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[General] Quiz Latest NCC - EFM - Certified - Electronic Fetal Monitoring Standard Answers

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【General】 Quiz Latest NCC - EFM - Certified - Electronic Fetal Monitoring Standard Answers

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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q24-Q29):NEW QUESTION # 24
The duration of a contraction is best represented by which colored arrow?

  • A. Green (B)
  • B. Blue (A)
  • C. Red (C)
Answer: A
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Contraction duration is defined as the length of time from the beginning of a contraction to the end of the same contraction (NICHD uterine activity definitions).
In the diagram:
* Green arrow (B) spans one individual contraction from rise # peak # return to baseline.
* Blue arrow (A) measures the interval between contractions (frequency).
* Red arrow (C) measures peak-to-peak amplitude shape, not duration.
Therefore, the green arrow correctly identifies contraction duration.
References:NCC Candidate Guide; AWHONN FHMPP; Menihan EFM; Simpson & Creehan.

NEW QUESTION # 25
A fetus displays a baseline heart rate of 125 beats per minute with moderate variability. During a contraction, the baseline rate drops abruptly to 80 beats per minute with gradual return to baseline over 90 seconds. This is classified as:
  • A. Early deceleration
  • B. Variable deceleration
  • C. Prolonged deceleration
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
NICHD definitions:
A variable deceleration is identified by:
* Abrupt onset(drop from baseline to nadir in <30 seconds)
* Depth #15 bpm
* Duration #15 seconds and <2 minutes
* Variable timing relative to contractions
* Variable shape (sharp drop, jagged descents, rapid recovery)
The scenario describes:
* Abrupt drop from 125 # 80 bpm (rapid onset)
* Lasting 90 seconds (still <2 minutes)
* Gradual return but still within variable range
* Occurring during a contraction
* Depth >15 bpm
This meets ALL criteria for a variable deceleration.
Why the other options are wrong:
* A. Early deceleration
* Requires gradual onset (>30 seconds).
* Mirrors contraction shape.
* Caused by head compression.
* This decel is abrupt, so NOT early.
* B. Prolonged deceleration
* Requires #2 minutes and <10 minutes.
* This decel lasts 90 seconds, which is below the threshold.
Correct classification: Variable deceleration.
References:NICHD FHR Definitions; NCC Pattern Recognition Domain; AWHONN FHMPP; Menihan; Simpson & Creehan.

NEW QUESTION # 26
(Full question)
This tracing would be categorized as a

  • A. Category III
  • B. Category II
  • C. Category I
Answer: B
Explanation:
Comprehensive and Detailed Explanation From Exact Extract (No URLs):
According to AWHONN Fetal Heart Monitoring Principles & Practice, Simpson & Miller, and the NCC C-EFM Content Outline, fetal heart rate categories are assigned based on baseline, variability, presence
/absence of accelerations, and type of decelerations.
A Category II tracing includes any pattern that is not clearly normal (Category I) or clearly abnormal (Category III). Classic Category II features include:
* Bradycardia NOT accompanied by absent variability
* Tachycardia
* Minimal variability
* Marked variability
* Absence of accelerations after stimulation
* Recurrent variable decelerations with minimal or moderate variability
* Prolonged decelerations (#2 min but <10 min)
In this tracing, the fetus demonstrates:
- A prolonged deceleration with subsequent recovery,
- Presence of baseline variability,
- Return toward baseline but not immediately normal.
AWHONN and Simpson state that any prolonged deceleration automatically places the tracing in Category II unless variability is absent (which would escalate it to Category III). Because variability is present, it cannot be Category III.
Therefore, by NCC standards, this tracing is Category II.

NEW QUESTION # 27
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 cesarean birth
  • B. increasing the oxytocin
  • C. preparing for operative vaginal birth
Answer: C
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 # 28
A woman at 38-weeks gestation is admitted to labor and delivery following a fall down the stairs three hours ago. She started feeling contractions in the ambulance. The fetal heart rate tracing shown is on initial evaluation and represents 25 minutes. This tracing is most consistent with a

  • A. category II tracing
  • B. category III tracing
  • C. category I tracing
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract without any URL or Links According to the NCC C-EFM 2025 Candidate Guide, Pattern Recognition and Intervention requires the candidate to classify fetal heart rate (FHR) patterns using the NICHD 2008 three-tier system, which NCC endorses across all recommended resources (AWHONN Fetal Heart Monitoring Principles and Practices, Menihan Electronic Fetal Monitoring, Simpson & Creasy, Miller's Pocket Guide).
A Category II tracing is defined as "indeterminate" and includes any FHR pattern that is not Category I and not Category III. NCC references indicate that Category II may include:
* Minimal or marked variability
* Absence of accelerations after fetal stimulation
* Recurrent variable decelerations with moderate variability
* Prolonged decelerations lasting 2-10 minutes
* Baseline tachycardia or bradycardia without absent variability
In the tracing provided:
* The baseline FHR is approximately 135-145 bpm, within normal limits.
* Moderate variability is not consistently present; variability is borderline minimal-moderate at times.
* No significant accelerations are seen over the 25-minute evaluation period.
* No recurrent late or prolonged decelerations are present.
* There are occasional subtle variable-type dips, but not enough to meet criteria for Category III.
NCC-endorsed texts (such as AWHONN and Menihan) state that a tracing with minimal variability for less than 40 minutes and without recurrent decelerations is Category II, as it fails to meet the requirements for Category I (must have moderate variability and accelerations absent decelerations) and lacks the criteria for Category III (must have absent variability with recurrent late decels, recurrent variable decels, bradycardia, or sinusoidal pattern).
Therefore, this pattern is indeterminate, consistent with Category II, and requires continued surveillance and evaluation, which aligns with NCC-recommended clinical decision-making competencies.

NEW QUESTION # 29
......
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