NCC ELECTRONIC FETAL MONITORING
CERTIFICATION (EFM) EXAM, PRACTICE EXAM
AND TEST BANK 2025/2026 | ACCURATE REAL
EXAM QUESTIONS AND ANSWERS | EXPERT
VERIFIED FOR GUARANTEED PASS | GRADED
A
Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above
e. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing its heart rate.
c. Increases cardiac output by increasing fetal movement.
b. Increases cardiac output by increasing its heart rate.
Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change
a. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D
g. C & D
The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect on the FHR baseline?
a. Increases baseline
b. Decreases baseline
b. Decreases baseline
[True or False] || Oxygen exchange in the placenta takes place in the intervillous space.
True
[True or False] || The parasympathetic nervous system is a cardioaccelerator.
_______ denotes an increase in hydrogen ions in the fetal tissues.
,A. Acidosis
B. Acidemia
C. Hypercapnia
A. Acidosis
_______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon
dioxide (PCO2) values.
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
A. Metabolic acidosis
_______ _______ occurs when there is high PCO2 with normal bicarbonate levels.
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
B. Respiratory acidosis
_______ _______ occurs when the HCO3 concentration is lower than normal.
A. Base deficit
B. Base excess
C. Metabolic acidosis
A. Base deficit
_______ _______ occurs when the HCO3 concentration is higher than normal.
A. Base deficit
B. Base excess
C. Metabolic acidosis
B. Base excess
_______ is defined as the energy-consuming process of metabolism.
Anabolism
_______ is defined as the energy-releasing process of metabolism.
Catabolism
[True or False] || It is an appropriate intervention to perform fetal scalp stimulation during a deceleration.
False
Normal oxygen saturation for the fetus in labor is ___% to ___%.
30% to 65%
A key point regarding the occurrence of tachysystole is that
A. It requires FHR decelerations to be significant
B. It can occur in spontaneous or stimulated labor
C. It should be documented as hyperstimulation if oxytocin is being used
B. It can occur in spontaneous or stimulated labor
A Category II tracing
A. Predicts abnormal fetal acid-base status
B. Excludes abnormal fetal acid-base status
C. Is not predictive of abnormal fetal acid-base status
C. Is not predictive of abnormal fetal acid-base status
Plans of the health care team with a patient with a sinusoidal FHR pattern may include
A. Administration of an NST
B. Administration of tocolytics
C. Kleinhauer-Betke lab test
C. Kleinhauer-Betke lab test
Stimulation of the fetal vagus nerve will
A. Increase FHR
B. Decrease FHR
C. Initially increase, then decrease FHR
B. Decrease FHR
Which of the following is not true when assessing preterm fetuses?
,A. FHR baseline may be in upper range of normal (150-160 bpm)
B. They may have fewer accels, and if <35 weeks, may be 10x10
C. Variability may be in lower range for moderate (6-10 bpm)
B. They may have fewer accels, and if <35 weeks, may be 10x10
One of the side effects of terbutaline as a tocolytic is
A. Fetal bradycardia
B. Increased oxygen consumption
C. Marked variability
B. Increased oxygen consumption
Common problems seen during monitoring of postterm fetuses include all of the following except
A. Baseline may be 100-110bpm
B. Increased variables
C. Polyhydramnios
C. Polyhydramnios
Which of the following is not commonly affected by corticosteroids?
A. Doppler flow studies
B. FHR baseline
C. Frequency of FHR accelerations
A. Doppler flow studies
A fetus of a diabetic mother may commonly develop
A. Polyhydramnios
B. Supraventricular tachycardia
C. Third-degree heart block
A. Polyhydramnios
The fetus of a mother with preeclampsia is at high risk for developing
A. Intrauterine growth restriction (IUGR)
B. Macrosomia
C. Polyhydramnios
A. Intrauterine growth restriction (IUGR)
Maternal infection most often results in
A. Fetal tachycardia
B. Moderate variability
C. Placenta previa
A. Fetal tachycardia
Uncontrolled maternal hypertension is often a causative factor in
A. Postmaturity
B. Preterm contractions
C. Placental abruption
C. Placental abruption
EFM is an excellent _____ test for determining the presence or absence of neurological injury.
A. Definitive
B. Diagnostic
C. Screening
C. Screening
The primary assumption when using EFM is that _____ produces physiological changes that can be detected by
changes in the FHR.
