Chapter 32 Obstetric & Gynecological Emergencies Pre-Test
You have delivered a 34-week gestation infant who is active and crying. Which of the following actions is the highest priority for this infant? A. Drying the infant thoroughly and wrapping him or her in warm blankets, covering the head B. Applying high-concentration oxygen by a pediatric nonrebreather mask C. Allowing the mother to breastfeed the infant D. Suctioning the mouth and nose with a bulb syringe
A
Your patient is 30 weeks pregnant. She is supine in bed, complaining of dizziness. Your partner reports that the patient is hypotensive. You should suspect: A. supine hypotensive syndrome. B. compensated shock. C. pregnancy-induced hypertension. D. hypertensive crises.
A
Which of the following is TRUE of an explosive delivery? A. There will be an immediate delivery of the placenta. B. The shoulders will be easier to deliver. C. There is an increased risk of fetal and maternal trauma. D. The infant is less likely to be hypothermic.
C
Which of the following mechanisms accounts for supine hypotensive syndrome? A. Compression of the umbilical cord between the fetus and the uterine wall results in decreased fetal cardiac output and hypotension. B. The weight of the enlarged uterus and fetus compresses the descending aorta, restricting blood flow to the rest of the body. C. The weight of the enlarged uterus and fetus presses on the inferior vena cava, causing inadequate blood return to the heart. D. The weight of the enlarged uterus and fetus compresses the vagus nerve, slowing the heart rate and decreasing cardiac output.
C
Which of the following statements BEST describes the third stage of labor? A. The infant's head appears at the opening of the birth canal. B. The infant is completely delivered. C. The placenta is expelled from the uterus. D. The amniotic sac ruptures.
C
Which organ allows exchange of nutrients, wastes, and oxygen between the mother and the developing fetus? A. Amniotic sac B. Fundus C. Placenta D. Endometrium
C
Premature babies are at high risk for: A. febrile seizures. B. positional asphyxia. C. hypothermia. D. hyperglycemia.
C
Supine hypotensive syndrome occurs as a result of: A. compression of the superior vena cava. B. hypovolemic shock. C. compression of the inferior vena cava. D. massive vasodilation.
C
The brownish-yellow or greenish material that can discolor the amniotic fluid is known as: A. mucus plug. B. bile. C. meconium. D. bloody show.
C
Which of the following is recommended for suctioning the newborn's mouth and nose? A. Bulb syringe B. Battery-powered suction C. French suction catheter D. Yankauer catheter
A
Which of the following is the MOST common cause of blunt trauma in pregnant patients? A. Motor vehicle accidents B. Falls C. Assaults D. Suicide attempt
A
Which of the following may indicate the need for neonatal resuscitation? A. Preterm delivery B. Term delivery C. A previous C-section D. Lack of visible meconium
A
If the ovum implants in the fallopian tubes, the patient is at risk for: A. ectopic pregnancy. B. hypertensive crises. C. supine hypotensive syndrome. D. pregnancy-induced hypertension.
A
In the process of delivering the infant, you notice that the umbilical cord is wrapped around the infant's neck. Which of the following actions is the appropriate FIRST step in managing this situation? A. Try to slip the cord over the baby's head. B. Clamp the cord in two places, and cut between the clamps. C. Place the mother in knee-chest position with pillows to help elevate the hips. Push the baby's head several inches back into the birth canal, and cover the cord with wet sterile dressings. D. Deliver as normal, but clamp and cut the cord as soon as the delivery is complete.
A
Shortly after delivery of the newborn, the mother experiences a return of labor pains. This likely indicates that: A. the placenta is preparing to deliver. B. the mother is bleeding. C. "false" labor has begun. D. it is time for the mother to breast-feed.
A
What is the typical duration of pregnancy? A. 40 weeks B. 44 weeks C. 36 weeks D. 32 weeks
A
When treating a patient who has been sexually assaulted, you should try to: A. provide a same-sex provider to assist the patient. B. tell the patient that everything will be fine. C. have the patient take a shower before transport. D. encourage the patient to explain to you exactly what happened.
