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[General] EFM Reliable Exam Practice | EFM Practice Test Fee

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【General】 EFM Reliable Exam Practice | EFM Practice Test Fee

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q71-Q76):NEW QUESTION # 71
Maternal conditions of autoimmunity can result in fetal heart block due to antibodies that target:
  • A. Fetal red blood cells
  • B. Maternal white blood cells
  • C. The fetal atrioventricular node
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC physiology content specifically includes maternal autoimmune influences on fetal cardiac conduction.
Conditions such as maternal lupus (SLE) or Sjogren's syndrome may produce anti-Ro/SSA and anti-La
/SSB antibodies. These antibodies cross the placenta and damage fetal conduction tissue.
The primary site of injury is the fetal atrioventricular (AV) node, leading to:
* First-, second-, or complete third-degree heart block
* A slow, regular ventricular rate typically 50-70 bpm
* Loss of beat-to-beat variability because ventricular myocardium does not display normal autonomic modulation This mechanism is extensively described in AWHONN, NCC physiology materials, and maternal-fetal physiology texts.
Option A: Antibodies do not target fetal RBCs; that describes hemolytic disease of the newborn.
Option B: Targeting maternal WBCs is not fetal-specific.
The correct affected structure is the fetal AV node.
Therefore, the correct answer is C. The fetal atrioventricular node.
References:NCC C-EFM Candidate Guide (2025); NCC Physiology Content Outline; AWHONN Fetal Heart Monitoring Principles & Practices; Menihan Electronic Fetal Monitoring; Simpson & Creehan Perinatal Nursing; Creasy & Resnik Maternal-Fetal Medicine.

NEW QUESTION # 72
A fetal heart rate deceleration that is episodic is a/an:
  • A. Late deceleration
  • B. Early deceleration
  • C. Variable deceleration
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC and NICHD differentiate:
* Periodic decelerations - those occurring with contractions
* Episodic decelerations - those occurring independent of contractions
Deceleration types:
* Early - periodic (mirror contractions)
* Late - periodic (after peak of contraction)
* Variable - may be periodic or episodic, and are the only type strongly associated with episodic patterns** Therefore, the only deceleration type that is characteristically episodic is a variable deceleration.
Correct answer: C. Variable deceleration
References:NICHD FHR Definitions; NCC C-EFM Guide; AWHONN; Menihan; Simpson & Creehan.

NEW QUESTION # 73
This patient received an epidural 15 minutes prior to the tracing shown. The next course of action is to:

  • A. Perform a cervical exam
  • B. Continue to monitor
  • C. Check maternal blood pressure
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
This tracing demonstrates:
* A sudden prolonged deceleration following epidural placement
* Minimal variability during the deceleration
* Event occurring within 15 minutes of epidural
NCC, AWHONN, and Menihan emphasize that maternal hypotension is the most common complication immediately following epidural analgesia. Hypotension leads to:
* Reduced uteroplacental perfusion
* Fetal bradycardia or prolonged decelerations
* Decreased variability during the deceleration
Typical fetal response to maternal hypotension:
Late-like or prolonged deceleration with weakening variability, exactly like the strip shown.
Therefore, the FIRST and most critical step is to check maternal blood pressure.
Other options:
* B. Continue to monitor - unsafe when a prolonged deceleration is present.
* C. Cervical exam - not indicated; the fetal tracing deterioration is temporally linked to epidural placement.
Thus, the correct action is A. Check maternal blood pressure.
References:NCC C-EFM Candidate Guide; AWHONN Fetal Heart Monitoring Principles & Practices; Menihan Electronic Fetal Monitoring; Miller's Fetal Monitoring Pocket Guide; Creasy & Resnik Maternal- Fetal Medicine.

NEW QUESTION # 74
(Full question statement)
Interobserver reliability in interpretation of fetal heart rate tracings is greatest when the tracing is:
  • A. Indeterminate
  • B. Normal
  • C. Abnormal
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract Without Links:
NCC examination standards and AWHONN clearly state that normal Category I patterns have the highest interobserver agreement because they contain objective, easily identifiable components:
* baseline 110-160 bpm
* moderate variability
* absence of late or variable decelerations
* presence or absence of accelerations
Simpson highlights that Category II tracings have poor reliability due to multiple combinations of variability and decelerations, while Category III patterns have higher agreement but occur far less frequently, limiting reliability measures.
Research cited within NCC-endorsed materials confirms that clinicians demonstrate the greatest agreement in identifying normal Category I patterns, making normal the correct answer.

NEW QUESTION # 75
Tachysystole can have a negative effect on fetal oxygenation during labor by
  • A. increasing maternal blood pressure
  • B. blocking active transport of oxygen to the fetus
  • C. interfering with reperfusion of the intervillous space
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract NCC-Recommended Sources NCC-recommended physiology references (AWHONN, Simpson & Creehan, Menihan, Creasy & Resnik) consistently state that the primary mechanism by which tachysystole affects fetal oxygenation is reduced uteroplacental perfusion, specifically through impaired intervillous space reperfusion.
During a normal contraction cycle, the fetus receives oxygen between contractions, when the uterus relaxes and maternal blood re-enters the intervillous space. AWHONN's Fetal Heart Monitoring Principles & Practices explains that tachysystole-defined as more than five contractions in 10 minutes averaged over 30 minutes-shortens or eliminates the relaxation phase, preventing adequate placental reoxygenation.
Simpson & Creehan highlight that "tachysystole decreases uteroplacental blood flow and interferes with replenishment of oxygenated maternal blood in the intervillous space." Menihan emphasizes that fetal hypoxemia in tachysystole results from interrupted perfusion, not from altered oxygen transport or maternal hemodynamic changes. Creasy & Resnik confirm that uterine overactivity reduces intervillous perfusion during contractions and impairs fetal oxygen exchange.
Thus, the physiologic problem is failure of the intervillous space to reperfuse, which compromises fetal oxygenation.
References:
AWHONN - Fetal Heart Monitoring Principles & PracticesSimpson & Creehan - Perinatal NursingMenihan
- Electronic Fetal MonitoringCreasy & Resnik - Maternal-Fetal MedicineMiller's Pocket Guide

NEW QUESTION # 76
......
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