NCC EFM
NCC Electronic Fetal Monitoring Certification Exam
Questions with Correct Answers Graded A+ 2026
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
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. -Correct Answer ✔-b.
Increases cardiac output by increasing it's heart rate.
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
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D -Correct Answer ✔-g. C & D
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: Oxygen exchange in the placenta takes place in the intervillous space. -Correct
Answer ✔-True
NCC EFM
,NCC EFM
T/F: The parasympathetic nervous system is a cardioaccelerator. -Correct Answer ✔-
False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in
blood pressure. -Correct Answer ✔-True
T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate:
the ultrasound transducer and the fetal spiral electrode. -Correct Answer ✔-True
T/F: Variability can be determined with the fetoscope. -Correct Answer ✔-False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can
be dipped in warm water to make cleaning easier. -Correct Answer ✔-False
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: The monitor should always be tested before starting a tracing, either external or
internal mode and labeled a test. -Correct Answer ✔-True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. -Correct
Answer ✔-False
T/F: Both internal and external monitoring methods are equally accurate means of
obtaining the fetal heart rate and contraction patterns. -Correct Answer ✔-False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. -
Correct Answer ✔-True
T/F: The external toco gives measurable uterine pressure. -Correct Answer ✔-False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is
present. -Correct Answer ✔-False
T/F: The ultrasound transducer is usually placed on the side of the uterus over the
baby's back, as the fetal heart is heard best there. -Correct Answer ✔-True
NCC EFM
,NCC EFM
T/F: The spiral electrode is used to more accurately determine the frequency, duration,
and intensity of uterine contractions. -Correct Answer ✔-False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not
maternal. -Correct Answer ✔-False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. -Correct Answer ✔-
False
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has
died. -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 result of cord compression. -Correct Answer ✔-True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a
sign of adequate fetal oxygenation. -Correct Answer ✔-True
T/F: Variable decelerations are a vagal response. -Correct Answer ✔-True
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and
are delayed in timing with the nadir of the deceleration occurring after the peak of the
contraction. -Correct Answer ✔-True
T/F: The fetal heart rate baseline can be determined during periods of marked
variability. -Correct Answer ✔-False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow
through the placenta. -Correct Answer ✔-True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration
pattern in labor. -Correct Answer ✔-True
NCC EFM
, NCC EFM
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is
indicated. -Correct Answer ✔-False
What is your first intervention in management of a patient experiencing variable
decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion -Correct Answer ✔-b. Change maternal position
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
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change -Correct Answer ✔-a. Utero-placental insufficiency
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 is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels -Correct Answer ✔-d. Maternal HCG levels
Which of the following conditions is not an indication for antepartum fetal surveillance?
a. Gestational hypertension
NCC EFM
NCC Electronic Fetal Monitoring Certification Exam
Questions with Correct Answers Graded A+ 2026
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
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. -Correct Answer ✔-b.
Increases cardiac output by increasing it's heart rate.
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
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D -Correct Answer ✔-g. C & D
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: Oxygen exchange in the placenta takes place in the intervillous space. -Correct
Answer ✔-True
NCC EFM
,NCC EFM
T/F: The parasympathetic nervous system is a cardioaccelerator. -Correct Answer ✔-
False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in
blood pressure. -Correct Answer ✔-True
T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate:
the ultrasound transducer and the fetal spiral electrode. -Correct Answer ✔-True
T/F: Variability can be determined with the fetoscope. -Correct Answer ✔-False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can
be dipped in warm water to make cleaning easier. -Correct Answer ✔-False
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: The monitor should always be tested before starting a tracing, either external or
internal mode and labeled a test. -Correct Answer ✔-True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. -Correct
Answer ✔-False
T/F: Both internal and external monitoring methods are equally accurate means of
obtaining the fetal heart rate and contraction patterns. -Correct Answer ✔-False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. -
Correct Answer ✔-True
T/F: The external toco gives measurable uterine pressure. -Correct Answer ✔-False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is
present. -Correct Answer ✔-False
T/F: The ultrasound transducer is usually placed on the side of the uterus over the
baby's back, as the fetal heart is heard best there. -Correct Answer ✔-True
NCC EFM
,NCC EFM
T/F: The spiral electrode is used to more accurately determine the frequency, duration,
and intensity of uterine contractions. -Correct Answer ✔-False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not
maternal. -Correct Answer ✔-False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. -Correct Answer ✔-
False
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has
died. -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 result of cord compression. -Correct Answer ✔-True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a
sign of adequate fetal oxygenation. -Correct Answer ✔-True
T/F: Variable decelerations are a vagal response. -Correct Answer ✔-True
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and
are delayed in timing with the nadir of the deceleration occurring after the peak of the
contraction. -Correct Answer ✔-True
T/F: The fetal heart rate baseline can be determined during periods of marked
variability. -Correct Answer ✔-False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow
through the placenta. -Correct Answer ✔-True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration
pattern in labor. -Correct Answer ✔-True
NCC EFM
, NCC EFM
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is
indicated. -Correct Answer ✔-False
What is your first intervention in management of a patient experiencing variable
decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion -Correct Answer ✔-b. Change maternal position
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
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change -Correct Answer ✔-a. Utero-placental insufficiency
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 is NOT used for antepartum fetal surveillance?
a. Fetal movement counting
b. Antepartum fetal heart rate testing
c. Biophysical profile testing
d. Maternal HCG levels -Correct Answer ✔-d. Maternal HCG levels
Which of the following conditions is not an indication for antepartum fetal surveillance?
a. Gestational hypertension
NCC EFM
