NCC ELECTRONIC FETAL MONITORING CERTIFICATION
QUESTIONS AND ANSWERS RATED A+
✔✔T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown
origin is present. - ✔✔False
✔✔T/F: The ultrasound transducer is usually placed on the side of the uterus over the
baby's back, as the fetal heart is heard best there. - ✔✔True
✔✔T/F: The spiral electrode is used to more accurately determine the frequency,
duration, and intensity of uterine contractions. - ✔✔False
✔✔T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not
maternal. - ✔✔False
✔✔T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ✔✔False
✔✔T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has
died. - ✔✔True
✔✔T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. -
✔✔True
✔✔T/F: Variability and periodic changes can be detected with both internal and external
monitoring. - ✔✔True
✔✔T/F: Variable decelerations are a result of cord compression. - ✔✔True
✔✔T/F: The presence of FHR accelerations in the intrapartum and antepartum periods
is a sign of adequate fetal oxygenation. - ✔✔True
✔✔T/F: Variable decelerations are a vagal response. - ✔✔True
✔✔T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds)
and are delayed in timing with the nadir of the deceleration occurring after the peak of
the contraction. - ✔✔True
✔✔T/F: The fetal heart rate baseline can be determined during periods of marked
variability. - ✔✔False
✔✔T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood
flow through the placenta. - ✔✔True
,✔✔T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration
pattern in labor. - ✔✔True
✔✔T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is
indicated. - ✔✔False
✔✔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 - ✔✔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 - ✔✔c. 2, 3 and 4
✔✔What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔b. 3 contractions in a 10 minute window
, ✔✔A negative contraction stress test is one in which:
a. No contractions are seen
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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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
C. Fetal movement
D. Sleep pattern - ✔✔A. Acceleration
✔✔You are evaluating a patient in the Prenatal Testing Department who has just
completed a biophysical profile (BPP). You suspect that there could be chronic fetal
asphyxia because the score is below
A. 10
B. 6
C. 8 - ✔✔B. 6
✔✔When using a fetal scalp electrode (FSE), you notice an abnormally low FHR on the
monitor. You should first
A. Compare maternal pulse simultaneously with FHR
QUESTIONS AND ANSWERS RATED A+
✔✔T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown
origin is present. - ✔✔False
✔✔T/F: The ultrasound transducer is usually placed on the side of the uterus over the
baby's back, as the fetal heart is heard best there. - ✔✔True
✔✔T/F: The spiral electrode is used to more accurately determine the frequency,
duration, and intensity of uterine contractions. - ✔✔False
✔✔T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not
maternal. - ✔✔False
✔✔T/F: The intrauterine catheter is used to pick up the fetal heart rate. - ✔✔False
✔✔T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has
died. - ✔✔True
✔✔T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. -
✔✔True
✔✔T/F: Variability and periodic changes can be detected with both internal and external
monitoring. - ✔✔True
✔✔T/F: Variable decelerations are a result of cord compression. - ✔✔True
✔✔T/F: The presence of FHR accelerations in the intrapartum and antepartum periods
is a sign of adequate fetal oxygenation. - ✔✔True
✔✔T/F: Variable decelerations are a vagal response. - ✔✔True
✔✔T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds)
and are delayed in timing with the nadir of the deceleration occurring after the peak of
the contraction. - ✔✔True
✔✔T/F: The fetal heart rate baseline can be determined during periods of marked
variability. - ✔✔False
✔✔T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood
flow through the placenta. - ✔✔True
,✔✔T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration
pattern in labor. - ✔✔True
✔✔T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is
indicated. - ✔✔False
✔✔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 - ✔✔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 - ✔✔c. 2, 3 and 4
✔✔What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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
c. 4 fetal heart rate accelerations in a 40 minute window
d. 2 fetal heart rate accelerations in a 20 minute window - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔b. 3 contractions in a 10 minute window
, ✔✔A negative contraction stress test is one in which:
a. No contractions are seen
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 - ✔✔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 - ✔✔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 - ✔✔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 - ✔✔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
C. Fetal movement
D. Sleep pattern - ✔✔A. Acceleration
✔✔You are evaluating a patient in the Prenatal Testing Department who has just
completed a biophysical profile (BPP). You suspect that there could be chronic fetal
asphyxia because the score is below
A. 10
B. 6
C. 8 - ✔✔B. 6
✔✔When using a fetal scalp electrode (FSE), you notice an abnormally low FHR on the
monitor. You should first
A. Compare maternal pulse simultaneously with FHR
