NCC Electronic Fetal Monitoring
Certification Exam 2025/2026 – Verified
Questions and Answers
Question 1
Which factor can negatively affect uterine blood flow?
A. Hypotension
B. Epidural
C. Hemorrhage
D. All of the above
Correct Answer: D. All of the above
Rationale: Uterine blood flow is critical for fetal oxygenation. Hypotension reduces maternal
blood pressure, limiting placental perfusion. Epidurals can cause vasodilation, potentially
decreasing blood flow. Hemorrhage reduces maternal blood volume, impairing oxygen delivery.
All these factors can negatively impact uterine blood flow, making D the correct choice.
Question 2
How does the fetus compensate for decreased maternal circulating volume?
A. Increases cardiac output by increasing stroke volume
B. Increases cardiac output by increasing heart rate
C. Decreases heart rate to conserve oxygen
D. Reduces metabolic rate
Correct Answer: B. Increases cardiac output by increasing heart rate
Rationale: When maternal circulating volume decreases (e.g., due to hemorrhage), the fetus
compensates by increasing cardiac output, primarily through an elevated heart rate (fetal
tachycardia). This enhances oxygen delivery to tissues despite reduced maternal blood flow.
Stroke volume increase is less significant, and decreasing heart rate or metabolism would not
aid compensation.
,Question 3
What is the first intervention for variable decelerations?
A. Immediate delivery
B. Change maternal position
C. Administer oxygen
D. Stop oxytocin infusion
Correct Answer: B. Change maternal position
Rationale: Variable decelerations are typically caused by umbilical cord compression, which
can be alleviated by changing the maternal position (e.g., to lateral) to improve cord blood flow.
Immediate delivery is not the first step unless the pattern persists. Oxygen and stopping oxytocin
are secondary interventions if repositioning fails.
Question 4
What is the most likely cause of recurrent late decelerations?
A. Utero-placental insufficiency
B. Head compression
C. Cord compression
D. Maternal position change
Correct Answer: A. Utero-placental insufficiency
Rationale: Late decelerations occur when fetal oxygen supply is inadequate due to
utero-placental insufficiency, often from reduced placental perfusion (e.g., maternal hypotension
or placental dysfunction). Head compression causes early decelerations, and cord compression
causes variable decelerations. Maternal position change is a corrective action, not a cause.
Question 5
Which statement best describes the relationship between maternal and fetal hemoglobin levels?
A. Fetal hemoglobin is higher than maternal hemoglobin
B. Maternal hemoglobin is higher than fetal hemoglobin
C. Maternal and fetal hemoglobin are the same
D. Fetal hemoglobin does not bind oxygen
Correct Answer: A. Fetal hemoglobin is higher
,Rationale: Fetal hemoglobin (HbF) has a higher affinity for oxygen than maternal hemoglobin,
allowing efficient oxygen transfer across the placenta. This ensures the fetus receives adequate
oxygen despite lower partial pressures in the fetal circulation. Fetal and maternal hemoglobin
levels are not the same, and HbF does bind oxygen effectively.
Question 6
When educating a patient about the ultrasound transducer, what should the nurse include?
A. Contraction strength alters fetal heart rate monitoring
B. Fetal movement may cause the tracing to drop or become erratic
C. The ultrasound detects electrical activity of the fetal heart
D. The transducer measures maternal heart rate
Correct Answer: B. Fetal movement may cause the tracing to drop or become erratic
Rationale: The ultrasound transducer detects fetal heart rate (FHR) via Doppler technology.
Fetal movement can disrupt the signal, causing the tracing to drop or become erratic, which
should be explained to the patient. Contraction strength affects uterine activity monitoring, not
FHR directly, and the transducer does not detect electrical activity or maternal heart rate.
Question 7
What is the most prevalent risk factor for fetal death before labor onset?
A. Low socioeconomic status
B. Maternal diabetes
C. Fetal anomalies
D. Placental abruption
Correct Answer: C. Fetal anomalies
Rationale: Fetal anomalies, such as congenital malformations, are the most prevalent risk
factor for fetal death before labor, as they can impair critical developmental processes. Maternal
diabetes and placental abruption are significant but less common causes, and socioeconomic
status is not a direct cause.
Question 8
Oxygen is transferred from mother to fetus via the placenta through:
A. Active transport
B. Passive diffusion
, C. Facilitated diffusion
D. Pinocytosis
Correct Answer: B. Passive diffusion
Rationale: Oxygen crosses the placenta from maternal to fetal blood via passive diffusion,
driven by the concentration gradient between maternal and fetal circulations. No energy or carrier
proteins are required, ruling out active transport, facilitated diffusion, or pinocytosis.
Question 9
Which maternal position best promotes maternal-fetal exchange?
A. Supine
B. Trendelenburg
C. Left lateral
D. Sitting upright
Correct Answer: C. Left lateral
Rationale: The left lateral position optimizes uterine and placental blood flow by preventing
compression of the inferior vena cava, enhancing maternal-fetal oxygen exchange. Supine
position risks aortocaval compression, and Trendelenburg or sitting upright are less effective for
this purpose.
Question 10
What is the most common fetal tachyarrhythmia?
A. Atrial fibrillation
B. Supraventricular tachycardia
C. Ventricular tachycardia
D. Bradycardia
Correct Answer: B. Supraventricular tachycardia
Rationale: Supraventricular tachycardia (SVT) is the most common fetal tachyarrhythmia,
characterized by a rapid heart rate (>200 bpm) originating above the ventricles. Atrial fibrillation
and ventricular tachycardia are rare in fetuses, and bradycardia is a slow heart rate.
Question 11
What is the normal range for baseline fetal heart rate (FHR)?
