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NCC Electronic Fetal Monitoring Certification Study Guide 2026/2027 latest update

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This document is a comprehensive study guide for the NCC (National Certification Corporation) Electronic Fetal Monitoring (EFM) Certification examination. It contains a collection of practice questions with correct answers covering all aspects of fetal monitoring including fetal heart rate patterns, decelerations, variability, uterine activity monitoring, NICHD terminology, antepartum surveillance, biophysical profile, contraction stress test, amnioinfusion, fetal dysrhythmias, and legal aspects of EFM. The guide addresses physiological concepts, interpretation of tracings, appropriate interventions, and clinical management of various fetal heart rate patterns in both antepartum and intrapartum settings.

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NCC ELECTRONIC FETAL MONITORING
CERTIFICATION| ACTUAL EXAM

QUESTIONS WITH CORRECT VERIFIED
ANSWERS 2026/2027 LATEST



What is your first intervention in management of a patient experiencing variable
decelerations?

a. Immediate delivery

b. Change maternal position

c. No treatment indicated

d. Oxygen

e. Stop oxytocin infusion - ✔✔✔ANSWER>>>>b. Change maternal position

Etiology of a baseline FHR of 165bpm occurring for the last hour can be:

1. Maternal supine hypotension

2. Maternal fever

3. Maternal dehydration 4. Unknown

a. 1 and 2

b. 1, 2 and 3

c. 2, 3 and 4 - ✔✔✔ANSWER>>>>c. 2, 3 and 4

What is the most probable cause of recurrent late decelerations? a. Utero-placental
insufficiency

b. Head compression


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,c. Cord compression

d. Maternal position change - ✔✔✔ANSWER>>>>a. Utero-placental insufficiency

The most prevalent risk factor associated with fetal death before the onset of labor is: a. Low
socioeconomic status

b. Fetal malpresentation

c. Uteroplacental insufficiency

d. Uterine anomalies - ✔✔✔ANSWER>>>>c. Uteroplacental insufficiency

Which of the following is NOT used for antepartum fetal surveillance? a. Fetal movement
counting

b. Antepartum fetal heart rate testing

c. Biophysical profile testing

d. Maternal HCG levels - ✔✔✔ANSWER>>>>d. Maternal HCG levels

Which of the following conditions is not an indication for antepartum fetal surveillance? a.
Gestational hypertension

b. Diabetes in pregnancy

c. Fetus in breech presentation

d. Decreased fetal movement - ✔✔✔ANSWER>>>>c. Fetus in breech presentation

Which of the following does not affect the degree of fetal activity? a. Vibroacoustic
stimulation

b. Smoking

c. Fetal position

d. Gestational age - ✔✔✔ANSWER>>>>a. Vibroacoustic stimulation

To be considered reactive, a nonstress test must have:

a. 4 fetal heart rate accelerations in a 20 minute window

b. 2 fetal heart rate accelerations in a 10 minute window

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,c. 4 fetal heart rate accelerations in a 40 minute window

d. 2 fetal heart rate accelerations in a 20 minute window - ✔✔✔ANSWER>>>>d. 2
fetal heart rate accelerations in a 20 minute window

If a nonstress test is nonreactive after 40 minutes, the next step should be: a. Have the client
go home and do fetal movement counts

b. Do a biophysical profile or contraction stress test

c. Repeat the nonstress test within a week

d. Admit the client for delivery - ✔✔✔ANSWER>>>>b. Do a biophysical profile or
contraction stress test

All of the following are components of a biophysical profile except: a. Contraction stress test

b. Assessment of fetal breathing

c. Amniotic fluid volume measurement

d. Fetal movement assessment - ✔✔✔ANSWER>>>>a. Contraction stress test

A modified biophysical profile includes a nonstress test and: a. Contraction stress test

b. Ultrasound assessment of fetal movement

c. Ultrasound assessment of amniotic fluid volume

d. Fetal movement counts - ✔✔✔ANSWER>>>>c. Ultrasound assessment of amniotic
fluid volume

For a contraction stress test to be interpretable, you must have a minimum of: a. 5
contractions in a 10-minute window

b. 3 contractions in a 10-minute window

c. 4 contractions in a 10-minute window

d. 2 contractions in a 10-minute window - ✔✔✔ANSWER>>>>b. 3 contractions in a 10
minute window

A negative contraction stress test is one in which: a. No contractions are seen



Page 3 of 84

, b. There are late decelerations with > 50% of the contractions seen

c. There are no fetal heart rate late decelerations with the contractions

d. There is one fetal heart rate deceleration seen - ✔✔✔ANSWER>>>>c. There are no
fetal heart rate late decelerations with the contractions

According to AWHONN, the normal baseline Fetal Heart Rate (FHR) is

A. 90-150 bpm

B. 100-170 bpm

C. 110-160 bpm

D. 120-140 bpm - ✔✔✔ANSWER>>>>C. 110-160 bpm

What are the two most important characteristics of the FHR?

A. Rate and decelerations

B. Variability and accelerations

C. Variability and decelerations

D. Rate and variability - ✔✔✔ANSWER>>>>B. Variability and accelerations

You recognize that an FHR tracing has been showing a decrease in variability for the last 45
minutes. Your first intervention should be to

A. Encourage ambulation

B. Administer oxygen

C. Discontinue IV fluids

D. Increase Pitocin rate - ✔✔✔ANSWER>>>>B. Administer oxygen

Resuscitation measures improves the baby's variability, but the FHR is still not reactive. You
attempt fetal scalp stimulation (FSE) because you know that a well-oxygenated fetus will
respond to FSE with a(n)

A. Acceleration

B. Deceleration


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