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CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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What is your first intervention in management of a client experiencing variable decelerations? CORRECT ANSWER>> 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:
- Maternal supine hypotension
- Maternal fever
- Maternal dehydration
- 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? CORRECT ANSWER>> a. Utero-placental insufficiency b. Head compression c. Cord compression d. Maternal position change a. Utero-placental insufficiency The most prevalent risk factor associated with fetal death before the onset of labor is: a. Low socioeconomic status b. Fetal malpresentation c. Uteroplacental insufficiency d. Uterine anomalies c. Uteroplacental insufficiency Which of the following is NOT used for antepartum fetal surveillance? CORRECT ANSWER>> a. Fetal movement counting b. Antepartum fetal heart rate testing
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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c. Biophysical profile testing d. Maternal HCG levels d. Maternal HCG levels Which of the following conditions is not an indication for antepartum fetal surveillance? CORRECT ANSWER>> a. Gestational hypertension b. Diabetes in pregnancy c. Fetus in breech presentation d. Decreased fetal movement c. Fetus in breech presentation Which of the following does not affect the degree of fetal activity? CORRECT ANSWER>> a. Vibroacoustic stimulation b. Smoking c. Fetal position d. Gestational age a. Vibroacoustic stimulation To be considered reactive, a nonstress test must have: a. 4 fetal heart rate accelerations in a 20 minute window b. 2 fetal heart rate accelerations in a 10 minute window c. 4 fetal heart rate accelerations in a 40 minute window d. 2 fetal heart rate accelerations in a 20 minute window d. 2 fetal heart rate accelerations in a 20 minute window If a nonstress test is nonreactive after 40 minutes, the next step should be: a. Have the client go home and do fetal movement counts b. Do a biophysical profile or contraction stress test c. Repeat the nonstress test within a week d. Admit the client for delivery b. Do a biophysical profile or contraction stress test All of the following are components of a biophysical profile except: a. Contraction stress test b. Assessment of fetal breathing c. Amniotic fluid volume measurement d. Fetal movement assessment a. Contraction stress test A modified biophysical profile includes a nonstress test and: a. Contraction stress test b. Ultrasound assessment of fetal movement
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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A. Acceleration B. Deceleration C. Fetal movement D. Sleep pattern A. Acceleration You are evaluating a client in the Prenatal Testing Department who has just completed a biophysical profile (BPP). You suspect that there could be chronic fetal asphyxia because the score is below A. 10 B. 6 C. 8 B. 6 When using a fetal scalp electrode (FSE), you notice an abnormally low FHR on the monitor. You should first A. Compare maternal pulse simultaneously with FHR B. Remove FSE C. Call the doctor immediately D. Turn off the monitor A. Compare maternal pulse simultaneously with FHR As a result of the intrinsic fetal response to oxygen deprivation, increased catecholamine levels cause the peripheral blood flow to decrease while the blood flow to vital organs increases. These flow changes along with increased catecholamine secretions have what effect on fetal blood pressure and fetal heart rate? CORRECT ANSWER>> A. Increase BP and increase HR B. Increase BP and decrease HR C. Decrease BP and increase HR D. Decrease BP and decrease HR B. Increase BP and decrease HR All of the following might indicate a pseudosinusoidal pattern as opposed to a sinusoidal pattern, except: A. Recent administration of narcotics to mother B. Accelerations in FHR C. Moderate variability D. Frequency of oscillations of two to five cycles/min D. Frequency of oscillations of two to five cycles/min All of the following are appropriate interventions for fetal tachycardia except: A. Increase maternal IV fluid rate B. Assess maternal vital signs
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
