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[General] Professional EFM Guide Torrent & Leader in Certification Exams Materials &am

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【General】 Professional EFM Guide Torrent & Leader in Certification Exams Materials &am

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q30-Q35):NEW QUESTION # 30
What is the appropriate interpretation of this tracing?

  • A. Marked variability
  • B. Multiple prolonged accelerations
  • C. Tachycardia with variable decelerations
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The tracing demonstrates:
* Baseline ~150 bpm
* Variability # 25 bpm amplitude, highly erratic and wide
* No sustained decelerations
* No sustained accelerations # 2 min
NICHD/NCC definition of marked variability:
Amplitude of baseline FHR fluctuations greater than 25 bpm.
Marked variability often reflects transient fetal autonomic instability due to:
* Fetal stimulation
* Mild hypoxemia
* Maternal anxiety
* Drugs (e.g., butorphanol)
Why other answers are incorrect:
* B. Multiple prolonged accelerations - No accelerations of #2 minutes are present.
* C. Tachycardia with variables - Baseline is NOT tachycardic (>160 bpm), and decelerations are not present.
Thus, the correct interpretation is A. Marked variability.
References:NICHD FHR Definitions; NCC C-EFM Candidate Guide; AWHONN; Menihan; Simpson & Creehan.

NEW QUESTION # 31
Interventions to decrease uterine activity should take place:
  • A. When labor is in the second stage
  • B. If tachysystole is seen for one or two 10-minute segments
  • C. After tachysystole has been occurring for at least 30 minutes
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 # 32
When accelerations precede a variable deceleration pattern, this is caused by
  • A. occlusion of the umbilical vein
  • B. oligohydramnios
  • C. hypoxic reflex response
Answer: A
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 # 33
When R-R intervals are short, the fetal heart rate is
  • A. normal
  • B. fast
  • C. slow
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract NCC-Recommended Sources The fetal heart rate is calculated from the interval between consecutive R waves in the fetal ECG. Shorter R- R intervals indicate more beats per unit of time, therefore resulting in a higher heart rate. AWHONN and Menihan both note that fetal ECG monitoring measures instantaneous rate based on R-R spacing, and "shorter intervals correspond to fetal tachycardia." Simpson & Creehan reinforce that fetal heart rate variability and baseline are derived from these R-R intervals, with shorter intervals consistently producing faster rates. Miller's Pocket Guide describes the relationship simply: "Short R-R = faster rate; long R-R = slower rate." References:
AWHONN - Fetal Heart MonitoringMenihan - Electronic Fetal MonitoringSimpson & Creehan - Perinatal NursingMiller's Pocket GuideCreasy & Resnik - Maternal-Fetal Medicine

NEW QUESTION # 34
Prenatal diagnosis shows that a fetus has renal agenesis. During delivery, what type of electronic fetal heart rate pattern is most likely to be seen due to a common complication associated with this syndrome?
  • A. Variable decelerations
  • B. Late decelerations
  • C. Fetal heart block
Answer: A
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Renal agenesis # severe oligohydramnios (due to absent fetal urine production).
Oligohydramnios causes:
* Cord compression
* Recurrent variable decelerations
* Possible prolonged decels from cord entrapment
This is one of the hallmark FHR complications in renal agenesis.
Why the other options are incorrect:
* A. Heart block - associated with maternal autoimmune antibodies, not renal anomalies.
* B. Late decelerations - associated with uteroplacental insufficiency, not fluid deficiency.
Correct answer: C. Variable decelerations.
References:NCC Physiology & Pattern Recognition; AWHONN FHMPP; Menihan; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 35
......
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