NCC ELECTRONIC FETAL MONITORING
COMPREHENSIVE EXAM ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Baroreceptors respond mainly to changes in
A. Blood pressure
B. Hormonal changes
C. Oxygen and carbon dioxide levels - ✔✔A. Blood pressure
✔✔Stimulation of the sympathetic nervous system causes the fetal heart rate to
A. Decrease
B. Increase
C. Remain the same - ✔✔B. Increase
✔✔Which statement describes normal uterine activity?
A. Frequency of 1-1/2 to 2 minutes
B. Intensity of 90 mmHg early in labor
C. Resting tone less than 20-25 mmHg - ✔✔C. Resting tone less than 20-25 mmHg
✔✔Greater than 5 contractions in 10 minutes averaged over 30 minutes indicates
A. Excessive uterine activity
B. Hyperstimulation
C. Tachysystole - ✔✔C. Tachysystole
✔✔A 36 week gestation patient is brought to triage by squad after an MVA on her back.
She is not bleeding and denies pain. She is not short of breath, but c/o dizziness and
nausea since they put her on the gurney. The most likely cause is
A. Abruptio placenta
B. Preterm labor
C. Supine hypotension - ✔✔C. Supine hypotension
✔✔One compensatory mechanism that helps maintain oxygen availability to the fetus
during maternal exercise is
A. A decrease in maternal hematocrit
B. Transient increase in uterine blood flow
C. An increase in uterine oxygen uptake - ✔✔C. An increase in uterine oxygen uptake
✔✔When the hydrogen ion content in the blood rises, the pH
A. Lowers
B. Neutralizes
C. Rises - ✔✔A. Lowers
,✔✔A woman receives terbutaline for an external version. You may expect what on the
fetal heart tracing?
A. Decrease in variability
B. Increase in baseline
C. No change - ✔✔B. Increase in baseline
✔✔What affect does magnesium sulfate have on the fetal heart rate?
A. Decreases variability
B. Increases variability
C. No change - ✔✔A. Decreases variability
✔✔NICHD guidelines apply only to
A. Intrapartum patients
B. Internal monitoring of fetal heart rate
C. Interpreting tracings of good quality - ✔✔C. Interpreting tracings of good quality
✔✔According to NICHD terminology, variability can be accurately accessed
A. Visually, by determining the number of R to R intervals in a one minute period
B. Visually, by determining the amplitude of the FHR change in bpm from the baseline
C. Only when a fetal spiral electrode is in place - ✔✔B. Visually, by determining the
amplitude of the FHR change in bpm from the baseline
✔✔When looking at the fetal heart rate, the most important characteristic to determine
the absence of metabolic acidemia is
A. Absence of late decelerations
B. Baseline rate within normal range
C. Presence of moderate variability - ✔✔C. Presence of moderate variability
✔✔Sinusoidal pattern can be documented when
A. Cycles are 4-6 beats per minute in frequency
B. The pattern lasts 20 minutes or longer
C. There is moderate or minimal variability - ✔✔B. The pattern lasts 20 minutes or
longer
✔✔Vagal stimulation would be manifested as what type of fetal heart rate pattern?
A. Acceleration
B. Early deceleration
C. Tachycardia - ✔✔B. Early deceleration
✔✔Which fetal monitoring pattern is characteristic of cephalopelvic disproportion,
especially when seen at the onset of labor?
A. Early deceleration
B. Late deceleration
C. Variable deceleration - ✔✔A. Early deceleration
,✔✔A risk of amnioinfusion is
A. Prolonged labor
B. Uterine overdistension
C. Water intoxication - ✔✔B. Uterine overdistension
✔✔A fetal heart rate pattern that the NICHD has identified as predictive of current or
impending fetal asphyxia so severe that the fetus is at risk of neurologic damage or
death is
A. Baseline tachycardia with absent variability
B. Minimal baseline variability with recurrent late decelerations
C. Recurrent late or variable decelerations with absent variability - ✔✔C. Recurrent late
or variable decelerations with absent variability
✔✔A fetal heart rate pattern that can occur when there is a prolapsed cord is
A. Marked variability
B. Prolonged decelerations
C. Tachycardia - ✔✔B. Prolonged decelerations
✔✔The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the
next 15 minutes, there are 18 uterine contractions. Recommended management is to
A. Address contraction frequency by reducing pitocin dose
B. Continue to increase pitocin as long as FHR is Category I
C. Turn the patient on her side and initiate an IV fluid bolus - ✔✔C. Turn the patient on
her side and initiate an IV fluid bolus
✔✔A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the
fetal heart tracings have been normal. Spontaneous rupture of membranes occurs; fetal
heart rate drops to 90 beats per minute for four minutes and then resumes a normal
pattern. The most likely etiology for this fetal heart rate change is
A. Abnormal fetal presentation
B. Impaired placental circulation
C. Possible cord compression - ✔✔C. Possible cord compression
✔✔A 42 week gestation woman has been diagnosed with oligohydramnios. Based on
this, a FHR change that can be expected is
A. Late deceleration
B. Minimal variability
C. Variable deceleration - ✔✔C. Variable deceleration
✔✔Mono-mono zygotic twins are prone to what type of deceleration during labor?
