NCC EFM EXAM BREAKDOWN & STUDY GUIDE
QUESTIONS WITH CORRECT ANSWERS.
Content,on,exam,,ANS,-,-Pattern,recognition,&,intervention:,70%
-Physiology:,11%
-Fetal,assessment,methods:,9%
-EFM,equipment:,5%
-Professional,issues:,5%
Pattern,recognition,&,intervention,,ANS,-,-FHR,baseline,✓
-FHR,variability,✓
-FHR,accelerations,✓
-FHR,decelerations,✓
-Normal,uterine,activity,✓
-Abnormal,uterine,activity,✓
-Fetal,dysrhythmias,✓
-Maternal,complications,✓
-Uteroplacental,complications,✓
-Fetal,complications,✓
FHR,Descriptors,,ANS,-,1),Baseline
2),Variability
3),Presence,of,accels
4),Presence,of,decels
5),Changes,in,trends,overtime
FHR,Baseline,,ANS,-,Average,FHR,rounded,to,nearest,5,during,a,10,min,window
-110,to,160
,-excludes,accels,,decels,,&,marked,variability
-must,have,2,mins,to,identify,as,a,baseline,(doesn't,need,to,be,continuous)
Fetal,Bradycardia,,ANS,-,<110,for,≥10,min
-
Causes:,hypotension,(ex:,after,epi),,cord,prolapse,,head,compression,,congenital,defect,,rapid,descent,,ab
ruption,or,rupture,,tachysystole,,post,dates,,hypoglycemia,,lupus,(heart,block)
-
With,↓,O2,,blood,will,be,shunted,to,brain,,heart,,&,adrenals,,eventually,↓,FHR,to,↓,O2,demands,of,heart
,muscle
-Verify,not,mom's,HR,,vaginal,exam,(r/o,prolapse),,resuscitate,,evaluate,arrhythmia,,expedite,delivery
Fetal,Tachycardia,,ANS,-,>160,for,≥10,min
-
Causes:,fetal,anemia,,maternal,fever,or,infection,,fetal,immaturity,(preterm),,SVT,,maternal,anxiety,(catec
holamines),,dehydration,,hyperthyroid,,hypoxia
-Med,causes:,terbutaline,,catecholamines,(epinephrine,,norepi)
-Assess,mom's,temp,&,infection,risk,(GBS,,PROM)
FHR,Variability,,ANS,-,Irregular,in,amplitude,&,frequency,,quantified,by,peak,to,trough
-Caused,by,sympathetic,vs,parasympathetic,,r/t,neuro,maturity
-Less,in,preterm,due,to,undeveloped,CNS
-Absent:,undetectable,,flat
-Minimal:,≤5,bpm,but,detectable
-Moderate:,6-25,bpm
-Marked:,>25,bpm,(indeterminate,baseline),,significance,unknown
Minimal,variability,,ANS,-,≤5,bpm,but,detectable
Sleep,,sedated,,or,sick
-Sleep,cycle:,20-60,mins
-Sedated:,CNS,depressant,(ex:,mag),,1-2,hrs
, -Sick,(acidemia):,unresolved,w,intervention
-Priority:,maximize,oxygenation,(position,,bolus,,O2,if,needed)
Moderate,variability,,ANS,-,6,to,25,bpm
-Reliably,predicts,the,absence,of,metabolic,acidosis,(even,w,decels)
FHR,Accelerations,,ANS,-,Reliably,predicts,absence,of,metabolic,acidemia,(spontaneous,or,stimulated)
-Onset,to,peak,in,<30,sec
-For,≥32,wks:,15x15,(peak,≥15,bpm,above,baseline,lasting,≥15,sec)
-For,<32,wks:,10x10
-Prolonged,accel:,2-9,mins,(at,10,becomes,change,of,baseline)
Early,deceleration,,ANS,-
,Nadir,aligns,w,contraction,peak,,gradual,onset,(≥30,secs,to,nadir),,benign,vagal,response
1),Pressure,on,fetal,head
2),Increased,intracranial,pressure
3),Alteration,in,cerebral,blood,flow
4),Central,vagal,stimulation
5),FHR,deceleration
Periodic,vs,Episodic,,ANS,-,Periodic:,caused,by,contractions
-recurrent:,occurs,w,≥50%,of,contractions,in,20,min
-intermittent:,w,<50%,of,contractions,in,20,mins
Episodic:,spontaneous
Variable,deceleration,,ANS,-,Caused,by,cord,compression
-Interventions:,position,change,,amnioinfusion
-Abrupt,onset:,<30,seconds,from,onset,to,nadir,dropping,≥15,bpm,lasting,15,secs,to,<2min
-Transient,rise,in,PCO2,&,fall,in,PO2
QUESTIONS WITH CORRECT ANSWERS.
