EFM Practice Test – Latest 2025/2026 Exam
Prep & Practice Questions
What FHR finding is top priority for immediate interventions?
a. heart block rate of 60 bpm
b.bradycardia
c.tachycardia with minimal variability rate of 170 with pushing - correct answerB.
BRADYCARDIA
The change from moderate to minimal variability which is most concerning would be
when:
a. association with tachysystole with or without pitocin
b. association after giving stadol and phenergan
c. association with active phase of pushing +3 station - correct answera. association
with tachysystole with or without pitocin
Explain the difference between "shoulders" and "overshoots" associated with variable
decels (not approved NICHD approved terminology
a.shoulders are associated with moderate variability
b. over shoots are associated with moderate variability
c. shoulders are associated with minimal variability and overshoots are associated with
absent variability - correct answera.shoulders are associated with moderate variability
Define tachysystole with pitocin:
a. tachysystole is > or equal to 5 contractions in 10 minutes averaged over a 30-minute
time frame but only with fetal intolerance
b. tachysystole is > or equal to 5 contractions in 10 minutes averaged over a 30-min
time despite fetal intolerance of pattern, category 1 tracing
c. tachysystole is >5 contractions in 10 minutes averaged over a 30-min period of time -
correct answerc. tachysystole is >5 contractions in 10 minutes averaged over a 30-min
period of time
What category tracing is baseline rate of 120, absent variability and prolonged 5-minute
decel to the 60s?
a. cat 1
b. cat 2
c. cat 3 - correct answercat 2
as the labor nurse is setting up for vacuum assisted or forcep assisted delivery by the
provider, the stimulation of the ___________ nerve occurs which results in fetal heart
characteristic of
a. vagus, tachycardia and minimal variability
b. vagus, bradycardia
,c. trigeminal, minimal variability and an arrhythmia - correct answerb. vagus,
bradycardia
which tracing reveals the highest indicator for potential fetal acidemia?
a. recurrent late decelerations with minimal variability, baseline rate of 115 bpm
b. bradycardia with minimal variability, baseline rate of 85 bpm
c.prolonged 7- minute decel with baseline recovery to 110s with minimal variability -
correct answerb. bradycardia with minimal variability, baseline rate of 85 bpm
NST for a 32.5 week gestation G2P1 with acceleration criteria 2 accelerations of 15 x 15
is considered
a. reactive
b.reassuring, cat 1
c. negative - correct answera. reactive
during the NST a qualifying acceleration:
a. does not have to return to the baseline rate.
b. must meet criteria of 10x10 in a fetus <32 weeks or 15 x 15 in a fetus >32 weeks.
c. if minimal variability accompanies the qualifying accels based on gestation, the NST
is considered non reassuring - correct answerb. must meet criteria of 10x10 in a fetus
<32 weeks or 15 x 15 in a fetus >32 weeks.
the baseline rate for marked variability is
a. find the mid-point of the baseline with marked variability and chart that number
b. there is no baseline rate in marked variability
c. establish a mid-point range of the baseline and if accels are present, assume fetus is
reactive - correct answerb. there is no baseline rate in marked variability
immediately following SROM a prolonged decel to 80 x 5 mins is noted. immediate
nursing action is
a. sterile vaginal exam
b. turn to lateral position and apply o2, prepare for stat c section
c. IVF bolus, O2 therapy, turn to lateral position - correct answera. sterile vaginal exam
the common finding of hypertension and the association with amniotic fluid index will be
a. oligo
b. poly
c. normal AFI - correct answera. oligo
when a fetal arrhythmia is heard on the EFM, what is the first thing to do?
