NCC C-EFM® 2024–2025 Full ACTUAL Exam:
Realistic Questions with Verified Answers and
Rationales (Graded A+) |DELIVERED AS
INSTSANT PDF DOWNLOAND
Question 1 – Fetal Bradycardia
A 40-week patient’s FHR baseline is 100 bpm with moderate variability and
occasional late decelerations.
Answer: Fetal bradycardia with non-reassuring features; evaluate for
immediate intervention
Rationale:
Bradycardia <110 bpm is abnormal.
Late decelerations indicate uteroplacental insufficiency.
Requires intrauterine resuscitation and urgent evaluation; may need delivery
if persistent.
Question 2 – Reassuring Pattern
A patient at 38 weeks has FHR 145 bpm, moderate variability, 2 accelerations of
20 bpm for 20 seconds over 20 minutes, no decelerations.
Answer: Reassuring; normal fetal status
Rationale:
Baseline 110–160 bpm, moderate variability, and reactive accelerations
indicate fetal well-being.
No intervention needed beyond routine monitoring.
,Question 3 – Late Decelerations with Tachycardia
FHR baseline 165 bpm, minimal variability, recurrent late decelerations. Maternal
temp 101°F.
Answer: Category II–III; intrauterine resuscitation and assess for infection or
hypoxia
Rationale:
Fetal tachycardia + late decelerations = concern for hypoxia or maternal
infection.
Initiate resuscitation: repositioning, oxygen, IV fluids, consider delivery if
unresolved.
Question 4 – Variable Deceleration with Shoulder
FHR baseline 140 bpm, moderate variability, variable decelerations with shoulder
noted, no accelerations.
Answer: Variable decelerations; perform intrauterine resuscitation
Rationale:
Shoulder in variable deceleration indicates partial cord compression.
Interventions: maternal repositioning, oxygen, IV fluids, stop oxytocin if
infused.
Question 5 – Accelerations During Contraction
FHR baseline 145 bpm, moderate variability, accelerations present during
contractions.
Answer: Normal; reassuring fetal status
Rationale:
Accelerations during contractions show adequate fetal oxygenation.
No intervention required.
, Question 6 – Prolonged Deceleration After Epidural
FHR drops from 145 to 90 bpm for 4 minutes immediately after epidural
placement.
Answer: Prolonged deceleration; initiate intrauterine resuscitation and assess
maternal hypotension
Rationale:
Epidural-induced maternal hypotension is a common cause.
Interventions: maternal reposition, IV fluids, oxygen, vasopressors if
needed.
Question 7 – Minimal Variability Without Decelerations
FHR 140 bpm, minimal variability, no decelerations, patient resting quietly.
Answer: Likely fetal sleep; continue monitoring
Rationale:
Short episodes of minimal variability (<30–60 min) are normal during fetal
rest.
Reassess if persists or other non-reassuring signs appear.
Question 8 – Sinusoidal Pattern in Preterm Fetus
FHR shows smooth, undulating sinusoidal pattern, baseline 150 bpm, absent
accelerations.
Answer: Category III; urgent evaluation for fetal anemia or hypoxia
Rationale:
Sinusoidal pattern indicates severe fetal compromise.
Immediate evaluation and preparation for possible delivery required.
Realistic Questions with Verified Answers and
Rationales (Graded A+) |DELIVERED AS
INSTSANT PDF DOWNLOAND
Question 1 – Fetal Bradycardia
A 40-week patient’s FHR baseline is 100 bpm with moderate variability and
occasional late decelerations.
Answer: Fetal bradycardia with non-reassuring features; evaluate for
immediate intervention
Rationale:
Bradycardia <110 bpm is abnormal.
Late decelerations indicate uteroplacental insufficiency.
Requires intrauterine resuscitation and urgent evaluation; may need delivery
if persistent.
Question 2 – Reassuring Pattern
A patient at 38 weeks has FHR 145 bpm, moderate variability, 2 accelerations of
20 bpm for 20 seconds over 20 minutes, no decelerations.
Answer: Reassuring; normal fetal status
Rationale:
Baseline 110–160 bpm, moderate variability, and reactive accelerations
indicate fetal well-being.
No intervention needed beyond routine monitoring.
,Question 3 – Late Decelerations with Tachycardia
FHR baseline 165 bpm, minimal variability, recurrent late decelerations. Maternal
temp 101°F.
Answer: Category II–III; intrauterine resuscitation and assess for infection or
hypoxia
Rationale:
Fetal tachycardia + late decelerations = concern for hypoxia or maternal
infection.
Initiate resuscitation: repositioning, oxygen, IV fluids, consider delivery if
unresolved.
Question 4 – Variable Deceleration with Shoulder
FHR baseline 140 bpm, moderate variability, variable decelerations with shoulder
noted, no accelerations.
Answer: Variable decelerations; perform intrauterine resuscitation
Rationale:
Shoulder in variable deceleration indicates partial cord compression.
Interventions: maternal repositioning, oxygen, IV fluids, stop oxytocin if
infused.
Question 5 – Accelerations During Contraction
FHR baseline 145 bpm, moderate variability, accelerations present during
contractions.
Answer: Normal; reassuring fetal status
Rationale:
Accelerations during contractions show adequate fetal oxygenation.
No intervention required.
, Question 6 – Prolonged Deceleration After Epidural
FHR drops from 145 to 90 bpm for 4 minutes immediately after epidural
placement.
Answer: Prolonged deceleration; initiate intrauterine resuscitation and assess
maternal hypotension
Rationale:
Epidural-induced maternal hypotension is a common cause.
Interventions: maternal reposition, IV fluids, oxygen, vasopressors if
needed.
Question 7 – Minimal Variability Without Decelerations
FHR 140 bpm, minimal variability, no decelerations, patient resting quietly.
Answer: Likely fetal sleep; continue monitoring
Rationale:
Short episodes of minimal variability (<30–60 min) are normal during fetal
rest.
Reassess if persists or other non-reassuring signs appear.
Question 8 – Sinusoidal Pattern in Preterm Fetus
FHR shows smooth, undulating sinusoidal pattern, baseline 150 bpm, absent
accelerations.
Answer: Category III; urgent evaluation for fetal anemia or hypoxia
Rationale:
Sinusoidal pattern indicates severe fetal compromise.
Immediate evaluation and preparation for possible delivery required.