A. Disruption of oxygen
B. Labor induction
C. Parity
A. Disruption of oxygen
The primary difference between intermittent auscultation (IA) and EFM is
A. EFM is primarily a visual assessment
B. IA is associated with worse outcomes
C. IA is less labor-intensive than EFM
, A. EFM is primarily a visual assessment
The tocodynamometer is completely unreliable for
A. Contraction duration
B. Contraction frequency
C. Contraction intensity
C. Contraction intensity
High resting tone may occur with an IUPC because of all of the following except
A. Extraovular placement
B. Maternal BMI
C. Multiple gestations
B. Maternal BMI
All of the following are disadvantages of the ultrasound transducer for monitoring the FHR except
A. It is noninvasive
B. It may half or double the actual FHR
C. It restricts patient movement
A. It is noninvasive
The internal scalp electrode works by
A. Detecting heart motion
B. Measuring the R-to-R interval of the fetal ECG
C. Sensing the opening and closing of the fetal heart valves
B. Measuring the R-to-R interval of the fetal ECG
When educating the patient about the ultrasound transducer, the nurse should include the following:
A. Contraction strength can alter the ability to monitor the FHR
B. If baby moves, the tracing may "drop" or become erratic
C. The ultrasound detects electrical activity of the fetal heart
B. If baby moves, the tracing may "drop" or become erratic
When educating the patient about the IUPC, the nurse should include the following:
A. Can't get out of bed
B. Does not accurately measure contraction strength
C. Measures the FHR more accurately
A. Can't get out of bed
Intrinsic factors are those that are
A. External to the fetus
B. Internal to the fetus
C. Related to the mother
B. Internal to the fetus
The parasympathetic branch of the autonomic nervous system
A. Decreases FHR
B. Increases contractility of the fetal heart
C. Increases FHR
A. Decreases FHR
Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system?
A. Acetylcholine
B. Dopamine
C. Norepinephrine
C. Norepinephrine
Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous
system?
A. Acetylcholine
B. Dopamine
C. Norepinephrine
A. Acetylcholine
Which of the following is responsible for variations in the FHR and fetal behavioral states?
CERTIFICATION (EFM) EXAM, PRACTICE EXAM
AND TEST BANK 2025/2026 | ACCURATE REAL
EXAM QUESTIONS AND ANSWERS | EXPERT
VERIFIED FOR GUARANTEED PASS | GRADED
A
Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above
e. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing its heart rate.
c. Increases cardiac output by increasing fetal movement.
b. Increases cardiac output by increasing its heart rate.
Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change
a. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D
g. C & D
The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect on the FHR baseline?
a. Increases baseline
b. Decreases baseline
b. Decreases baseline
[True or False] || Oxygen exchange in the placenta takes place in the intervillous space.
True
[True or False] || The parasympathetic nervous system is a cardioaccelerator.
_______ denotes an increase in hydrogen ions in the fetal tissues.
,A. Acidosis
B. Acidemia
C. Hypercapnia
A. Acidosis
_______ _______ occurs when there is low bicarbonate (base excess) in the presence of normal pressure of carbon
dioxide (PCO2) values.
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
A. Metabolic acidosis
_______ _______ occurs when there is high PCO2 with normal bicarbonate levels.
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
B. Respiratory acidosis
_______ _______ occurs when the HCO3 concentration is lower than normal.
A. Base deficit
B. Base excess
C. Metabolic acidosis
A. Base deficit
_______ _______ occurs when the HCO3 concentration is higher than normal.
A. Base deficit
B. Base excess
C. Metabolic acidosis
B. Base excess
_______ is defined as the energy-consuming process of metabolism.
Anabolism
_______ is defined as the energy-releasing process of metabolism.
Catabolism
[True or False] || It is an appropriate intervention to perform fetal scalp stimulation during a deceleration.
False
Normal oxygen saturation for the fetus in labor is ___% to ___%.
30% to 65%
A key point regarding the occurrence of tachysystole is that
A. It requires FHR decelerations to be significant
B. It can occur in spontaneous or stimulated labor
C. It should be documented as hyperstimulation if oxytocin is being used
B. It can occur in spontaneous or stimulated labor
A Category II tracing
A. Predicts abnormal fetal acid-base status
B. Excludes abnormal fetal acid-base status
C. Is not predictive of abnormal fetal acid-base status
C. Is not predictive of abnormal fetal acid-base status
Plans of the health care team with a patient with a sinusoidal FHR pattern may include
A. Administration of an NST
B. Administration of tocolytics
C. Kleinhauer-Betke lab test
C. Kleinhauer-Betke lab test
Stimulation of the fetal vagus nerve will
A. Increase FHR
B. Decrease FHR
C. Initially increase, then decrease FHR
B. Decrease FHR
Which of the following is not true when assessing preterm fetuses?
