Page 1 of 223
NCC EFM CERTIFICATION EXAM NEWEST 2025 TEST
BANK| 2 VERSIONS (VERSION A & B) WITH COMPLETE
650 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+| NCC ELECTRONIC FETAL MONITORING
CERTIFICATION EXAM PREP 2025 (BRAN
Polyhydramnios .....ANSWER..... single MVP > 8 cm or AFI >24;
1% of pregnancies; 60% idiopathic; multiple gestation, maternal
diabetes, hydrops, anomalies, TORCH; ass'd with cardiac/GI
issues/renal issues
Oligohydramnios .....ANSWER..... single MVP < 2 cm or AFI < 5
at term (less than 5%ile); associated with FGR, placental
abnormalities, urinary tract abnormalities, post-term pregnancies,
ruptured or idiopathic membranes
,Page 2 of 223
Doppler .....ANSWER..... US transducer, depicts valve closure;
uses autocorrelation
Autocorrelation .....ANSWER..... successive US waveforms at many
points; current technology which is more accurate at detecting
FHR variability; controls artifact sound waves
Toco/tocotransducer .....ANSWER..... detects change in contour
with contractions; place at fundus or at area of maximum
palpation; difficult to measure with obesity, polyhydramnios
Fetal scalp electrode measures .....ANSWER..... R-R waves; still
has issues with artifact; risk of injury, measuring maternal HR in
instance of fetal demise; rupture and dilation required
IUPC .....ANSWER..... solid>fluid filled tips, measures mmHg and
allows amnioinfusion; issue with displacement, perforation,
placental abruption
Intermittent auscultation .....ANSWER..... goal is baseline 110-
160, +/-accels, no decels; if present, put on continuous monitor
,Page 3 of 223
min 20 minutes); cannot determine variability or types of FHR
decels
Active phase auscultation .....ANSWER..... q15 min for high risk up
to q30min
Second stage auscultation .....ANSWER..... q5 min if high risk up
to q15min
Fetal tolerance of labor .....ANSWER..... auscultate after a
contraction x 30-60 seconds; document rate, rhythm, accels,
decels
Doppler vs. fetoscope .....ANSWER..... doppler uses
autocorrelation and detects valve closure; fetoscope listens
through opening in heart wall?
Signal ambiguity .....ANSWER..... confusing maternal and fetal
heart rate; common with repositioning, fetal movement, during
pushing (maternal tachycardia); can occur even with fetal demise
due to FSE recording maternal blood flow through the placenta
, Page 4 of 223
Suspect signal ambiguity .....ANSWER..... when there is lower
baseline or >50% contractions with accelerations (especially with
pushing); verify and document maternal heart rate via pulse
oximetry
Halving/doubling .....ANSWER..... Halving occurs if FHR >180-
200; may double if rate <50
Extrinsic factors .....ANSWER..... maternal oxygenation, uterine
blood flow, placenta exchange, umbilical blood flow; intrinsic
factors = fetal circulation, oxygenation of tissues, FHR regulation
Primary source of oxygen for the feus .....ANSWER..... the
maternal respiratory system
Uterine blood flow .....ANSWER..... 60ml/min non-pregnant vs.
500-1000ml/min; 10-15% maternal cardiac output
Normal blood flow pathway .....ANSWER..... Blood from maternal
vein > intervillous pool of maternal blood > umbilical vein
(oxygenated blood)
NCC EFM CERTIFICATION EXAM NEWEST 2025 TEST
BANK| 2 VERSIONS (VERSION A & B) WITH COMPLETE
650 ACTUAL EXAM QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS) ALREADY
GRADED A+| NCC ELECTRONIC FETAL MONITORING
CERTIFICATION EXAM PREP 2025 (BRAN
Polyhydramnios .....ANSWER..... single MVP > 8 cm or AFI >24;
1% of pregnancies; 60% idiopathic; multiple gestation, maternal
diabetes, hydrops, anomalies, TORCH; ass'd with cardiac/GI
issues/renal issues
Oligohydramnios .....ANSWER..... single MVP < 2 cm or AFI < 5
at term (less than 5%ile); associated with FGR, placental
abnormalities, urinary tract abnormalities, post-term pregnancies,
ruptured or idiopathic membranes
,Page 2 of 223
Doppler .....ANSWER..... US transducer, depicts valve closure;
uses autocorrelation
Autocorrelation .....ANSWER..... successive US waveforms at many
points; current technology which is more accurate at detecting
FHR variability; controls artifact sound waves
Toco/tocotransducer .....ANSWER..... detects change in contour
with contractions; place at fundus or at area of maximum
palpation; difficult to measure with obesity, polyhydramnios
Fetal scalp electrode measures .....ANSWER..... R-R waves; still
has issues with artifact; risk of injury, measuring maternal HR in
instance of fetal demise; rupture and dilation required
IUPC .....ANSWER..... solid>fluid filled tips, measures mmHg and
allows amnioinfusion; issue with displacement, perforation,
placental abruption
Intermittent auscultation .....ANSWER..... goal is baseline 110-
160, +/-accels, no decels; if present, put on continuous monitor
,Page 3 of 223
min 20 minutes); cannot determine variability or types of FHR
decels
Active phase auscultation .....ANSWER..... q15 min for high risk up
to q30min
Second stage auscultation .....ANSWER..... q5 min if high risk up
to q15min
Fetal tolerance of labor .....ANSWER..... auscultate after a
contraction x 30-60 seconds; document rate, rhythm, accels,
decels
Doppler vs. fetoscope .....ANSWER..... doppler uses
autocorrelation and detects valve closure; fetoscope listens
through opening in heart wall?
Signal ambiguity .....ANSWER..... confusing maternal and fetal
heart rate; common with repositioning, fetal movement, during
pushing (maternal tachycardia); can occur even with fetal demise
due to FSE recording maternal blood flow through the placenta
, Page 4 of 223
Suspect signal ambiguity .....ANSWER..... when there is lower
baseline or >50% contractions with accelerations (especially with
pushing); verify and document maternal heart rate via pulse
oximetry
Halving/doubling .....ANSWER..... Halving occurs if FHR >180-
200; may double if rate <50
Extrinsic factors .....ANSWER..... maternal oxygenation, uterine
blood flow, placenta exchange, umbilical blood flow; intrinsic
factors = fetal circulation, oxygenation of tissues, FHR regulation
Primary source of oxygen for the feus .....ANSWER..... the
maternal respiratory system
Uterine blood flow .....ANSWER..... 60ml/min non-pregnant vs.
500-1000ml/min; 10-15% maternal cardiac output
Normal blood flow pathway .....ANSWER..... Blood from maternal
vein > intervillous pool of maternal blood > umbilical vein
(oxygenated blood)
