C-EFM (Certified Electronic Fetal Monitoring)
CORRECT ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST ALREADY
GRADED A+ (2026/2027).,
Question 1
A nurse is preparing to apply an external fetal monitor.
Which of the following is the correct placement for the
ultrasound transducer to obtain the fetal heart rate?
A) Over the fetal back, where the fetal heart tones are
loudest
B) Over the fetal abdomen, directly over the fetal
stomach
C) Over the maternal symphysis pubis
D) Over the maternal umbilicus
Answer: A
Rationale: The ultrasound transducer for external fetal
monitoring should be placed over the fetal back, where
1
,the fetal heart tones are heard most clearly. This position
provides the strongest signal for the Doppler ultrasound
to detect fetal cardiac motion. Placement over the fetal
abdomen, symphysis pubis, or umbilicus may not capture
the fetal heart rate accurately.
Question 2
Which of the following describes the function of the
tocodynamometer (toco) in external fetal monitoring?
A) Measures the intensity of uterine contractions
B) Measures the frequency and duration of uterine
contractions
C) Measures fetal heart rate variability
D) Measures maternal blood pressure during contractions
Answer: B
Rationale: The tocodynamometer measures the frequency
and duration of uterine contractions by detecting changes
in the contour of the maternal abdomen. It does NOT
2
,measure contraction intensity—only internal intrauterine
pressure catheters (IUPCs) can accurately measure the
intensity (in mmHg) of uterine contractions.
Question 3
An intrauterine pressure catheter (IUPC) provides which of
the following measurements that cannot be obtained with
external monitoring?
A) Fetal heart rate
B) Contraction frequency
C) Contraction intensity in mmHg
D) Fetal movement
Answer: C
Rationale: An IUPC measures the actual pressure of
uterine contractions in mmHg, providing objective data on
contraction intensity. External tocodynamometry only
measures contraction frequency and duration. Fetal heart
rate and fetal movement are not measured by IUPC.
3
, Question 4
A fetal scalp electrode (FSE) is indicated in which of the
following situations?
A) When maternal obesity prevents adequate external
monitoring
B) When fetal heart rate variability needs to be assessed
more accurately
C) When the fetal presenting part is not engaged
D) When the mother has a suspected uterine infection
Answer: A
Rationale: A fetal scalp electrode is indicated when
external monitoring is inadequate—commonly due to
maternal obesity, excessive fetal movement, or poor
signal quality. The FSE provides a more reliable and
continuous fetal heart rate tracing. Contraindications
include maternal infections such as HIV, hepatitis B/C, or
active herpes lesions, as well as fetal bleeding disorders.
4
CORRECT ACTUAL QUESTIONS AND CORRECTLY
WELL DEFINED ANSWERS LATEST ALREADY
GRADED A+ (2026/2027).,
Question 1
A nurse is preparing to apply an external fetal monitor.
Which of the following is the correct placement for the
ultrasound transducer to obtain the fetal heart rate?
A) Over the fetal back, where the fetal heart tones are
loudest
B) Over the fetal abdomen, directly over the fetal
stomach
C) Over the maternal symphysis pubis
D) Over the maternal umbilicus
Answer: A
Rationale: The ultrasound transducer for external fetal
monitoring should be placed over the fetal back, where
1
,the fetal heart tones are heard most clearly. This position
provides the strongest signal for the Doppler ultrasound
to detect fetal cardiac motion. Placement over the fetal
abdomen, symphysis pubis, or umbilicus may not capture
the fetal heart rate accurately.
Question 2
Which of the following describes the function of the
tocodynamometer (toco) in external fetal monitoring?
A) Measures the intensity of uterine contractions
B) Measures the frequency and duration of uterine
contractions
C) Measures fetal heart rate variability
D) Measures maternal blood pressure during contractions
Answer: B
Rationale: The tocodynamometer measures the frequency
and duration of uterine contractions by detecting changes
in the contour of the maternal abdomen. It does NOT
2
,measure contraction intensity—only internal intrauterine
pressure catheters (IUPCs) can accurately measure the
intensity (in mmHg) of uterine contractions.
Question 3
An intrauterine pressure catheter (IUPC) provides which of
the following measurements that cannot be obtained with
external monitoring?
A) Fetal heart rate
B) Contraction frequency
C) Contraction intensity in mmHg
D) Fetal movement
Answer: C
Rationale: An IUPC measures the actual pressure of
uterine contractions in mmHg, providing objective data on
contraction intensity. External tocodynamometry only
measures contraction frequency and duration. Fetal heart
rate and fetal movement are not measured by IUPC.
3
, Question 4
A fetal scalp electrode (FSE) is indicated in which of the
following situations?
A) When maternal obesity prevents adequate external
monitoring
B) When fetal heart rate variability needs to be assessed
more accurately
C) When the fetal presenting part is not engaged
D) When the mother has a suspected uterine infection
Answer: A
Rationale: A fetal scalp electrode is indicated when
external monitoring is inadequate—commonly due to
maternal obesity, excessive fetal movement, or poor
signal quality. The FSE provides a more reliable and
continuous fetal heart rate tracing. Contraindications
include maternal infections such as HIV, hepatitis B/C, or
active herpes lesions, as well as fetal bleeding disorders.
4
