NCC EFM Exam Breakdown & Study Guide
QUESTIONS AND DETAIED ANSWERS
Content ion iexam i- icorrect iAnswers i✔✔ i--Pattern irecognition i& iintervention: i70%
-Physiology: i11%
-Fetal iassessment imethods: i9%
-EFM iequipment: i5%
-Professional iissues: i5%
Pattern irecognition i& iintervention i- icorrect iAnswers i✔✔ i--FHR ibaseline i✓
-FHR ivariability i✓
-FHR iaccelerations i✓
-FHR idecelerations i✓
-Normal iuterine iactivity i✓
-Abnormal iuterine iactivity i✓
-Fetal idysrhythmias i✓
-Maternal icomplications i✓
-Uteroplacental icomplications i✓
-Fetal icomplications i✓
FHR iDescriptors i- icorrect iAnswers i✔✔ i-1) iBaseline
2) iVariability
,3) iPresence iof iaccels
4) iPresence iof idecels
5) iChanges iin itrends iovertime
FHR iBaseline i- icorrect iAnswers i✔✔ i-Average iFHR irounded ito inearest i5 iduring ia i10 imin iwindow
-110 ito i160
-excludes iaccels, idecels, i& imarked ivariability
-must ihave i2 imins ito iidentify ias ia ibaseline i(doesn't ineed ito ibe icontinuous)
Fetal iBradycardia i- icorrect iAnswers i✔✔ i-<110 ifor i≥10 imin
-Causes: ihypotension i(ex: iafter iepi), icord iprolapse, ihead icompression, icongenital idefect, irapid
idescent, iabruption ior irupture, itachysystole, ipost idates, ihypoglycemia, ilupus i(heart iblock)
-With i↓ iO2, iblood iwill ibe ishunted ito ibrain, iheart, i& iadrenals, ieventually i↓ iFHR ito i↓ iO2 idemands
iof iheart imuscle
-Verify inot imom's iHR, ivaginal iexam i(r/o iprolapse), iresuscitate, ievaluate iarrhythmia, iexpedite
idelivery
Fetal iTachycardia i- icorrect iAnswers i✔✔ i->160 ifor i≥10 imin
-Causes: ifetal ianemia, imaternal ifever ior iinfection, ifetal iimmaturity i(preterm), iSVT, imaternal ianxiety
i(catecholamines), idehydration, ihyperthyroid, ihypoxia
-Med icauses: iterbutaline, icatecholamines i(epinephrine, inorepi)
-Assess imom's itemp i& iinfection irisk i(GBS, iPROM)
FHR iVariability i- icorrect iAnswers i✔✔ i-Irregular iin iamplitude i& ifrequency, iquantified iby ipeak ito
itrough
-Caused iby isympathetic ivs iparasympathetic, ir/t ineuro imaturity
-Less iin ipreterm idue ito iundeveloped iCNS
-Absent: iundetectable, iflat
-Minimal: i≤5 ibpm ibut idetectable
-Moderate: i6-25 ibpm
-Marked: i>25 ibpm i(indeterminate ibaseline), isignificance iunknown
, Minimal ivariability i- icorrect iAnswers i✔✔ i-≤5 ibpm ibut idetectable
Sleep, isedated, ior isick
-Sleep icycle: i20-60 imins
-Sedated: iCNS idepressant i(ex: imag), i1-2 ihrs
-Sick i(acidemia): iunresolved iw iintervention
-Priority: imaximize ioxygenation i(position, ibolus, iO2 iif ineeded)
Moderate ivariability i- icorrect iAnswers i✔✔ i-6 ito i25 ibpm
-Reliably ipredicts ithe iabsence iof imetabolic iacidosis i(even iw idecels)
FHR iAccelerations i- icorrect iAnswers i✔✔ i-Reliably ipredicts iabsence iof imetabolic iacidemia
i(spontaneous ior istimulated)
-Onset ito ipeak iin i<30 isec
-For i≥32 iwks: i15x15 i(peak i≥15 ibpm iabove ibaseline ilasting i≥15 isec)
-For i<32 iwks: i10x10
-Prolonged iaccel: i2-9 imins i(at i10 ibecomes ichange iof ibaseline)
Early ideceleration i- icorrect iAnswers i✔✔ i-Nadir ialigns iw icontraction ipeak, igradual ionset i(≥30 isecs
ito inadir), ibenign ivagal iresponse
1) iPressure ion ifetal ihead
2) iIncreased iintracranial ipressure
3) iAlteration iin icerebral iblood iflow
4) iCentral ivagal istimulation
5) iFHR ideceleration
Periodic ivs iEpisodic i- icorrect iAnswers i✔✔ i-Periodic: icaused iby icontractions
-recurrent: ioccurs iw i≥50% iof icontractions iin i20 imin
-intermittent: iw i<50% iof icontractions iin i20 imins
Episodic: ispontaneous
Variable ideceleration i- icorrect iAnswers i✔✔ i-Caused iby icord icompression