NCC EFM EXAMINATION TEST 2026 QUESTIONS AND
ANSWERS RATED A+
✔✔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
B. Remove FSE
C. Call the doctor immediately
D. Turn off the monitor - ✔✔A. Compare maternal pulse simultaneously with FHR
✔✔T/F: Umbilical cord influences that can alter blood flow include true knots,
hematomas, and number of umbilical vessels. - ✔✔True
✔✔T/F: Low amplitude contractions are not an early sign of preterm labor. - ✔✔False
✔✔T/F: Preterm contractions are usually painful. - ✔✔False
✔✔T/F: Corticosteroid administration may cause an increase in FHR accelerations. -
✔✔False
✔✔T/F: Corticosteroid administration may cause an increase in FHR. - ✔✔True
✔✔T/F: Contractions cause an increase in uterine venous pressure and a decrease in
uterine artery perfusion. - ✔✔True
✔✔As a result of the intrinsic fetal response to oxygen deprivation, increased
catecholamine levels cause the peripheral blood flow to decrease while the blood flow
to vital organs increases. These flow changes along with increased catecholamine
secretions have what effect on fetal blood pressure and fetal heart rate?
A. Increase BP and increase HR
B. Increase BP and decrease HR
C. Decrease BP and increase HR
D. Decrease BP and decrease HR - ✔✔B. Increase BP and decrease HR
✔✔All of the following might indicate a pseudosinusoidal pattern as opposed to a
sinusoidal pattern, except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min - ✔✔D. Frequency of oscillations
of two to five cycles/min
✔✔All of the following are appropriate interventions for fetal tachycardia except:
A. Increase maternal IV fluid rate
B. Assess maternal vital signs
C. Perform SVE
ANSWERS RATED A+
✔✔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
B. Remove FSE
C. Call the doctor immediately
D. Turn off the monitor - ✔✔A. Compare maternal pulse simultaneously with FHR
✔✔T/F: Umbilical cord influences that can alter blood flow include true knots,
hematomas, and number of umbilical vessels. - ✔✔True
✔✔T/F: Low amplitude contractions are not an early sign of preterm labor. - ✔✔False
✔✔T/F: Preterm contractions are usually painful. - ✔✔False
✔✔T/F: Corticosteroid administration may cause an increase in FHR accelerations. -
✔✔False
✔✔T/F: Corticosteroid administration may cause an increase in FHR. - ✔✔True
✔✔T/F: Contractions cause an increase in uterine venous pressure and a decrease in
uterine artery perfusion. - ✔✔True
✔✔As a result of the intrinsic fetal response to oxygen deprivation, increased
catecholamine levels cause the peripheral blood flow to decrease while the blood flow
to vital organs increases. These flow changes along with increased catecholamine
secretions have what effect on fetal blood pressure and fetal heart rate?
A. Increase BP and increase HR
B. Increase BP and decrease HR
C. Decrease BP and increase HR
D. Decrease BP and decrease HR - ✔✔B. Increase BP and decrease HR
✔✔All of the following might indicate a pseudosinusoidal pattern as opposed to a
sinusoidal pattern, except:
A. Recent administration of narcotics to mother
B. Accelerations in FHR
C. Moderate variability
D. Frequency of oscillations of two to five cycles/min - ✔✔D. Frequency of oscillations
of two to five cycles/min
✔✔All of the following are appropriate interventions for fetal tachycardia except:
A. Increase maternal IV fluid rate
B. Assess maternal vital signs
C. Perform SVE
