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最新的 NCC C-EFM EFM 免費考試真題 (Q91-Q96):
問題 #91
(Full question)
Vibroacoustic stimulation (VAS) is a useful intervention which can
- A. relax the uterus during tachysystole
- B. provide an indication of the amount of amniotic fluid
- C. shorten the length of the nonstress test (NST)
答案:C
解題說明:
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.
問題 #92
The factor that differentiates a prolonged deceleration from bradycardia is:
- A. Baseline rate
- B. Relationship to contractions
- C. Length of time it lasts
答案:C
解題說明:
Comprehensive and Detailed Explanation From Exact Extract-Based NCC C-EFM References:
NICHD/NCC definitions:
* Prolonged deceleration: decrease in FHR #15 bpm lasting 2 to 10 minutes
* Bradycardia: baseline FHR <110 bpm lasting #10 minutes
The differentiating factor is duration, not rate and not contraction relationship.
* Before 10 minutes # prolonged deceleration
* At or beyond 10 minutes # new baseline # bradycardia
Thus, the factor that differentiates the two is length of time it lasts.
References:NICHD FHR Definitions; NCC C-EFM Candidate Guide; AWHONN; Miller; Menihan.
問題 #93
The baseline heart rate of a 28-week fetus is 170 bpm. The next step is to:
- A. Perform a biophysical profile
- B. Continue observation
- C. Assess maternal vital signs
答案:C
解題說明:
Comprehensive and Detailed Explanation From Exact Extract Without Any URLs or Links:
NCC references (AWHONN, Simpson, Menihan) and the Physiology domain emphasize that baseline fetal heart rate is higher at earlier gestational ages due to predominant sympathetic tone and immature parasympathetic modulation. For a 28-week fetus, a baseline between 150-170 bpm may fall within the upper normal/mild tachycardic range.
Before classifying fetal tachycardia, recommended by AWHONN and Simpson, clinicians must first assess maternal contributors:
* Fever
* Tachycardia
* Infection
* Dehydration
* Medications (e.g., beta-agonists)
* Anxiety
This matches NCC's required first-line action: evaluate maternal status before escalating fetal assessment.
A biophysical profile (BPP) is not the immediate next step unless maternal status and fetal environment do not explain the finding. Continuing observation without maternal evaluation is contrary to perinatal safety standards.
References:AWHONN Fetal Monitoring PrinciplesSimpson & Miller Fetal MonitoringMenihan EFM Interpretation GuideNCC C-EFM Exam Content Domains 2025
問題 #94
Upon admission, the clinician discusses indications, risks, and benefits of electronic fetal monitoring.
This reflects which ethical concept?
- A. Autonomy
- B. Informed consent
- C. Fiduciary
答案:B
解題說明:
Comprehensive and Detailed Explanation From Exact Extract Without Any URLs or Links:
The NCC C-EFM Professional Issues domain identifies informed consent as a fundamental ethical requirement in fetal monitoring. AWHONN's perinatal nursing standards state that the clinician must provide clear explanation of risks, benefits, alternatives, and the purpose of EFM, ensuring the patient makes a voluntary and informed decision.
Simpson, Creasy & Resnik, and ACOG-referenced materials used by NCC emphasize that informed consent is the process, while autonomy is the principle that supports it. The act of explaining EFM and its implications is therefore informed consent, not autonomy itself.
In the NCC competencies, clinicians must:
* Provide accurate information
* Support shared decision-making
* Verify maternal understandingThis exactly matches the process of informed consent, not merely respecting autonomy or acting as a fiduciary.
References:AWHONN Standards for Professional Nursing PracticeSimpson: Fetal Monitoring TextCreasy & Resnik: Maternal-Fetal MedicineNCC C-EFM Candidate Guide 2025
問題 #95
Fetal cardiac output is essentially dependent on the fetal:
- A. Baroreceptors
- B. Heart rate
- C. Activity
答案:B
解題說明:
Comprehensive and Detailed Explanation From NCC-Aligned Sources:
Because the fetal myocardium is immature, it has:
* Limited ability to increase stroke volume
* Limited ability to increase contractility
Therefore, fetal cardiac output (CO) is almost entirely dependent on heart rate.
NCC and AWHONN physiology describe:
* CO = stroke volume × heart rate
* In the fetus, stroke volume is relatively fixed
* Therefore, changes in HR directly affect cardiac output
* Tachycardia # increases CO
* Bradycardia # decreases CO # decreased perfusion and oxygen delivery
Why the other options are incorrect:
* A. Activity does not fundamentally determine CO.
* B. Baroreceptors regulate HR reflexively but are not the primary determinant of cardiac output.
Correct answer: C. Heart rate
References:NCC Physiology Domain; AWHONN FHMPP; Menihan; Simpson & Creehan; Creasy & Resnik.
問題 #96
......
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