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C. Perform SVE D. Administer oxygen C. Perform SVE During a term antepartum NST (non-stress test), you notice several variable decelerations that decrease at least 15 bpm and last at least 15 sec long. Which of the following is the least likely explanation? CORRECT ANSWER>> A. True knot B. Gestational diabetes C. Umbilical cord entanglement D. Oligohydramnios B. Gestational diabetes All of the following are likely causes of prolonged decelerations except: A. Uterine tachysystole B. Prolapsed cord C. Maternal hypotension D. Maternal fever D. Maternal fever decelerations occur with less than 50% of contractions. A. Recurrent B. Intermittent C. Repetitive B. Intermittent decelerations occur with greater than or equal to 50% of contractions. A. Recurrent B. Intermittent C. Repetitive A. Recurrent All of the following could likely cause minimal variability in FHR except A. Magnesium sulfate administration B. Fetal sleep cycle C. Narcotic administration D. Ephedrine administration D. Ephedrine administration When an IUPC has been placed, Montevideo units must be or greater for adequate cervical change to occur. A. 100 B. 200
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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c. Acceleration followed by a 15 - second deceleration of the heart rate d. Acceleration of at least 10 beats per minute for 10 seconds d. Acceleration of at least 10 beats per minute for 10 seconds The nurse notes a pattern of variable decelerations to 75 bpm on the fetal monitor. The initial nursing action is to: a. Reposition the woman b. Administer oxygen c. Increase the intravenous fluid infusion d. Stimulate the fetal scalp a. Reposition the woman The tocotransducer should be placed: a. In the suprapubic area b. In the fundal area c. Over the xiphoid process d. Within the uterus b. In the fundal area The nurse notes a pattern of decelerations on the fetal monitor that begins shortly after the contraction and returns to baseline just before the contraction is over. The correct nursing response is to: a. Give the woman oxygen by facemask at 8- 10 L/min b. Position the woman on her opposite side c. Increase the rate of the woman's intravenous fluid d. Continue to observe and record the normal pattern d. Continue to observe and record the normal pattern Determining the FHR baseline requires the nurse to approximate the mean FHR rounded to increments of 5 bpm during a - minute window (excluding accelerations and decelerations). A. 2 B. 5 C. 10 D. 20 C. 10 Uterine tachysystole is observed when there are A. 5 or more contractions in 10 min B. 6 or more contractions in 10 min C. 10 or more contractions in 10 min D. 7 or more contractions in 10 min B. 6 or more contractions in 10 min
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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Which of the following interventions would best stimulate an acceleration in the FHR? CORRECT ANSWER>> A. Provide juice to client B. Perform vaginal exam C. Turn client on left side D. Vibroacoustic stimulation B. Perform vaginal exam Scalp stimulation Assessment of the is an indirect measurement of fetal oxygenation. A. Fetal heart rate B. Fetal scalp sampling C. Uterine activity D. Direct Coombs A. Fetal heart rate T/F: Intrauterine pressure catheters (IUPCs) do not increase risk for infection when placed on clients with intact membranes. False Membranes must be ruptured for use; infection is a risk What are abnormal fetal heart rate tracings predictive of? CORRECT ANSWER>> A. Likelihood of spontaneous vaginal delivery B. Newborn condition at time of delivery C. Fetal acid-base abnormalities D. Fetal intrauterine growth C. Fetal acid-base abnormalities Which of the following is not an intervention that should be implemented in a client with uterine tachysystole? CORRECT ANSWER>> A. Administer terbutaline B. Increase IV fluid rate C. Decrease or discontinue IV oxytocin D. Prepare client for cesarean section D. Prepare client for cesarean section Which of the following is most effective in determining the strength of a client's contractions? CORRECT ANSWER>> A. Client report B. Tocodynanamometer tracing C. RN palpation D. Sterile vaginal exam during a contraction
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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A deceleration from 145bpm down to 100bpm lasting 12 minutes may be defined as a A. Prolonged deceleration B. Variable deceleration C. Late deceleration D. Baseline change D. Baseline change Reduced respiratory gas exchange from persistent decelerations may cause a rise in fetal PCO2, which leads first to , then. A. Respiratory alkalosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis C. Respiratory alkalosis; metabolic alkalosis D. Respiratory acidosis; metabolic acidosis B. Respiratory acidosis; metabolic acidosis Decreased intervillious exchange of oxygenated blood resulting in fetal hypoxia is typically present in. A. Variable decelerations B. Late decelerations C. Early decelerations D. Accelerations B. Late decelerations Place the following interventions for a sinusoidal FHR in the correct order:
- Prepare for cesarean delivery
- Place client in lateral position
- Determine if pattern is related to narcotic analgesic administration
