NCC Electronic Fetal Monitoring Certification Exam
Questions and Answers (2026/2027) (Verified
Answers)
NCC EFM Certification Exam – Questions 1–25
1. A fetal heart rate (FHR) tracing shows baseline 150 bpm, moderate variability, and recurrent
variable decelerations after a contraction. The most appropriate initial intervention is:
A. Immediate cesarean delivery
B. Maternal repositioning and oxygen administration
C. Continue monitoring with no intervention
D. Administer IV fluid bolus only
Answer : B
Rationale: Recurrent variable decelerations are usually due to cord compression. Initial
management includes maternal repositioning, oxygen, and IV fluid to improve fetal
oxygenation. Cesarean is reserved if interventions fail.
2. A category II FHR tracing is characterized by:
A. Absent variability
B. Recurrent late decelerations
C. Tachycardia with minimal variability
D. All of the above
Answer : D
Rationale: Category II tracings are indeterminate, including any combination of abnormal
baseline, variability, or decelerations that do not clearly indicate fetal compromise (Category
III).
,3. A fetal tracing shows late decelerations with minimal variability. The priority nursing
intervention is:
A. Document and continue monitoring
B. Discontinue oxytocin and place the mother in lateral position
C. Encourage ambulation
D. Provide pain medication only
Answer : B
Rationale: Late decelerations indicate uteroplacental insufficiency. Interventions: stop
oxytocin, lateral position, IV fluids, oxygen, and prepare for possible operative delivery if
persistent.
4. Which of the following factors increases the risk of fetal tachycardia?
A. Maternal fever
B. Beta-sympathomimetic drugs
C. Fetal infection
D. All of the above
Answer : D
Rationale: Fetal tachycardia (>160 bpm) can result from maternal fever, infection, drugs, or
fetal hypoxia.
5. Variable decelerations are typically:
A. Gradual, mirror contractions
B. Abrupt, V-shaped, often with cord compression
C. Indicative of fetal acidemia
D. Always require immediate cesarean
Answer : B
Rationale: Variable decelerations are abrupt decreases in FHR, usually due to cord
compression; interventions include repositioning and oxygen.
6. Moderate FHR variability is defined as:
A. 0 bpm change
B. 6–25 bpm change
C. >25 bpm change
D. <5 bpm change
, Answer : B
Rationale: Moderate variability (6–25 bpm) reflects well-oxygenated and neurologically intact
fetus.
7. Which of the following is a Category III FHR tracing?
A. Minimal variability with recurrent late decelerations
B. Tachycardia with accelerations
C. Baseline 140 bpm with moderate variability
D. Variable decelerations with good recovery
Answer : A
Rationale: Category III indicates abnormal fetal status, requiring prompt evaluation and
possible delivery. Includes absent variability with recurrent late or variable decelerations or
bradycardia.
8. A prolonged deceleration is defined as:
A. Lasting 10–20 seconds
B. Lasting 2–10 minutes
C. Lasting <30 seconds
D. Lasting >30 minutes
Answer : B
Rationale: Prolonged deceleration lasts 2–10 minutes, often indicating hypoxia, cord
compression, or maternal hypotension. Immediate interventions are required.
9. A tracing shows baseline FHR 100 bpm, absent variability, and recurrent late decelerations.
This indicates:
A. Category I
B. Category II
C. Category III
D. Normal variation
Answer : C
Rationale: Category III tracing includes absent variability with recurrent late decelerations or
bradycardia, indicating fetal compromise.
10. Fetal accelerations:
A. Are a sign of fetal hypoxia
, B. Indicate fetal well-being
C. Always require delivery
D. Are abnormal in term fetuses
Answer : B
Rationale: Accelerations are reassuring signs, reflecting adequate oxygenation and
neurological integrity.
11. A patient in labor has tachysystole (excessive uterine contractions) and variable
decelerations. Initial intervention should include:
A. Administering oxytocin
B. Stopping oxytocin and providing maternal repositioning
C. Immediate vacuum extraction
D. No intervention
Answer : B
Rationale: Tachysystole can cause fetal hypoxia. Stopping oxytocin and repositioning the
mother reduces stress on the fetus.
12. Early decelerations are typically caused by:
A. Uteroplacental insufficiency
B. Head compression during contractions
C. Maternal hypotension
D. Maternal fever
Answer : B
Rationale: Early decelerations mirror contractions and are caused by fetal head compression,
generally considered benign.
13. Which maternal condition is most likely to cause fetal bradycardia?
A. Maternal hypothermia
B. Maternal hypotension
C. Maternal fever
D. Maternal hyperglycemia
Answer : B
Rationale: Maternal hypotension decreases uteroplacental perfusion, which can lead to fetal
bradycardia.
