NCC EFM FINAL PAPER BUNDLED EXAMS
TESTED QUESTIONS 2026 ALREADY
PASSED GRADED A+.
◉ Sinusoidal pattern. 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. 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. Answer: Normal acid base balance
-Baseline between 110 to 160
,-Moderate variability
-No late, variable, or prolonged decels
-May have early decels
-May or may not have accels
◉ Category II tracing. 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. 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. 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. 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. Answer: With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
-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. Answer: Frequent & painful but poor quality
contractions occurring in latent labor
TESTED QUESTIONS 2026 ALREADY
PASSED GRADED A+.
◉ Sinusoidal pattern. 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. 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. Answer: Normal acid base balance
-Baseline between 110 to 160
,-Moderate variability
-No late, variable, or prolonged decels
-May have early decels
-May or may not have accels
◉ Category II tracing. 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. 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. 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. 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. Answer: With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
-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. Answer: Frequent & painful but poor quality
contractions occurring in latent labor
