NCC EFM CORE EXAMS 2026 SET QUESTIONS AND
ANSWERS RATED A+
✔✔An appropriate initial treatment for recurrent late decelerations with moderate
variability during first stage labor is
A. Amnioinfusion
B. Maternal repositioning
C. Oxygen at 10L per nonrebreather face mask - ✔✔B. Maternal repositioning
✔✔Most fetal dysrhythmias are not life-threatening, except for _______, which may lead
to fetal congestive heart failure. - ✔✔Supraventricular tachycardia
✔✔Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or
cardiac anomalies may result in _______ variability. - ✔✔Decreased
✔✔Stimulation of the _____ _____ _____ releases acetylcholine, resulting in decreased
FHR. - ✔✔Parasympathetic nervous system
✔✔The _____ _____ _____ maintains transmission of beat-to-beat variability. -
✔✔Parasympathetic nervous system
✔✔Stimulation of the _____ _____ _____ releases catecholamines, resulting in
increased FHR. - ✔✔Sympathetic nervous system
✔✔Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. -
✔✔Baroreceptors
✔✔Baroreceptors influence _____ decelerations with moderate variability. - ✔✔Variable
✔✔In comparing early and late decelerations, a distinguishing factor between the two is
A. Onset time to the nadir of the deceleration
B. The number of decelerations that occur
C. Timing in relation to contractions - ✔✔C. Timing in relation to contractions
✔✔The underlying cause of early decelerations is decreased
A. Baroceptor response
B. Increased peripheral resistance
C. Vagal reflex - ✔✔C. Vagal reflex
✔✔Glucose is transferred across the placenta via _____ _____. - ✔✔Facilitated
diffusion
,✔✔Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble
vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the
placenta via _____ _____. - ✔✔Simple (passive) diffusion
✔✔Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are
transferred across the placenta via _____ _____. - ✔✔Active transport
✔✔Well-oxygenated fetal blood enters the _____ ventricle, which supplies the heart and
brain. Less-oxygenated blood enters the ______ ventricle, which supplies the rest of the
body. - ✔✔Left; right
✔✔Fetal blood has a _______ affinity for oxygen compared with the mother's blood,
which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus.
A. Higher
B. Lower - ✔✔A. Higher
✔✔The fetus has a _______ cardiac output and heart rate than the adult, resulting in
rapid circulation.
A. Higher
B. Lower - ✔✔A. Higher
✔✔Which statement best describes the relationship between maternal and fetal
hemoglobin levels?
A. Fetal hemoglobin is higher than maternal hemoglobin
B. Maternal hemoglobin is higher than fetal hemoglobin
C. Maternal and fetal hemoglobin are the same - ✔✔A. Fetal hemoglobin is higher than
maternal hemoglobin
✔✔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
✔✔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
✔✔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 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
ANSWERS RATED A+
✔✔An appropriate initial treatment for recurrent late decelerations with moderate
variability during first stage labor is
A. Amnioinfusion
B. Maternal repositioning
C. Oxygen at 10L per nonrebreather face mask - ✔✔B. Maternal repositioning
✔✔Most fetal dysrhythmias are not life-threatening, except for _______, which may lead
to fetal congestive heart failure. - ✔✔Supraventricular tachycardia
✔✔Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or
cardiac anomalies may result in _______ variability. - ✔✔Decreased
✔✔Stimulation of the _____ _____ _____ releases acetylcholine, resulting in decreased
FHR. - ✔✔Parasympathetic nervous system
✔✔The _____ _____ _____ maintains transmission of beat-to-beat variability. -
✔✔Parasympathetic nervous system
✔✔Stimulation of the _____ _____ _____ releases catecholamines, resulting in
increased FHR. - ✔✔Sympathetic nervous system
✔✔Stimulation of _____ results in abrupt decreases in FHR, CO, and BP. -
✔✔Baroreceptors
✔✔Baroreceptors influence _____ decelerations with moderate variability. - ✔✔Variable
✔✔In comparing early and late decelerations, a distinguishing factor between the two is
A. Onset time to the nadir of the deceleration
B. The number of decelerations that occur
C. Timing in relation to contractions - ✔✔C. Timing in relation to contractions
✔✔The underlying cause of early decelerations is decreased
A. Baroceptor response
B. Increased peripheral resistance
C. Vagal reflex - ✔✔C. Vagal reflex
✔✔Glucose is transferred across the placenta via _____ _____. - ✔✔Facilitated
diffusion
,✔✔Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble
vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the
placenta via _____ _____. - ✔✔Simple (passive) diffusion
✔✔Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are
transferred across the placenta via _____ _____. - ✔✔Active transport
✔✔Well-oxygenated fetal blood enters the _____ ventricle, which supplies the heart and
brain. Less-oxygenated blood enters the ______ ventricle, which supplies the rest of the
body. - ✔✔Left; right
✔✔Fetal blood has a _______ affinity for oxygen compared with the mother's blood,
which facilitates adaptation to the low PO2 at which the placenta oxygenates the fetus.
A. Higher
B. Lower - ✔✔A. Higher
✔✔The fetus has a _______ cardiac output and heart rate than the adult, resulting in
rapid circulation.
A. Higher
B. Lower - ✔✔A. Higher
✔✔Which statement best describes the relationship between maternal and fetal
hemoglobin levels?
A. Fetal hemoglobin is higher than maternal hemoglobin
B. Maternal hemoglobin is higher than fetal hemoglobin
C. Maternal and fetal hemoglobin are the same - ✔✔A. Fetal hemoglobin is higher than
maternal hemoglobin
✔✔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
✔✔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
✔✔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 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
