NCC (EFM) CERTIFICATION EXAM 2026 – COMPLETE PRACTICE
QUESTIONS, ANSWERS, AND RATIONALES| PDF FOMART
Actual Test Bank with | Graded A | 100% Pass
Guarantee
1. A patient at 39 weeks gestation shows recurrent variable decelerations on the
fetal monitor. The first action is:
a. Immediate delivery
b. Change maternal position
c. Administer IV fluids only
d. Administer oxygen
Rationale: Variable decelerations are usually caused by cord compression.
Repositioning the mother can relieve pressure and often resolves the decelerations.
2. A nonstress test (NST) lasting 40 minutes shows no accelerations. The next step
is:
a. Send patient home
b. Perform a biophysical profile (BPP) or contraction stress test (CST)
c. Repeat the NST next week
d. Immediate delivery
Rationale: A nonreactive NST requires additional testing such as a BPP or CST
to assess fetal oxygenation and risk.
3. Which of the following is NOT part of a biophysical profile?
a. Fetal breathing movements
b. Fetal movement
c. Amniotic fluid volume
d. Maternal HCG levels
,Rationale: A BPP evaluates fetal well-being (breathing, movement, tone, fluid,
NST), but maternal HCG levels are unrelated.
4. A fetal baseline heart rate of 170 bpm is noted. Possible causes include:
a. Maternal supine hypotension
b. Maternal fever and dehydration
c. Maternal hypoglycemia
d. Maternal hypotension
Rationale: Fetal tachycardia (>160 bpm) is commonly caused by maternal fever
or dehydration, which increase fetal metabolic demand.
5. Recurrent late decelerations are most likely due to:
a. Cord compression
b. Head compression
c. Maternal position change
d. Utero-placental insufficiency
Rationale: Late decelerations indicate uteroplacental insufficiency, meaning the
fetus is not receiving adequate oxygen during contractions.
6. The most important characteristics of the fetal heart rate (FHR) are:
a. Rate and decelerations
b. Variability and accelerations
c. Variability and decelerations
d. Rate and variability
Rationale: Variability and accelerations reflect fetal oxygenation and neurologic
status.
7. During labor, the FHR tracing shows decreased variability for 45 minutes.
First action:
a. Encourage ambulation
,b. Administer oxygen
c. Discontinue IV fluids
d. Increase Pitocin rate
Rationale: Low variability suggests fetal hypoxia. Initial resuscitative measures
include maternal oxygen administration.
8. Fetal scalp stimulation (FSE) is used to:
a. Cause deceleration
b. Elicit acceleration
c. Induce fetal movement
d. Put the fetus to sleep
Rationale: A well-oxygenated fetus responds to FSE with an acceleration,
confirming fetal well-being.
9. Chronic fetal asphyxia is suspected if a BPP score is below:
a. 10
b. 6
c. 8
d. 5
Rationale: BPP scores of 6 or less indicate possible chronic fetal compromise
requiring intervention.
10. When using a fetal scalp electrode (FSE), an abnormally low FHR is noted.
First action:
a. Compare maternal pulse with FHR
b. Remove FSE
c. Call the doctor immediately
d. Turn off the monitor
Rationale: Low FHR readings may reflect maternal pulse being picked up;
always verify before intervention.
, 11. The fetal response to oxygen deprivation includes:
a. Increase BP and increase HR
b. Increase BP and decrease HR
c. Decrease BP and increase HR
d. Decrease BP and decrease HR
Rationale: Hypoxia causes peripheral vasoconstriction to vital organs, raising
BP, and reflex bradycardia.
12. A pseudosinusoidal FHR pattern is indicated by all EXCEPT:
a. Recent maternal narcotics
b. Accelerations in FHR
c. Moderate variability
d. Frequency of oscillations of 2–5 cycles/min
Rationale: True sinusoidal patterns have smooth, regular oscillations, while
pseudosinusoidal patterns have variability present.
13. Appropriate interventions for fetal tachycardia include all EXCEPT:
a. Increase maternal IV fluids
b. Assess maternal vital signs
c. Administer oxytocin
d. Treat maternal fever
Rationale: Oxytocin may increase stress on the fetus, worsening tachycardia.
Other interventions address underlying causes.
