NCC EFM EXAM VERSION 1,2 AND 3 NEWEST 2025 ACTUAL EXAM COMPLETE 450 QUESTIONS
AND CORRECT DETAILED ANSWERS
The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the next 15
minutes, there are 18 uterine contractions. Recommended management is to
A. Address contraction frequency by reducing pitocin dose
B. Continue to increase pitocin as long as FHR is Category I
C. Turn the patient on her side and initiate an IV fluid bolus - ANSWER-C. Turn the patient on her
side and initiate an IV fluid bolus
A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the fetal heart
tracings have been normal. Spontaneous rupture of membranes occurs; fetal heart rate drops to
90 beats per minute for four minutes and then resumes a normal pattern. The most likely
etiology for this fetal heart rate change is
A. Abnormal fetal presentation
B. Impaired placental circulation
C. Possible cord compression - ANSWER-C. Possible cord compression
A 42 week gestation woman has been diagnosed with oligohydramnios. Based on this, a FHR
change that can be expected is
A. Late deceleration
B. Minimal variability
C. Variable deceleration - ANSWER-C. Variable deceleration
Mono-mono zygotic twins are prone to what type of deceleration during labor?
A. Early
B. Late
C. Variable - ANSWER-C. Variable
,During labor, the recommended fetal heart rate assessment interval for auscultation is every
A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage
B. 15 minutes no matter what stage of labor
C. 60 minutes in the active phase of the first stage and every 30 minutes in second stage -
ANSWER-A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in
second stage
What fetal heart rate characteristics can be determined with auscultation?
A. Baseline
B. Early decelerations
C. Variability - ANSWER-A. Baseline
When auscultating the fetal heart rate, the provider/nurse should simultaneously assess the
maternal
A. Blood pressure
B. Pain level
C. Radial pulse - ANSWER-C. Radial pulse
A woman has 10 fetal movements in one hour. This is considered what kind of movement?
A. Decreased
B. Excessive
C. Normal - ANSWER-C. Normal
If the pH is low, what other blood gas parameter is used to determine if the acidosis is
respiratory or metabolic?
A. HCO3
,B. PCO2
C. PO2 - ANSWER-B. PCO2
The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10
A. Metabolic acidosis
B. Mixed acidosis
C. Respiratory acidosis - ANSWER-C. Respiratory acidosis
A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic fluid was scored
as normal. The expected management is
A. Immediate delivery
B. Repeat the test in 24 hours
C. Schedule the next test in one week - ANSWER-B. Repeat the test in 24 hours
A woman with gestational diabetes is 38 weeks gestation. Her Biophysical Profile score is 4. This
indicates need for
A. Follow up in one week
B. Induction of labor
C. Emergent cesarean section - ANSWER-B. Induction of labor
A 35 week gestation fetus is having an NST. The fetal heart rate baseline is 130 bpm. The nurse is
using vibroacoustic stimulation to reduce the length of time needed to obtain the NST. Fetal
well-being requires
A. 1 acceleration to 145 bpm
B. 2 accelerations to 140 bpm
C. 2 accelerations to at least 145 bpm - ANSWER-C. 2 accelerations to at least 145 bpm
, A woman desires a natural childbirth. The nurse puts pressure on her to get an epidural. This is
an example of going against which ethical principle?
A. Autonomy
B. Beneficence
C. Justice - ANSWER-A. Autonomy
One characteristic of a high reliability perinatal unit is
A. Alarms can only be called by unit leaders
B. Reliance on memorization of protocols
C. The organization creates a safety-oriented culture - ANSWER-C. The organization creates a
safety-oriented culture
One example of evidence-based practice related to fetal monitoring is
A. Diagnosis of uterine rupture with an IUPC
B. Intermittent auscultation for the low-risk patient
C. Using electronic fetal monitoring to prevent cerebral palsy - ANSWER-B. Intermittent
auscultation for the low-risk patient
Supporting the parents decision to choose no extraordinary measures on their baby who is
about to deliver at 24 3/7 weeks gestation despite the nurses personal opinion is an example of
A. Autonomy
B. Beneficence
C. Non-maleficence - ANSWER-A. Autonomy
_______ primarily function(s) to regulate respiratory activity and control circulation by
responding to changes in arterial PO2, PCO2, and acid-base balance.