Content,on,exam,,ANS,-,-Pattern,recognition,&,intervention:,70%
-Physiology:,11%
-Fetal,assessment,methods:,9%
-EFM,equipment:,5%
-Professional,issues:,5%
Pattern,recognition,&,intervention,,ANS,-,-FHR,baseline,✓
-FHR,variability,✓
-FHR,accelerations,✓
-FHR,decelerations,✓
-Normal,uterine,activity,✓
-Abnormal,uterine,activity,✓
-Fetal,dysrhythmias,✓
-Maternal,complications,✓
-Uteroplacental,complications,✓
-Fetal,complications,✓
FHR,Descriptors,,ANS,-,1),Baseline
2),Variability
3),Presence,of,accels
4),Presence,of,decels
5),Changes,in,trends,overtime
FHR,Baseline,,ANS,-,Average,FHR,rounded,to,nearest,5,during,a,10,min,window
-110,to,160
,-excludes,accels,,decels,,&,marked,variability
-must,have,2,mins,to,identify,as,a,baseline,(doesn't,need,to,be,continuous)
Fetal,Bradycardia,,ANS,-,<110,for,≥10,min
-
Causes:,hypotension,(ex:,after,epi),,cord,prolapse,,head,compression,,congenital,defect,,rapid,descent,,ab
ruption,or,rupture,,tachysystole,,post,dates,,hypoglycemia,,lupus,(heart,block)
-
With,↓,O2,,blood,will,be,shunted,to,brain,,heart,,&,adrenals,,eventually,↓,FHR,to,↓,O2,demands,of,heart
,muscle
-Verify,not,mom's,HR,,vaginal,exam,(r/o,prolapse),,resuscitate,,evaluate,arrhythmia,,expedite,delivery
Fetal,Tachycardia,,ANS,-,>160,for,≥10,min
-
Causes:,fetal,anemia,,maternal,fever,or,infection,,fetal,immaturity,(preterm),,SVT,,maternal,anxiety,(catec
holamines),,dehydration,,hyperthyroid,,hypoxia
-Med,causes:,terbutaline,,catecholamines,(epinephrine,,norepi)
-Assess,mom's,temp,&,infection,risk,(GBS,,PROM)
FHR,Variability,,ANS,-,Irregular,in,amplitude,&,frequency,,quantified,by,peak,to,trough
-Caused,by,sympathetic,vs,parasympathetic,,r/t,neuro,maturity
-Less,in,preterm,due,to,undeveloped,CNS
-Absent:,undetectable,,flat
-Minimal:,≤5,bpm,but,detectable
-Moderate:,6-25,bpm
-Marked:,>25,bpm,(indeterminate,baseline),,significance,unknown
Minimal,variability,,ANS,-,≤5,bpm,but,detectable
Sleep,,sedated,,or,sick
-Sleep,cycle:,20-60,mins
-Sedated:,CNS,depressant,(ex:,mag),,1-2,hrs
, -Sick,(acidemia):,unresolved,w,intervention
-Priority:,maximize,oxygenation,(position,,bolus,,O2,if,needed)
Moderate,variability,,ANS,-,6,to,25,bpm
-Reliably,predicts,the,absence,of,metabolic,acidosis,(even,w,decels)
FHR,Accelerations,,ANS,-,Reliably,predicts,absence,of,metabolic,acidemia,(spontaneous,or,stimulated)
-Onset,to,peak,in,<30,sec
-For,≥32,wks:,15x15,(peak,≥15,bpm,above,baseline,lasting,≥15,sec)
-For,<32,wks:,10x10
-Prolonged,accel:,2-9,mins,(at,10,becomes,change,of,baseline)
Early,deceleration,,ANS,-
,Nadir,aligns,w,contraction,peak,,gradual,onset,(≥30,secs,to,nadir),,benign,vagal,response
1),Pressure,on,fetal,head
2),Increased,intracranial,pressure
3),Alteration,in,cerebral,blood,flow
4),Central,vagal,stimulation
5),FHR,deceleration
Periodic,vs,Episodic,,ANS,-,Periodic:,caused,by,contractions
-recurrent:,occurs,w,≥50%,of,contractions,in,20,min
-intermittent:,w,<50%,of,contractions,in,20,mins
Episodic:,spontaneous
Variable,deceleration,,ANS,-,Caused,by,cord,compression
-Interventions:,position,change,,amnioinfusion
-Abrupt,onset:,<30,seconds,from,onset,to,nadir,dropping,≥15,bpm,lasting,15,secs,to,<2min
-Transient,rise,in,PCO2,&,fall,in,PO2
