3/2/26, 12:12
PM
NCC EFM EXAM BREAKDOWN & STUDY GUIDE WITH ANSWERS 2026 UPDATE.
Content on exam -Pattern recognition & intervention: 70%
-Physiology: 11%
-Fetal assessment methods: 9%
-EFM equipment: 5%
-Professional issues: 5%
Pattern recognition & -FHR baseline ✓
intervention -FHR variability ✓
-FHR accelerations ✓
-FHR decelerations ✓
-Normal uterine activity ✓
-Abnormal uterine activity ✓
-Fetal dysrhythmias ✓
-Maternal complications ✓
-Uteroplacental complications ✓
-Fetal complications ✓
FHR Descriptors 1) Baseline
2)Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
FHR Baseline Average FHR rounded to nearest 5 during a 10 min
window
-110 to 160
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 1/27
flash-cards/
,3/2/26, 12:12
PM
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't
need to be continuous)
Fetal Bradycardia <110 for ≥10 min
-Causes: hypotension (ex: after epi), cord
prolapse, head compression, congenital defect,
rapid descent, abruption or rupture,
tachysystole, post dates, hypoglycemia, lupus
(heart block)
-With ↓ O2, blood will be shunted to brain, heart, &
adrenals, eventually ↓ FHR to ↓ O2 demands of
heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse),
resuscitate, evaluate arrhythmia, expedite delivery
Fetal Tachycardia >160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection,
fetal immaturity (preterm), SVT, maternal anxiety
(catecholamines), dehydration, hyperthyroid,
hypoxia
-Med causes: terbutaline, catecholamines (epinephrine,
norepi)
-Assess mom's temp & infection risk (GBS, PROM)
FHR Variability Irregular in amplitude & frequency, quantified by
peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro
maturity
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 2/27
flash-cards/
, 3/2/26, 12:12
PM
-Less in preterm due to undeveloped CNS
-Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline),
significance unknown
Minimal variability ≤5 bpm but
detectable
Sleep, sedated,
or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if
needed)
Moderate variability 6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis
(even w decels)
FHR Accelerations Reliably predicts absence of metabolic acidemia
(spontaneous or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 3/27
flash-cards/
PM
NCC EFM EXAM BREAKDOWN & STUDY GUIDE WITH ANSWERS 2026 UPDATE.
Content on exam -Pattern recognition & intervention: 70%
-Physiology: 11%
-Fetal assessment methods: 9%
-EFM equipment: 5%
-Professional issues: 5%
Pattern recognition & -FHR baseline ✓
intervention -FHR variability ✓
-FHR accelerations ✓
-FHR decelerations ✓
-Normal uterine activity ✓
-Abnormal uterine activity ✓
-Fetal dysrhythmias ✓
-Maternal complications ✓
-Uteroplacental complications ✓
-Fetal complications ✓
FHR Descriptors 1) Baseline
2)Variability
3) Presence of accels
4) Presence of decels
5) Changes in trends overtime
FHR Baseline Average FHR rounded to nearest 5 during a 10 min
window
-110 to 160
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 1/27
flash-cards/
,3/2/26, 12:12
PM
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't
need to be continuous)
Fetal Bradycardia <110 for ≥10 min
-Causes: hypotension (ex: after epi), cord
prolapse, head compression, congenital defect,
rapid descent, abruption or rupture,
tachysystole, post dates, hypoglycemia, lupus
(heart block)
-With ↓ O2, blood will be shunted to brain, heart, &
adrenals, eventually ↓ FHR to ↓ O2 demands of
heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse),
resuscitate, evaluate arrhythmia, expedite delivery
Fetal Tachycardia >160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection,
fetal immaturity (preterm), SVT, maternal anxiety
(catecholamines), dehydration, hyperthyroid,
hypoxia
-Med causes: terbutaline, catecholamines (epinephrine,
norepi)
-Assess mom's temp & infection risk (GBS, PROM)
FHR Variability Irregular in amplitude & frequency, quantified by
peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro
maturity
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 2/27
flash-cards/
, 3/2/26, 12:12
PM
-Less in preterm due to undeveloped CNS
-Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline),
significance unknown
Minimal variability ≤5 bpm but
detectable
Sleep, sedated,
or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if
needed)
Moderate variability 6 to 25 bpm
-Reliably predicts the absence of metabolic acidosis
(even w decels)
FHR Accelerations Reliably predicts absence of metabolic acidemia
(spontaneous or stimulated)
-Onset to peak in <30 sec
-For ≥32 wks: 15x15 (peak ≥15 bpm above baseline
https://quizlet.com/566465443/ncc-efm-exam-breakdown-study-guide- 3/27
flash-cards/
