NCC EFM PRACTICE EXAMINATION TEST 2026
FULL SOLVED QUESTIONS AND SOLUTIONS
◉ Normal baseline. Answer: 110-160
◉ Accelerations. Answer: abrupt increase of at least 15 bpm in FHR
above the baseline; onset to peak less than 30 seconds, =/>15
seconds, less than 2 minutes from onset to return to baseline
◉ Accelerations at >/. Answer: 32 weeks gestations = 15 beats x 15
seconds; 28-32 weeks 10 x 10; whether spontaneous or provoked,
they are predictive of adequate central fetal oxygenation and a pH of
at least 7.19; rule out acidemia at time they are observed
◉ Vibroacoustic/scalp stimulation. Answer: during sleep periods;
never attempt to stimulate a stressed baby
◉ Prolonged acceleration. Answer: 2-10 minutes
◉ Change in baseline. Answer: >10 minutes
,◉ Early decelerations. Answer: usually symmetrical, graduate
decrease in FHR; >30 seconds from onset to nadir; nadir of
deceleration occurs at the same time as peak of the contraction
◉ Late decelerations. Answer: usually symmetrical, gradual
decrease in FHR; >/=30 seconds from onset to nadir; nadir of
deceleration after the peak of the contraction; subtle "depth" still
counts as late decelerations
◉ Variable decelerations. Answer: abrupt < 30 seconds deceleration
to the nadir. Decrease in FHR below the baseline =/> 15 bpm lasting
15 seconds or more, <2 minutes from onset to return to baseline;
can vary with morphology
◉ Prolonged decelerations. Answer: FHR decrease below baseline
by 15 bpm lasting 2-10 minutes; may be followed by
overcompensation/increased baseline; can be from tachysystole,
placental abruption, maternal hypotension, uterine rupture,
maternal hypoxia, cord accidents, terminal fetal conditions, rapid
fetal descent
◉ Sinusoidal FHR. Answer: smooth, sine-line, 3-5 cycles per minute,
must be present for 20 minutes to diagnose; caused by fetal anemia
or severe hypoxia/acidosis; may be drug-induced (staydol); category
3
, ◉ Periodic decelerations. Answer: associated with uterine
contractions (period cramping); e.g. late decelerations
◉ Episodic decelerations. Answer: not associated with uterine
contractions; e.g. variables
◉ Recurrent. Answer: decelerations that occur >/=50% of uterine
contractions within a 20 minute period; vs. intermittent (<50% of
ctx)
◉ Baseline variability. Answer: irregular fluctuations in baseline
FHR; peak to trough; absent is undetectable; minimal 1-5, moderate
6-25, marked >25
◉ Decreased variability. Answer: hypoxia, sleep cycle, drugs,
anomalies, prematurity, tachycardia
◉ Increased variability. Answer: fetal activity, fetal stimulation,
alpha-adrenergic activity; in absence or abnormal FHR changes,
marked variability is not ass'd with acidemia
◉ Fetal tachycardia. Answer: hypoxia, maternal fever, medications
(terbutaline), maternal thyroid disease, fetal anemia/heart failure,
amnionitis, fetal arrhythmia
FULL SOLVED QUESTIONS AND SOLUTIONS
◉ Normal baseline. Answer: 110-160
◉ Accelerations. Answer: abrupt increase of at least 15 bpm in FHR
above the baseline; onset to peak less than 30 seconds, =/>15
seconds, less than 2 minutes from onset to return to baseline
◉ Accelerations at >/. Answer: 32 weeks gestations = 15 beats x 15
seconds; 28-32 weeks 10 x 10; whether spontaneous or provoked,
they are predictive of adequate central fetal oxygenation and a pH of
at least 7.19; rule out acidemia at time they are observed
◉ Vibroacoustic/scalp stimulation. Answer: during sleep periods;
never attempt to stimulate a stressed baby
◉ Prolonged acceleration. Answer: 2-10 minutes
◉ Change in baseline. Answer: >10 minutes
,◉ Early decelerations. Answer: usually symmetrical, graduate
decrease in FHR; >30 seconds from onset to nadir; nadir of
deceleration occurs at the same time as peak of the contraction
◉ Late decelerations. Answer: usually symmetrical, gradual
decrease in FHR; >/=30 seconds from onset to nadir; nadir of
deceleration after the peak of the contraction; subtle "depth" still
counts as late decelerations
◉ Variable decelerations. Answer: abrupt < 30 seconds deceleration
to the nadir. Decrease in FHR below the baseline =/> 15 bpm lasting
15 seconds or more, <2 minutes from onset to return to baseline;
can vary with morphology
◉ Prolonged decelerations. Answer: FHR decrease below baseline
by 15 bpm lasting 2-10 minutes; may be followed by
overcompensation/increased baseline; can be from tachysystole,
placental abruption, maternal hypotension, uterine rupture,
maternal hypoxia, cord accidents, terminal fetal conditions, rapid
fetal descent
◉ Sinusoidal FHR. Answer: smooth, sine-line, 3-5 cycles per minute,
must be present for 20 minutes to diagnose; caused by fetal anemia
or severe hypoxia/acidosis; may be drug-induced (staydol); category
3
, ◉ Periodic decelerations. Answer: associated with uterine
contractions (period cramping); e.g. late decelerations
◉ Episodic decelerations. Answer: not associated with uterine
contractions; e.g. variables
◉ Recurrent. Answer: decelerations that occur >/=50% of uterine
contractions within a 20 minute period; vs. intermittent (<50% of
ctx)
◉ Baseline variability. Answer: irregular fluctuations in baseline
FHR; peak to trough; absent is undetectable; minimal 1-5, moderate
6-25, marked >25
◉ Decreased variability. Answer: hypoxia, sleep cycle, drugs,
anomalies, prematurity, tachycardia
◉ Increased variability. Answer: fetal activity, fetal stimulation,
alpha-adrenergic activity; in absence or abnormal FHR changes,
marked variability is not ass'd with acidemia
◉ Fetal tachycardia. Answer: hypoxia, maternal fever, medications
(terbutaline), maternal thyroid disease, fetal anemia/heart failure,
amnionitis, fetal arrhythmia
