NCC EFM® (Electronic Fetal Monitoring) Certification
Exam–style test bank with verified questions, correct
answers, and clear rationales,
1. A fetal heart rate (FHR) baseline is defined as:
A. The average FHR during uterine contractions
B. The mean FHR rounded to increments of 5 bpm during a 10-minute window
C. The highest FHR during fetal movement
D. The FHR measured during active labor only
Correct Answer: B
Rationale:
Baseline FHR is determined by the mean FHR over a 10-minute segment, excluding
accelerations, decelerations, and periods of marked variability, and is rounded to the
nearest 5 bpm.
2. Which FHR baseline is considered normal?
A. 95 bpm
B. 105 bpm
C. 120 bpm
D. 165 bpm
Correct Answer: C
Rationale:
A normal baseline FHR is 110–160 bpm. Values below 110 indicate bradycardia, and
above 160 indicate tachycardia.
3. Moderate variability is defined as amplitude fluctuations of:
A. ≤5 bpm
B. 6–25 bpm
C. >25 bpm
D. Absent variability
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,Correct Answer: B
Rationale:
Moderate variability (6–25 bpm) is a reassuring sign of adequate fetal
oxygenation and intact CNS function.
4. Which finding is the strongest indicator of fetal well-being?
A. Baseline FHR of 140 bpm
B. Early decelerations
C. Moderate variability
D. Occasional variable decelerations
Correct Answer: C
Rationale:
Moderate variability is the most reliable indicator of fetal acid-base balance and
neurologic integrity.
5. Early decelerations are typically caused by:
A. Umbilical cord compression
B. Uteroplacental insufficiency
C. Fetal head compression
D. Maternal hypotension
Correct Answer: C
Rationale:
Early decelerations mirror contractions and are caused by fetal head compression,
leading to vagal stimulation.
6. Variable decelerations are most commonly associated with:
A. Uterine tachysystole
B. Umbilical cord compression
C. Placental abruption
D. Maternal fever
Correct Answer: B
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,Rationale:
Variable decelerations are abrupt and variable in timing and are caused by umbilical cord
compression.
7. Late decelerations indicate:
A. Fetal head compression
B. Umbilical cord prolapse
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Correct Answer: C
Rationale:
Late decelerations occur after the peak of the contraction and reflect impaired
placental perfusion and fetal hypoxia.
8. Which intervention is priority for recurrent late decelerations?
A. Vaginal exam
B. Administer oxygen to the mother
C. Increase oxytocin
D. Encourage pushing
Correct Answer: B
Rationale:
Initial management includes intrauterine resuscitation: maternal repositioning, oxygen,
IV fluids, and reducing uterine activity.
9. Uterine tachysystole is defined as:
A. ≥4 contractions in 10 minutes
B. ≥5 contractions in 10 minutes averaged over 30 minutes
C. Contractions lasting >120 seconds
D. No resting tone between contractions
Correct Answer: B
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, Rationale:
Tachysystole is more than 5 contractions in 10 minutes, averaged over 30
minutes, with or without FHR changes.
10. Which FHR pattern is classified as Category I?
A. Absent variability with recurrent decelerations
B. Moderate variability with accelerations
C. Minimal variability with tachycardia
D. Recurrent late decelerations
Correct Answer: B
Rationale:
Category I tracings include baseline 110–160 bpm, moderate variability, no late
or variable decelerations, and may include accelerations.
11. Category III FHR tracings include:
A. Minimal variability only
B. Moderate variability with decelerations
C. Absent variability with recurrent late decelerations
D. Accelerations with normal baseline
Correct Answer: C
Rationale:
Category III patterns are abnormal and predictive of fetal acidemia, requiring immediate
evaluation and intervention.
12. Which intervention is appropriate for recurrent variable decelerations?
A. Increase oxytocin
B. Amnioinfusion
C. Administer magnesium sulfate
D. Encourage maternal pushing
Correct Answer: B
Rationale:
Amnioinfusion can relieve cord compression by increasing amniotic fluid volume.
