NCC EFM Exam Breakdown &
Study Guide QUESTIONS AND
VERIFIED CORRECT
ANSWERS GRADED A+
[LATEST 2026-2027] 100%
GUARANTEED PASS
Sinusoidal pattern - CORRECT ANSWER-Visually apparent, smooth, sine wave-like pattern in FHR
lasting ≥20 minutes
-oscillation frequency: 3-5 cycles/min
-no variability classification or reactivity
-r/t severe anemia: previa, hemorrhage, abruption, RH isoimmunization, asphyxia, infection,
cardiac anomaly, twin to twin transfusion, gastroschesis
-Transient if <20min, can be r/t thumb sucking or opioids (stadol, fentanyl)
Interventions - CORRECT ANSWER--Position change: off of vena cava & aorta, least invasive, 1st
line of treatment
-Fluid bolus
-Amnioinfusion (for variables)
-Tocolytics (terb)
,-Ephedrine to ↑ BP
-Supplemental O2: not used w O2 >95%, can cause vasoconstriction, free radical formation,
ocular toxicity if used limit to 15-30min
Category I tracing - CORRECT ANSWER-Normal acid base balance
-Baseline between 110 to 160
-Moderate variability
-No late, variable, or prolonged decels
-May have early decels
-May or may not have accels
Category II tracing - CORRECT ANSWER-Indeterminate acid base balance
-Minimal variability
-Marked variability
-Late or variable decels
-Bradycardia with variability
-Tachycardia
-Prolonged decels
-Absent variability w NO decels
-Absence of induced acccel WITH fetal stimulation
Category III tracing - CORRECT ANSWER-Predictive of abnormal acid base balance at that
moment
-Sinusoidal rhythm: has to last ≥20min, r/t anemia (previa, bleeding, abruption)
-Absent variability WITH one of the following: bradycardia, recurrent late or recurrent variable
decels
-Decide for c/s within 30min
, Normal uterine activity - CORRECT ANSWER-≤5 contractions in 10 mins averaging over 30 min
window
-adequate contractions: q2-3 lasting 80-90s
-intensity: 25-75 mmhg
-resting tone: 10-15 mmhg
-MVU: 200-220 in 10 mins
-intercontraction interval (relaxation time) should be 45-60sec
Tachysystole - CORRECT ANSWER->5 contractions in 10 mins averaged over 30 min window
-tetanic contractions: >90 secs
-position change
-500 LR to dilute uterotonic
-↓ pitocin (see protocol)
-tocolytic (terbutaline)
-O2 if decel
Tachysystole & pitocin - CORRECT ANSWER-With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
-If not resolved in another 15min, pause pit
-If pit's off for <30 min, resume pit at 1/2 of current dose
-If off for >30 min, start @ initial order dose
With fetal intolerance: pit off immediately
Hypertonous labor - CORRECT ANSWER-Frequent & painful but poor quality contractions
occurring in latent labor
-despite increased tone, not enough pressure to cause cx change
Study Guide QUESTIONS AND
VERIFIED CORRECT
ANSWERS GRADED A+
[LATEST 2026-2027] 100%
GUARANTEED PASS
Sinusoidal pattern - CORRECT ANSWER-Visually apparent, smooth, sine wave-like pattern in FHR
lasting ≥20 minutes
-oscillation frequency: 3-5 cycles/min
-no variability classification or reactivity
-r/t severe anemia: previa, hemorrhage, abruption, RH isoimmunization, asphyxia, infection,
cardiac anomaly, twin to twin transfusion, gastroschesis
-Transient if <20min, can be r/t thumb sucking or opioids (stadol, fentanyl)
Interventions - CORRECT ANSWER--Position change: off of vena cava & aorta, least invasive, 1st
line of treatment
-Fluid bolus
-Amnioinfusion (for variables)
-Tocolytics (terb)
,-Ephedrine to ↑ BP
-Supplemental O2: not used w O2 >95%, can cause vasoconstriction, free radical formation,
ocular toxicity if used limit to 15-30min
Category I tracing - CORRECT ANSWER-Normal acid base balance
-Baseline between 110 to 160
-Moderate variability
-No late, variable, or prolonged decels
-May have early decels
-May or may not have accels
Category II tracing - CORRECT ANSWER-Indeterminate acid base balance
-Minimal variability
-Marked variability
-Late or variable decels
-Bradycardia with variability
-Tachycardia
-Prolonged decels
-Absent variability w NO decels
-Absence of induced acccel WITH fetal stimulation
Category III tracing - CORRECT ANSWER-Predictive of abnormal acid base balance at that
moment
-Sinusoidal rhythm: has to last ≥20min, r/t anemia (previa, bleeding, abruption)
-Absent variability WITH one of the following: bradycardia, recurrent late or recurrent variable
decels
-Decide for c/s within 30min
, Normal uterine activity - CORRECT ANSWER-≤5 contractions in 10 mins averaging over 30 min
window
-adequate contractions: q2-3 lasting 80-90s
-intensity: 25-75 mmhg
-resting tone: 10-15 mmhg
-MVU: 200-220 in 10 mins
-intercontraction interval (relaxation time) should be 45-60sec
Tachysystole - CORRECT ANSWER->5 contractions in 10 mins averaged over 30 min window
-tetanic contractions: >90 secs
-position change
-500 LR to dilute uterotonic
-↓ pitocin (see protocol)
-tocolytic (terbutaline)
-O2 if decel
Tachysystole & pitocin - CORRECT ANSWER-With fetal tolerance
-If not resolved in 15min, ↓ pit by 1/2
-If not resolved in another 15min, pause pit
-If pit's off for <30 min, resume pit at 1/2 of current dose
-If off for >30 min, start @ initial order dose
With fetal intolerance: pit off immediately
Hypertonous labor - CORRECT ANSWER-Frequent & painful but poor quality contractions
occurring in latent labor
-despite increased tone, not enough pressure to cause cx change
