Uteroplacental insufficiency
d. Uterine anomalies - CORRECT ANSWER c. Uteroplacental insufficiency

Which of the following conditions is not an indication for antepartum fetal surveillance?
a. Gestational hypertension
b. Diabetes in pregnancy
c. Fetus in breech presentation
d. Decreased fetal movement - CORRECT ANSWER c. Fetus in breech
presentation

Which of the following does not affect the degree of fetal activity?
a. Vibroacoustic stimulation
b. Smoking
c. Fetal position
d. Gestational age - CORRECT ANSWER a. Vibroacoustic stimulation

T/F: Umbilical cord influences that can alter blood flow include true knots, hematomas,
and number of umbilical vessels. - CORRECT ANSWER True

T/F: Low amplitude contractions are not an early sign of preterm labor. - CORRECT
ANSWER False

T/F: Corticosteroid administration may cause an increase in FHR accelerations. -
CORRECT ANSWER False

T/F: Corticosteroid administration may cause an increase in FHR. - CORRECT
ANSWER True

T/F: Contractions cause an increase in uterine venous pressure and a decrease in
uterine artery perfusion. - CORRECT ANSWER True

As a result of the intrinsic fetal response to oxygen deprivation, increased
catecholamine levels cause the peripheral blood flow to decrease while the blood flow
to vital organs increases. These flow changes along with increased catecholamine
secretions have what effect on fetal blood pressure and fetal heart rate?
A. Increase BP and increase HR
B. Increase BP and decrease HR
C. Decrease BP and increase HR

, D. Decrease BP and decrease HR - CORRECT ANSWER B. Increase BP and
decrease HR

During a term antepartum NST (non-stress test), you notice several variable
decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the
following is the least likely explanation?
A. True knot
B. Gestational diabetes
C. Umbilical cord entanglement
D. Oligohydramnios - CORRECT ANSWER B. Gestational diabetes

All of the following are likely causes of prolonged decelerations except:
A. Uterine tachysystole
B. Prolapsed cord
C. Maternal hypotension
D. Maternal fever - CORRECT ANSWER D. Maternal fever

All of the following could likely cause minimal variability in FHR except
A. Magnesium sulfate administration
B. Fetal sleep cycle
C. Narcotic administration
D. Ephedrine administration - CORRECT ANSWER D. Ephedrine administration

When an IUPC has been placed, Montevideo units must be ___ or greater for adequate
cervical change to occur.
A. 100
B. 200
C. 300
D. 400 - CORRECT ANSWER B. 200

What would be a suspected pH in a fetus whose FHTs included recurrent late
decelerations during labor?
A. 7.10
B. 7.26
C. 7.32
D. 7.41 - CORRECT ANSWER A. 7.10

The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after
the contraction and returns to baseline just before the contraction is over. The correct
nursing response is to:
a. Give the woman oxygen by facemask at 8-10 L/min
b. Position the woman on her opposite side
c. Increase the rate of the woman's intravenous fluid
d. Continue to observe and record the normal pattern - CORRECT ANSWER d.
Continue to observe and record the normal pattern

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