a. prepare for an urgent delivery/apply FSE during this time/ O2 therapy
b. reassure the patient that arrythmias are always benign but still notify MD
c. listen to the rhythm and notify MD, inform nursery personnel - correct answerc. listen
to the rhythm and notify MD, inform nursery personnel
, if you are unable to trace uterine contractions adequately (maternal
movement/obesity,poly), can you chart lates or earlies? - correct answerNO
baseline rate of 150 bpm, 4-minute decel to 70 bpm with return to baseline rate of 150
bpm, the fetus has:
a. unable to determine at this time, watch the baseline for another 10 minutes
b. developed acidemia and anticipate pH <7.10
c. compensated well, especially if accompanied by moderate variability - correct
answerc. compensated well, especially if accompanied by moderate variability
the underlying cause of tachycardia in a preterm fetus with minimal variability is due to:
a. immaturity of the PNS
b. maturity of the PNS
c. maturity of the SNS and the PNS - correct answera. immaturity of the PNS
with change from moderate variability to minimal variability with intermittent lates,
compensation could be occuring due to
a. progressing fetal hypoxemia
b. sleeping fetus as well as uteroplacental insufficency
c. lack of perfusion of the autonomic nervous system and immediately prepare for
aggressive resuscitative needs at delivery of the infant - correct answera. progressing
fetal hypoxemia
causes of fetal tachycardia are:
a. infection, terb, prematurity, hypothyroidism, maternal fever
b. abruption, prolapsed cord, post-dates, hypoxemia
c. maternal anxiety, fetal immaturity, fetal anemia, SVT, maternal fever - correct
answerc. maternal anxiety, fetal immaturity, fetal anemia, SVT, maternal fever
appropriate interventions for inability to trace uterine contractions with use of pitocin will
be
a. palpate and mark tracing
b. continue to increase pit as long as fetus has a cat 1 tracing
c. call MD and request IUPC or place IUPC if allowed in your state - correct answerc.
call MD and request IUPC or place IUPC if allowed in your state
i am more concerned with lack of fetal oxygenation with presentation of:
a. tachycardia with moderate variability
b. return to normal baseline rate with minimal variability
c. variabile decel becoming longer in duration and moderate variability is maintained -
correct answerb. return to normal baseline rate with minimal variability
what statement is true regarding an FSE?
a. FSE has been applied there is a risk of double counting the MHR especially if MHR is
stronger than the FHR
b. FSE is most accurate to access a fetal arrhythmia
Prep & Practice Questions
What FHR finding is top priority for immediate interventions?
a. heart block rate of 60 bpm
b.bradycardia
c.tachycardia with minimal variability rate of 170 with pushing - correct answerB.
BRADYCARDIA
The change from moderate to minimal variability which is most concerning would be
when:
a. association with tachysystole with or without pitocin
b. association after giving stadol and phenergan
c. association with active phase of pushing +3 station - correct answera. association
with tachysystole with or without pitocin
Explain the difference between "shoulders" and "overshoots" associated with variable
decels (not approved NICHD approved terminology
a.shoulders are associated with moderate variability
b. over shoots are associated with moderate variability
c. shoulders are associated with minimal variability and overshoots are associated with
absent variability - correct answera.shoulders are associated with moderate variability
Define tachysystole with pitocin:
a. tachysystole is > or equal to 5 contractions in 10 minutes averaged over a 30-minute
time frame but only with fetal intolerance
b. tachysystole is > or equal to 5 contractions in 10 minutes averaged over a 30-min
time despite fetal intolerance of pattern, category 1 tracing
c. tachysystole is >5 contractions in 10 minutes averaged over a 30-min period of time -
correct answerc. tachysystole is >5 contractions in 10 minutes averaged over a 30-min
period of time
What category tracing is baseline rate of 120, absent variability and prolonged 5-minute
decel to the 60s?
a. cat 1
b. cat 2
c. cat 3 - correct answercat 2
as the labor nurse is setting up for vacuum assisted or forcep assisted delivery by the
provider, the stimulation of the ___________ nerve occurs which results in fetal heart
characteristic of
a. vagus, tachycardia and minimal variability
b. vagus, bradycardia
,c. trigeminal, minimal variability and an arrhythmia - correct answerb. vagus,
bradycardia
which tracing reveals the highest indicator for potential fetal acidemia?
