ELECTRONIC FETAL MONITORING CERTIFICATION (EFM) ACTUAL
EXAM AND 2025 REAL EXAM QUESTIONS AND ANSWERS EXPERT
VERIFIED GRADED A+
_____________________________________________________________________________________
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
As the FHR increases, the myocardium consumes _____ oxygen.
A. More
B. Less
A. More
The fetal spiral electrode measures the
A. Peaks of the Doppler waveforms
B. R to R intervals of the fetal heart
C. ST segments of the fetal ECG
B. R to R intervals of the fetal heart
A woman who is admitted for an induction of labor with oxytocin is questioning the need for
continuous electronic fetal monitoring. The appropriate response to this woman is
A. Hospital policy requires that all patients have continuous electronic fetal monitoring.
B. I would like to answer your questions about continuous monitoring and give you some information
about why continuous monitoring is recommended.
C. Nurses have more training with continuous electronic fetal monitoring than intermittent
auscultation so it is safer for you and your baby to use this method.
B. I would like to answer your questions about continuous monitoring and give you some information
about why continuous monitoring is recommended.
The greater affinity that fetal hemoglobin has for oxygen allows for
A. Easier release of oxygen to the tissues
B. Greater binding of oxygen
C. Stimulation of erythropoietin release
,B. Greater binding of oxygen
The process by which oxygen and carbon dioxide pass from a region of higher concentration to one of
a lower concentration is called
A. Active transport
B. Simple diffusion
C. Facilitated diffusion
B. Simple diffusion
In the healthy fetus, blood flows from the right atrium to the left atrium through the
A. Ductus arteriosus
B. Ductus venosus
C. Foramen ovale
C. Foramen ovale
In the healthy fetus, the umbilical cord enters the fetal abdomen and bypasses the liver through the
A. Ductus arteriosus
B. Ductus venosus
C. Foramen ovale
B. Ductus venosus
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
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
EXAM AND 2025 REAL EXAM QUESTIONS AND ANSWERS EXPERT
VERIFIED GRADED A+
_____________________________________________________________________________________
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
As the FHR increases, the myocardium consumes _____ oxygen.
A. More
B. Less
A. More
The fetal spiral electrode measures the
A. Peaks of the Doppler waveforms
B. R to R intervals of the fetal heart
C. ST segments of the fetal ECG
B. R to R intervals of the fetal heart
A woman who is admitted for an induction of labor with oxytocin is questioning the need for
continuous electronic fetal monitoring. The appropriate response to this woman is
A. Hospital policy requires that all patients have continuous electronic fetal monitoring.
B. I would like to answer your questions about continuous monitoring and give you some information
about why continuous monitoring is recommended.
C. Nurses have more training with continuous electronic fetal monitoring than intermittent
auscultation so it is safer for you and your baby to use this method.
B. I would like to answer your questions about continuous monitoring and give you some information
about why continuous monitoring is recommended.
The greater affinity that fetal hemoglobin has for oxygen allows for
A. Easier release of oxygen to the tissues
B. Greater binding of oxygen
C. Stimulation of erythropoietin release
,B. Greater binding of oxygen
The process by which oxygen and carbon dioxide pass from a region of higher concentration to one of
a lower concentration is called
A. Active transport
B. Simple diffusion
C. Facilitated diffusion
B. Simple diffusion
In the healthy fetus, blood flows from the right atrium to the left atrium through the
A. Ductus arteriosus
B. Ductus venosus
C. Foramen ovale
C. Foramen ovale
In the healthy fetus, the umbilical cord enters the fetal abdomen and bypasses the liver through the
A. Ductus arteriosus
B. Ductus venosus
C. Foramen ovale
B. Ductus venosus
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
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
