EFM Exam Dumps : Certified - Electronic Fetal Monitoring

Comprehensive and Detailed Explanation From NCC-Aligned Sources:

NCC and AWHONN auscultation standards emphasize the need to document FHR findings relative to uterine contractions, including:

The FHR between contractions (baseline)

FHR during contractions

Presence/absence of decelerations

Recovery after a contraction

Uterine activity determines whether findings are:

Baseline

Accelerations

Early/late/variable decelerations

Why the other options are incorrect:

A. Fetal position — relevant for Doppler placement, not auscultation documentation.

B. Stage of labor — affects monitoring frequency but does not change how findings are documented.

Correct answer: C. Uterine activity.

Comprehensive and Detailed Explanation From NCC-Aligned Sources:

A prolonged deceleration is defined by NICHD and NCC as:

A deceleration lasting ≥2 minutes but <10 minutes

Decrease in FHR of ≥15 bpm

Can occur with or without uterine contractions

This tracing shows:

A deep drop in FHR down to ~60–70 bpm

Duration lasting several minutes

Recovery back to baseline

Moderate variability present afterward

Because variability remains present and the tracing does not show:

Absent variability

Recurrent late decelerations

Recurrent variable decelerations with absent variability

Bradycardia for ≥10 minutes

…it does not meet criteria for Category III.

It is also not bradycardia, because bradycardia requires:

Baseline <110 bpm for 10 minutes or longer

Therefore the correct interpretation is a prolonged deceleration.

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