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NCC Electronic Fetal Monitoring (EFM) Exam Questions and Answers 2025–2026 | Advanced Fetal Heart Rate Interpretation Review | Obstetric Nursing Certification Study Guide | A+ Verified

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Prepare for success on the NCC Electronic Fetal Monitoring (EFM) Certification Exam with this comprehensive collection of verified questions and answers covering fetal physiology, fetal oxygenation, fetal circulation, fetal heart rate (FHR) interpretation, NICHD terminology, variability, accelerations, decelerations, tachysystole, uteroplacental insufficiency, fetal acid-base balance, cord blood gases, biophysical profiles (BPP), nonstress tests (NST), and evidence-based intrapartum nursing interventions. This study guide is designed for labor and delivery nurses, obstetric nurses, maternal-newborn nursing students, and certification candidates seeking a thorough review of fetal monitoring principles and clinical decision-making. The material includes high-yield content on baroreceptors, chemoreceptors, fetal hypoxia, fetal acidemia, amnioinfusion, fetal arrhythmias, Leopold's maneuvers, intermittent auscultation, oxytocin management, preterm fetal monitoring, intrauterine resuscitation, and Category I, II, and III fetal heart rate tracings. It provides a strong foundation for certification success while enhancing clinical judgment and patient safety in obstetric practice.

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NCC Electronic Fetal
Monitoring Certification 2024
Latest Questions and
Answers (Verified by Expert)
PR
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 - ANSWER e. All of the above
O

How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
FD
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. - ANSWER b. Increases cardiac
output by increasing it's heart rate.

Stimulating the vagus nerve typically produces:
O
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
C
d. No change - 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 - 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 - ANSWER b. Decreases baseline

T/F: Oxygen exchange in the placenta takes place in the intervillous space. - ANSWER
True

T/F: The parasympathetic nervous system is a cardioaccelerator. - ANSWER False

T/F: Baroreceptors are stretch receptors which respond to increases or decreases in
blood pressure. - 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. - ANSWER True
PR
T/F: Variability can be determined with the fetoscope. - 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. - ANSWER False

T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
O
increased variability. - ANSWER True

T/F: All fetal monitors contain a logic system designed to reject artifact. - ANSWER True
FD

T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. - ANSWER True

T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - ANSWER False
O

T/F: Both internal and external monitoring methods are equally accurate means of obtaining the
fetal heart rate and contraction patterns. - ANSWER False
C

T/F: The external toco is usually placed over the uterine fundus to pick up contractions. -
ANSWER True

T/F: The external toco gives measurable uterine pressure. - ANSWER False

T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is
present. - 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. - ANSWER True

,T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. - ANSWER False

T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. -
ANSWER False

T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ANSWER False

T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. -
ANSWER True

T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. - ANSWER
True
PR
T/F: Variability and periodic changes can be detected with both internal and external monitoring.
- ANSWER True

T/F: Variable decelerations are a result of cord compression. - ANSWER True

T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of
O
adequate fetal oxygenation. - ANSWER True

T/F: Variable decelerations are a vagal response. - ANSWER True
FD

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. -
ANSWER True
O
T/F: The fetal heart rate baseline can be determined during periods of marked variability. -
ANSWER False
C
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through
the placenta. - ANSWER True

T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in
labor. - ANSWER True

T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated. -
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 - 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 - ANSWER c. 2, 3 and 4

What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
PR
b. Head compression
c. Cord compression
d. Maternal position change - ANSWER a. Utero-placental insufficiency

The most prevalent risk factor associated with fetal death before the onset of labor is:
a. Low socioeconomic status
O
b. Fetal malpresentation
c. Uteroplacental insufficiency
d. Uterine anomalies - ANSWER c. Uteroplacental insufficiency
FD

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
O
d. Maternal HCG levels - ANSWER d. Maternal HCG levels

Which of the following conditions is not an indication for antepartum fetal surveillance?
C
a. Gestational hypertension
b. Diabetes in pregnancy
c. Fetus in breech presentation
d. Decreased fetal movement - ANSWER c. Fetus in breech presentation

Which of the following does not affect the degree of fetal activity?
a. Vibroacoustic stimulation
b. Smoking
c. Fetal position
d. Gestational age - ANSWER a. Vibroacoustic stimulation

To be considered reactive, a nonstress test must have:
a. 4 fetal heart rate accelerations in a 20 minute window

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