Chapter 23 - Gynecologic Emergencies - Quiz Questions
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A) provide emotional support and visually assess her for obvious trauma. B) advise her that she cannot clean herself up because this will destroy evidence. C) ask her if there is anyone you can contact, such as a friend or relative. D) perform a limited hands-on assessment to detect life-threatening injuries.
Correct Answer A) provide emotional support and visually assess her for obvious trauma.
In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A) thins and begins to separate. B) becomes engorged with blood. C) diverts blood flow to the vagina. D) sheds and is expelled externally.
Correct Answer B) becomes engorged with blood.
Your _____ is the best tool to gain the patient's confidence to seek medical help. A) explain to her that she cannot be transported without a physical exam. B) have the police take the patient into custody in order to legally force a physical exam. Incorrect Response C) explain to her that this is a criminal case and that she must be examined. D) follow your system's refusal of treatment policy and respect the patient's wishes without judgment.
Correct Answer D) follow your system's refusal of treatment policy and respect the patient's wishes without judgment.
Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? A) Chlamydia B) Ovarian cysts C) Genital herpes D) Ectopic pregnancy
Correct Response A) Chlamydia
Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following? A) Pelvic inflammatory disease B) Chlamydia C) Bacterial vaginosis D) Gonorrhea
Correct Response A) Pelvic inflammatory disease
A patient with pelvic inflammatory disease will typically complain of _________. A) abdominal pain associated with menstruation B) nausea and vomiting associated with intercourse C) aches and fever associated with urination D) bleeding associated with stress
Correct Response A) abdominal pain associated with menstruation
Often the most important intervention for a sexual assault patient is _____ and transport to a facility with a staff specially trained to deal with this scenario. A) comforting reassurance B) excellent assessment skills C) bandaging skills D) emotional sympathy
Correct Response A) comforting reassurance
Whenever possible, a female sexual assault victim should be: A) given the option of being treated by a female EMT. B) encouraged to take a shower and change her clothes. C) thoroughly assessed, even if no signs of injury exist. D) asked to provide a brief description of the perpetrator.
Correct Response A) given the option of being treated by a female EMT.
When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A) has gathered patient history information. B) has obtained a complete set of vital signs. C) ascertains if the patient was ever pregnant. D) has formed a general impression of the patient.
Correct Response A) has gathered patient history information.
The __________ and _________ are folds of tissue that surround the urethral and vaginal openings. A) labia majora; labia minora B) perineum; anus C) vagina; cervix D) fallopian tubes; uterus
Correct Response A) labia majora; labia minora
The physical examination of a sexual assault victim should be: A) limited to a brief survey for life-threatening injuries. B) performed in the presence of at least two police officers. C) as detailed as possible so all injuries can be documented. D) deferred until the patient can be evaluated by a physician.
Correct Response A) limited to a brief survey for life-threatening injuries.
In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A) may be relatively painless. B) is typically not as severe. C) can be controlled in the field. D) often presents with acute pain.
Correct Response A) may be relatively painless
While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age. A) 10; 40 B) 11; 50 C) 20; 60 D) 10; 70
Correct Response B) 11; 50
Which of the following statements regarding gonorrhea is correct? A) Most men who are infected with gonorrhea do not experience symptoms. B) Painful urination is a common symptom of gonorrhea in both men and women. C) Symptoms of gonorrhea usually appear within 3 months of being infected. D) Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.
Correct Response B) Painful urination is a common symptom of gonorrhea in both men and women.
Which of the following statements regarding rape is correct? A) The EMT should try to determine if rape occurred. B) Rape is a legal diagnosis, not a medical diagnosis. C) Rape causes more physical harm than emotional harm. D) Only a licensed physician can make a diagnosis of rape.
Correct Response B) Rape is a legal diagnosis, not a medical diagnosis.
The onset of menstruation usually occurs in women who are: A) between 8 and 10 years of age. B) between 11 and 16 years of age. C) between 18 and 23 years of age. D) between 25 and 28 years of age.
Correct Response B) between 11 and 16 years of age.
