NCC EFM EXAM STUDY GUIDE
QUESTIONS AND CORRECT
SOLUTIONS||100% GUARANTEED
PASS||UPDATED 2026\2027
SYLLABUS||A+ GRADED||<<RECENT
VERSION>>
Hypertension (HTN) - ANSWER ✓ BP > 140/90
-tx w Ca channel blockers, thiazides, BB
-avoid ACE inhibitors & ARBs (congenital defect)
1) Chronic: present prior to pregnancy
-risk of superimposed preeclampsia, abruption, stroke (endothelial damage to
vessels), stress on L ventricle (to overcome pressure)
2) Gestational: begins after 20 wks, returns to normal PP (no proteinuria:
<300mg/<0.3 pcr)
-↑ BP is sustained 6 hrs apart
-risk of poor perfusion, SGA
Preeclampsia & HELLP - ANSWER ✓ ↑BP & proteinuria or a s/s: poor
implantation of arterioles & trophoblasts cause ↓ blood flow to placenta, ↑ BP to
compensate
-mild: 140/90, protein 300mg/24hr or 1-2g dipstick
-severe: 160/110, protein 5g/24hr or 3g dipstick, N/V, HA, hyperreflexia, clonus
-prevent w baby ASA in 1st trimester (vasodilate)
-damages kidneys, liver, heart, lungs, blood cells & vessels, neuro (cerebral
edema), optic nerve
-AE: oligo, IUGR, pulmonary edema, HA, epigastric pain, blurry vision, abruption,
IUFD, seizure, liver rupture, renal failure, DIC, CVA
-can cause eclampsia (seizure) from cerebral ischemia & edema, may abrupt or
rapidly dilate
-HELLP: hemolysis, ↑ liver enzymes (AST, ALT), ↓ platelets (<100k)
Treatment of preeclampsia & HTN - ANSWER ✓ -Induce by 39 wks
, 1) Mag: muscle relaxant used to prevent seizure
-loading dose 4-6g/hr, maintenance 2-4g/hr
-therapeutic lvl: 4-8 mEq/L
-↓ FHR variability, hypotonia, resp depression
-antidote: calcium gluconate 1g/10ml D5W
-SE: NV, flushing, HA, ↓ reflexes, pulmonary edema, hypotension, resp
depression, oliguria
2) BB: don't use w asthma or ↓ HR, caution w diabetes (masks hypoglycemia)
3) Hydralazine: relaxes smooth muscles
-can cause rebound tachycardia
4) Ca channel blocker (procardia, nifedipine): relaxes smooth muscles, ↑ renal
perfusion & urinary output
5) Valium or keppra w eclampsia
Diabetes - ANSWER ✓ -Excess glucose delays surfactant production (RDS)
-T1 & T2 more likely to cause congenital abnormalities (heart & neural tube
defect)
-Hypoglycemia at birth: glucose crosses placenta but not insulin, fetus has ↑ insulin
production & bottoms out after delivery
-Risk of LGA, fetal acidosis, impaired perfusion, polycythemia, demise, UTI,
polyhydramnios, abruption, PPH, Pre-E (r/t vascular damage), miscarriage
-Induce at 38-39 wks
Types of diabetes - ANSWER ✓ 1) T1: insulin dependent (don't secrete insulin)
2) T2: insulin resistant
3) Gestational: placenta acts as antagonist to insulin, demand for production ↑ 2-3x
-resolves w placental expulsion
Infection - ANSWER ✓ 1) GBS: bacteria normally found in the vagina & rectum,
typically harmless but can pass to fetus during delivery
-can cause meningitis, pneumonia, or sepsis
-screened from 36-38 wks, tx w antibiotics during labor if positive
2) Chorioamnionitis: infection of membranes, can cause PTD, requires antibiotic tx
(risk w PROM)
3) HepB: give infant hepB vax & HBIG
4) HIV: infant will need antivirals, no breastfeed
5) TORCH (toxoplasmosis, other, rubella, cytomegalovirus, herpes): commonly
associated w congenital abnormalities
-other: syphillis, varicella zoster, parvovirus B19
