NCC EFM (ELECTRONIC FETAL
MONITORING) CERTIFICATION EXAM
CURRENTLY TESTING COMPLETE
ACTUAL EXAM JUST RELEASED
/ALREADY GRADED A+
Q1
A laboring patient at 39 weeks presents with a baseline
FHR of 145 bpm, moderate variability, and recurrent
accelerations without decelerations over 30 minutes. What
is the most appropriate interpretation?
A. Category II requiring continuous observation
B. Category I indicating normal fetal acid-base status
C. Category III requiring immediate intervention
D. Indeterminate pattern requiring scalp stimulation
Answer: B
Rationale: Moderate variability + accelerations =
reassuring. This is Category I, indicating normal
oxygenation.
Q2
,A patient receiving oxytocin develops 6 contractions
within 10 minutes with late decelerations. What is the
priority action?
A. Increase oxytocin rate
B. Administer narcotic analgesia
C. Discontinue oxytocin infusion
D. Encourage pushing
Answer: C
Rationale: Tachysystole with late decels = uteroplacental
insufficiency. First step is stop oxytocin.
Q3
A fetal heart tracing shows minimal variability for 50
minutes without accelerations or decelerations. What is
the most likely explanation?
A. Fetal sleep cycle
B. Severe fetal hypoxia
C. Cord compression
D. Maternal hypotension
Answer: A
Rationale: Minimal variability alone may reflect sleep
cycle, especially <60 minutes.
,Q4
Recurrent variable decelerations with “shoulders” before
and after the drop are observed. What is the physiological
cause?
A. Head compression
B. Cord compression with compensatory response
C. Placental insufficiency
D. Maternal hypoxia
Answer: B
Rationale: “Shoulders” indicate baroreceptor response due
to cord compression.
Q5
A tracing shows absent variability with recurrent late
decelerations. How should this be classified?
A. Category I
B. Category II
C. Category III
D. Normal variant
Answer: C
Rationale: Absent variability + late decels = Category III
(abnormal) → immediate action required.
, Q6
Which intervention is MOST appropriate for recurrent late
decelerations in a supine patient receiving epidural
anesthesia?
A. Encourage ambulation
B. Reposition to lateral position
C. Increase oxytocin
D. Start pushing
Answer: B
Rationale: Supine hypotension reduces placental perfusion
→ reposition laterally.
Q7
A prolonged deceleration lasting 3 minutes occurs
following epidural placement. What is the priority
assessment?
A. Fetal weight estimation
B. Maternal blood pressure
C. Cervical dilation
D. Amniotic fluid color
Answer: B
Rationale: Epidural → hypotension → fetal deceleration.
Check maternal BP first.
MONITORING) CERTIFICATION EXAM
CURRENTLY TESTING COMPLETE
ACTUAL EXAM JUST RELEASED
/ALREADY GRADED A+
Q1
A laboring patient at 39 weeks presents with a baseline
FHR of 145 bpm, moderate variability, and recurrent
accelerations without decelerations over 30 minutes. What
is the most appropriate interpretation?
A. Category II requiring continuous observation
B. Category I indicating normal fetal acid-base status
C. Category III requiring immediate intervention
D. Indeterminate pattern requiring scalp stimulation
Answer: B
Rationale: Moderate variability + accelerations =
reassuring. This is Category I, indicating normal
oxygenation.
Q2
,A patient receiving oxytocin develops 6 contractions
within 10 minutes with late decelerations. What is the
priority action?
A. Increase oxytocin rate
B. Administer narcotic analgesia
C. Discontinue oxytocin infusion
D. Encourage pushing
Answer: C
Rationale: Tachysystole with late decels = uteroplacental
insufficiency. First step is stop oxytocin.
Q3
A fetal heart tracing shows minimal variability for 50
minutes without accelerations or decelerations. What is
the most likely explanation?
A. Fetal sleep cycle
B. Severe fetal hypoxia
C. Cord compression
D. Maternal hypotension
Answer: A
Rationale: Minimal variability alone may reflect sleep
cycle, especially <60 minutes.
,Q4
Recurrent variable decelerations with “shoulders” before
and after the drop are observed. What is the physiological
cause?
A. Head compression
B. Cord compression with compensatory response
C. Placental insufficiency
D. Maternal hypoxia
Answer: B
Rationale: “Shoulders” indicate baroreceptor response due
to cord compression.
Q5
A tracing shows absent variability with recurrent late
decelerations. How should this be classified?
A. Category I
B. Category II
C. Category III
D. Normal variant
Answer: C
Rationale: Absent variability + late decels = Category III
(abnormal) → immediate action required.
, Q6
Which intervention is MOST appropriate for recurrent late
decelerations in a supine patient receiving epidural
anesthesia?
A. Encourage ambulation
B. Reposition to lateral position
C. Increase oxytocin
D. Start pushing
Answer: B
Rationale: Supine hypotension reduces placental perfusion
→ reposition laterally.
Q7
A prolonged deceleration lasting 3 minutes occurs
following epidural placement. What is the priority
assessment?
A. Fetal weight estimation
B. Maternal blood pressure
C. Cervical dilation
D. Amniotic fluid color
Answer: B
Rationale: Epidural → hypotension → fetal deceleration.
Check maternal BP first.
