Chapter 33 EMT

If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:57. B. 7:59. C. 8:00. D. 7:53.

A. 7:57.

During your visual inspection of a 19-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? A. Apply gentle pressure to the baby's head as it delivers. B. Maintain firm pressure to the head until it completely delivers. C. Place your fingers in the vagina to assess for a nuchal cord. D. Tell the mother not to push and transport her immediately.

A. Apply gentle pressure to the baby's head as it delivers.

Braxton-Hicks contractions are characterized by: A. alleviation of pain with movement or changing positions. B. regular contractions of progressively increasing intensity. C. pink or red bloody show in conjunction with the contractions. D. a rupture of the amniotic sac just before the contractions begin.

A. alleviation of pain with movement or changing positions.

Placenta previa is MOST accurately defined as: A. development of the placenta over the cervical opening. B. delivery of a portion of the placenta before the baby. C. abnormal development and functioning of the placenta. D. premature placental separation from the uterine wall.

A. development of the placenta over the cervical opening.

In contrast to a full-term infant, a premature infant: A. has an even proportionately larger head. B. retains heat better because of excess body hair. C. is one who is born before 38 weeks' gestation. D. is often covered with excess vernix material.

A. has an even proportionately larger head.

A precipitous labor and delivery is MOST common in women who: A. have delivered a baby before. B. are younger than 30 years of age. C. are pregnant for the first time. D. have gestational diabetes.

A. have delivered a baby before.

Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: A. placing the mother in a recumbent position and rapidly transporting. B. carefully attempting to push the infant's leg off of the umbilical cord. C. gently pulling on the infant's leg in an attempt to facilitate delivery. D. placing the mother supine with her head down and pelvis elevated.

A. placing the mother in a recumbent position and rapidly transporting.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. positive-pressure ventilations B. thorough drying with a towel. C. suctioning of the upper airway. D. some form of tactile stimulation.

A. positive-pressure ventilations

Vigorous suctioning of a newborn's airway is indicated if: A. there is meconium in the amniotic fluid. B. his or her heart rate is less than 60 beats/min. C. positive-pressure ventilations are indicated. D. the newborn presents with labored breathing.

A. there is meconium in the amniotic fluid.

General treatment guidelines when caring for a woman with traumatic vaginal bleeding include: A. transporting to an appropriate facility. B. carefully removing impaled objects. C. packing the vagina with sterile dressings. D. cleaning external wounds with sterile water.

A. transporting to an appropriate facility.

An infant is considered to be premature if it: A. weighs less than 5 lb or is born before 36 weeks' gestation. B. weighs less than 5.5 lb or is born before 37 weeks' gestation. C. is born before 38 weeks' gestation or weighs less than 6 lb. D. is born before 40 weeks' gestation or weighs less than 7 lb.

A. weighs less than 5 lb or is born before 36 weeks' gestation.

An abortion occurs when the fetus and placenta deliver before: A. 28 weeks. B. 20 weeks. C. 24 weeks. D. 26 weeks.

B. 20 weeks

The third stage of labor begins when the: A. umbilical cord has been clamped. B. baby is expelled from the vagina. C. placenta is fully delivered. D. cervix is completely dilated.

B. baby is expelled from the vagina

The ONLY indications for placing your gloved fingers in the vagina during delivery are: A. nuchal cord and presentation of an arm or leg. B. breech presentation and prolapsed umbilical cord. C. vertex presentation and delivery of the placenta. D. limb presentation and severe vaginal hemorrhage.

B. breech presentation and prolapsed umbilical cord.

The umbilical cord: Select one: A. carries blood away from the baby via the artery. B. carries oxygen to the baby via the umbilical vein. C. separates from the placenta shortly after birth. D. contains two veins and one large umbilical artery.

B. carries oxygen to the baby via the umbilical vein.

Signs and symptoms of preeclampsia include: A. dyspnea and bradycardia. B. headache and edema. C. marked hypoglycemia. D. dysuria and constipation.

B. headache and edema.

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because: A. iron makes the blood clot faster, which protects the mother from excessive bleeding during delivery. B. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia. C. the blood naturally thins during pregnancy, which predisposes the mother to severe bleeding. D. white blood cells decrease during pregnancy, which increases the mother's risk of an infection.

B. pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia.

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT: A. respiratory depression. B. profound tachycardia. C. low birth weight. D. premature delivery.

B. profound tachycardia.

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should: A. begin full resuscitation and transport. B. provide emotional support to the mother. C. report the case to the medical examiner. D. dry the infant off to stimulate breathing.

B. provide emotional support to the mother.

Upon delivery of the baby's head, you note that its face is encased in the unruptured amniotic sac. You should: A. leave the amniotic sac intact until arrival at the hospital. B. puncture the sac and suction the baby's mouth and nose. C. note the color of the amniotic fluid before breaking the sac. D. give the mother 100% oxygen and transport at once.

B. puncture the sac and suction the baby's mouth and nose.

Eclampsia is MOST accurately defined as: A. hypertension in the 20th week of pregnancy. B. seizures that result from severe hypertension. C. high levels of protein in the patient's urine. D. a blood pressure greater than 140/90 mm Hg.

B. seizures that result from severe hypertension.

During delivery, it is MOST important to position your partner at the mother's head because: A. mothers often need assisted ventilation during delivery. B. the mother may become nauseated and vomit. C. she may need emotional support during the delivery. D. the mother needs to be apprised of the situation.

