CEFM Exam Questions and Verified Answers Graded A+ 2026/27
what does a category I tracing predict? - a normal acid-base balance
what is the baseline for a category I strip? - 110 to 160 BPM
what is the variability for a category I strip? - moderate (6 to 25 bpm)
what decelerations can be present in a category I strip? - early decelerations
late and variable decelerations must be absent
does a category I tracing have to have accelerations? - no; accelerations are not required
for a category I tracing
category I tracing example -
what does a category II tracing mean? - the acid-base balance is indeterminate
includes anything that is not category I or III
what is the baseline rate of a category II tracing? - - bradycardia WITHOUT absent
variability
- tachycardia
,what is the variability of a category II tracing? - - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
minimal variability example - less than 5 BPM
marked variability example - greater than 25 BPM
are accelerations present in category II tracings after fetal stimulations? - accelerations are
not present after fetal stimulation to classify tracing as category II
what are the possible periodic or episodic decelerations present in category II tracings? - -
recurrent variable decelerations accompanied by minimal or moderate baseline variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or shoulders)
variable deceleration example - an abrupt decrease in FHR below baseline; greater than 15
BPM lasting greater than 15 seconds, but less than 2 minutes from onset to return to baseline
prolonged deceleration example - a decrease in FHR below the baseline of 15 bpm or
more, lasting at least 2 minutes but < 10 minutes from onset to return to baseline
,late deceleration example - a gradual decrease and return to baseline of the fetal heart rate
associated with uterine contractions
what does a category III tracing predict? - predicts abnormal acid-base status
a category III tracing includes either of the following... - - absent baseline FHR variability
and ANY of the following:
- recurrent late decelerations
- recurrent variable decelerations
- bradycardia
- sinusoidal pattern
what does absent variability with recurrent late decelerations or variable deceleration indicate? -
predictive of current or impending fetal asphyxia so severe that fetus is at risk for
neurologic damage and death
what is a sinusoidal pattern? - smooth, wave-like baseline appears 3 to 6 time per minute
can be documented if pattern lasts for > 20 minutes
what do indeterminate and abnormal (category II or III) tracings require? - tracings
require evaluation of possible etiology
, what are some initial assessments and interventions for category II or III tracings? - -
discontinuation of labor stimulating agents
- vaginal examination
- maternal repositioning
- correction of maternal hypotension
- IV fluid bolus of LR solution
- assessment of tachysystole (reduce uterine activity if noted)
- amnioinfusion
- modification of maternal pushing maternal efforts in 2nd stage
- maternal O2 at 10L per non-rebreather (used with minimal variability or recurrent lates that
have not resolved with initial uterine measures)
what is an amnioinfusion? - a transvaginal infusion of room temperature isotonic fluid
(normal saline or lactated ringers) by gravity of infusion pump to compensate for the loss of
amniotic fluid
what are indications for an amnioinfusion? - - laboring preterm women with PPROM
- variable deceleration uncorrectable with conventional interventions
- significant oligohydramnios (AFI < or equal to 5) at term when labor is being induced
how is an amnioinfusion run? - bolus of 250 to 500 mL over 20 to 30 minutes followed by
2-3 mL per minute (max 180 mL per hr)
what does a category I tracing predict? - a normal acid-base balance
what is the baseline for a category I strip? - 110 to 160 BPM
what is the variability for a category I strip? - moderate (6 to 25 bpm)
what decelerations can be present in a category I strip? - early decelerations
late and variable decelerations must be absent
does a category I tracing have to have accelerations? - no; accelerations are not required
for a category I tracing
category I tracing example -
what does a category II tracing mean? - the acid-base balance is indeterminate
includes anything that is not category I or III
what is the baseline rate of a category II tracing? - - bradycardia WITHOUT absent
variability
- tachycardia
,what is the variability of a category II tracing? - - minimal baseline variability
- absent baseline variability WITHOUT recurrent decelerations
- marked variability
minimal variability example - less than 5 BPM
marked variability example - greater than 25 BPM
are accelerations present in category II tracings after fetal stimulations? - accelerations are
not present after fetal stimulation to classify tracing as category II
what are the possible periodic or episodic decelerations present in category II tracings? - -
recurrent variable decelerations accompanied by minimal or moderate baseline variability
- prolonged deceleration > 2 minutes but < 10 minutes
- recurrent late decelerations with moderate baseline variability
- variable decelerations with other characters (slow return to baseline or shoulders)
variable deceleration example - an abrupt decrease in FHR below baseline; greater than 15
BPM lasting greater than 15 seconds, but less than 2 minutes from onset to return to baseline
prolonged deceleration example - a decrease in FHR below the baseline of 15 bpm or
more, lasting at least 2 minutes but < 10 minutes from onset to return to baseline
,late deceleration example - a gradual decrease and return to baseline of the fetal heart rate
associated with uterine contractions
what does a category III tracing predict? - predicts abnormal acid-base status
a category III tracing includes either of the following... - - absent baseline FHR variability
and ANY of the following:
- recurrent late decelerations
- recurrent variable decelerations
- bradycardia
- sinusoidal pattern
what does absent variability with recurrent late decelerations or variable deceleration indicate? -
predictive of current or impending fetal asphyxia so severe that fetus is at risk for
neurologic damage and death
what is a sinusoidal pattern? - smooth, wave-like baseline appears 3 to 6 time per minute
can be documented if pattern lasts for > 20 minutes
what do indeterminate and abnormal (category II or III) tracings require? - tracings
require evaluation of possible etiology
, what are some initial assessments and interventions for category II or III tracings? - -
discontinuation of labor stimulating agents
- vaginal examination
- maternal repositioning
- correction of maternal hypotension
- IV fluid bolus of LR solution
- assessment of tachysystole (reduce uterine activity if noted)
- amnioinfusion
- modification of maternal pushing maternal efforts in 2nd stage
- maternal O2 at 10L per non-rebreather (used with minimal variability or recurrent lates that
have not resolved with initial uterine measures)
what is an amnioinfusion? - a transvaginal infusion of room temperature isotonic fluid
(normal saline or lactated ringers) by gravity of infusion pump to compensate for the loss of
amniotic fluid
what are indications for an amnioinfusion? - - laboring preterm women with PPROM
- variable deceleration uncorrectable with conventional interventions
- significant oligohydramnios (AFI < or equal to 5) at term when labor is being induced
how is an amnioinfusion run? - bolus of 250 to 500 mL over 20 to 30 minutes followed by
2-3 mL per minute (max 180 mL per hr)
