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NCC EFM Exam Breakdown & Study Guide Questions and and answers.
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NCC EFM Exam Breakdown & Study Guide Questions and and answers.
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NCC EFM Exam Breakdown & StudyGuide
Arrest of labor - correct answer->6cm dilated w/ ROM & one of the following w no cx change:
-4 hrs of adequate contractions (>200 MVUs)
-6 hrs of inadequate contractions
Artifact - correct answer-Interference in recording or transmission, seen as vertical lines
along tracing
-Causes: vaginal exam, fetal movement, connection issue, hair or caput w ISE
-R/o arrhythmia (can see & hear skips, has baseline, isolated spikes), try another method of
monitoring, verify w fetoscope
Auscultation - correct answer-Intermittently listening to fetal heart sounds w fetoscope or
doppler to assess FHR
-Detects baseline, rhythm, increases & decreases from baseline
-Cannot determine variability or classify decels
-Use of fetoscope can verify presence of arrhythmia (most accurate) & clarifies halving or
doubling
-Listen to FHR before, during, & for 30 sec after contraction
-Feel for mom's radial pulse to differentiate
Biophysical Profile (BPP) - correct answer-Normal = 2 points, abnormal = 0
-Can be done ≥28 wks, valid for 7 days
-BPP done over 30 mins
1) Fetal heart rate
2) Breathing movements
3) Gross body movements
4) Muscle tone: extension/flexion
5) Amniotic fluid volume: (>2cm or AFI >5)
Category I tracing - correct answer-Normal acid base balance
-Baseline between 110 to 160
-Moderate variability
-No late, variable, or prolonged decels
-May have early decels
-May or may not have accels
Category II tracing - correct answer-Indeterminate acid base balance
-Minimal variability
-Marked variability
-Late or variable decels
-Bradycardia with variability
-Tachycardia
-Prolonged decels
, -Absent variability w NO decels
-Absence of induced acccel WITH fetal stimulation
Category III tracing - correct answer-Predictive of abnormal acid base balance at that
moment
-Sinusoidal rhythm: has to last ≥20min, r/t anemia (previa, bleeding, abruption)
-Absent variability WITH one of the following: bradycardia, recurrent late or recurrent
variable decels
-Decide for c/s within 30min
Content on exam - correct answer--Pattern recognition & intervention: 70%
-Physiology: 11%
-Fetal assessment methods: 9%
-EFM equipment: 5%
-Professional issues: 5%
Cord blood & acid base balance - correct answer-Direct measurement of oxygenation (at the
time of delivery)
-Base deficit or base excess of +/-12 & a pH <7.1 = high probability of neonatal
encephalopathy r/t intrapartum
-Umbilical artery value is more predictive
-Respiratory acidosis: ↑ CO2 >60, normal BD/BE, normal bicarb, can develop quickly & be
resolved easily
-Metabolic acidosis: normal CO2, ↓ bicarb <22, abnormal BD/BE, r/t anaerobic metabolism
(lactic acid build up), difficult to resolve
-CAN have both metabolic & respiratory (↑ CO2, ↓ bicarb, abnormal BD/BE)
Diabetes - correct answer--Excess glucose delays surfactant production (RDS)
-T1 & T2 more likely to cause congenital abnormalities (heart & neural tube defect)
-Hypoglycemia at birth: glucose crosses placenta but not insulin, fetus has ↑ insulin
production & bottoms out after delivery
-Risk of LGA, fetal acidosis, impaired perfusion, polycythemia, demise, UTI, polyhydramnios,
abruption, PPH, Pre-E (r/t vascular damage), miscarriage
-Induce at 38-39 wks
Early deceleration - correct answer-Nadir aligns w contraction peak, gradual onset (≥30 secs
to nadir), benign vagal response
1) Pressure on fetal head
2) Increased intracranial pressure
3) Alteration in cerebral blood flow
4) Central vagal stimulation
5) FHR deceleration
EFM Equipment - correct answer--External EFM ✓
-Internal EFM (ISE & IUPC) ✓
-Artifact ✓
-Signal ambiguity ✓
-Failure & troubleshooting ✓
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