14. The normal baseline FHR according to AWHONN is:
a. 90–150 bpm
b. 100–170 bpm
c. 110–160 bpm
d. 120–140 bpm
QUESTIONS, ANSWERS, AND RATIONALES| PDF FOMART
Actual Test Bank with | Graded A | 100% Pass
Guarantee
1. A patient at 39 weeks gestation shows recurrent variable decelerations on the
fetal monitor. The first action is:
a. Immediate delivery
b. Change maternal position
c. Administer IV fluids only
d. Administer oxygen
Rationale: Variable decelerations are usually caused by cord compression.
Repositioning the mother can relieve pressure and often resolves the decelerations.
2. A nonstress test (NST) lasting 40 minutes shows no accelerations. The next step
is:
a. Send patient home
b. Perform a biophysical profile (BPP) or contraction stress test (CST)
c. Repeat the NST next week
d. Immediate delivery
Rationale: A nonreactive NST requires additional testing such as a BPP or CST
to assess fetal oxygenation and risk.
3. Which of the following is NOT part of a biophysical profile?
a. Fetal breathing movements
b. Fetal movement
c. Amniotic fluid volume
d. Maternal HCG levels
,Rationale: A BPP evaluates fetal well-being (breathing, movement, tone, fluid,
NST), but maternal HCG levels are unrelated.
4. A fetal baseline heart rate of 170 bpm is noted. Possible causes include:
a. Maternal supine hypotension
b. Maternal fever and dehydration
c. Maternal hypoglycemia
d. Maternal hypotension
Rationale: Fetal tachycardia (>160 bpm) is commonly caused by maternal fever
or dehydration, which increase fetal metabolic demand.
5. Recurrent late decelerations are most likely due to:
a. Cord compression
b. Head compression
c. Maternal position change
d. Utero-placental insufficiency
Rationale: Late decelerations indicate uteroplacental insufficiency, meaning the
fetus is not receiving adequate oxygen during contractions.
6. The most important characteristics of the fetal heart rate (FHR) are:
a. Rate and decelerations
b. Variability and accelerations
c. Variability and decelerations
d. Rate and variability
Rationale: Variability and accelerations reflect fetal oxygenation and neurologic
status.
7. During labor, the FHR tracing shows decreased variability for 45 minutes.
First action:
a. Encourage ambulation
,b. Administer oxygen
c. Discontinue IV fluids
d. Increase Pitocin rate
Rationale: Low variability suggests fetal hypoxia. Initial resuscitative measures
include maternal oxygen administration.
8. Fetal scalp stimulation (FSE) is used to:
a. Cause deceleration
b. Elicit acceleration
c. Induce fetal movement
d. Put the fetus to sleep
Rationale: A well-oxygenated fetus responds to FSE with an acceleration,
confirming fetal well-being.
9. Chronic fetal asphyxia is suspected if a BPP score is below:
a. 10
b. 6
c. 8
d. 5
Rationale: BPP scores of 6 or less indicate possible chronic fetal compromise
requiring intervention.
10. When using a fetal scalp electrode (FSE), an abnormally low FHR is noted.
First action:
a. Compare maternal pulse with FHR
b. Remove FSE
c. Call the doctor immediately
d. Turn off the monitor
Rationale: Low FHR readings may reflect maternal pulse being picked up;
always verify before intervention.
, 11. The fetal response to oxygen deprivation includes:
a. Increase BP and increase HR
b. Increase BP and decrease HR
c. Decrease BP and increase HR
d. Decrease BP and decrease HR
Rationale: Hypoxia causes peripheral vasoconstriction to vital organs, raising
BP, and reflex bradycardia.
12. A pseudosinusoidal FHR pattern is indicated by all EXCEPT:
a. Recent maternal narcotics
b. Accelerations in FHR
c. Moderate variability
d. Frequency of oscillations of 2–5 cycles/min
Rationale: True sinusoidal patterns have smooth, regular oscillations, while
pseudosinusoidal patterns have variability present.
13. Appropriate interventions for fetal tachycardia include all EXCEPT:
a. Increase maternal IV fluids
b. Assess maternal vital signs
c. Administer oxytocin
d. Treat maternal fever
Rationale: Oxytocin may increase stress on the fetus, worsening tachycardia.
Other interventions address underlying causes.
14. The normal baseline FHR according to AWHONN is:
a. 90–150 bpm
b. 100–170 bpm
c. 110–160 bpm
d. 120–140 bpm
