EMT Chapter 34 Obstetrics and Neonatal Care

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

B. 7:57

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

B. an ectopic pregnancy

Which of the following is not a component of the Apgar score? A. Pulse B. Body size C. Activity D. Grimace

B. body size

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

B. development of the placenta over the cervical opening

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

B. profound tachycardia

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

B. provide emotional support to the mother

Which of the following processes occurs immediately after ovulation? A. Numerous follicles mature and release eggs into the fallopian tubes. B. The inner lining of the uterus thickens in preparation for implantation. C. Certain female hormone levels decrease significantly in quantity. D. The endometrium sheds its lining and is expelled from the vagina.

B. the inner lining of the uterus thickens in preparation for implantation

After delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breastfeed, the bleeding stops. This occurred because: A. uterine massage increases blood flow to the uterus. B. the production of oxytocin caused uterine contraction. C. a portion of the placenta was retained in the uterus. D. breastfeeding causes uterine blood vessels to dilate.

B. the production of oxytocin caused uterine contraction

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

C. 15 to 30

You have just delivered a baby boy. His body is pink, but his hands and feet are blue. His heart rate is approximately 110 beats/min, and his respirations are rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his legs. His Apgar score is: A. 9 B. 7 C. 8 D. 6

C. 8

Which of the following statements regarding gestational diabetes is correct? A. Diet and exercise are typically ineffective in controlling gestational diabetes. B. Gestational diabetes results in permanent diabetes mellitus after delivery. C. In some cases, women with gestational diabetes require insulin injections. D. The onset of gestational diabetes typically manifests with hypoglycemia.

C. In some cases, women with gestational diabetes require insulin injections

Which of the following is a normal physiologic change that occurs in the mother's respiratory system during pregnancy? A. Increased respiratory reserve and decreased oxygen demand B. Decreased respiratory rate and increased minute volume C. Increased respiratory rate and decreased respiratory reserve D. Increased respiratory depth and decreased respiratory rate

C. Increased respiratory rate and decreased respiratory reserve

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

C. alleviation of pain with movement or changing positions

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

C. contractions of the uterus

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

C. ensure that it is thoroughly dried and warmed

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

C. internal bleeding caused by a ruptured ectopic pregnancy

Which of the following statements regarding twins is correct? A. Twins are typically larger than single infants. B. Identical twins are typically of different gender. C. Most twins are born within 45 minutes of each other. D. Fraternal twins have two cords coming from one placenta.

C. most twins are born within 45 minutes of each other

A pregnant trauma patient might lose a significant amount of blood before showing signs of shock because: A. pregnancy causes vasodilation and a lower blood pressure. B. pregnant patients can dramatically increase their heart rate. 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

Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased, and she is tachycardic. The EMT should suspect: A. intrauterine bleeding. B. acute pulmonary edema. C. pulmonary embolism. D. spontaneous pneumothorax.

C. pulmonary embolism

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

C. seizures that result from severe hypertension

When determining the frequency of contractions, you should time the contractions from the: A. end of one to the end of the next. B. start of one to the end of the next. C. start of one to the start of the next. D. end of one to the start of the next.

C. start of one to the start of the next

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

C. the placenta prematurely separates from the uterine wall

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next? A. Allow the mother to hold her baby. B. Clamp and cut the umbilical cord. C. Begin assisting the newborn's breathing. D. Check the pulse rate at the brachial artery.

D. check the pulse rate at the brachial artery

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

D. easier breathing

If a pregnant patient must be placed onto a backboard, you should: A. raise the foot of the board 12 inches in order to maintain blood pressure. B. elevate the head of the board six inches to prevent breathing impairment. C. place a folded towel behind her head to make it easier to breathe. D. elevate the right side of the board with rolled towels or blankets.

D. elevate the right side of the board with rolled towels or blankets

The term primigravida refers to a woman who: A. has never been pregnant. B. has had more than one live baby. C. has had only one live birth. D. is pregnant for the first time.

D. is pregnant for the first time

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

D. is wrapped around the baby's neck

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

D. positive pressure ventilations

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

D. the mother might become nauseated and vomit

Which of the following statements regarding the placenta is correct? A. The placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus. B. The placenta, also referred to as the afterbirth, provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born. C. The placental barrier consists of two layers of cells and allows the mother's blood that contains high concentrations of oxygen to directly mix with the blood of the fetus. D. The placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus.

D. the placenta allows oxygen, carbon dioxide, and other products to transfer between the mother and fetus but does not allow blood to mix between the mother and fetus

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

D. weighs less than 5 pounds or is born before 36 weeks' gestation

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

A. 20 weeks

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

A. belly button

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

A. carries oxygen to the baby via the umbilical vein

Which of the following is an indication of imminent birth? A. Crowning of the baby's head B. Expulsion of the mucus plug from the vagina C. Rupture of the amniotic sac D. Irregular contractions lasting 10 minutes

A. crowning of the baby's head

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. firmly massage the uterine fundus with a circular motion. B. elevate her legs six to eight inches and cover her with a blanket. C. carefully insert a sterile trauma dressing into her vagina. D. place her legs together and position her on her left side

A. firmly massage the uterine fundus with a circular motion

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

A. have delivered a baby before

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

A. headache and edema

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct? A. Suctioning is indicated prior to cutting the cord if respiratory distress is present. B. Suctioning should be performed on all newborns immediately following delivery. C. If the head delivers face-down, the mouth and nose should be suctioned at once. D. Newborns rapidly expel fluid from their lungs and do not require suctioning.

A. suctioning is indicated prior to cutting the cord if respiratory distress is present

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

A. the pregnant uterus compresses the inferior vena cava