A
Which of the following figures indicates the CORRECT chest compression-to-ventilation ratio for CPR in a newborn? A. 3:1 B. 5:1 C. 15:2 D. 30:2
A
Which of the following is TRUE about a breech delivery? A. It is the most common abnormal delivery. B. Breech presentation means that a limb is presenting first in the birth canal. C. Breech presentations are rare occurrences. D. When a baby is in breech presentation, it is best to deliver before transport.
A
Your patient is 39 weeks pregnant and complaining of contractions that are 2 minutes apart. She tells you that she needs to use the bathroom before transport. You should: A. explain that the sensation might indicate that she is close to delivery and you need to check to see whether the baby's head is in the birth canal. B. explain that it is not possible to allow her to go to the restroom and place her on the stretcher for transport. C. explain that it is a normal sensation that will go away as birth gets closer. D. assist the patient in getting up and let her know that you will be right outside the bathroom if she needs anything.
A
Your patient is a 16-year-old girl who is complaining of lower abdominal pain, back pain, and heavy vaginal bleeding. After a primary assessment and receiving parental permission to transport, you place the patient in the ambulance, where you have some privacy. Her vital signs are stable. Which of the following questions is relevant and appropriate to an EMT's history-taking for this patient? A. What was the day of your last menstrual period? B. What kind of birth control do you use? C. Have you ever had sex? D. Have you ever had a sexually transmitted disease?
A
If a patient is in labor, what is the MOST reliable indication that delivery will happen imminently? A. Onset of contractions B. Bulging perineum C. Passing the mucus plug ("bloody show") D. Ruptured amniotic sac
B
Obtaining a thorough history from your pregnant patient will: A. help you to rule out most complications. B. help you to anticipate possible complications. C. confirm whether ALS personnel are needed. D. prevent the mother from panicking.
B
Which of the following questions is LEAST relevant in obtaining an obstetric history of a 25-year-old patient who is 26 weeks pregnant and complaining of back pain? A. Have you received prenatal care? B. Are your breasts tender? C. Is this your first pregnancy? D. Can you describe what the pain feels like?
B
You are assisting a woman in the delivery of her infant when you note that a segment of the umbilical cord is sticking out of her birth canal. What is the prehospital treatment of this condition? A. Deliver the infant as normal, making sure that the infant's limbs do not become entangled in the cord. B. Instruct the patient not to push. Place the mother in knee-chest position or elevate the hips with pillows, push the baby's head several inches upward into the birth canal, and cover the exposed cord with wet sterile dressings. C. Place the mother in left lateral recumbent position, and advise her not to push. D. Instruct the mother not to push and to "pant like a dog." Clamp the cord in two places, and cut between the clamps. Proceed with delivery.
B
You are caring for a 19-year-old female who is complaining of vaginal bleeding. She states that she is not pregnant and is not menstruating. You should: A. inform the patient that she must be either pregnant or menstruating. B. assess for shock and transport the patient. C. recommend that the patient contact her gynecologist. D. let the patient know that the bleeding is normal.
B
As an infant's head emerges during a normal delivery, few secretions are present. As the infant's body is delivered, the infant begins to cry normally. Which of the following statements BEST describes the proper care of the infant's airway? A. Use a bulb syringe to suction first the infant's mouth, then the nose. B. To allow all secretions to drain, hold the infant with the head lower than the feet for several seconds before drying and warming the infant and cutting the umbilical cord. C. Use mechanical suction with a soft suction catheter to clear the infant's nose and mouth of secretions. D. No intervention is needed for the airway. Clamp and cut the cord, and warm and dry the infant.
D
By what percentage does the maternal blood volume increase by the end of pregnancy? A. About 25% B. About 16% C. Up to 60% D. Up to 48%
D
If the placenta does not deliver within about 20 minutes after delivery of the newborn, you should: A. remain on scene. B. assess vitals, then decide. C. ask the mother what she prefers. D. transport immediately.
D
Which of the following interventions is required in a newborn who has spontaneous breathing and a heart rate greater than 100 per minute but who still has cyanotic skin? A. Suctioning with a bulb syringe B. Chest compressions C. Bag-valve-mask ventilations D. Provide blow-by oxygen
D
