Page 1 of 70
NCC EFM EXAM BREAKDOWN &
STUDY GUIDE| NCC EFM CERT EXAM|
NCC EFM CERT EXAM KNOWLEDGE
CHECK EXAM QUESTIONS AND
ANSWERS WITH RATIONALES
Maternal factors affecting fetal oxygenation - ✔✔✔ Correct Answer > 1) ↓
maternal O2: respiratory distress, hypoventilation, seizures, trauma,
smoking
2) ↓ maternal O2 carrying capacity: anemia, carboxihemoglobin
(smoking, poisoning, drugs)
3) ↓ uterine blood flow: hypovolemia, hypotension, anesthesia, dorsal or
lithotomy positioning
4) chronic maternal conditions: vasculopathy (lupus, diabetes,
HTN), antiphospholipid
Uteroplacental factors affecting fetal oxygenation - ✔✔✔ Correct
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Answer > 1) tachysystole
2) placental abruption
3) uteroplacental dysfunction
4) placental infarction
5) chorioamnionitis
6) abnormalities (fibroids, septum)
7) abnormal implantation of placenta (previa) or cord
(valementous, marginal, vasa previa)
Fetal assessment methods - ✔✔✔ Correct Answer > -Auscultation ✓
-Fetal movement & stimulation ✓
-Non stress test (NST) ✓
-Biophysical profile (BPP) ✓
-Cord blood & acid base balance ✓
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Auscultation - ✔✔✔ Correct Answer > Intermittently listening to fetal heart
sounds w fetoscope or doppler to assess FHR
-Detects baseline, rhythm, increases & decreases from baseline
-Cannot determine variability or classify decels
-Use of fetoscope can verify presence of arrhythmia (most accurate) &
clarifies halving or doubling
-Listen to FHR before, during, & for 30 sec after contraction
-Feel for mom's radial pulse to differentiate
Fetal movement & stimulation - ✔✔✔ Correct Answer > -Kick count: 10
movements in 2 hrs (starting at 28 wks)
-To ↑ movement, have ice chips (auditory stimulation) or juice (sugar)
-Do not do scalp stim when FHR is not at baseline (don't use during a
decel)
Non stress test (NST) - ✔✔✔ Correct Answer > Can be done >26 wks
-Reactive: 2 accels in 20 mins (can prolong to 40min) with moderate
variability
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-Acoustic stim: ≤3, 1 min apart lasting 3 sec each (not used for oligo or
<32 wks), elicits startle reflex
-Valid for 24 hrs
Biophysical Profile (BPP) - ✔✔✔ Correct Answer > Normal = 2 points,
abnormal = 0
-Can be done ≥28 wks, valid for 7 days
-BPP done over 30 mins
1) Fetal heart rate
2) Breathing movements
3) Gross body movements
4) Muscle tone: extension/flexion
5) Amniotic fluid volume: (>2cm or AFI >5)
Scoring a BPP - ✔✔✔ Correct Answer > Will get 2 points for each of the
following:
-Reactive NST: 2 accles in 20min
NCC EFM EXAM BREAKDOWN &
STUDY GUIDE| NCC EFM CERT EXAM|
NCC EFM CERT EXAM KNOWLEDGE
CHECK EXAM QUESTIONS AND
ANSWERS WITH RATIONALES
Maternal factors affecting fetal oxygenation - ✔✔✔ Correct Answer > 1) ↓
maternal O2: respiratory distress, hypoventilation, seizures, trauma,
smoking
2) ↓ maternal O2 carrying capacity: anemia, carboxihemoglobin
(smoking, poisoning, drugs)
3) ↓ uterine blood flow: hypovolemia, hypotension, anesthesia, dorsal or
lithotomy positioning
4) chronic maternal conditions: vasculopathy (lupus, diabetes,
HTN), antiphospholipid
Uteroplacental factors affecting fetal oxygenation - ✔✔✔ Correct
,Page 2 of 70
Answer > 1) tachysystole
2) placental abruption
3) uteroplacental dysfunction
4) placental infarction
5) chorioamnionitis
6) abnormalities (fibroids, septum)
7) abnormal implantation of placenta (previa) or cord
(valementous, marginal, vasa previa)
Fetal assessment methods - ✔✔✔ Correct Answer > -Auscultation ✓
-Fetal movement & stimulation ✓
-Non stress test (NST) ✓
-Biophysical profile (BPP) ✓
-Cord blood & acid base balance ✓
,Page 3 of 70
Auscultation - ✔✔✔ Correct Answer > Intermittently listening to fetal heart
sounds w fetoscope or doppler to assess FHR
-Detects baseline, rhythm, increases & decreases from baseline
-Cannot determine variability or classify decels
-Use of fetoscope can verify presence of arrhythmia (most accurate) &
clarifies halving or doubling
-Listen to FHR before, during, & for 30 sec after contraction
-Feel for mom's radial pulse to differentiate
Fetal movement & stimulation - ✔✔✔ Correct Answer > -Kick count: 10
movements in 2 hrs (starting at 28 wks)
-To ↑ movement, have ice chips (auditory stimulation) or juice (sugar)
-Do not do scalp stim when FHR is not at baseline (don't use during a
decel)
Non stress test (NST) - ✔✔✔ Correct Answer > Can be done >26 wks
-Reactive: 2 accels in 20 mins (can prolong to 40min) with moderate
variability
, Page 4 of 70
-Acoustic stim: ≤3, 1 min apart lasting 3 sec each (not used for oligo or
<32 wks), elicits startle reflex
-Valid for 24 hrs
Biophysical Profile (BPP) - ✔✔✔ Correct Answer > Normal = 2 points,
abnormal = 0
-Can be done ≥28 wks, valid for 7 days
-BPP done over 30 mins
1) Fetal heart rate
2) Breathing movements
3) Gross body movements
4) Muscle tone: extension/flexion
5) Amniotic fluid volume: (>2cm or AFI >5)
Scoring a BPP - ✔✔✔ Correct Answer > Will get 2 points for each of the
following:
-Reactive NST: 2 accles in 20min
