NCC ELECTRONIC FETAL
MONITORING CERTIFICATION FINAL
EXAM QUESTIONS AND ANSWERS
1. Which physiological mechanism is primarily responsible for the development of late
decelerations?
A. Parasympathetic response to head compression
B. Baroreceptor-mediated response to umbilical cord compression
C. Chemoreceptor-mediated reflex to fetal hypoxemia
D. Direct myocardial depression from severe acidemia
Answer: C
Conceptual Explanation: Late decelerations are typically a chemoreceptor-mediated
reflex response to fetal hypoxemia caused by uteroplacental insufficiency.
2. A fetal heart rate (FHR) tracing shows a baseline of 145 bpm, moderate variability, and
recurrent variable decelerations. What is the correct NICHD Category?
A. Category I
B. Category III
,C. Category II
D. Category IV
Answer: C
Conceptual Explanation: Category II includes all FHR tracings that are not Category I or
Category III. Recurrent variable decelerations with moderate variability fall into Category
II.
3. What is the defining characteristic of a sinusoidal FHR pattern?
A. Cycle frequency of 3-5 per minute for at least 20 minutes
B. Zig-zag pattern with amplitude greater than 25 bpm
C. Abrupt accelerations followed by prolonged decelerations
D. Absent variability with a baseline rate below 110 bpm
Answer: A
Conceptual Explanation: A true sinusoidal pattern is a smooth, sine wave-like undulating
pattern with a cycle frequency of 3-5 per minute that persists for 20 minutes or more.
4. Which of the following umbilical cord gas results is most indicative of metabolic acidemia?
A. pH 7.05, pCO2 50, Base Deficit 14
B. pH 7.15, pCO2 65, Base Deficit 4
C. pH 7.25, pCO2 40, Base Deficit 2
, D. pH 7.10, pCO2 80, Base Deficit 6
Answer: A
Conceptual Explanation: Metabolic acidemia is characterized by a low pH and a high base
deficit (usually >12 mmol/L) with a relatively normal pCO2.
5. Uterine tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a
how many minute window?
A. 10 minutes
B. 20 minutes
C. 60 minutes
D. 30 minutes
Answer: D
Conceptual Explanation: Uterine tachysystole is defined as more than five contractions in
10 minutes, averaged over a 30-minute window.
6. The primary goal of amnioinfusion is to treat which of the following?
A. Recurrent late decelerations
B. Recurrent variable decelerations
C. Fetal tachycardia
D. Meconium-stained amniotic fluid
MONITORING CERTIFICATION FINAL
EXAM QUESTIONS AND ANSWERS
1. Which physiological mechanism is primarily responsible for the development of late
decelerations?
A. Parasympathetic response to head compression
B. Baroreceptor-mediated response to umbilical cord compression
C. Chemoreceptor-mediated reflex to fetal hypoxemia
D. Direct myocardial depression from severe acidemia
Answer: C
Conceptual Explanation: Late decelerations are typically a chemoreceptor-mediated
reflex response to fetal hypoxemia caused by uteroplacental insufficiency.
2. A fetal heart rate (FHR) tracing shows a baseline of 145 bpm, moderate variability, and
recurrent variable decelerations. What is the correct NICHD Category?
A. Category I
B. Category III
,C. Category II
D. Category IV
Answer: C
Conceptual Explanation: Category II includes all FHR tracings that are not Category I or
Category III. Recurrent variable decelerations with moderate variability fall into Category
II.
3. What is the defining characteristic of a sinusoidal FHR pattern?
A. Cycle frequency of 3-5 per minute for at least 20 minutes
B. Zig-zag pattern with amplitude greater than 25 bpm
C. Abrupt accelerations followed by prolonged decelerations
D. Absent variability with a baseline rate below 110 bpm
Answer: A
Conceptual Explanation: A true sinusoidal pattern is a smooth, sine wave-like undulating
pattern with a cycle frequency of 3-5 per minute that persists for 20 minutes or more.
4. Which of the following umbilical cord gas results is most indicative of metabolic acidemia?
A. pH 7.05, pCO2 50, Base Deficit 14
B. pH 7.15, pCO2 65, Base Deficit 4
C. pH 7.25, pCO2 40, Base Deficit 2
, D. pH 7.10, pCO2 80, Base Deficit 6
Answer: A
Conceptual Explanation: Metabolic acidemia is characterized by a low pH and a high base
deficit (usually >12 mmol/L) with a relatively normal pCO2.
5. Uterine tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a
how many minute window?
A. 10 minutes
B. 20 minutes
C. 60 minutes
D. 30 minutes
Answer: D
Conceptual Explanation: Uterine tachysystole is defined as more than five contractions in
10 minutes, averaged over a 30-minute window.
6. The primary goal of amnioinfusion is to treat which of the following?
A. Recurrent late decelerations
B. Recurrent variable decelerations
C. Fetal tachycardia
D. Meconium-stained amniotic fluid
