初段のNCC EFM: Certified - Electronic Fetal Monitoring学習関連題 -パススルーShikenPASS EFMサンプル問題集

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NCC EFM Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Fetal Assessment Methods9%- Assessment Techniques
  • 1. Cord Blood and Acid-Base Analysis
  • 2. Fetal Movement Assessment
  • 3. Contraction Stress Testing
Topic 2: Electronic Monitoring Equipment5%- Monitoring Systems
  • 1. External Monitoring
  • 2. Internal Monitoring
  • 3. Equipment Troubleshooting
Topic 3: Pattern Recognition and Intervention70%- Maternal and Fetal Complications
  • 1. Fetal Dysrhythmias
  • 2. Tachysystole
  • 3. Intrauterine Resuscitation
- Fetal Heart Rate Patterns
  • 1. Accelerations and Decelerations
  • 2. Baseline Variability
  • 3. Sinusoidal Patterns
Topic 4: Professional Issues5%- Clinical Practice and Safety
  • 1. Quality Improvement
  • 2. Patient Safety
  • 3. Legal and Ethical Issues
Topic 5: Physiology11%- Maternal-Fetal Physiology
  • 1. Fetal Heart Rate Regulation
  • 2. Uteroplacental Circulation
  • 3. Fetal Oxygenation

>> EFM学習関連題 <<

EFMサンプル問題集 & EFM合格問題

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NCC Certified - Electronic Fetal Monitoring 認定 EFM 試験問題 (Q116-Q121):

質問 # 116
(Full question)
Vibroacoustic stimulation (VAS) is a useful intervention which can

正解：B

解説：
Comprehensive and Detailed Explanation From Exact Extract (No URLs):
According to AWHONN's Fetal Assessment Text, Simpson & Miller, and Menihan, vibroacoustic stimulation is utilized during NSTs to elicit fetal accelerations, thereby minimizing testing time.
NCC-referenced sources describe VAS as:
* A method that awakens the fetus,
* Stimulates the fetal auditory system,
* Produces reactive accelerations in a neurologically intact fetus,
* Dramatically shortens NST duration, especially when the fetus is in a sleep cycle.
VAS does NOT measure amniotic fluid, nor does it have any effect on uterine activity (therefore cannot treat tachysystole).
The only correct purpose supported by NCC-cited literature is that VAS shortens the duration of the NST, making Option C correct.


質問 # 117
During amnioinfusion, the infusion should be stopped periodically to assess changes in:

正解：B

解説：
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
During amnioinfusion, NCC emphasizes monitoring for uterine overdistention, which can lead to uterine hypertonus, uterine rupture, or placental separation. The primary way to evaluate overdistention is by measuring baseline uterine pressure via IUPC.
* Rising resting tone (>20-25 mmHg) indicates accumulating fluid and risk.
* Stopping the infusion intermittently allows recalibration and assessment of uterine baseline pressure.
* Contraction pattern (option B) is important but not the primary safety parameter.
* Pain (option C) is nonspecific and not a reliable indicator of uterine overdistention.
Thus, the infusion is stopped to assess baseline uterine pressure.
References:NCC C-EFM Candidate Guide; AWHONN Fetal Heart Monitoring Principles & Practices; Miller' s Fetal Monitoring Pocket Guide; Menihan Electronic Fetal Monitoring.


質問 # 118
Stimulation of the vagus nerve in a healthy fetus will cause:

正解：C

解説：
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Vagal stimulation is part of the parasympathetic nervous system, which causes:
* Slowing of the fetal heart rate (FHR)
* Rapid but temporary changes in HR
* Seen with head compression, scalp stimulation, or fetal movement
NICHD/NCC physiology explains:
* Vagus nerve activation # acetylcholine release # slowed SA node firing # decrease in FHR
* This mechanism is responsible for early decelerations during labor due to head compression.
Why the incorrect answers are wrong:
* B. Increased cardiac contractility # sympathetic effect, not vagal.
* C. Increased fetal blood pressure # also a sympathetic effect.
Correct answer: A. Decreased fetal heart rate
References:NCC Candidate Guide; AWHONN FHMPP; Menihan; Miller's Pocket Guide; Simpson & Creehan.


質問 # 119
A woman has been 5 cm dilated for the past 3 hours. The tracing shown has developed over the last 30 minutes. The best initial course of action is to:

正解：C

解説：
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
The fetal heart rate tracing demonstrates recurrent deep variable decelerations with a rapid drop in FHR, a V-shaped pattern, and slow return to baseline. These are classic signs of cord compression. According to NCC, AWHONN, Miller, Menihan, and Simpson, recurrent variable decelerations require immediate intrauterine resuscitative interventions before any decision regarding operative birth.
NCC-aligned intervention steps include:
* Maternal repositioning (first-line for cord compression)
* Reducing or stopping oxytocin if infusing
* IV fluid bolus
* Amnioinfusion (if appropriate and recurrent deep variables persist)
* Oxygen only if other measures fail (per NCC/AWHONN updated guidance)
The cervix has remained unchanged at 5 cm for 3 hours (a prolonged latent or early active labor pattern), but the fetal tracing shows Category II-recurrent variable decelerations. Category II dictates corrective action, not immediate delivery unless it progresses to Category III.
Cesarean birth (option C) is reserved for:
* Persistent Category III
* Failure of intrauterine resuscitation
* Proven fetal intoleranceNone of these conditions have been met yet.
Thus, the correct initial management is B. Perform intrauterine resuscitative measures.
References:NCC C-EFM Candidate Guide (2025); NCC Content Outline; NICHD FHR Definitions; AWHONN Fetal Heart Monitoring Principles & Practices; Miller's Fetal Monitoring Pocket Guide; Menihan Electronic Fetal Monitoring; Simpson & Creehan Perinatal Nursing; Creasy & Resnik Maternal-Fetal Medicine.


質問 # 120
(Full question statement)
The American College of Obstetricians and Gynecologists (ACOG) recommends continuous electronic fetal monitoring in pregnancies when there is:

正解：A

解説：
Comprehensive and Detailed Explanation From Exact Extract Without Links:
NCC relies heavily on ACOG Practice Bulletins for risk-based monitoring decisions. ACOG identifies maternal diabetes (pregestational or poorly controlled gestational diabetes) as a key high-risk obstetric condition warranting continuous electronic fetal monitoring due to risks such as fetal hypoxia, macrosomia, and metabolic complications.
In contrast, a history of preterm birth does not necessarily require continuous monitoring unless current pregnancy complications are present.
Macrosomia alone does not automatically justify continuous EFM unless accompanied by other risk factors.
Therefore, according to NCC-aligned ACOG clinical criteria, maternal diabetes is the correct indication.


質問 # 121
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