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NCC Certified - Electronic Fetal Monitoring Sample Questions (Q29-Q34):
NEW QUESTION # 29
The presence of fetal breathing movements on a biophysical profile reflects adequate:
- A. Neurologic function
- B. Surfactant levels
- C. Pulmonary vasoconstriction
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
A biophysical profile (BPP) assesses 5 components:
* FHR reactivity
* Fetal breathing movements
* Fetal tone
* Fetal movement
* Amniotic fluid volume
According to NCC/AWHONN, fetal breathing movements are controlled by the fetal central nervous system, specifically brainstem integrity.
Thus, fetal breathing movements signify normal neurologic function, particularly intact CNS and oxygenation.
Why the others are incorrect:
* Pulmonary vasoconstriction is not assessed by BPP.
* Surfactant levels do not correlate directly with fetal breathing movement scores.
Correct answer: A. Neurologic function.
References:NCC C-EFM Candidate Guide; AWHONN; Simpson & Creehan; Creasy & Resnik.
NEW QUESTION # 30
When R-R intervals are short, the fetal heart rate is
- A. slow
- B. normal
- C. fast
Answer: C
Explanation:
Comprehensive and Detailed Explanation From Exact Extract NCC-Recommended Sources The fetal heart rate is calculated from the interval between consecutive R waves in the fetal ECG. Shorter R- R intervals indicate more beats per unit of time, therefore resulting in a higher heart rate. AWHONN and Menihan both note that fetal ECG monitoring measures instantaneous rate based on R-R spacing, and "shorter intervals correspond to fetal tachycardia." Simpson & Creehan reinforce that fetal heart rate variability and baseline are derived from these R-R intervals, with shorter intervals consistently producing faster rates. Miller's Pocket Guide describes the relationship simply: "Short R-R = faster rate; long R-R = slower rate." References:
AWHONN - Fetal Heart MonitoringMenihan - Electronic Fetal MonitoringSimpson & Creehan - Perinatal NursingMiller's Pocket GuideCreasy & Resnik - Maternal-Fetal Medicine
NEW QUESTION # 31
A woman at 36-weeks gestation comes in because of uterine contractions radiating to the back. She has no insurance. In accordance with the Emergency Medical Treatment and Active Labor Act (EMTALA), she is obligated to be:
- A. Stabilized and receive a medical screening examination
- B. Admitted without delay
- C. Transferred to a safety-net hospital
Answer: A
Explanation:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NCC's Professional Issues domain includes EMTALA obligations for pregnant patients. EMTALA requires that ANY individual who presents to a hospital emergency department-regardless of insurance status- must receive:
* A Medical Screening Examination (MSE)
* Stabilization of any identified emergency medical condition (including labor)
* No transfer unless the patient requests it or the hospital cannot provide necessary stabilizing care This patient reports contractions at 36 weeks, which qualifies as a potential emergency medical condition until ruled out by the medical screening exam.
Correct obligations per EMTALA:
* She must NOT be transferred solely due to lack of insurance (option C).
* She does NOT need to be admitted unless labor is confirmed (option A).
* She must receive a medical screening examination and stabilization (option B).
Thus, the correct answer is B. Stabilized and receive a medical screening examination.
References:NCC C-EFM Candidate Guide (Professional Issues); EMTALA Statutory Requirements; AWHONN Fetal Heart Monitoring Principles & Practices.
NEW QUESTION # 32
The fetal heart rate baseline is
- A. normally between 110 and 170 beats per minute
- B. documented in a 15 beats per minute range
- C. established between periodic and episodic changes
Answer: C
Explanation:
Comprehensive and Detailed Explanation (From NCC C-EFM-Referenced Sources) The NCC C-EFM exam outline, along with AWHONN and Miller's Pocket Guide, define baseline fetal heart rate as the mean FHR rounded to increments of 5 bpm, measured over a 10-minute window, excluding:
* accelerations
* decelerations
* periods of marked variability
* any segments differing by >25 bpm
This aligns with ACOG, AWHONN, and Simpson's interpretation standards.
Option A is incorrect: the baseline is not documented as a 15-bpm range; it is documented as a single value (e.g., 140 bpm).
Option C is incorrect: the correct NCC/ACOG standardized normal baseline is 110-160 bpm, not 170.
Exact Extract Concepts Referenced:
- "Baseline is determined over a 10-minute period excluding periodic or episodic changes." (AWHONN FHR Principles)
- "Baseline is the mean FHR rounded to 5-bpm increments." (Miller's Pocket Guide)
- "Normal baseline is 110-160 bpm." (Simpson & Menihan; Creasy & Resnik)
NEW QUESTION # 33
A woman with hypertension at 38-weeks gestation has a biophysical profile. The result is 4/10 with decreased amniotic fluid volume. The next step should be to:
- A. Repeat the biophysical profile in 24 hours
- B. Admit for delivery
- C. Discharge home on bedrest
Answer: B
Explanation:
Comprehensive and Detailed Explanation From NCC-Aligned BPP Management Standards:
NCC, AWHONN, and maternal-fetal medicine guidelines state:
* A BPP score of 4/10 at term is abnormal.
* A low score indicates hypoxia-related CNS suppression.
* Oligohydramnios is an additional high-risk finding, especially in hypertension.
* At # 37 weeks, a BPP score of # 4/10 warrants immediate delivery.
Repeating the test is acceptable at preterm gestations (e.g., < 32-34 weeks), but not at 38 weeks.
Why the other answers are incorrect:
* B. Discharge home - Contraindicated with abnormal BPP.
* C. Repeat in 24 hours - Not recommended at term with a score of 4.
Correct answer: A. Admit for delivery
References:NCC C-EFM Candidate Guide; AWHONN FHMPP; Creasy & Resnik MFM; Simpson & Creehan; Menihan.
NEW QUESTION # 34
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