NCC EFM STUDY EXAMS GUIDE QUESTIONS AND
ANSWERS RATED A+
✔✔All of the following are likely causes of prolonged decelerations except:
A. Uterine tachysystole
B. Prolapsed cord
C. Maternal hypotension
D. Maternal fever - ✔✔D. Maternal fever
✔✔All of the following could likely cause minimal variability in FHR except
A. Magnesium sulfate administration
B. Fetal sleep cycle
C. Narcotic administration
D. Ephedrine administration - ✔✔D. Ephedrine administration
✔✔When an IUPC has been placed, Montevideo units must be ___ or greater for
adequate cervical change to occur.
A. 100
B. 200
C. 300
D. 400 - ✔✔B. 200
✔✔What would be a suspected pH in a fetus whose FHTs included recurrent late
decelerations during labor?
A. 7.10
B. 7.26
C. 7.32
D. 7.41 - ✔✔A. 7.10
✔✔The nurse notes a pattern of decelerations on the fetal monitor that begins shortly
after the contraction and returns to baseline just before the contraction is over. The
correct nursing response is to:
a. Give the woman oxygen by facemask at 8-10 L/min
b. Position the woman on her opposite side
c. Increase the rate of the woman's intravenous fluid
d. Continue to observe and record the normal pattern - ✔✔d. Continue to observe and
record the normal pattern
✔✔Determining the FHR baseline requires the nurse to approximate the mean FHR
rounded to increments of 5 bpm during a ___-minute window (excluding accelerations
and decelerations).
A. 2
B. 5
C. 10
,D. 20 - ✔✔C. 10
✔✔Which of the following interventions would best stimulate an acceleration in the
FHR?
A. Provide juice to patient
B. Perform vaginal exam
C. Turn patient on left side
D. Vibroacoustic stimulation - ✔✔B. Perform vaginal exam
Scalp stimulation
✔✔The FHR is controlled by the
A. Sympathetic nervous system
B. Sinoatrial node
C. Atrioventricular node
D. Parasympathetic nervous system - ✔✔B. Sinoatrial node
✔✔T/F: Fetal tachycardia is a normal compensatory response to transient fetal
hypoxemia. - ✔✔True
✔✔At how many weeks gestation should FHR variability be normal in manner?
A. 24 weeks
B. 28 weeks
C. 32 weeks
D. 36 weeks - ✔✔B. 28 weeks
✔✔Reduced respiratory gas exchange from persistent decelerations may cause a rise
in fetal PCO2, which leads first to _______ _______, then _______ _______.
A. Respiratory alkalosis; metabolic acidosis
B. Respiratory acidosis; metabolic acidosis
C. Respiratory alkalosis; metabolic alkalosis
D. Respiratory acidosis; metabolic acidosis - ✔✔B. Respiratory acidosis; metabolic
acidosis
✔✔Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is
typically present in _______.
A. Variable decelerations
B. Late decelerations
C. Early decelerations
D. Accelerations - ✔✔B. Late decelerations
✔✔Place the following interventions for a sinusoidal FHR in the correct order:
1. Prepare for cesarean delivery
2. Place patient in lateral position
, 3. Determine if pattern is related to narcotic analgesic administration
4. Provide oxygen via face mask
A. 4, 2, 3, 1
B. 3, 1, 2, 4
C. 4, 3, 2, 1
D. 3, 2, 4, 1 - ✔✔D. 3, 2, 4, 1
✔✔FHTs with accelerations, no decelerations, and minimal variability would be
categorized as
A. Category I
B. Category II
C. Category III - ✔✔B. Category II
✔✔FHTs with minimal variability, absent accelerations, and a 3-minute prolonged
deceleration would be categorized as
A. Category I
B. Category II
C. Category III - ✔✔B. Category II
✔✔Which of the following is not a likely cause of a sinusoidal FHR pattern?
A. Chronic fetal bleeding
B. Fetal hypoxia or anemia
C. Triple screen positive for Trisomy 21
D. Fetal isoimmunization - ✔✔C. Triple screen positive for Trisomy 21
✔✔Which of the following factors is not likely to cause uteroplacental insufficiency?