Certification Exam 2025/2026 – Verified
Questions and Answers
Question 1
Which factor can negatively affect uterine blood flow?
A. Hypotension
B. Epidural
C. Hemorrhage
D. All of the above
Correct Answer: D. All of the above
Rationale: Uterine blood flow is critical for fetal oxygenation. Hypotension reduces maternal
blood pressure, limiting placental perfusion. Epidurals can cause vasodilation, potentially
decreasing blood flow. Hemorrhage reduces maternal blood volume, impairing oxygen delivery.
All these factors can negatively impact uterine blood flow, making D the correct choice.
Question 2
How does the fetus compensate for decreased maternal circulating volume?
A. Increases cardiac output by increasing stroke volume
B. Increases cardiac output by increasing heart rate
C. Decreases heart rate to conserve oxygen
D. Reduces metabolic rate
Correct Answer: B. Increases cardiac output by increasing heart rate
Rationale: When maternal circulating volume decreases (e.g., due to hemorrhage), the fetus
compensates by increasing cardiac output, primarily through an elevated heart rate (fetal
tachycardia). This enhances oxygen delivery to tissues despite reduced maternal blood flow.
Stroke volume increase is less significant, and decreasing heart rate or metabolism would not
aid compensation.
,Question 3
What is the first intervention for variable decelerations?
A. Immediate delivery
B. Change maternal position
C. Administer oxygen
D. Stop oxytocin infusion
Correct Answer: B. Change maternal position
Rationale: Variable decelerations are typically caused by umbilical cord compression, which
can be alleviated by changing the maternal position (e.g., to lateral) to improve cord blood flow.
Immediate delivery is not the first step unless the pattern persists. Oxygen and stopping oxytocin
are secondary interventions if repositioning fails.
Question 4
What is the most likely cause of recurrent late decelerations?
A. Utero-placental insufficiency
B. Head compression
C. Cord compression
D. Maternal position change
Correct Answer: A. Utero-placental insufficiency
Rationale: Late decelerations occur when fetal oxygen supply is inadequate due to
utero-placental insufficiency, often from reduced placental perfusion (e.g., maternal hypotension
or placental dysfunction). Head compression causes early decelerations, and cord compression
causes variable decelerations. Maternal position change is a corrective action, not a cause.
Question 5
Which statement best describes the relationship between maternal and fetal hemoglobin levels?
A. Fetal hemoglobin is higher than maternal hemoglobin
B. Maternal hemoglobin is higher than fetal hemoglobin
C. Maternal and fetal hemoglobin are the same
D. Fetal hemoglobin does not bind oxygen
Correct Answer: A. Fetal hemoglobin is higher
,Rationale: Fetal hemoglobin (HbF) has a higher affinity for oxygen than maternal hemoglobin,
allowing efficient oxygen transfer across the placenta. This ensures the fetus receives adequate
oxygen despite lower partial pressures in the fetal circulation. Fetal and maternal hemoglobin
levels are not the same, and HbF does bind oxygen effectively.
Question 6
When educating a patient about the ultrasound transducer, what should the nurse include?
A. Contraction strength alters fetal heart rate monitoring
B. Fetal movement may cause the tracing to drop or become erratic
C. The ultrasound detects electrical activity of the fetal heart
D. The transducer measures maternal heart rate
Correct Answer: B. Fetal movement may cause the tracing to drop or become erratic
Rationale: The ultrasound transducer detects fetal heart rate (FHR) via Doppler technology.
Fetal movement can disrupt the signal, causing the tracing to drop or become erratic, which
should be explained to the patient. Contraction strength affects uterine activity monitoring, not
FHR directly, and the transducer does not detect electrical activity or maternal heart rate.
Question 7
What is the most prevalent risk factor for fetal death before labor onset?
A. Low socioeconomic status
B. Maternal diabetes
C. Fetal anomalies
D. Placental abruption
Correct Answer: C. Fetal anomalies
Rationale: Fetal anomalies, such as congenital malformations, are the most prevalent risk
factor for fetal death before labor, as they can impair critical developmental processes. Maternal
diabetes and placental abruption are significant but less common causes, and socioeconomic
status is not a direct cause.
Question 8
Oxygen is transferred from mother to fetus via the placenta through:
A. Active transport
B. Passive diffusion
, C. Facilitated diffusion
D. Pinocytosis
Correct Answer: B. Passive diffusion
Rationale: Oxygen crosses the placenta from maternal to fetal blood via passive diffusion,
driven by the concentration gradient between maternal and fetal circulations. No energy or carrier
proteins are required, ruling out active transport, facilitated diffusion, or pinocytosis.
Question 9
Which maternal position best promotes maternal-fetal exchange?
A. Supine
B. Trendelenburg
C. Left lateral
D. Sitting upright
Correct Answer: C. Left lateral
Rationale: The left lateral position optimizes uterine and placental blood flow by preventing
compression of the inferior vena cava, enhancing maternal-fetal oxygen exchange. Supine
position risks aortocaval compression, and Trendelenburg or sitting upright are less effective for
this purpose.
Question 10
What is the most common fetal tachyarrhythmia?
A. Atrial fibrillation
B. Supraventricular tachycardia
C. Ventricular tachycardia
D. Bradycardia
Correct Answer: B. Supraventricular tachycardia
Rationale: Supraventricular tachycardia (SVT) is the most common fetal tachyarrhythmia,
characterized by a rapid heart rate (>200 bpm) originating above the ventricles. Atrial fibrillation
and ventricular tachycardia are rare in fetuses, and bradycardia is a slow heart rate.
Question 11
What is the normal range for baseline fetal heart rate (FHR)?
