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[General] NCC EFM Exam Actual Tests - EFM Exams Torrent

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【General】 NCC EFM Exam Actual Tests - EFM Exams Torrent

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q104-Q109):NEW QUESTION # 104
The tracing shown is a:

  • A. Category II
  • B. Category III
  • C. Category I
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References (No URLs):
Interpretation of fetal heart rate (FHR) tracings in the NCC C-EFM exam follows the standardized NICHD three-tier classification, which is fully adopted in NCC's content outline and recommended references such as AWHONN Fetal Heart Monitoring Principles & Practices, Miller's EFM Pocket Guide, Menihan, Simpson' s Perinatal Nursing, and Creasy & Resnik.
Baseline:
The tracing demonstrates an FHR baseline around 145-150 bpm, which falls within the normal range of 110-
160 bpm. NCC references define baseline as the mean FHR rounded to increments of 5 bpm over a 10-minute window.
Variability:
The strip shows minimal variability, with amplitude fluctuations approximately 0-2 bpm.
According to NCC-aligned definitions:
* Moderate variability: 6-25 bpm
* Minimal variability: 1-5 bpm
* Absent variability: undetectable amplitude
This tracing shows minimal variability, not moderate, so it cannot be Category I.
Accelerations:
No accelerations are present. Lack of accelerations alone does not classify the tracing as Category III.
Decelerations:
There are no recurrent late decelerations, no recurrent variable decelerations, and no prolonged decelerations. Without these, and with minimal variability, the tracing does not meet Category III criteria.
Category III criteria (per NICHD/NCC):
Must include at least one of the following:
* Absent variability with recurrent late decelerations
* Absent variability with recurrent variable decelerations
* Absent variability with bradycardia
* Sinusoidal pattern
None of these are present.
Category II criteria (per NICHD/NCC):
Category II includes tracings that are not Category I or III.
Examples specifically listed include:
* Minimal variability
* Absent accelerations after fetal stimulation
* Tachycardia
* Bradycardia without absent variability
* Variable or late decelerations occurring intermittently
Because this tracing shows minimal variability, a normal baseline, no accelerations, and no recurrent decelerations, it fits squarely into Category II.
Therefore, the correct classification is Category II.
References:NCC C-EFM Candidate Guide and Content Outline (2025); 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; NICHD Three-Tier FHR Interpretation System.

NEW QUESTION # 105
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. Discharge to home
  • B. Adjust tocotransducer and continue to monitor
  • C. Admit for induction
Answer: B
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 # 106
A 20-year-old woman (G1P0) at 40-weeks gestation was admitted for cervical ripening with dinoprostone (Cervidil) four hours ago. She developed the pattern shown one hour ago. She has been changed to a lateral position and given a fluid bolus, and the pattern continues. An appropriate intervention would be to:

  • A. Remove the dinoprostone (Cervidil) insert
  • B. Give 0.25 mg of terbutaline subcutaneously
  • C. Continue to observe
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The tracing shows tachysystole (more than 5 contractions in 10 minutes) with minimal variability and recurrent decelerations consistent with uteroplacental insufficiency caused by excessive uterine activity.
Dinoprostone (Cervidil) is a uterotonic prostaglandin, and one of its known complications is uterine tachysystole with Category II or III fetal heart rate patterns.
NCC/AWHONN guidance for tachysystole caused by prostaglandins:
* FIRST intervention: Remove the dinoprostone insert.
* Reposition the patient (already done).
* IV fluid bolus (already done).
* Consider terbutaline only if tachysystole persists after removal of the agent.
Since maternal repositioning and IV fluids have already failed, the next step is to remove the cervical ripening agent.
Why other answers are incorrect:
* A. Continue to observe - Never acceptable with tachysystole + fetal intolerance.
* B. Terbutaline - May be used after prostaglandin removal, not before.
Thus, the correct answer is C. Remove the dinoprostone insert.
References:NCC C-EFM Candidate Guide; AWHONN Fetal Heart Monitoring Principles & Practices; Menihan; Miller's Pocket Guide; NICHD Definitions; Creasy & Resnik.

NEW QUESTION # 107
What is the appropriate interpretation of this tracing?

  • A. Tachycardia with variable decelerations
  • B. Multiple prolonged accelerations
  • C. Marked variability
Answer: C
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 # 108
This tracing reflects:

  • A. Category III
  • B. Category II
  • C. Category I
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
In NCC C-EFM interpretation, classification of a fetal heart tracing is based on NICHD's three-tier system:
Category I, II, and III. Category III represents an abnormal tracing requiring immediate evaluation and prompt intervention.
Key findings in this tracing:
* Baseline:Baseline is approximately 140 bpm, within the normal range (110-160 bpm).Baseline alone does not determine category.
* Variability:The tracing shows absent variability:
* No beat-to-beat oscillations
* Flat, minimal fluctuationNICHD and NCC define absent variability as amplitude range undetectable.
* Accelerations:No accelerations are present.
* Decelerations:The strip does not show decelerations or bradycardia.However, absent variability alone with no accelerations for 20 minutes is highly concerning.
Category Classification per NICHD/NCC:
Category III criteria include ANY of the following:
* Absent variability with recurrent late decelerations
* Absent variability with recurrent variable decelerations
* Absent variability with bradycardia
* Sinusoidal pattern
Also recognized as Category III:
* Persistent absent variability lasting #20 minutes with no accelerations, which is strongly suggestive of fetal acidemia when sustained.
This tracing shows:
* Absent variability (flat line)
* No accelerations
* Persisting over an extended period
Under NCC and AWHONN guidance:
A persistently flat tracing must be classified as Category III unless proven otherwise (e.g., fetal sleep, maternal medications), and it requires immediate intrauterine resuscitation and evaluation for potential expedited delivery.
Why Category I is NOT correct:
Category I requires:
* Moderate variability
* No late or variable decelerationsThis tracing does not have moderate variability.
Why Category II is NOT correct:
Category II includes minimal variability, marked variability, intermittent variables/lates, absence of accelerations after stimulation.
This tracing is worse than Category II because variability is absent, not minimal.
Thus, the tracing fits Category III.
References:NCC C-EFM Candidate Guide (2025); NCC Content Outline; NICHD Three-Tier FHR Interpretation System; 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 # 109
......
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