A. Late-term gestation
B. Preeclampsia
C. Gestational diabetes
D. Polyhydramnios
E. Maternal smoking or drug use - ✔✔D. Polyhydramnios
✔✔The normal FHR baseline
A. Decreases during labor
B. Fluctuates during labor
C. Increases during labor - ✔✔B. Fluctuates during labor
✔✔Bradycardia in the second stage of labor following a previously normal tracing may
be caused by fetal
A. Hypoxemia
B. Rotation
C. Vagal stimulation - ✔✔C. Vagal stimulation
ANSWERS RATED A+
✔✔All of the following are likely causes of prolonged decelerations except:
A. Uterine tachysystole
B. Prolapsed cord
C. Maternal hypotension
D. Maternal fever - ✔✔D. Maternal fever
✔✔All of the following could likely cause minimal variability in FHR except
A. Magnesium sulfate administration
B. Fetal sleep cycle
C. Narcotic administration
D. Ephedrine administration - ✔✔D. Ephedrine administration
✔✔When an IUPC has been placed, Montevideo units must be ___ or greater for
adequate cervical change to occur.
A. 100
B. 200
C. 300
D. 400 - ✔✔B. 200
✔✔What would be a suspected pH in a fetus whose FHTs included recurrent late
decelerations during labor?
A. 7.10
B. 7.26
C. 7.32
D. 7.41 - ✔✔A. 7.10
✔✔The nurse notes a pattern of decelerations on the fetal monitor that begins shortly
after the contraction and returns to baseline just before the contraction is over. The
correct nursing response is to:
a. Give the woman oxygen by facemask at 8-10 L/min
b. Position the woman on her opposite side
c. Increase the rate of the woman's intravenous fluid
d. Continue to observe and record the normal pattern - ✔✔d. Continue to observe and
record the normal pattern
✔✔Determining the FHR baseline requires the nurse to approximate the mean FHR
rounded to increments of 5 bpm during a ___-minute window (excluding accelerations
and decelerations).
A. 2
B. 5
C. 10
,D. 20 - ✔✔C. 10
✔✔Which of the following interventions would best stimulate an acceleration in the
FHR?
A. Provide juice to patient
B. Perform vaginal exam
C. Turn patient on left side
D. Vibroacoustic stimulation - ✔✔B. Perform vaginal exam
Scalp stimulation
✔✔The FHR is controlled by the
A. Sympathetic nervous system
B. Sinoatrial node
C. Atrioventricular node
D. Parasympathetic nervous system - ✔✔B. Sinoatrial node
✔✔T/F: Fetal tachycardia is a normal compensatory response to transient fetal
hypoxemia. - ✔✔True
✔✔At how many weeks gestation should FHR variability be normal in manner?
A. 24 weeks
B. 28 weeks
C. 32 weeks
D. 36 weeks - ✔✔B. 28 weeks
✔✔Reduced respiratory gas exchange from persistent decelerations may cause a rise
in fetal PCO2, which leads first to _______ _______, then _______ _______.
A. Respiratory alkalosis; metabolic acidosis
B. Respiratory acidosis; metabolic acidosis
C. Respiratory alkalosis; metabolic alkalosis
D. Respiratory acidosis; metabolic acidosis - ✔✔B. Respiratory acidosis; metabolic
acidosis
✔✔Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is
typically present in _______.
A. Variable decelerations
B. Late decelerations
C. Early decelerations
D. Accelerations - ✔✔B. Late decelerations
✔✔Place the following interventions for a sinusoidal FHR in the correct order:
1. Prepare for cesarean delivery
2. Place patient in lateral position
, 3. Determine if pattern is related to narcotic analgesic administration
4. Provide oxygen via face mask
A. 4, 2, 3, 1
B. 3, 1, 2, 4
C. 4, 3, 2, 1
D. 3, 2, 4, 1 - ✔✔D. 3, 2, 4, 1
✔✔FHTs with accelerations, no decelerations, and minimal variability would be
categorized as
A. Category I
B. Category II
C. Category III - ✔✔B. Category II
✔✔FHTs with minimal variability, absent accelerations, and a 3-minute prolonged
deceleration would be categorized as
A. Category I
B. Category II
C. Category III - ✔✔B. Category II
✔✔Which of the following is not a likely cause of a sinusoidal FHR pattern?
A. Chronic fetal bleeding
B. Fetal hypoxia or anemia
C. Triple screen positive for Trisomy 21
D. Fetal isoimmunization - ✔✔C. Triple screen positive for Trisomy 21
✔✔Which of the following factors is not likely to cause uteroplacental insufficiency?
A. Late-term gestation
B. Preeclampsia
C. Gestational diabetes
D. Polyhydramnios
E. Maternal smoking or drug use - ✔✔D. Polyhydramnios
✔✔The normal FHR baseline
A. Decreases during labor
B. Fluctuates during labor
C. Increases during labor - ✔✔B. Fluctuates during labor
✔✔Bradycardia in the second stage of labor following a previously normal tracing may
be caused by fetal
A. Hypoxemia
B. Rotation
C. Vagal stimulation - ✔✔C. Vagal stimulation