- Provide oxygen via face mask A. 4, 2, 3, 1 B. 3, 1, 2, 4 C. 4, 3, 2, 1 D. 3, 2, 4, 1 D. 3, 2, 4, 1 The is the source of all fetal oxygenation. A. Placenta B. Umbilical cord C. Mother D. Amniotic fluid C. Mother FHTs with recurrent variable decelerations, no accelerations, and minimal variability would be categorized as
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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A. Category I B. Category II C. Category III B. Category II FHTs with absent variability and bradycardia would be categorized as A. Category I B. Category II C. Category III C. Category III FHTs with moderate variability, no accelerations, and early decelerations would be categorized as A. Category I B. Category II C. Category III A. Category I FHTs with accelerations, no decelerations, and minimal variability would be categorized as A. Category I B. Category II C. Category III B. Category II Sinusoidal pattern is categorized as A. Category I B. Category II C. Category III B. Category III FHTs with absent variability and no accelerations or decelerations would be categorized as A. Category I B. Category II C. Category III B. Category II Absence of accelerations following fetal stimulation (i.e. scalp stimulation) is categorized as A. Category I B. Category II C. Category III B. Category II
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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B. Episodic C. Recurrent D. Irregular B. Episodic Which of the following is not a likely cause of a sinusoidal FHR pattern? CORRECT ANSWER>> A. Chronic fetal bleeding B. Fetal hypoxia or anemia C. Triple screen positive for Trisomy 21 D. Fetal isoimmunization C. Triple screen positive for Trisomy 21 Which of the following factors is not likely to cause uteroplacental insufficiency? CORRECT ANSWER>> A. Late-term gestation B. Preeclampsia C. Gestational diabetes D. Polyhydramnios E. Maternal smoking or drug use D. Polyhydramnios Which of the following are considered determinants of fetal well-being? CORRECT ANSWER>> (Select all that apply). A. Absence of decelerations in FHR B. Palpation of fetal movement C. Presence of accelerations in FHR D. Moderate variability in FHR E. Presence of early decelerations in second stage C. Presence of accelerations in FHR D. Moderate variability in FHR When auscultation is used for fetal assessment during labor for a low-risk woman, the FHR should be auscultated in the first stage of labor every A. 5 min B. 15 - 30 min C. 60 min B. 15 - 30 min For a low-risk woman in the second stage of labor, the FHR should be auscultated every A. 5 - 15 min B. 30 min C. 60 min A. 5 - 15 min
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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The normal FHR baseline A. Decreases during labor B. Fluctuates during labor C. Increases during labor B. Fluctuates during labor Bradycardia in the second stage of labor following a previously normal tracing may be caused by fetal A. Hypoxemia B. Rotation C. Vagal stimulation C. Vagal stimulation A likely cause of fetal tachycardia with moderate variability is A. Fetal hypoxemia B. Maternal fever C. Vagal stimulation B. Maternal fever Reduction in FHR variability can result from A. Fetal scalp stimulation B. Medication administration C. Vaginal examination B. Medication administration The primary goal in treatment for late decelerations is to A. Correct cord compression B. Improve maternal oxygenation C. Maximize uteroplacental blood flow C. Maximize uteroplacental blood flow The most frequently observed type of FHR deceleration is A. Early B. Late C. Variable C. Variable Amnioinfusion may be useful in alleviating recurrent decelerations that are A. Early B. Late C. Variable C. Variable
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
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C. Variable An FHR pattern associated with severe fetal anemia is A. Lambda B. Saltatory C. Sinusoidal C. Sinusoidal A workup for maternal systemic lupus erythematosus would likely be ordered in the presence of A. Complete fetal heart block B. Premature ventricular contractions C. Fetal supraventricular tachycardia A. Complete fetal heart block Which IV fluid is most appropriate for maternal administration for intrauterine resuscitation? CORRECT ANSWER>> A. Lactated Ringer's solution B. D5L/R C. Normal saline C. Normal saline The position that best promotes maternal-fetal exchange is A. Left lateral B. Right lateral C. Either right or left lateral C. Either right or left lateral The most appropriate equipment for administration of maternal oxygen for intrauterine resuscitation at 10 L/min is a A. Nasal cannula B. Simple face mask C. Nonrebreather face mask C. Nonrebreather face mask Accurate determination of baseline rate requires A. At least 2 contiguous minutes of FHR in a 10 - min window B. Evaluation of the FHR over at least a 10 - min window C. Averaging the FHR over 30 min B. Evaluation of the FHR over at least a 10 - min window An EFM tracing with absent variability and no decelerations would be classified as A. Category I B. Category II (indeterminate) C. Category III
