,NCC EFM Exam Breakdown & Study
Guide Questions and Answers (Latest
Update 2025)
4) Presence of decels
5) Changes in trends overtime
FHR Baseline - Correct Answer ✅Average FHR rounded to
nearest 5 during a 10 min window
-110 to 160
-excludes accels, decels, & marked variability
-must have 2 mins to identify as a baseline (doesn't need to
be continuous)
Fetal Bradycardia - Correct Answer ✅<110 for ≥10 min
-Causes: hypotension (ex: after epi), cord prolapse, head
compression, congenital defect, rapid descent, abruption or
rupture, tachysystole, post dates, hypoglycemia, lupus (heart
block)
-With ↓ O2, blood will be shunted to brain, heart, & adrenals,
eventually ↓ FHR to ↓ O2 demands of heart muscle
-Verify not mom's HR, vaginal exam (r/o prolapse),
resuscitate, evaluate arrhythmia, expedite delivery
Fetal Tachycardia - Correct Answer ✅>160 for ≥10 min
-Causes: fetal anemia, maternal fever or infection, fetal
immaturity (preterm), SVT, maternal anxiety
(catecholamines), dehydration, hyperthyroid, hypoxia
FHR Variability - Correct Answer ✅Irregular in amplitude &
frequency, quantified by peak to trough
-Caused by sympathetic vs parasympathetic, r/t neuro
maturity
-Less in preterm due to undeveloped CNS
-Absent: undetectable, flat
-Minimal: ≤5 bpm but detectable
-Moderate: 6-25 bpm
-Marked: >25 bpm (indeterminate baseline), significance
unknown
Minimal variability - Correct Answer ✅≤5 bpm but
detectable
Sleep, sedated, or sick
-Sleep cycle: 20-60 mins
-Sedated: CNS depressant (ex: mag), 1-2 hrs
-Sick (acidemia): unresolved w intervention
-Priority: maximize oxygenation (position, bolus, O2 if
needed)
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