B. the mother may become nauseated and vomit.

Abruptio placenta occurs when: A. the placenta develops over and covers the cervical opening. B. the placenta prematurely separates from the uterine wall. C. the placenta affixes itself to the outer layer of the uterus. D. a tear in the placenta causes severe internal hemorrhage.

B. the placenta prematurely separates from the uterine wall.

The term "bloody show" is defined as: A. any volume of blood that is expelled from the vagina after the amniotic sac has ruptured and contractions have begun. B. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug. C. mild vaginal bleeding that occurs within the first 30 minutes after the onset of the second stage of the labor process. D. the normal amount of vaginal bleeding that occurs within the first 24 hours following delivery of the baby and placenta.

B. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

From what internal female organ is the fetus expelled during delivery? A. vagina B. uterus C. cervix D. perineum

B. uterus

Spina bifida is a developmental defect in which: A. the spinal column is severely deformed, resulting in permanent paralysis. B. nerve fibers that arise from the spinal cord do not function properly. C. a portion of the spinal cord or meninges protrudes outside of the vertebrae. D. an excessive amount of cerebrospinal fluid damages the spinal cord.

C. a portion of the spinal cord or meninges protrudes outside of the vertebrae.

You are assessing a 25-year-old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately 3 minutes apart and states that her amniotic sac broke 2 hours ago. After taking the standard precautions, you should: A. apply 100% oxygen. B. place her on her left side. C. assess her for crowning. D. transport her immediately.

C. assess her for crowning.

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should: A. immediately clamp and cut the umbilical cord. B. provide free-flow oxygen to the infant and transport. C. attempt to slip the cord gently over the infant's head. D. give 100% oxygen to the mother and transport at once.

C. attempt to slip the cord gently over the infant's head.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. pubic bone. B. xiphoid process. C. belly button. D. superior diaphragm.

C. belly button.

Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: A. carefully insert a sterile trauma dressing into her vagina. B. elevate her legs 6″ to 8″ and cover her with a blanket. C. firmly massage the uterine fundus with a circular motion. D. place her legs together and position her on her left side.

C. firmly massage the uterine fundus with a circular motion.

A nuchal cord is defined as an umbilical cord that: A. has separated from the placenta. B. has abnormally developed blood vessels. C. is wrapped around the baby's neck. D. is lacerated due to a traumatic delivery.

C. is wrapped around the baby's neck.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A. pregnant patients can dramatically increase their heart rate. B. pregnancy causes vasodilation and a lower blood pressure. C. pregnant patients have an overall increase in blood volume. D. blood is shunted to the uterus and fetus during major trauma.

C. pregnant patients have an overall increase in blood volume.

Supine hypotensive syndrome occurs when: A. blood pressure decreases as a result of hypovolemia. B. the superior vena cava is compressed by the uterus. C. the pregnant uterus compresses the inferior vena cava. D. a supine position kinks the ascending aorta.

C. the pregnant uterus compresses the inferior vena cava.

A newborn infant will usually begin breathing spontaneously within _______ seconds following birth. A. 30 to 60 B. 5 to 10 C. 3 to 5 D. 15 to 30

D. 15 to 30

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A. 4 hours. B. 10 hours. C. 8 hours. D. 16 hours.

D. 16 hours.

Preeclampsia MOST commonly occurs after the ____ week of gestation. A. 12th B. 30th C. 24th D. 20th

D. 20th

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: A. gestational diabetes. B. preeclampsia. C. placenta previa. D. an ectopic pregnancy.

D. an ectopic pregnancy.

The onset of labor begins with: A. full dilation of the cervix. B. thinning of the uterus. C. increased fetal movement. D. contractions of the uterus.

D. contractions of the uterus.

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience: A. midback pain. B. an urge to push. C. a bloated feeling. D. easier breathing

D. easier breathing

After a baby is born, it is important to: A. cool the infant to stimulate effective breathing. B. position it so that its head is higher than its body. C. immediately clamp and cut the umbilical cord. D. ensure that it is thoroughly dried and warmed.

D. ensure that it is thoroughly dried and warmed.

The amniotic fluid serves to: A. assist in fetal development. B. transfer oxygen to the fetus. C. remove viruses from the fetus. D. insulate and protect the fetus.

D. insulate and protect the fetus.

The leading cause of maternal death during the first trimester of pregnancy is: A. blunt trauma to the abdomen during a motor vehicle crash. B. massive brain damage secondary to a prolonged seizure. C. unrecognized or untreated supine hypotensive syndrome. D. internal bleeding caused by a ruptured ectopic pregnancy.

D. internal bleeding caused by a ruptured ectopic pregnancy.

A 33-year-old woman who is 36 weeks pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should: A. assist her ventilations with a bag-mask device. B. carefully place sterile gauze into her vagina. C. position her supine and elevate her legs 12″. D. place her in a left lateral recumbent position.

D. place her in a left lateral recumbent position.

If a newborn's heart rate is less than 60 beats/min following delivery, you should: A. begin chest compressions. B. resuction the mouth only. C. flick the soles of its feet. D. provide ventilations for 30 seconds.

D. provide ventilations for 30 seconds.

During delivery of the baby's head, you should suction the mouth before the nose because: A. the mucosa of the nose is fragile and is easily damaged by vigorous suctioning. B. babies are primarily mouth breathers and do not breathe through their nose. C. it is easier to suction larger volumes of fluid from the baby's oropharynx. D. suctioning the nose first may cause the baby to gasp and aspirate fluid.

D. suctioning the nose first may cause the baby to gasp and aspirate fluid.