A. Early
B. Late
C. Variable - ✔✔C. Variable
, ✔✔During labor, the recommended fetal heart rate assessment interval for auscultation
is every
A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second
stage
B. 15 minutes no matter what stage of labor
C. 60 minutes in the active phase of the first stage and every 30 minutes in second
stage - ✔✔A. 15-30 minutes in the active phase of the first stage and every 5-15
minutes in second stage
✔✔What fetal heart rate characteristics can be determined with auscultation?
A. Baseline
B. Early decelerations
C. Variability - ✔✔A. Baseline
✔✔When auscultating the fetal heart rate, the provider/nurse should simultaneously
assess the maternal
A. Blood pressure
B. Pain level
C. Radial pulse - ✔✔C. Radial pulse
✔✔A woman has 10 fetal movements in one hour. This is considered what kind of
movement?
A. Decreased
B. Excessive
C. Normal - ✔✔C. Normal
✔✔If the pH is low, what other blood gas parameter is used to determine if the acidosis
is respiratory or metabolic?
A. HCO3
B. PCO2
C. PO2 - ✔✔B. PCO2
✔✔The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25,
base excess -10
A. Metabolic acidosis
B. Mixed acidosis
C. Respiratory acidosis - ✔✔C. Respiratory acidosis
✔✔A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic
fluid was scored as normal. The expected management is
A. Immediate delivery
B. Repeat the test in 24 hours
C. Schedule the next test in one week - ✔✔B. Repeat the test in 24 hours
COMPREHENSIVE EXAM ACTUAL QUESTIONS AND
ANSWERS RATED A+
✔✔Baroreceptors respond mainly to changes in
A. Blood pressure
B. Hormonal changes
C. Oxygen and carbon dioxide levels - ✔✔A. Blood pressure
✔✔Stimulation of the sympathetic nervous system causes the fetal heart rate to
A. Decrease
B. Increase
C. Remain the same - ✔✔B. Increase
✔✔Which statement describes normal uterine activity?
A. Frequency of 1-1/2 to 2 minutes
B. Intensity of 90 mmHg early in labor
C. Resting tone less than 20-25 mmHg - ✔✔C. Resting tone less than 20-25 mmHg
✔✔Greater than 5 contractions in 10 minutes averaged over 30 minutes indicates
A. Excessive uterine activity
B. Hyperstimulation
C. Tachysystole - ✔✔C. Tachysystole
✔✔A 36 week gestation patient is brought to triage by squad after an MVA on her back.
She is not bleeding and denies pain. She is not short of breath, but c/o dizziness and
nausea since they put her on the gurney. The most likely cause is
A. Abruptio placenta
B. Preterm labor
C. Supine hypotension - ✔✔C. Supine hypotension
✔✔One compensatory mechanism that helps maintain oxygen availability to the fetus
during maternal exercise is
A. A decrease in maternal hematocrit
B. Transient increase in uterine blood flow
C. An increase in uterine oxygen uptake - ✔✔C. An increase in uterine oxygen uptake
✔✔When the hydrogen ion content in the blood rises, the pH
A. Lowers
B. Neutralizes
C. Rises - ✔✔A. Lowers
,✔✔A woman receives terbutaline for an external version. You may expect what on the
fetal heart tracing?
A. Decrease in variability
B. Increase in baseline
C. No change - ✔✔B. Increase in baseline
✔✔What affect does magnesium sulfate have on the fetal heart rate?
