NCC EFM Exam Questions and Answers
(2026/2027) | Real Practice Questions |
Verified Answers | A+
• Pattern recognition & intervention. CORRECT ANSWER: -FHR baseline ✓
-FHR variability ✓
-FHR accelerations ✓
-FHR decelerations ✓
-Normal uterine activity ✓
-Abnormal uterine activity ✓
-Fetal dysrhythmias ✓
-Maternal complications ✓
-Uteroplacental complications ✓
-Fetal complications ✓
• FHR Descriptors. CORRECT ANSWER: 1) Baseline
2) Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
• FHR Baseline. CORRECT ANSWER: Average FHR rounded to nearest 5 during a 10
min window
-110 to 160
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't need to be continuous)
• Fetal Bradycardia. CORRECT ANSWER: <110 for ≥10 min
-Causes: hypotension (ex: after epi), cord prolapse, head compression, congenital
defect, rapid descent, abruption or rupture, tachysystole, post dates, hypoglycemia,
lupus (heart block)
-With ↓ O2, blood will be shunted to brain, heart, & adrenals, eventually ↓ FHR to ↓ O2
demands of heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse), resuscitate, evaluate arrhythmia,
expedite delivery
• Fetal Tachycardia. CORRECT ANSWER: >160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection, fetal immaturity (preterm), SVT,
maternal anxiety (catecholamines), dehydration, hyperthyroid, hypoxia
-Med causes: terbutaline, catecholamines (epinephrine, norepi)
-Assess mom's temp & infection risk (GBS, PROM)
, • FHR Variability. CORRECT ANSWER: Irregular in amplitude & frequency, quantified
by peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro maturity
-Less in preterm due to undeveloped CNS
-Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline), significance unknown
• Minimal variability. CORRECT ANSWER: ≤5 bpm but detectable
Sleep, sedated, or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if needed)
• Moderate variability. CORRECT ANSWER: 6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis (even w decels)
• FHR Accelerations. CORRECT ANSWER: Reliably predicts absence of metabolic
acidemia (spontaneous or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline lasting ≥15 sec)
-For <32 wks: 10x10
-Prolonged accel: 2-9 mins (at 10 becomes change of baseline)
• Early deceleration. CORRECT ANSWER: Nadir aligns w contraction peak, gradual
onset (≥30 secs to nadir), benign vagal response
1) Pressure on fetal head
2) Increased intracranial pressure
3) Alteration in cerebral blood flow
4) Central vagal stimulation
5) FHR deceleration
• Periodic vs Episodic. CORRECT ANSWER: Periodic: caused by contractions
-recurrent: occurs w ≥50% of contractions in 20 min
-intermittent: w <50% of contractions in 20 mins
Episodic: spontaneous
• Variable deceleration. CORRECT ANSWER: Caused by cord compression
-Interventions: position change, amnioinfusion
-Abrupt onset: <30 seconds from onset to nadir dropping ≥15 bpm lasting 15 secs to
<2min
-Transient rise in PCO2 & fall in PO2
(2026/2027) | Real Practice Questions |
Verified Answers | A+
• Pattern recognition & intervention. CORRECT ANSWER: -FHR baseline ✓
-FHR variability ✓
-FHR accelerations ✓
-FHR decelerations ✓
-Normal uterine activity ✓
-Abnormal uterine activity ✓
-Fetal dysrhythmias ✓
-Maternal complications ✓
-Uteroplacental complications ✓
-Fetal complications ✓
• FHR Descriptors. CORRECT ANSWER: 1) Baseline
2) Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
• FHR Baseline. CORRECT ANSWER: Average FHR rounded to nearest 5 during a 10
min window
-110 to 160
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't need to be continuous)
• Fetal Bradycardia. CORRECT ANSWER: <110 for ≥10 min
-Causes: hypotension (ex: after epi), cord prolapse, head compression, congenital
defect, rapid descent, abruption or rupture, tachysystole, post dates, hypoglycemia,
lupus (heart block)
-With ↓ O2, blood will be shunted to brain, heart, & adrenals, eventually ↓ FHR to ↓ O2
demands of heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse), resuscitate, evaluate arrhythmia,
expedite delivery
• Fetal Tachycardia. CORRECT ANSWER: >160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection, fetal immaturity (preterm), SVT,
maternal anxiety (catecholamines), dehydration, hyperthyroid, hypoxia
-Med causes: terbutaline, catecholamines (epinephrine, norepi)
-Assess mom's temp & infection risk (GBS, PROM)
, • FHR Variability. CORRECT ANSWER: Irregular in amplitude & frequency, quantified
by peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro maturity
-Less in preterm due to undeveloped CNS
-Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline), significance unknown
• Minimal variability. CORRECT ANSWER: ≤5 bpm but detectable
Sleep, sedated, or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if needed)
• Moderate variability. CORRECT ANSWER: 6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis (even w decels)
• FHR Accelerations. CORRECT ANSWER: Reliably predicts absence of metabolic
acidemia (spontaneous or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline lasting ≥15 sec)
-For <32 wks: 10x10
-Prolonged accel: 2-9 mins (at 10 becomes change of baseline)
• Early deceleration. CORRECT ANSWER: Nadir aligns w contraction peak, gradual
onset (≥30 secs to nadir), benign vagal response
1) Pressure on fetal head
2) Increased intracranial pressure
3) Alteration in cerebral blood flow
4) Central vagal stimulation
5) FHR deceleration
• Periodic vs Episodic. CORRECT ANSWER: Periodic: caused by contractions
-recurrent: occurs w ≥50% of contractions in 20 min
-intermittent: w <50% of contractions in 20 mins
Episodic: spontaneous
• Variable deceleration. CORRECT ANSWER: Caused by cord compression
-Interventions: position change, amnioinfusion
-Abrupt onset: <30 seconds from onset to nadir dropping ≥15 bpm lasting 15 secs to
<2min
-Transient rise in PCO2 & fall in PO2
