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What is the normal baseline fetal heart rate (FHR) range at term?
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B
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Sample C-EFM Practice Questions
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1What is the normal baseline fetal heart rate (FHR) range at term?
A.80-100 bpm
B.110-160 bpm
C.160-180 bpm
D.100-120 bpm
Explanation: The normal baseline fetal heart rate at term is 110-160 beats per minute (bpm). This range indicates a well-oxygenated fetus. Rates outside of this range may indicate fetal distress and require further evaluation.
2Which of the following is the most important characteristic of the fetal heart rate, indicating a well-functioning autonomic nervous system?
A.Accelerations
B.Decelerations
C.Variability
D.Baseline rate
Explanation: Moderate variability (6-25 bpm) is the most important indicator of fetal well-being. It reflects the interplay between the sympathetic and parasympathetic nervous systems and indicates that the fetus is well-oxygenated and not in distress.
3An acceleration of the fetal heart rate is defined as an increase of at least:
A.10 bpm for 10 seconds
B.15 bpm for 15 seconds
C.20 bpm for 20 seconds
D.5 bpm for 5 seconds
Explanation: For a term fetus, an acceleration is defined as an increase in the fetal heart rate of at least 15 bpm above the baseline, lasting for at least 15 seconds. The presence of accelerations is a reassuring sign of fetal well-being.
4Early decelerations are caused by:
A.Uteroplacental insufficiency
B.Umbilical cord compression
C.Fetal head compression
D.Maternal hypotension
Explanation: Early decelerations are caused by compression of the fetal head during contractions. They are considered a benign finding and do not require intervention. The deceleration mirrors the contraction, with the nadir of the deceleration corresponding to the peak of the contraction.
5A sinusoidal fetal heart rate pattern is associated with:
A.Fetal sleep
B.Maternal sedation
C.Severe fetal anemia
D.Normal fetal movement
Explanation: A sinusoidal pattern is a rare but ominous finding associated with severe fetal anemia, often due to conditions like Rh isoimmunization or fetal-maternal hemorrhage. It is characterized by a smooth, sine-wave-like pattern with a frequency of 3-5 cycles per minute and an amplitude of 5-15 bpm.
6Variable decelerations are typically caused by:
A.Head compression
B.Uteroplacental insufficiency
C.Cord compression
D.Maternal fever
Explanation: Variable decelerations are caused by umbilical cord compression. They are characterized by an abrupt decrease in the fetal heart rate of at least 15 bpm, lasting for at least 15 seconds but less than 2 minutes. The shape of the deceleration can be a V, U, or W.
7A prolonged deceleration is a decrease in the fetal heart rate of at least 15 bpm below the baseline, lasting for:
A.More than 2 minutes but less than 10 minutes
B.More than 1 minute but less than 5 minutes
C.More than 30 seconds but less than 2 minutes
D.More than 10 minutes
Explanation: A prolonged deceleration is a decrease in the fetal heart rate of at least 15 bpm below the baseline, lasting for more than 2 minutes but less than 10 minutes. If the deceleration lasts for more than 10 minutes, it is considered a change in baseline.
8Tachysystole is defined as:
A.More than 5 contractions in 10 minutes, averaged over a 30-minute window
B.Less than 2 contractions in 10 minutes, averaged over a 30-minute window
C.Contractions lasting longer than 90 seconds
D.A resting tone of greater than 20 mmHg
Explanation: Tachysystole is defined as more than 5 contractions in 10 minutes, averaged over a 30-minute window. It can be a side effect of labor-inducing agents like oxytocin and can lead to fetal hypoxia if not managed.
9The primary nursing intervention for recurrent late decelerations is to:
A.Administer a tocolytic
B.Increase the oxytocin infusion
C.Improve fetal oxygenation
D.Prepare for an amnioinfusion
Explanation: The primary goal of nursing interventions for recurrent late decelerations is to improve fetal oxygenation. This can be achieved by measures such as maternal position change, administration of intravenous fluids, and supplemental oxygen.
10What is the most common fetal arrhythmia?
A.Atrial fibrillation
B.Ventricular tachycardia
C.Premature atrial contractions (PACs)
D.Complete heart block
Explanation: Premature atrial contractions (PACs) are the most common fetal arrhythmia. They are usually benign and resolve on their own. On the EFM tracing, they may appear as a brief spike or dip in the heart rate.
About the C-EFM Exam
The Certified Electronic Fetal Monitoring (C-EFM) credential validates the specialized knowledge of nurses and other healthcare professionals in interpreting electronic fetal monitoring strips, recognizing patterns, and implementing appropriate interventions during labor and delivery.
Questions
100 scored questions
Time Limit
2 hours
Passing Score
Pass/Fail
Exam Fee
$350 (National Certification Corporation (NCC))
C-EFM Exam Content Outline
70%
Pattern Recognition & Intervention
Interpretation of FHR patterns including baseline, variability, accelerations, and decelerations, plus appropriate nursing interventions.
11%
Physiology
Maternal-fetal physiology, uteroplacental circulation, and factors affecting fetal oxygenation.
19%
Fetal Monitoring Equipment & Professional Issues
Fetal monitoring equipment operation, surveillance methods, documentation, communication, and professional standards.
How to Pass the C-EFM Exam
What You Need to Know
- Passing score: Pass/Fail
- Exam length: 100 questions
- Time limit: 2 hours
- Exam fee: $350
Keys to Passing
- Complete 500+ practice questions
- Score 80%+ consistently before scheduling
- Focus on highest-weighted sections
- Use our AI tutor for tough concepts