ELECTRONIC FETAL MONITORING (C-EFM)
PRACTICE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 29-year-old G2P1 at 39 weeks is undergoing continuous
electronic fetal monitoring during spontaneous labor. The fetal
heart rate baseline is 145 beats/min, variability is moderate, and
there are accelerations of 15 beats/min lasting 15 seconds. No
decelerations are present. Which interpretation is most
appropriate?
A. Category I tracing with reassuring fetal status
B. Category II tracing because accelerations are present
C. Category III tracing because the baseline exceeds 140 beats/min
D. Category II tracing because the variability is moderate
Answer: A. Category I tracing with reassuring fetal status
Rationale: A Category I tracing includes a baseline of 110–160
beats/min, moderate variability, and absence of late or variable
decelerations. Accelerations may be present or absent. This pattern is
strongly reassuring and is associated with normal fetal acid-base
status at the time of observation. A baseline of 145 beats/min is
normal, and moderate variability is reassuring.
2. During labor, the fetal heart rate baseline is 165 beats/min for 12
minutes. Variability remains moderate, and there are no
1
, decelerations. What is the most accurate classification of the
baseline?
A. Normal baseline
B. Fetal bradycardia
C. Fetal tachycardia
D. Sinusoidal pattern
Answer: C. Fetal tachycardia
Rationale: Fetal tachycardia is a baseline fetal heart rate greater than
160 beats/min for at least 10 minutes. The baseline of 165 beats/min
persisting for 12 minutes therefore meets the definition. Possible
causes include maternal fever, infection, medications such as beta-
agonists, fetal hypoxemia, maternal dehydration, and fetal arrhythmia.
Moderate variability without recurrent decelerations is reassuring, but
the underlying cause of tachycardia should be evaluated.
3. A fetal heart rate tracing shows a baseline of 135 beats/min with
fluctuations of 6–25 beats/min around the baseline. Which
description best characterizes the variability?
A. Absent
B. Minimal
C. Moderate
D. Marked
Answer: C. Moderate
Rationale: Moderate variability is defined as amplitude fluctuations of
6–25 beats/min. Absent variability means no detectable fluctuation,
minimal variability is detectable but 5 beats/min or less, and marked
variability exceeds 25 beats/min. Moderate variability is one of the
most important reassuring characteristics of a fetal heart rate tracing
because it generally reflects an intact fetal autonomic nervous system
and is associated with adequate oxygenation at the time observed.
2
, 4. A laboring patient's fetal heart rate tracing demonstrates recurrent
abrupt decreases in fetal heart rate from 145 to 90 beats/min, with
rapid return to baseline. The timing varies in relation to
contractions. Which type of deceleration is most likely?
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Prolonged deceleration
Answer: C. Variable deceleration
Rationale: Variable decelerations are abrupt decreases in fetal heart
rate, typically at least 15 beats/min below baseline and lasting at least
15 seconds but less than 2 minutes. Their timing, shape, and
relationship to contractions may vary. They most commonly result
from umbilical cord compression. Recurrent variable decelerations
require assessment and appropriate intrauterine resuscitative
measures when clinically indicated.
5. A fetal heart rate decreases gradually from 145 to 120 beats/min
beginning approximately 30 seconds after the onset of a
contraction. The nadir occurs after the contraction's peak, and the
fetal heart rate returns to baseline after the contraction ends. Which
interpretation is most appropriate?
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Sinusoidal pattern
Answer: B. Late deceleration
Rationale: Late decelerations are gradual decreases in fetal heart rate
associated with uteroplacental insufficiency. The onset, nadir, and
recovery occur after the corresponding points of the contraction.
3
, Recurrent late decelerations are concerning, particularly when
accompanied by minimal or absent variability. Maternal repositioning,
assessment of uterine activity, correction of hypotension,
discontinuation or reduction of uterotonic agents when appropriate,
and other intrauterine resuscitative measures may be required.
6. During a contraction, the fetal heart rate gradually decreases from
140 to 115 beats/min, reaches its nadir at approximately the peak
of the contraction, and returns to baseline by the end of the
contraction. Which type of deceleration is this?
A. Early
B. Late
C. Variable
D. Prolonged
Answer: A. Early
Rationale: Early decelerations are gradual decreases and returns to
baseline that mirror the contraction. The nadir generally corresponds
with the peak of the contraction. They are classically associated with
fetal head compression and are usually considered benign when they
occur without other concerning abnormalities. Routine corrective
intervention is generally unnecessary when the remainder of the
tracing is reassuring.
7. A patient receiving oxytocin has contractions occurring every 1.5–
2 minutes, each lasting approximately 90 seconds. Which finding
meets the definition of tachysystole?