,A. FHR baseline may be in upper range of normal (150-160 bpm)
B. They may have fewer accels, and if <35 weeks, may be 10x10
C. Variability may be in lower range for moderate (6-10 bpm)
B. They may have fewer accels, and if <35 weeks, may be 10x10
One of the side effects of terbutaline as a tocolytic is
A. Fetal bradycardia
B. Increased oxygen consumption
C. Marked variability
B. Increased oxygen consumption
Common problems seen during monitoring of postterm fetuses include all of the following except
A. Baseline may be 100-110bpm
B. Increased variables
C. Polyhydramnios
C. Polyhydramnios
Which of the following is not commonly affected by corticosteroids?
A. Doppler flow studies
B. FHR baseline
C. Frequency of FHR accelerations
A. Doppler flow studies
A fetus of a diabetic mother may commonly develop
A. Polyhydramnios
B. Supraventricular tachycardia
C. Third-degree heart block
A. Polyhydramnios
The fetus of a mother with preeclampsia is at high risk for developing
A. Intrauterine growth restriction (IUGR)
B. Macrosomia
C. Polyhydramnios
A. Intrauterine growth restriction (IUGR)
Maternal infection most often results in
A. Fetal tachycardia
B. Moderate variability
C. Placenta previa
A. Fetal tachycardia
Uncontrolled maternal hypertension is often a causative factor in
A. Postmaturity
B. Preterm contractions
C. Placental abruption
C. Placental abruption
EFM is an excellent _____ test for determining the presence or absence of neurological injury.
A. Definitive
B. Diagnostic
C. Screening
C. Screening
The primary assumption when using EFM is that _____ produces physiological changes that can be detected by
changes in the FHR.
A. Disruption of oxygen
B. Labor induction
C. Parity
A. Disruption of oxygen
The primary difference between intermittent auscultation (IA) and EFM is
A. EFM is primarily a visual assessment
B. IA is associated with worse outcomes
C. IA is less labor-intensive than EFM
, A. EFM is primarily a visual assessment
The tocodynamometer is completely unreliable for
A. Contraction duration
B. Contraction frequency
C. Contraction intensity
C. Contraction intensity
High resting tone may occur with an IUPC because of all of the following except
A. Extraovular placement
B. Maternal BMI
C. Multiple gestations
B. Maternal BMI
All of the following are disadvantages of the ultrasound transducer for monitoring the FHR except
A. It is noninvasive
B. It may half or double the actual FHR
C. It restricts patient movement
A. It is noninvasive
The internal scalp electrode works by
A. Detecting heart motion
B. Measuring the R-to-R interval of the fetal ECG
C. Sensing the opening and closing of the fetal heart valves
B. Measuring the R-to-R interval of the fetal ECG
When educating the patient about the ultrasound transducer, the nurse should include the following:
A. Contraction strength can alter the ability to monitor the FHR
B. If baby moves, the tracing may "drop" or become erratic
C. The ultrasound detects electrical activity of the fetal heart
B. If baby moves, the tracing may "drop" or become erratic
When educating the patient about the IUPC, the nurse should include the following:
A. Can't get out of bed
B. Does not accurately measure contraction strength
C. Measures the FHR more accurately
A. Can't get out of bed
Intrinsic factors are those that are
A. External to the fetus
B. Internal to the fetus
C. Related to the mother
B. Internal to the fetus
The parasympathetic branch of the autonomic nervous system
A. Decreases FHR
B. Increases contractility of the fetal heart
C. Increases FHR
A. Decreases FHR
Which of the following is the primary neurotransmitter of the sympathetic branch of the autonomic nervous system?
A. Acetylcholine
B. Dopamine
C. Norepinephrine
C. Norepinephrine
Which of the following is the primary neurotransmitter of the parasympathetic branch of the autonomic nervous
system?
A. Acetylcholine
B. Dopamine
C. Norepinephrine
A. Acetylcholine
Which of the following is responsible for variations in the FHR and fetal behavioral states?