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Exam–style test bank with verified questions, correct
answers, and clear rationales,
1. A fetal heart rate (FHR) baseline is defined as:
A. The average FHR during uterine contractions
B. The mean FHR rounded to increments of 5 bpm during a 10-minute window
C. The highest FHR during fetal movement
D. The FHR measured during active labor only
Correct Answer: B
Rationale:
Baseline FHR is determined by the mean FHR over a 10-minute segment, excluding
accelerations, decelerations, and periods of marked variability, and is rounded to the
nearest 5 bpm.
2. Which FHR baseline is considered normal?
A. 95 bpm
B. 105 bpm
C. 120 bpm
D. 165 bpm
Correct Answer: C
Rationale:
A normal baseline FHR is 110–160 bpm. Values below 110 indicate bradycardia, and
above 160 indicate tachycardia.
3. Moderate variability is defined as amplitude fluctuations of:
A. ≤5 bpm
B. 6–25 bpm
C. >25 bpm
D. Absent variability
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,Correct Answer: B
Rationale:
Moderate variability (6–25 bpm) is a reassuring sign of adequate fetal
oxygenation and intact CNS function.
4. Which finding is the strongest indicator of fetal well-being?
A. Baseline FHR of 140 bpm
B. Early decelerations
C. Moderate variability
D. Occasional variable decelerations
Correct Answer: C
Rationale:
Moderate variability is the most reliable indicator of fetal acid-base balance and
neurologic integrity.
5. Early decelerations are typically caused by:
A. Umbilical cord compression
B. Uteroplacental insufficiency
C. Fetal head compression
D. Maternal hypotension
Correct Answer: C
Rationale:
Early decelerations mirror contractions and are caused by fetal head compression,
leading to vagal stimulation.
6. Variable decelerations are most commonly associated with:
A. Uterine tachysystole
B. Umbilical cord compression
C. Placental abruption
D. Maternal fever
Correct Answer: B
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,Rationale:
Variable decelerations are abrupt and variable in timing and are caused by umbilical cord
compression.
7. Late decelerations indicate:
A. Fetal head compression
B. Umbilical cord prolapse
C. Uteroplacental insufficiency
D. Fetal sleep cycle
Correct Answer: C
Rationale:
Late decelerations occur after the peak of the contraction and reflect impaired
placental perfusion and fetal hypoxia.
8. Which intervention is priority for recurrent late decelerations?
A. Vaginal exam
B. Administer oxygen to the mother
C. Increase oxytocin
D. Encourage pushing
Correct Answer: B
Rationale:
Initial management includes intrauterine resuscitation: maternal repositioning, oxygen,
IV fluids, and reducing uterine activity.
9. Uterine tachysystole is defined as:
A. ≥4 contractions in 10 minutes
B. ≥5 contractions in 10 minutes averaged over 30 minutes
C. Contractions lasting >120 seconds
D. No resting tone between contractions
Correct Answer: B
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, Rationale:
Tachysystole is more than 5 contractions in 10 minutes, averaged over 30
minutes, with or without FHR changes.
10. Which FHR pattern is classified as Category I?
A. Absent variability with recurrent decelerations
B. Moderate variability with accelerations
C. Minimal variability with tachycardia
D. Recurrent late decelerations
Correct Answer: B
Rationale:
Category I tracings include baseline 110–160 bpm, moderate variability, no late
or variable decelerations, and may include accelerations.
11. Category III FHR tracings include:
A. Minimal variability only
B. Moderate variability with decelerations
C. Absent variability with recurrent late decelerations
D. Accelerations with normal baseline
Correct Answer: C
Rationale:
Category III patterns are abnormal and predictive of fetal acidemia, requiring immediate
evaluation and intervention.
12. Which intervention is appropriate for recurrent variable decelerations?
A. Increase oxytocin
B. Amnioinfusion
C. Administer magnesium sulfate
D. Encourage maternal pushing
Correct Answer: B
Rationale:
Amnioinfusion can relieve cord compression by increasing amniotic fluid volume.
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