NCC Electronic Fetal Monitoring Certification (NCC EFM) Questions with Answers
Which of the following factors can have a negative effect on uterine blood flow?
a. Hypertension
b. Epidural
c. Hemorrhage
d. Diabetes
e. All of the above - e. All of the above
How does the fetus compensate for decreased maternal circulating volume?
a. Increases cardiac output by increasing stroke volume.
b. Increases cardiac output by increasing it's heart rate.
c. Increases cardiac output by increasing fetal movement. - b. Increases cardiac output by
increasing it's heart rate.
Stimulating the vagus nerve typically produces:
a. A decrease in the heart rate
b. An increase in the heart rate
c. An increase in stroke volume
d. No change - a. A decrease in the heart rate
What initially causes a chemoreceptor response?
a. Epidurals
b. Supine maternal position
c. Increased CO2 levels
d. Decreased O2 levels
e. A & C
f. A & B
g. C & D - g. C & D
The vagus nerve begins maturation 26 to 28 weeks. Its dominance results in what effect to the
FHR baseline?
a. Increases baseline
b. Decreases baseline - b. Decreases baseline
T/F: Oxygen exchange in the placenta takes place in the intervillous space. - True
T/F: The parasympathetic nervous system is a cardioaccelerator. - False
T/F: Baroreceptors are stretch receptors which respond to increases or decreases in blood
pressure. - True
T/F: There are two electronic fetal monitoring methods of obtaining the fetal heart rate: the
ultrasound transducer and the fetal spiral electrode. - True
T/F: Variability can be determined with the fetoscope. - False
T/F: Because the ultrasound transducer and toco transducer are sealed units, they can be dipped
in warm water to make cleaning easier. - False
T/F: The most common artifact with the ultrasound transducer system for fetal heart rate is
increased variability. - True
T/F: All fetal monitors contain a logic system designed to reject artifact. - True
T/F: The monitor should always be tested before starting a tracing, either external or internal
mode and labeled a test. - True
T/F: The paper speed on the fetal monitor should always be set at 1cm/min. - False
T/F: Both internal and external monitoring methods are equally accurate means of obtaining the
fetal heart rate and contraction patterns. - False
T/F: The external toco is usually placed over the uterine fundus to pick up contractions. - True
T/F: The external toco gives measurable uterine pressure. - False
T/F: The fetal spiral electrode can be placed when vaginal bleeding of unknown origin is present.
- False
T/F: The ultrasound transducer is usually placed on the side of the uterus over the baby's back, as
the fetal heart is heard best there. - True
T/F: The spiral electrode is used to more accurately determine the frequency, duration, and
intensity of uterine contractions. - False
T/F: The heart rate from a well-applied fetal spiral electrode can only be fetal, not maternal. -
False
T/F: The intrauterine catheter is used to pick up the fetal heart rate. - False
T/F: The internal spiral electrode may pick up the maternal heart rate if the baby has died. - True
T/F: Fetal arrhythmias can be seen on both internal and external monitor tracings. - True
T/F: Variability and periodic changes can be detected with both internal and external monitoring.
- True
T/F: Variable decelerations are a result of cord compression. - True
T/F: The presence of FHR accelerations in the intrapartum and antepartum periods is a sign of
adequate fetal oxygenation. - True
T/F: Variable decelerations are a vagal response. - True
T/F: Late decelerations have a gradual decrease in FHR (onset to nadir 30 seconds) and are
delayed in timing with the nadir of the deceleration occurring after the peak of the contraction. -
True
T/F: The fetal heart rate baseline can be determined during periods of marked variability. - False
T/F: Anything that affects maternal blood flow (cardiac output) can affect the blood flow through
the placenta. - True
T/F: Variable decelerations are the most frequently seen fetal heart rate deceleration pattern in
labor. - True
T/F: Minimal variability is always an indicator of hypoxia and a Cesarean section is indicated. -
False
What is your first intervention in management of a patient experiencing variable decelerations?
a. Immediate delivery
b. Change maternal position
c. No treatment indicated
d. Oxygen
e. Stop oxytocin infusion - b. Change maternal position
Etiology of a baseline FHR of 165bpm occurring for the last hour can be:
1. Maternal supine hypotension
2. Maternal fever
3. Maternal dehydration
4. Unknown
a. 1 and 2
b. 1, 2 and 3
c. 2, 3 and 4 - c. 2, 3 and 4
What is the most probable cause of recurrent late decelerations?
a. Utero-placental insufficiency
b. Head compression
c. Cord compression
d. Maternal position change - a. Utero-placental insufficiency
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