a. recurrent late decelerations with minimal variability, baseline rate of 115 bpm
b. bradycardia with minimal variability, baseline rate of 85 bpm
c.prolonged 7- minute decel with baseline recovery to 110s with minimal variability -
correct answerb. bradycardia with minimal variability, baseline rate of 85 bpm
NST for a 32.5 week gestation G2P1 with acceleration criteria 2 accelerations of 15 x 15
is considered
a. reactive
b.reassuring, cat 1
c. negative - correct answera. reactive
during the NST a qualifying acceleration:
a. does not have to return to the baseline rate.
b. must meet criteria of 10x10 in a fetus <32 weeks or 15 x 15 in a fetus >32 weeks.
c. if minimal variability accompanies the qualifying accels based on gestation, the NST
is considered non reassuring - correct answerb. must meet criteria of 10x10 in a fetus
<32 weeks or 15 x 15 in a fetus >32 weeks.
the baseline rate for marked variability is
a. find the mid-point of the baseline with marked variability and chart that number
b. there is no baseline rate in marked variability
c. establish a mid-point range of the baseline and if accels are present, assume fetus is
reactive - correct answerb. there is no baseline rate in marked variability
immediately following SROM a prolonged decel to 80 x 5 mins is noted. immediate
nursing action is
a. sterile vaginal exam
b. turn to lateral position and apply o2, prepare for stat c section
c. IVF bolus, O2 therapy, turn to lateral position - correct answera. sterile vaginal exam
the common finding of hypertension and the association with amniotic fluid index will be
a. oligo
b. poly
c. normal AFI - correct answera. oligo
when a fetal arrhythmia is heard on the EFM, what is the first thing to do?
a. prepare for an urgent delivery/apply FSE during this time/ O2 therapy
b. reassure the patient that arrythmias are always benign but still notify MD
c. listen to the rhythm and notify MD, inform nursery personnel - correct answerc. listen
to the rhythm and notify MD, inform nursery personnel
, if you are unable to trace uterine contractions adequately (maternal
movement/obesity,poly), can you chart lates or earlies? - correct answerNO
baseline rate of 150 bpm, 4-minute decel to 70 bpm with return to baseline rate of 150
bpm, the fetus has:
a. unable to determine at this time, watch the baseline for another 10 minutes
b. developed acidemia and anticipate pH <7.10
c. compensated well, especially if accompanied by moderate variability - correct
answerc. compensated well, especially if accompanied by moderate variability
the underlying cause of tachycardia in a preterm fetus with minimal variability is due to:
a. immaturity of the PNS
b. maturity of the PNS
c. maturity of the SNS and the PNS - correct answera. immaturity of the PNS
with change from moderate variability to minimal variability with intermittent lates,
compensation could be occuring due to
a. progressing fetal hypoxemia
b. sleeping fetus as well as uteroplacental insufficency
c. lack of perfusion of the autonomic nervous system and immediately prepare for
aggressive resuscitative needs at delivery of the infant - correct answera. progressing
fetal hypoxemia
causes of fetal tachycardia are:
a. infection, terb, prematurity, hypothyroidism, maternal fever
b. abruption, prolapsed cord, post-dates, hypoxemia
c. maternal anxiety, fetal immaturity, fetal anemia, SVT, maternal fever - correct
answerc. maternal anxiety, fetal immaturity, fetal anemia, SVT, maternal fever
appropriate interventions for inability to trace uterine contractions with use of pitocin will
be
a. palpate and mark tracing
b. continue to increase pit as long as fetus has a cat 1 tracing
c. call MD and request IUPC or place IUPC if allowed in your state - correct answerc.
call MD and request IUPC or place IUPC if allowed in your state
i am more concerned with lack of fetal oxygenation with presentation of:
a. tachycardia with moderate variability
b. return to normal baseline rate with minimal variability
c. variabile decel becoming longer in duration and moderate variability is maintained -
correct answerb. return to normal baseline rate with minimal variability
what statement is true regarding an FSE?
a. FSE has been applied there is a risk of double counting the MHR especially if MHR is
stronger than the FHR
b. FSE is most accurate to access a fetal arrhythmia