Questions and Answers (2026/2027) (Verified
Answers)
NCC EFM Certification Exam – Questions 1–25
1. A fetal heart rate (FHR) tracing shows baseline 150 bpm, moderate variability, and recurrent
variable decelerations after a contraction. The most appropriate initial intervention is:
A. Immediate cesarean delivery
B. Maternal repositioning and oxygen administration
C. Continue monitoring with no intervention
D. Administer IV fluid bolus only
Answer : B
Rationale: Recurrent variable decelerations are usually due to cord compression. Initial
management includes maternal repositioning, oxygen, and IV fluid to improve fetal
oxygenation. Cesarean is reserved if interventions fail.
2. A category II FHR tracing is characterized by:
A. Absent variability
B. Recurrent late decelerations
C. Tachycardia with minimal variability
D. All of the above
Answer : D
Rationale: Category II tracings are indeterminate, including any combination of abnormal
baseline, variability, or decelerations that do not clearly indicate fetal compromise (Category
III).
,3. A fetal tracing shows late decelerations with minimal variability. The priority nursing
intervention is:
A. Document and continue monitoring
B. Discontinue oxytocin and place the mother in lateral position
C. Encourage ambulation
D. Provide pain medication only
Answer : B
Rationale: Late decelerations indicate uteroplacental insufficiency. Interventions: stop
oxytocin, lateral position, IV fluids, oxygen, and prepare for possible operative delivery if
persistent.
4. Which of the following factors increases the risk of fetal tachycardia?
A. Maternal fever
B. Beta-sympathomimetic drugs
C. Fetal infection
D. All of the above
Answer : D
Rationale: Fetal tachycardia (>160 bpm) can result from maternal fever, infection, drugs, or
fetal hypoxia.
5. Variable decelerations are typically:
A. Gradual, mirror contractions
B. Abrupt, V-shaped, often with cord compression
C. Indicative of fetal acidemia
D. Always require immediate cesarean
Answer : B
Rationale: Variable decelerations are abrupt decreases in FHR, usually due to cord
compression; interventions include repositioning and oxygen.
6. Moderate FHR variability is defined as:
A. 0 bpm change
B. 6–25 bpm change
C. >25 bpm change
D. <5 bpm change
, Answer : B
Rationale: Moderate variability (6–25 bpm) reflects well-oxygenated and neurologically intact
fetus.
7. Which of the following is a Category III FHR tracing?
A. Minimal variability with recurrent late decelerations
B. Tachycardia with accelerations
C. Baseline 140 bpm with moderate variability
D. Variable decelerations with good recovery
Answer : A
Rationale: Category III indicates abnormal fetal status, requiring prompt evaluation and
possible delivery. Includes absent variability with recurrent late or variable decelerations or
bradycardia.
8. A prolonged deceleration is defined as:
A. Lasting 10–20 seconds
B. Lasting 2–10 minutes
C. Lasting <30 seconds
D. Lasting >30 minutes
Answer : B
Rationale: Prolonged deceleration lasts 2–10 minutes, often indicating hypoxia, cord
compression, or maternal hypotension. Immediate interventions are required.
9. A tracing shows baseline FHR 100 bpm, absent variability, and recurrent late decelerations.
This indicates:
A. Category I
B. Category II
C. Category III
D. Normal variation
Answer : C
Rationale: Category III tracing includes absent variability with recurrent late decelerations or
bradycardia, indicating fetal compromise.
10. Fetal accelerations:
A. Are a sign of fetal hypoxia
, B. Indicate fetal well-being
C. Always require delivery
D. Are abnormal in term fetuses
Answer : B
Rationale: Accelerations are reassuring signs, reflecting adequate oxygenation and
neurological integrity.
11. A patient in labor has tachysystole (excessive uterine contractions) and variable
decelerations. Initial intervention should include:
A. Administering oxytocin
B. Stopping oxytocin and providing maternal repositioning
C. Immediate vacuum extraction
D. No intervention
Answer : B
Rationale: Tachysystole can cause fetal hypoxia. Stopping oxytocin and repositioning the
mother reduces stress on the fetus.
12. Early decelerations are typically caused by:
A. Uteroplacental insufficiency
B. Head compression during contractions
C. Maternal hypotension
D. Maternal fever
Answer : B
Rationale: Early decelerations mirror contractions and are caused by fetal head compression,
generally considered benign.
13. Which maternal condition is most likely to cause fetal bradycardia?
A. Maternal hypothermia
B. Maternal hypotension
C. Maternal fever
D. Maternal hyperglycemia
Answer : B
Rationale: Maternal hypotension decreases uteroplacental perfusion, which can lead to fetal
bradycardia.