A. Baroreceptors
AND CORRECT DETAILED ANSWERS
The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the next 15
minutes, there are 18 uterine contractions. Recommended management is to
A. Address contraction frequency by reducing pitocin dose
B. Continue to increase pitocin as long as FHR is Category I
C. Turn the patient on her side and initiate an IV fluid bolus - ANSWER-C. Turn the patient on her
side and initiate an IV fluid bolus
A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the fetal heart
tracings have been normal. Spontaneous rupture of membranes occurs; fetal heart rate drops to
90 beats per minute for four minutes and then resumes a normal pattern. The most likely
etiology for this fetal heart rate change is
A. Abnormal fetal presentation
B. Impaired placental circulation
C. Possible cord compression - ANSWER-C. Possible cord compression
A 42 week gestation woman has been diagnosed with oligohydramnios. Based on this, a FHR
change that can be expected is
A. Late deceleration
B. Minimal variability
C. Variable deceleration - ANSWER-C. Variable deceleration
Mono-mono zygotic twins are prone to what type of deceleration during labor?
A. Early
B. Late
C. Variable - ANSWER-C. Variable
,During labor, the recommended fetal heart rate assessment interval for auscultation is every
A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second stage
B. 15 minutes no matter what stage of labor
C. 60 minutes in the active phase of the first stage and every 30 minutes in second stage -
ANSWER-A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in
second stage
What fetal heart rate characteristics can be determined with auscultation?
A. Baseline
B. Early decelerations
C. Variability - ANSWER-A. Baseline
When auscultating the fetal heart rate, the provider/nurse should simultaneously assess the
maternal
A. Blood pressure
B. Pain level
C. Radial pulse - ANSWER-C. Radial pulse
A woman has 10 fetal movements in one hour. This is considered what kind of movement?
A. Decreased
B. Excessive
C. Normal - ANSWER-C. Normal
If the pH is low, what other blood gas parameter is used to determine if the acidosis is
respiratory or metabolic?
A. HCO3
,B. PCO2
C. PO2 - ANSWER-B. PCO2
The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25, base excess -10
A. Metabolic acidosis
B. Mixed acidosis
C. Respiratory acidosis - ANSWER-C. Respiratory acidosis
A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic fluid was scored
as normal. The expected management is
A. Immediate delivery
B. Repeat the test in 24 hours
C. Schedule the next test in one week - ANSWER-B. Repeat the test in 24 hours
A woman with gestational diabetes is 38 weeks gestation. Her Biophysical Profile score is 4. This
indicates need for
A. Follow up in one week
B. Induction of labor
C. Emergent cesarean section - ANSWER-B. Induction of labor
A 35 week gestation fetus is having an NST. The fetal heart rate baseline is 130 bpm. The nurse is
using vibroacoustic stimulation to reduce the length of time needed to obtain the NST. Fetal
well-being requires
A. 1 acceleration to 145 bpm
B. 2 accelerations to 140 bpm
C. 2 accelerations to at least 145 bpm - ANSWER-C. 2 accelerations to at least 145 bpm
, A woman desires a natural childbirth. The nurse puts pressure on her to get an epidural. This is
an example of going against which ethical principle?
A. Autonomy
B. Beneficence
C. Justice - ANSWER-A. Autonomy
One characteristic of a high reliability perinatal unit is
A. Alarms can only be called by unit leaders
B. Reliance on memorization of protocols
C. The organization creates a safety-oriented culture - ANSWER-C. The organization creates a
safety-oriented culture
One example of evidence-based practice related to fetal monitoring is
A. Diagnosis of uterine rupture with an IUPC
B. Intermittent auscultation for the low-risk patient
C. Using electronic fetal monitoring to prevent cerebral palsy - ANSWER-B. Intermittent
auscultation for the low-risk patient
Supporting the parents decision to choose no extraordinary measures on their baby who is
about to deliver at 24 3/7 weeks gestation despite the nurses personal opinion is an example of
A. Autonomy
B. Beneficence
C. Non-maleficence - ANSWER-A. Autonomy
_______ primarily function(s) to regulate respiratory activity and control circulation by
responding to changes in arterial PO2, PCO2, and acid-base balance.
A. Baroreceptors
