(Updated) NCC EFM Exam Breakdown & Complete Study Guide with verified solutions | Latest 2025/2026 Update.

(Updated) NCC EFM Exam Breakdown &
Complete Study Guide with verified
solutions | Latest 2025/2026 Update.

Question:
Normal uterine activity?
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Answer:

≤5 contractions in 10 mins averaging over 30 min window
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-adequate contractions: q2-3 lasting 80-90s
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-intensity: 25-75 mmhg i,- i,-




-resting tone: 10-15 mmhg
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-MVU: 200-220 in 10 mins
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-intercontraction interval (relaxation time) should be 45-60sec
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Question:

Tachysystole?

Answer:

>5 contractions in 10 mins averaged over 30 min window
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-tetanic contractions: >90 secs
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-position change i,-

,-500 LR to dilute uterotonic
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-↓ pitocin (see protocol)
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-tocolytic (terbutaline) i,-




-O2 if decel
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Question:
Tachysystole & pitocin? i,- i,-




Answer:

With fetal tolerance
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-If not resolved in 15min, ↓ pit by 1/2
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-If not resolved in another 15min, pause pit
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-If pit's off for <30 min, resume pit at 1/2 of current dose
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-If off for >30 min, start @ initial order dose
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With fetal intolerance: pit off immediately
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Question:

Hypertonous labor? i,-




Answer:

Frequent & painful but poor quality contractions occurring in latent labor
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-despite increased tone, not enough pressure to cause cx change
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-indicative of CPD or malpresentation i,- i,- i,- i,-

,-tx: comfort care, pitocin, AROM
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Question:

Hypotonic labor? i,-




Answer:

Weak & insufficient labor occurring during the active phase
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-inadequate, infrequent, & less intense contractions don't dilate or efface
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cx

-caused by tired uterus or overdistention (poly, multiple gestation, LGA)
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Question:

Arrest of labor? i,- i,-




Answer:
>6cm dilated w/ ROM & one of the following w no cx change:
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-4 hrs of adequate contractions (>200 MVUs)
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-6 hrs of inadequate contractions
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Question:

Fetal dysrhythmias?
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Answer:

, 1) SVT: 210-300 bpm
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-tx w digoxin (↑ dose to cross placenta)
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-concern w hydrops, CHF (heart stress), ↑ O2 demand & use, ↓ stroke
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volume, demise i,-




2) Congenital heart block (<60 bpm): 3rd degree → concern w hydrops,
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lupus, CHF i,-




3) Ectopic beats: extra beats heard, benign, may be transient
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Question:
Lupus (SLE)? i,-




Answer:
Can cause congenital 3rd degree heart block
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-bradycardia

-autoimmune → inflammatory response → overgrowth of collagen in i,- i,- i,- i,- i,- i,- i,- i,- i,-


heart muscle i,-




-damages fetal conduction system of the heart, attacks fetal tissue
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-usually diagnosed in 2nd trimester i,- i,- i,- i,-




Question:

Preterm labor? i,-




Answer:
Cx dilation bw 20-36.6 wks
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