A. More than three contractions in 10 minutes
B. More than five contractions in 10 minutes averaged over 30 minutes
C. Any contraction lasting longer than 60 seconds
D. Two contractions occurring within 5 minutes
4
PRACTICE EXAM WITH ACTUAL
QUESTIONS AND VERIFIED ANSWERS,
PLUS EXPLAINED RATIONALES/EXPERT
VERIFIED FOR GUARANTEED 100% PASS
2026/LATEST UPDATE/INSTANT
DOWNLOAD PDF
1. A 29-year-old G2P1 at 39 weeks is undergoing continuous
electronic fetal monitoring during spontaneous labor. The fetal
heart rate baseline is 145 beats/min, variability is moderate, and
there are accelerations of 15 beats/min lasting 15 seconds. No
decelerations are present. Which interpretation is most
appropriate?
A. Category I tracing with reassuring fetal status
B. Category II tracing because accelerations are present
C. Category III tracing because the baseline exceeds 140 beats/min
D. Category II tracing because the variability is moderate
Answer: A. Category I tracing with reassuring fetal status
Rationale: A Category I tracing includes a baseline of 110–160
beats/min, moderate variability, and absence of late or variable
decelerations. Accelerations may be present or absent. This pattern is
strongly reassuring and is associated with normal fetal acid-base
status at the time of observation. A baseline of 145 beats/min is
normal, and moderate variability is reassuring.
2. During labor, the fetal heart rate baseline is 165 beats/min for 12
minutes. Variability remains moderate, and there are no
1
, decelerations. What is the most accurate classification of the
baseline?
A. Normal baseline
B. Fetal bradycardia
C. Fetal tachycardia
D. Sinusoidal pattern
Answer: C. Fetal tachycardia
Rationale: Fetal tachycardia is a baseline fetal heart rate greater than
160 beats/min for at least 10 minutes. The baseline of 165 beats/min
persisting for 12 minutes therefore meets the definition. Possible
causes include maternal fever, infection, medications such as beta-
agonists, fetal hypoxemia, maternal dehydration, and fetal arrhythmia.
Moderate variability without recurrent decelerations is reassuring, but
the underlying cause of tachycardia should be evaluated.
3. A fetal heart rate tracing shows a baseline of 135 beats/min with
fluctuations of 6–25 beats/min around the baseline. Which
description best characterizes the variability?
A. Absent
B. Minimal
C. Moderate
D. Marked
Answer: C. Moderate
Rationale: Moderate variability is defined as amplitude fluctuations of
6–25 beats/min. Absent variability means no detectable fluctuation,
minimal variability is detectable but 5 beats/min or less, and marked
variability exceeds 25 beats/min. Moderate variability is one of the
most important reassuring characteristics of a fetal heart rate tracing
because it generally reflects an intact fetal autonomic nervous system
and is associated with adequate oxygenation at the time observed.
2
, 4. A laboring patient's fetal heart rate tracing demonstrates recurrent
abrupt decreases in fetal heart rate from 145 to 90 beats/min, with
rapid return to baseline. The timing varies in relation to
contractions. Which type of deceleration is most likely?
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Prolonged deceleration
Answer: C. Variable deceleration
Rationale: Variable decelerations are abrupt decreases in fetal heart
rate, typically at least 15 beats/min below baseline and lasting at least
15 seconds but less than 2 minutes. Their timing, shape, and
relationship to contractions may vary. They most commonly result
from umbilical cord compression. Recurrent variable decelerations
require assessment and appropriate intrauterine resuscitative
measures when clinically indicated.
5. A fetal heart rate decreases gradually from 145 to 120 beats/min
beginning approximately 30 seconds after the onset of a
contraction. The nadir occurs after the contraction's peak, and the
fetal heart rate returns to baseline after the contraction ends. Which
interpretation is most appropriate?
A. Early deceleration
B. Late deceleration
C. Variable deceleration
D. Sinusoidal pattern
Answer: B. Late deceleration
Rationale: Late decelerations are gradual decreases in fetal heart rate
associated with uteroplacental insufficiency. The onset, nadir, and
recovery occur after the corresponding points of the contraction.
3
, Recurrent late decelerations are concerning, particularly when
accompanied by minimal or absent variability. Maternal repositioning,
assessment of uterine activity, correction of hypotension,
discontinuation or reduction of uterotonic agents when appropriate,
and other intrauterine resuscitative measures may be required.
6. During a contraction, the fetal heart rate gradually decreases from
140 to 115 beats/min, reaches its nadir at approximately the peak
of the contraction, and returns to baseline by the end of the
contraction. Which type of deceleration is this?
A. Early
B. Late
C. Variable
D. Prolonged
Answer: A. Early
Rationale: Early decelerations are gradual decreases and returns to
baseline that mirror the contraction. The nadir generally corresponds
with the peak of the contraction. They are classically associated with
fetal head compression and are usually considered benign when they
occur without other concerning abnormalities. Routine corrective
intervention is generally unnecessary when the remainder of the
tracing is reassuring.
7. A patient receiving oxytocin has contractions occurring every 1.5–
2 minutes, each lasting approximately 90 seconds. Which finding
meets the definition of tachysystole?
A. More than three contractions in 10 minutes
B. More than five contractions in 10 minutes averaged over 30 minutes
C. Any contraction lasting longer than 60 seconds
D. Two contractions occurring within 5 minutes
4