QUESTIONS AND CORRECT
SOLUTIONS||100% GUARANTEED
PASS||UPDATED 2026\2027
SYLLABUS||A+ GRADED||<<RECENT
VERSION>>
Hypertension (HTN) - ANSWER ✓ BP > 140/90
-tx w Ca channel blockers, thiazides, BB
-avoid ACE inhibitors & ARBs (congenital defect)
1) Chronic: present prior to pregnancy
-risk of superimposed preeclampsia, abruption, stroke (endothelial damage to
vessels), stress on L ventricle (to overcome pressure)
2) Gestational: begins after 20 wks, returns to normal PP (no proteinuria:
<300mg/<0.3 pcr)
-↑ BP is sustained 6 hrs apart
-risk of poor perfusion, SGA
Preeclampsia & HELLP - ANSWER ✓ ↑BP & proteinuria or a s/s: poor
implantation of arterioles & trophoblasts cause ↓ blood flow to placenta, ↑ BP to
compensate
-mild: 140/90, protein 300mg/24hr or 1-2g dipstick
-severe: 160/110, protein 5g/24hr or 3g dipstick, N/V, HA, hyperreflexia, clonus
-prevent w baby ASA in 1st trimester (vasodilate)
-damages kidneys, liver, heart, lungs, blood cells & vessels, neuro (cerebral
edema), optic nerve
-AE: oligo, IUGR, pulmonary edema, HA, epigastric pain, blurry vision, abruption,
IUFD, seizure, liver rupture, renal failure, DIC, CVA
-can cause eclampsia (seizure) from cerebral ischemia & edema, may abrupt or
rapidly dilate
-HELLP: hemolysis, ↑ liver enzymes (AST, ALT), ↓ platelets (<100k)
Treatment of preeclampsia & HTN - ANSWER ✓ -Induce by 39 wks
, 1) Mag: muscle relaxant used to prevent seizure
-loading dose 4-6g/hr, maintenance 2-4g/hr
-therapeutic lvl: 4-8 mEq/L
-↓ FHR variability, hypotonia, resp depression
-antidote: calcium gluconate 1g/10ml D5W
-SE: NV, flushing, HA, ↓ reflexes, pulmonary edema, hypotension, resp
depression, oliguria
2) BB: don't use w asthma or ↓ HR, caution w diabetes (masks hypoglycemia)
3) Hydralazine: relaxes smooth muscles
-can cause rebound tachycardia
4) Ca channel blocker (procardia, nifedipine): relaxes smooth muscles, ↑ renal
perfusion & urinary output
5) Valium or keppra w eclampsia
Diabetes - ANSWER ✓ -Excess glucose delays surfactant production (RDS)
-T1 & T2 more likely to cause congenital abnormalities (heart & neural tube
defect)
-Hypoglycemia at birth: glucose crosses placenta but not insulin, fetus has ↑ insulin
production & bottoms out after delivery
-Risk of LGA, fetal acidosis, impaired perfusion, polycythemia, demise, UTI,
polyhydramnios, abruption, PPH, Pre-E (r/t vascular damage), miscarriage
-Induce at 38-39 wks
Types of diabetes - ANSWER ✓ 1) T1: insulin dependent (don't secrete insulin)
2) T2: insulin resistant
3) Gestational: placenta acts as antagonist to insulin, demand for production ↑ 2-3x
-resolves w placental expulsion
Infection - ANSWER ✓ 1) GBS: bacteria normally found in the vagina & rectum,
typically harmless but can pass to fetus during delivery
-can cause meningitis, pneumonia, or sepsis
-screened from 36-38 wks, tx w antibiotics during labor if positive
2) Chorioamnionitis: infection of membranes, can cause PTD, requires antibiotic tx
(risk w PROM)
3) HepB: give infant hepB vax & HBIG
4) HIV: infant will need antivirals, no breastfeed
5) TORCH (toxoplasmosis, other, rubella, cytomegalovirus, herpes): commonly
associated w congenital abnormalities
-other: syphillis, varicella zoster, parvovirus B19
