Title: Hot EFM Spot Questions Exam Pass Certify | EFM: Certified - Electronic Fetal Mon [Print This Page] Author: donyoun866 Time: yesterday 15:37 Title: Hot EFM Spot Questions Exam Pass Certify | EFM: Certified - Electronic Fetal Mon The NCC market has become so competitive and tough with time. To satisfy this task the professionals have to analyze new in-name for skills and improve their expertise. With the NCC EFM certification exam they could do that activity fast and well. Your examination training with NCC Certification Questions is our top priority at Pass4guide. To do this they just join up in Certified - Electronic Fetal Monitoring (EFM) certification exam and show a few firm dedication and self-discipline and prepare well to crack the EFM examination.
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The decelerations seen in the fetal monitoring tracing shown are best described as:
A. Late
B. Early
C. Variable
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
Accurate classification of decelerations requires evaluating their shape, onset, nadir, recovery, relationship to contractions, and variability characteristics. NCC uses the NICHD standardized definitions, reinforced across AWHONN, Miller's Pocket Guide, Menihan, Simpson, and Creasy & Resnik.
Key features in this tracing:
* Abrupt onsetThe FHR drops rapidly from baseline to nadir in less than 30 seconds-this is the defining hallmark of a variable deceleration per NICHD.
* Sharp V-shape and deep amplitudeThe tracing shows steep descents and ascents, characteristic of cord compression-type variable decelerations.
* Inconsistent timing with contractionsThe decelerations do not begin at the start of contractions (as early decelerations would) and do not consistently begin after the peak of contractions (as late decelerations would). Variable decelerations can occur before, during, or after a contraction-exactly what is demonstrated here.
* Rapid return to baselineAnother core feature of variable decelerations in NICHD/NCC definitions.
* No uniform contraction relationshipEarly decelerations are symmetrical and mirror contractions.
Late decelerations begin after the peak of the contraction. This strip does not match either pattern.
Differentiation per NCC-aligned definitions:
* Early Decelerations:Gradual onset (>30 sec), nadir mirrors contraction peak, shallow, uniform.Not present.
* Late Decelerations:Gradual descent, nadir after contraction peak, smooth shape.Not present.
* Variable Decelerations:Abrupt onset (<30 sec), variable timing, sharp V-shape, rapid recovery, often with shoulders.Exactly matches the tracing.
Therefore, according to NICHD/NCC criteria, the decelerations shown are variable decelerations.
References:NCC C-EFM Candidate Guide (2025); NCC Content Outline; NICHD Standardized Definitions; AWHONN Fetal Heart Monitoring Principles & Practices; Miller's Fetal Monitoring Pocket Guide; Menihan Electronic Fetal Monitoring; Simpson & Creehan Perinatal Nursing; Creasy & Resnik Maternal-Fetal Medicine.
NEW QUESTION # 81
A woman with hypertension at 38-weeks gestation has a biophysical profile. The result is 4/10 with decreased amniotic fluid volume. The next step should be to:
A. Discharge home on bedrest
B. Admit for delivery
C. Repeat the biophysical profile in 24 hours
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned BPP Management Standards:
NCC, AWHONN, and maternal-fetal medicine guidelines state:
* A BPP score of 4/10 at term is abnormal.
* A low score indicates hypoxia-related CNS suppression.
* Oligohydramnios is an additional high-risk finding, especially in hypertension.
* At # 37 weeks, a BPP score of # 4/10 warrants immediate delivery.
Repeating the test is acceptable at preterm gestations (e.g., < 32-34 weeks), but not at 38 weeks.
Why the other answers are incorrect:
* B. Discharge home - Contraindicated with abnormal BPP.
* C. Repeat in 24 hours - Not recommended at term with a score of 4.
Correct answer: A. Admit for delivery
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Creasy & Resnik MFM; Simpson & Creehan; Menihan.
NEW QUESTION # 82
Interventions to decrease uterine activity should take place:
A. After tachysystole has been occurring for at least 30 minutes
B. If tachysystole is seen for one or two 10-minute segments
C. When labor is in the second stage
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Tachysystole = >5 contractions in 10 minutes averaged over 30 minutes (NICHD).
However, NCC and AWHONN intervention guidelines state:
* If tachysystole appears in one or two consecutive 10-minute segments, especially with Category II or III patterns, intervention must begin immediately.
* Intervention includes:
* Stopping/reducing oxytocin
* Maternal repositioning
* IV bolus
* Tocolysis if needed
Why the wrong answers are wrong:
* A. Waiting 30 minutes delays necessary fetal resuscitation.
* C. Stage of labor does not determine when to intervene.
Correct answer: B. If tachysystole is seen for one or two 10-minute segments References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Menihan.
NEW QUESTION # 83
When accelerations precede a variable deceleration pattern, this is caused by
A. hypoxic reflex response
B. oligohydramnios
C. occlusion of the umbilical vein
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract (No URLs or Links) NCC-recommended physiologic texts (AWHONN, Menihan, Simpson, Creasy & Resnik) explain that variable decelerations are caused by umbilical cord compression. This process occurs in a three-step sequence, well known in fetal monitoring physiology:
* Umbilical vein occlusion occurs first # decreases fetal venous return # brief fetal acceleration (a compensatory sympathetic response).
* Umbilical artery occlusion follows # increases fetal systemic vascular resistance # variable deceleration as vagal stimulation lowers the fetal heart rate.
* Release of compression # post-deceleration acceleration may occur.
Thus, an acceleration immediately before a variable deceleration represents the initial compression of the umbilical vein, not a hypoxic response. This is a normal physiologic response to transient cord compression, often described in AWHONN and Menihan's physiologic explanation of "shoulders" around variable decelerations.
Oligohydramnios can contribute to cord compression but does not explain accelerations preceding the deceleration. A "hypoxic reflex" would not produce a pre-deceleration acceleration.
Therefore, the correct physiologic cause is:
Umbilical vein occlusion.
References (No URLs)
* NCC C-EFM Candidate Guide 2025 - Physiology
* AWHONN Fetal Heart Monitoring Principles
* Menihan: Electronic Fetal Monitoring
* Simpson & Creehan: Perinatal Nursing
* Creasy & Resnik: Maternal-Fetal Medicine
NEW QUESTION # 84
A woman experiences an eclamptic seizure during the second stage of labor. An anticipated fetal heart rate abnormality post-seizure would be:
A. Variable decelerations
B. Bradycardia
C. Sinusoidal pattern
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Emergency Fetal Response Principles:
Following an eclamptic seizure:
* Maternal hypoxia, apnea, and intense sympathetic discharge occur
* Uteroplacental perfusion drops
* Fetus experiences acute hypoxemia
* The expected fetal heart rate response is a prolonged bradycardia
This is well-described in NCC and AWHONN emergency physiology:
* "Post-seizure fetal bradycardia is common and often resolves within 5-10 minutes as maternal oxygenation stabilizes." Why other answers are incorrect:
* B. Sinusoidal pattern - Rare and usually indicates fetal anemia, not post-seizure status.
* C. Variable decelerations - Associated with cord compression, not seizures.
Correct answer: A. Bradycardia
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Menihan; Simpson & Creehan.
NEW QUESTION # 85
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