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[General] Exam EFM Simulator Online - EFM Examinations Actual Questions

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【General】 Exam EFM Simulator Online - EFM Examinations Actual Questions

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q69-Q74):NEW QUESTION # 69
This fetal heart rate pattern is classified as Category III based on:

  • A. Type of deceleration
  • B. Absent variability
  • C. Contraction pattern
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
This tracing shows recurrent late decelerations accompanied by absent variability.
Per NICHD/NCC, a tracing is Category III if ANY of the following are present:
* Absent variability AND recurrent late decelerations
* Absent variability AND recurrent variable decelerations
* Absent variability AND bradycardia
* Sinusoidal pattern
In this strip:
* Variability is absent
* Decelerations are recurrent and late
The determining feature for the classification is absent variability, which indicates significant risk for fetal acidemia.
The contraction pattern (option B) does not determine category.
The deceleration type alone (option C) does not determine Category III without absent variability.
Thus, the classification is Category III because of absent variability.
References:NCC C-EFM Candidate Guide; NICHD Three-Tier System; AWHONN Fetal Heart Monitoring Principles & Practices; Miller's Fetal Monitoring Pocket Guide; Menihan Electronic Fetal Monitoring.

NEW QUESTION # 70
Fetal respiratory acidosis is most likely to present with which of the following fetal heart rate decelerations?
  • A. Early
  • B. Late
  • C. Variable
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC and AWHONN physiology teachings:
* Variable decelerations caused by cord compression lead to:
* Transient interruption of umbilical venous flow
* Impaired fetal gas exchange
* Acute rise in CO#
* Respiratory acidosis (early phase of hypoxemia)
This is well documented:
* Early decelerations # head compression # NOT associated with acidemia.
* Late decelerations # uteroplacental insufficiency # metabolic acidosis, not respiratory.
Thus:
* Variable decelerations # respiratory acidosis
* Late decelerations # metabolic acidosis
Correct answer: C. Variable
References:NCC Physiology Domain; AWHONN FHMPP; Menihan EFM; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 71
Interventions to decrease uterine activity should take place:
  • A. When labor is in the second stage
  • B. After tachysystole has been occurring for at least 30 minutes
  • C. If tachysystole is seen for one or two 10-minute segments
Answer: C
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 # 72
The tracing shown is from a woman at 28-weeks gestation in the post-anesthesia care unit (PACU) after an appendectomy. She is alert and awake. Based on this fetal heart rate pattern, the most appropriate intervention is:

  • A. Administer terbutaline
  • B. Perform cesarean birth
  • C. Continued monitoring
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The fetal heart rate tracing shows:
* Baseline around 140 bpm
* Minimal variability
* No accelerations
* No decelerations
* Regular uterine activity but not tachysystole
This pattern is Category II, but in the context of:
* 28-week gestation
* Immediate postoperative status after anesthesia
* Maternal alertness and stability
NCC and AWHONN emphasize that maternal sedation, post-anesthesia effects, medications, and physiologic stress commonly cause temporary minimal variability without acidemia, especially at preterm gestations where baseline variability is normally lower.
Key NCC principle:
Minimal variability in a stable mother without decelerations does NOT require emergent delivery.
Instead, the fetus should be observed as anesthesia effects wear off.
Why other answers are incorrect:
* A. Terbutaline - No tachysystole and no recurrent decels are present.
* C. Cesarean birth - No bradycardia, no late decels, no absent variability, and no Category III criteria.
Thus, appropriate management is B. Continued monitoring.
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Menihan EFM; Miller's Pocket Guide; NICHD Definitions; Creasy & Resnik.

NEW QUESTION # 73
A woman (G1P0) arrives in triage with a pain score of 4/10 at 39-weeks gestation. The fetal heart rate tracing shown is obtained. The best intervention is to:

  • A. Adjust tocotransducer and continue to monitor
  • B. Admit for induction
  • C. Discharge to home
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
This tracing demonstrates a normal, reassuring fetal heart pattern that is technically categorized as Category I, indicating normal fetal acid-base status. Before any decision regarding discharge or induction, NCC emphasizes correct assessment of the tracing quality, fetal status, and uterine activity.
Key Tracing Characteristics
* Baseline:Approximately 135-145 bpm, well within the normal range of 110-160 bpm.
* Variability:The strip shows moderate variability (6-25 bpm), the strongest indicator of adequate fetal oxygenation per NCC, AWHONN, and NICHD.
* Accelerations:Several accelerations are present-another reassuring feature of normal fetal well-being.
* Decelerations:No variable, late, or prolonged decelerations are present.
* Uterine Activity:The lower channel shows poor recording quality and inconsistent signal- suggesting the toco is not capturing contractions well, not that the patient is contracting excessively or not at all.
Correct interpretation per NCC:
NCC emphasizes distinguishing between physiologic assessment and technical artifact.
The fetal tracing is completely reassuring.
The only abnormality is the poor uterine activity signal, a common triage occurrence due to:
* Toco placement
* Maternal body habitus
* Positioning
* Low contraction intensity in early labor
Thus, the correct next step is to optimize equipment (reposition the toco, adjust belt, palpate contractions) and continue to monitor.
Why the other options are incorrect:
B). Admit for induction - NOT indicated
* There is no evidence of fetal compromise.
* No indication for induction is present (pain score 4/10, reassuring FHR, term pregnancy).
* NCC emphasizes avoiding unnecessary interventions.
C). Discharge to home - NOT yet appropriate
* You cannot safely discharge a patient with a poorly monitored contraction pattern.
* Adequate assessment requires confirming uterine activity-after fixing the toco.
Therefore, the appropriate action is:
A). Adjust tocotransducer and continue to monitor.
References:NCC C-EFM Candidate Guide (2025); NCC Content Outline; AWHONN Fetal Heart Monitoring Principles & Practices; NICHD Definitions; Miller's Fetal Monitoring Pocket Guide; Menihan Electronic Fetal Monitoring; Simpson & Creehan Perinatal Nursing; Creasy & Resnik Maternal-Fetal Medicine.

NEW QUESTION # 74
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