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[General] New EFM Exam Dumps | EFM Exam PDF

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【General】 New EFM Exam Dumps | EFM Exam PDF

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q70-Q75):NEW QUESTION # 70
A woman at 41-weeks gestation is being induced. She is 2 cm dilated and is on oxytocin at 8 milliunits
/minute. Based on the fetal heart rate tracing shown, the best initial response is to:

  • A. Place a fetal spiral electrode
  • B. Continue to observe
  • C. Decrease the oxytocin
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The tracing shows tachysystole with emerging late decelerations and minimal variability:
* 5 contractions in 10 minutes
* Deceleration nadirs occur after the peak of the contraction (late pattern)
* Variability begins to trend toward minimal
* The tracing has deteriorated while on oxytocin 8 mU/min, a common threshold for overstimulation NCC and AWHONN emphasize that when tachysystole occurs with any fetal intolerance, the first action is to reduce or stop oxytocin.
Key NCC principles:
* Late decelerations + tachysystole = uteroplacental insufficiency caused by excessive uterine activity
* Interventions:
* Stop or reduce oxytocin
* Maternal repositioning
* IV fluid bolus
* Possible oxygen if other measures fail
Why the other options are incorrect:
* A. Continue to observe - not acceptable with late decels + tachysystole.
* C. Place a spiral electrode - this corrects signal quality, not uterine overstimulation or fetal oxygenation.
Thus, the best initial response is B. Decrease the oxytocin.
References:NCC C-EFM Candidate Guide; AWHONN Fetal Heart Monitoring Principles & Practices; NICHD Definitions; Miller & Menihan EFM texts; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 71
Fetal heart rate variability results from normal variance in fetal:
  • A. R-R intervals
  • B. Levels of carbon dioxide
  • C. Cardiac responsiveness
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
Variability reflects the interplay of the autonomic nervous system-sympathetic and parasympathetic influences-on the fetal myocardium. NCC defines variability as variation in the R-R intervals on the fetal ECG.
Key points:
* Variability originates from beat-to-beat fluctuations in ventricular depolarization timing.
* These R-R interval changes result from baroreceptor and chemoreceptor responses, vagal modulation, and fetal behavioral states.
* Carbon dioxide levels affect chemoreceptors but do not directly define variability.
Thus, variability is best described as resulting from variance in R-R intervals.
References:NCC C-EFM Candidate Guide; NICHD Definitions; AWHONN Fetal Heart Monitoring Principles & Practices; Menihan Electronic Fetal Monitoring.

NEW QUESTION # 72
The most probable underlying fetal physiologic cause for this tracing would be:

  • A. Myocardial hypoxic depression
  • B. Release of catecholamines
  • C. Vagal nerve stimulation in response to hypoxemia
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
This tracing shows:
* Baseline ~145 bpm
* Minimal variability
* No accelerations or decelerations
* Very little fluctuation # resembles a flat/minimal variability Category II tracing The key physiologic mechanism behind minimal variability in the presence of a normal baseline and normal contraction pattern is most often:
Increased fetal sympathetic tone, driven by catecholamine release (epinephrine and norepinephrine).
NCC and AWHONN explain:
* Catecholamine release (due to fetal stress, early hypoxemia, or maternal stress) results in:
* Reduced beat-to-beat fluctuation
* Minimal baseline variability
* This is considered an early compensatory mechanism, not yet a decompensated hypoxic state.
Why the other answers are incorrect:
* A. Myocardial hypoxic depression
* Causes absent variability, NOT minimal variability.
* Represents advanced or severe hypoxia. The FHR here is not absent variability.
* C. Vagal stimulation in response to hypoxemia
* Produces decelerations, especially late or prolonged.
* This strip shows no decelerations, ruling this out.
Therefore the most accurate physiologic explanation is B. Release of catecholamines.
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; NICHD Baseline Variability Definitions; Menihan EFM; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 73
This external tracing is from a 19-year-old (G1P0) at 39-weeks gestation. She is 6 cm dilated, 100% effaced, and -2 station. The fetus is in an occiput posterior position. She rates her pain as 8. She reports being lightheaded. She is most likely at risk for respiratory:

  • A. Acidosis
  • B. Alkalosis
  • C. Depression
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Physiologic References:
This strip shows:
* Baseline around 150 bpm
* Moderate variability
* No decelerations
* Consistent, strong contractions
* A maternal report of severe pain (8/10) and feeling lightheaded
In labor, severe pain + anxiety + hyperventilation commonly cause maternal respiratory alkalosis.
NCC and AWHONN physiology guidance explain:
* Hyperventilation # # PaCO# # respiratory alkalosis
* Symptoms include:
* Lightheadedness
* Tingling
* Dizziness
* Sometimes palpitations
* This frequently occurs during painful contractions, especially with occiput posterior labor, which is notoriously more painful due to back pressure.
Why other answers are incorrect:
* A. Respiratory acidosis occurs with hypoventilation-not present here.
* C. Respiratory depression occurs with opioids, magnesium sulfate, or anesthesia-not part of this scenario.
Therefore, the correct answer is B. Alkalosis.
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Menihan EFM; Miller's Pocket Guide; Simpson & Creehan; Creasy & Resnik.

NEW QUESTION # 74
A woman at 36-weeks gestation comes in because of uterine contractions radiating to the back. She has no insurance. In accordance with the Emergency Medical Treatment and Active Labor Act (EMTALA), she is obligated to be:
  • A. Admitted without delay
  • B. Transferred to a safety-net hospital
  • C. Stabilized and receive a medical screening examination
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC's Professional Issues domain includes EMTALA obligations for pregnant patients. EMTALA requires that ANY individual who presents to a hospital emergency department-regardless of insurance status- must receive:
* A Medical Screening Examination (MSE)
* Stabilization of any identified emergency medical condition (including labor)
* No transfer unless the patient requests it or the hospital cannot provide necessary stabilizing care This patient reports contractions at 36 weeks, which qualifies as a potential emergency medical condition until ruled out by the medical screening exam.
Correct obligations per EMTALA:
* She must NOT be transferred solely due to lack of insurance (option C).
* She does NOT need to be admitted unless labor is confirmed (option A).
* She must receive a medical screening examination and stabilization (option B).
Thus, the correct answer is B. Stabilized and receive a medical screening examination.
References:NCC C-EFM Candidate Guide (Professional Issues); EMTALA Statutory Requirements; AWHONN Fetal Heart Monitoring Principles & Practices.

NEW QUESTION # 75
......
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