Electronic Fetal Monitoring Comprehensive Exam With Actual Solutions.

NCC C-EFM ELECTRONIC
FETAL MONITORING
REVIEW QUESTIONS
WITH ACTUAL
SOLUTIONS.
[Document subtitle]

,Which of the following is true about electronic fetal monitoring (EFM)?



a. It is a reliable tool for the prediction of fetal well-being

b. It is a reliable tool for the prediction of fetal compromise.

c. It is a reliable tool for identifying fetal arrhythmias. - correct ans:Answer: a.



Electronic fetal monitoring (EFM) is a reliable tool for the prediction of fetal
well-being. It is not, however, a reliable tool for the prediction of fetal
compromise. Fetal arrhythmias are best detected by auscultation using a
fetoscope or doppler device.



When choosing a method of fetal monitoring, which of the following is the
least important?



a. Maternal preference

b. Fetal status

c. Provider preference - correct ans:Answer: c



Maternal/fetal status should be considered first when choosing a method of
fetal monitoring, followed by maternal preference, institutional policies, and
national guidelines. Provider preference is the least important factor to
consider.



To best auscultate the fetal heart rate (FHR), the electronic fetal monitor
(EFM) ultrasound transducer should be placed over the fetal:



a. Head

b. Heart

c. Back - correct ans:Answer: c

,The FHR will be best heard if the EFM ultrasound transducer is placed over
the fetal back when the fetus is anterior or over the small parts if posterior.



Signal transmission of the EFM ultrasound transducer may be affected by
any of the following except:



a. Placental position

b. Rupture of membranes

c. Amount of coupling gel - correct ans:Answer: b



Signal transmission of the EFM ultrasound transducer may be more difficult if
the placenta is anterior or if there is not enough coupling gel. Other factors
that may influence signal transmission are maternal habitus, fetal position,
and maternal/fetal movement. Rupture of membranes is only necessary if
using internal monitors.



Which of the following is true concerning the fetal spiral electrode (FSE)?



a. Detects R-to-R intervals to determine FHR

b. May be affected by maternal movement.

c. Can be used on the extremely premature fetus. - correct ans:Answer: a



The fetal spiral electrode uses electronic logic to detect and measure the R-
to-R intervals in consecutive QRS complexes to determine the FHR. Its signal
is not affected by maternal movement, and it cannot be used on an
extremely premature fetus.



The fetal spiral electrode (FSE) is applied directly to the fetus and requires:

, a. Presence of active labor

b. Cervical dilation (≥ 2 cm) and ruptured membranes

c. Determination of presenting part, cervical dilation (≥ 2 cm), and ruptured
membranes - correct ans:Answer: c



The fetal spiral electrode (FSE) is applied directly to the fetus and requires
determination of presenting part, cervical dilation (≥ 2 cm), and ruptured
membranes. The FSE should not be applied to the fetal face, fontanels, or
genitalia.



The fetal spiral electrode (FSE) placed directly on the fetal presenting part
can provide highly accurate continuous detection of FHR. Which of the
following is not a limitation of FSE?



a. May record maternal heart rate in the event of a fetal demise.

b. Requires ruptured membranes.

c. May decrease the risk of infection. - correct ans:Answer: c



Use of the FSE is an invasive procedure with a risk for infection. It is possible
for the FSE to record the maternal heart rate in the case of fetal demise and
does require ruptured membranes.



To confirm that the heart rate shown on the EFM is that of the fetus and not
the mother, the maternal heart rate should be:



a. Palpated upon initiation of EFM (and periodically throughout labor)

b. Assessed using pulse oximetry.

c. Both palpated and assessed using pulse oximetry - correct ans:Answer: c