A. Decreases variability
B. Increases variability
C. No change - ✔✔A. Decreases variability
✔✔NICHD guidelines apply only to
A. Intrapartum patients
B. Internal monitoring of fetal heart rate
C. Interpreting tracings of good quality - ✔✔C. Interpreting tracings of good quality
✔✔According to NICHD terminology, variability can be accurately accessed
A. Visually, by determining the number of R to R intervals in a one minute period
B. Visually, by determining the amplitude of the FHR change in bpm from the baseline
C. Only when a fetal spiral electrode is in place - ✔✔B. Visually, by determining the
amplitude of the FHR change in bpm from the baseline
✔✔When looking at the fetal heart rate, the most important characteristic to determine
the absence of metabolic acidemia is
A. Absence of late decelerations
B. Baseline rate within normal range
C. Presence of moderate variability - ✔✔C. Presence of moderate variability
✔✔Sinusoidal pattern can be documented when
A. Cycles are 4-6 beats per minute in frequency
B. The pattern lasts 20 minutes or longer
C. There is moderate or minimal variability - ✔✔B. The pattern lasts 20 minutes or
longer
✔✔Vagal stimulation would be manifested as what type of fetal heart rate pattern?
A. Acceleration
B. Early deceleration
C. Tachycardia - ✔✔B. Early deceleration
✔✔Which fetal monitoring pattern is characteristic of cephalopelvic disproportion,
especially when seen at the onset of labor?
A. Early deceleration
B. Late deceleration
C. Variable deceleration - ✔✔A. Early deceleration
,✔✔A risk of amnioinfusion is
A. Prolonged labor
B. Uterine overdistension
C. Water intoxication - ✔✔B. Uterine overdistension
✔✔A fetal heart rate pattern that the NICHD has identified as predictive of current or
impending fetal asphyxia so severe that the fetus is at risk of neurologic damage or
death is
A. Baseline tachycardia with absent variability
B. Minimal baseline variability with recurrent late decelerations
C. Recurrent late or variable decelerations with absent variability - ✔✔C. Recurrent late
or variable decelerations with absent variability
✔✔A fetal heart rate pattern that can occur when there is a prolapsed cord is
A. Marked variability
B. Prolonged decelerations
C. Tachycardia - ✔✔B. Prolonged decelerations
✔✔The patient is in early labor with pitocin at 8 mu/min, and FHR is Category I. In the
next 15 minutes, there are 18 uterine contractions. Recommended management is to
A. Address contraction frequency by reducing pitocin dose
B. Continue to increase pitocin as long as FHR is Category I
C. Turn the patient on her side and initiate an IV fluid bolus - ✔✔C. Turn the patient on
her side and initiate an IV fluid bolus
✔✔A woman at 38 weeks gestation is in labor. The labor has been uneventful, and the
fetal heart tracings have been normal. Spontaneous rupture of membranes occurs; fetal
heart rate drops to 90 beats per minute for four minutes and then resumes a normal
pattern. The most likely etiology for this fetal heart rate change is
A. Abnormal fetal presentation
B. Impaired placental circulation
C. Possible cord compression - ✔✔C. Possible cord compression
✔✔A 42 week gestation woman has been diagnosed with oligohydramnios. Based on
this, a FHR change that can be expected is
A. Late deceleration
B. Minimal variability
C. Variable deceleration - ✔✔C. Variable deceleration
✔✔Mono-mono zygotic twins are prone to what type of deceleration during labor?
A. Early
B. Late
C. Variable - ✔✔C. Variable
, ✔✔During labor, the recommended fetal heart rate assessment interval for auscultation
is every
A. 15-30 minutes in the active phase of the first stage and every 5-15 minutes in second
stage
B. 15 minutes no matter what stage of labor
C. 60 minutes in the active phase of the first stage and every 30 minutes in second
stage - ✔✔A. 15-30 minutes in the active phase of the first stage and every 5-15
minutes in second stage
✔✔What fetal heart rate characteristics can be determined with auscultation?
A. Baseline
B. Early decelerations
C. Variability - ✔✔A. Baseline
✔✔When auscultating the fetal heart rate, the provider/nurse should simultaneously
assess the maternal
A. Blood pressure
B. Pain level
C. Radial pulse - ✔✔C. Radial pulse
✔✔A woman has 10 fetal movements in one hour. This is considered what kind of
movement?
A. Decreased
B. Excessive
C. Normal - ✔✔C. Normal
✔✔If the pH is low, what other blood gas parameter is used to determine if the acidosis
is respiratory or metabolic?
A. HCO3
B. PCO2
C. PO2 - ✔✔B. PCO2
✔✔The following cord blood gasses are consistent with: pH 7.10, pCO2 70, pO2 25,
base excess -10
A. Metabolic acidosis
B. Mixed acidosis
C. Respiratory acidosis - ✔✔C. Respiratory acidosis
✔✔A fetus at 36 weeks receives a biophysical profile (BBP) score of 6. The amniotic
fluid was scored as normal. The expected management is
A. Immediate delivery
B. Repeat the test in 24 hours
C. Schedule the next test in one week - ✔✔B. Repeat the test in 24 hours