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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B. Category II (indeterminate) An EFM tracing with absent variability and intermittent late decelerations would be classified as A. Category I B. Category II C. Category III B. Category II Interpretation and classification of FHR patterns are based on predictability of fetal status A. At birth B. At the time the pattern is observed C. Over the previous hour B. At the time the pattern is observed Amnioinfusion is an appropriate measure for A. Thick, meconium-stained fluid B. Oligohydramnios C. Recurrent variable decelerations unresolved by position changes C. Recurrent variable decelerations unresolved by position changes Baroreceptors respond to changes in fetal A. Blood pressure B. Oxygen status C. Acid-base status A. Blood pressure Fetal scalp stimulation is appropriate in the context of A. Minimal variability B. Prolonged deceleration C. Bradycardia A. Minimal variability Maternal oxygen administration is appropriate in the context of A. Recurrent variable decelerations/moderate variability B. Intermittent late decelerations/minimal variability C. Prolonged decelerations/moderate variability B. Intermittent late decelerations/minimal variability A preterm fetus A. Is more susceptible to hypoxic insults during labor than the term fetus B. Requires internal monitoring if oxytocin is used for labor induction or augmentation C. Should be born via cesarean section unless there are maternal contraindications A. Is more susceptible to hypoxic insults during labor than the term fetus
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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An appropriate initial treatment for recurrent late decelerations with moderate variability during first stage labor is A. Amnioinfusion B. Maternal repositioning C. Oxygen at 10L per nonrebreather face mask B. Maternal repositioning Most fetal dysrhythmias are not life-threatening, except for , which may lead to fetal congestive heart failure. Supraventricular tachycardia Medications, prematurity, fetal sleep, fetal dysrhythmia, anesthetic agents, or cardiac anomalies may result in variability. Decreased In the presence of late or variable decelerations, two parameters that indicate adequate fetal oxygenation are and. Moderate variability; normal baseline rate To correctly interpret a baseline FHR as tachycardic or bradycardic, the rate must persist for a minimum of min. 10 In assessing fetal well-being, the most important characteristic of the FHR is A. Rate B. Variability C. Presence of accelerations D. Absence of decelerations B. Variability Stimulation of the releases acetylcholine, resulting in decreased FHR. Parasympathetic nervous system The maintains transmission of beat-to-beat variability. Parasympathetic nervous system Stimulation of the releases catecholamines, resulting in increased FHR. Sympathetic nervous system Stimulation of results in abrupt decreases in FHR, CO, and BP. Baroreceptors
CERTIFICATION (EFM) ACTUAL EXAM AND TEST
BANK 2025 REAL EXAM QUESTIONS AND
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PASS GRADED A+
Baroreceptors influence decelerations with moderate variability. Variable Following an ultrasound which revealed decreased amniotic fluid, a woman at term is admitted in early labor. It should be recognized that oligohydramnios often results in fetal heart rate decelerations that are A. Late in onset or occur after the peak of the contraction B. Synchronous with that of the contraction C. Varied in depth and duration C. Varied in depth and duration In comparing early and late decelerations, a distinguishing factor between the two is A. Onset time to the nadir of the deceleration B. The number of decelerations that occur C. Timing in relation to contractions C. Timing in relation to contractions The underlying cause of early decelerations is decreased A. Baroceptor response B. Increased peripheral resistance C. Vagal reflex C. Vagal reflex Glucose is transferred across the placenta via. Facilitated diffusion Oxygen, carbon dioxide, water, electrolytes, urea, uric acid, fatty acids, fat-soluble vitamins, narcotics barbiturates, anesthetics, and antibiotics are transferred across the placenta via . Simple (passive) diffusion Amino acids, water-soluble vitamins, calcium, phosphorus, iron, and iodine are transferred across the placenta via. Active transport Well-oxygenated fetal blood enters the ventricle, which supplies the heart and brain. Less- oxygenated blood enters the ventricle, which supplies the rest of the body. Left; right The allows relatively well-oxygenated blood to enter the fetal heart directly, bypassing the liver. Ductus venosus
