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[Hardware] EFM Learning Materials & EFM Exam Simulation & EFM Test Dumps

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【Hardware】 EFM Learning Materials & EFM Exam Simulation & EFM Test Dumps

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q96-Q101):NEW QUESTION # 96
This is a tracing of a multiparous woman in the second stage of labor. The vertex is at +3 station. This pattern has continued for the last 20 minutes. She has been pushing for 2½ hours, and oxytocin is infusing at 12 milliunits/minute. Management should include

  • A. preparing for operative vaginal birth
  • B. increasing the oxytocin
  • C. preparing for cesarean birth
Answer: A
Explanation:
Comprehensive and Detailed Explanation (From NCC C-EFM-Referenced Sources) According to NCC C-EFM content guidance and AWHONN Fetal Heart Monitoring Principles (2022), recurrent variable and late patterns in second stage with descent to +2/+3 station require consideration of expediting delivery, especially when maternal effort is prolonged and oxytocin augmentation is already present.
Menihan & Simpson emphasize that with prolonged second stage, continued pushing beyond 2-3 hours, and vertex at +3 station, the evidence-based next step is operative vaginal birth, provided prerequisites are met. Cesarean is not indicated when the fetal head is already low and deliverable vaginally.
AWHONN and Creasy & Resnik state that increasing oxytocin when facing fetal stress and prolonged second stage is contraindicated, because tachysystole worsens fetal oxygenation and increases risk of fetal compromise.
Exact Extract Concepts Referenced:
- "Expedited delivery is recommended when recurrent decelerations persist in second stage and the head is low enough for operative vaginal birth." (AWHONN Principles)
- "Oxytocin should be reduced or discontinued in the presence of nonreassuring patterns." (Simpson, Obstetric Interventions)
- "Operative vaginal delivery is appropriate with full dilation, engaged head, and prolonged second stage." (Menihan, Simpson; Creasy & Resnik)

NEW QUESTION # 97
When auscultating the fetal heart rate, the Doppler should be placed over the fetal:
  • A. Abdomen
  • B. Back
  • C. Chest
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC and AWHONN standards state that the fetal heart tones are most clearly heard when the Doppler probe is placed over the fetal back, because:
* The fetal heart transmits sound most directly through the fetal spine.
* Amniotic fluid and fetal position allow the strongest conduction at the back.
* During Leopold maneuvers, identification of the back guides optimal placement.
Placing the Doppler over the abdomen or chest does not provide the strongest or most reliable fetal signal.
Therefore, the correct placement is over the fetal back.
References:NCC C-EFM Candidate Guide; AWHONN Fetal Heart Monitoring Principles & Practices; Simpson & Creehan Perinatal Nursing.

NEW QUESTION # 98
The baseline fetal heart rate decreases with gestational age as a result of an increase in:
  • A. Parasympathetic tone
  • B. Intrinsic ventricular rate
  • C. Catecholamine production
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
As gestation advances:
* Vagal (parasympathetic) control increases,
* Sympathetic dominance decreases,
* Resulting in a lower baseline heart rate.
NCC physiology teaching:
"Baseline FHR decreases with advancing gestational age due to maturation and increasing parasympathetic tone." Why the others are incorrect:
* Catecholamines increase heart rate, not decrease it.
* Intrinsic ventricular rate does not change significantly with gestational age.
Thus, the correct physiologic factor is increased parasympathetic tone.
References:NCC Physiology Domain; AWHONN; Menihan; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 99
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. Fetal heart block
  • B. Late decelerations
  • C. Variable decelerations
Answer: C
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 # 100
To differentiate a fetal dysrhythmia from artifact, it is important to recognize that artifact appears as deflections that are:
  • A. Varied and disorganized
  • B. Similar in pattern
  • C. Uniform but occur irregularly
Answer: A
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Artifact on fetal monitoring:
* Appears erratic, disorganized, and without physiologic pattern
* Shows random amplitude changes
* Often correlates with maternal movement, monitor displacement, or poor signal
* Lacks cyclical, repetitive characteristics seen in true dysrhythmias
Fetal dysrhythmias, by contrast:
* Have repetitive, patterned, predictable rhythm disturbances
* May show uniform premature beats, bigeminy, or sudden rate shifts
Therefore, varied and disorganized = artifact.
References:NCC Candidate Guide; AWHONN FHMPP; Menihan; Miller's Pocket Guide.

NEW QUESTION # 101
......
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