The _____________ connect(s) each ovary with the uterus. A) egg B) fallopian tubes C) abdomen D) cervix
Correct Response B) fallopian tubes
Painful urination associated with burning and a yellowish discharge is associated with: A) chlamydia. B) gonorrhea. C) endometriosis. D) syphilis.
Correct Response B) gonorrhea.
If a woman with vaginal bleeding reports syncope, the EMT should assume that she: A) is pregnant. B) is in shock. C) has an infection. D) has an ectopic pregnancy.
Correct Response B) is in shock.
Bacterial vaginosis is a condition that occurs when: A) harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes. B) normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. C) numerous bacteria enter the uterus through the cervix and cause severe tissue damage. D) abnormal bacteria enter the vagina and cause damage without causing any symptoms.
Correct Response B) normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.
If a patient with vaginal bleeding presents with a rapid pulse and pale or cool skin, you should: A) attempt to locate the source of bleeding and correct it. B) place the patient in a supine position with her legs elevated. C) consider this to be a normal sign in a menstruating woman. D) inquire about recent problems with urination.
Correct Response B) place the patient in a supine position with her legs elevated.
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A) administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B) administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C) administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D) assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport.
Correct Response C) administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.
Left untreated, _____ can lead to premature birth or low birth weight in pregnant women. A) chlamydia B) gonorrhea C) bacterial vaginosis D) vaginal bleeding
Correct Response C) bacterial vaginosis
It is common for young females who experience their first menstrual period to: A) have a false positive home pregnancy test result. B) lose up to 500 mL of blood within the first 24 hours. C) experience abdominal cramping, which may be misinterpreted. D) become so emotionally distraught that they contemplate suicide.
Correct Response C) experience abdominal cramping, which may be misinterpreted.
When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A) determine the underlying cause of her problem. B) ask questions related to her gynecologic history. C) maintain her ABCs and transport without delay. D) keep assessment and treatment to a minimum.
Correct Response C) maintain her ABCs and transport without delay.
Some women experience ___________ during ovulation. A) hypotension B) severe abdominal pain C) slight cramping D) severe bleeding
Correct Response C) slight cramping
The EMT should ensure that vaginal bleeding is _________. A) severe enough to warrant transport B) controlled directly by the patient C) taken seriously and the patient is transported for gynecologic evaluation D) not caused by traumatic injury
Correct Response C) taken seriously and the patient is transported for gynecologic evaluation
Pelvic inflammatory disease (PID) typically does NOT affect the: A) uterus. B) ovaries. C) urinary bladder. D) fallopian tubes.
Correct Response C) urinary bladder.
Causes of vaginal bleeding include which of the following? A) Ectopic pregnancy B) Vaginal trauma C) Spontaneous abortion D) All of these answers are correct.
Correct Response D) All of these answers are correct.
During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following? A) The amount of time since of the patient's last menstrual cycle B) The possibility that the patient may be pregnant C) If the patient is sexually active D) All of these answers are correct.
Correct Response D) All of these answers are correct.
In cases of sexual assault, it is important to ensure that you do which of the following? A) Immediately write down your observations of the scene before assessing the patient. B) Call for a female EMT or ALS care provider. C) Discuss with law enforcement any suspicions that you may have about the perpetrator. D) All of these answers are correct.
Correct Response D) All of these answers are correct.
Which of the following infections, when left untreated, may lead to infection of the blood and brain? A) Pelvic inflammatory disease B) Chlamydia C) Bacterial vaginosis D) Gonorrhea
Correct Response D) Gonorrhea
Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? A) Left lower quadrant pain, referred pain to the left shoulder, and fever B) Pain around the umbilicus, low-grade fever, and generalized weakness C) Upper abdominal cramping, severe headache, and heavy vaginal bleeding D) Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
Correct Response D) Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
Which of the following drugs is commonly referred to as "roofies"? A) GHB B) MDMA C) Ketamine D) Rohypnol
Correct Response D) Rohypnol
Each ovary produces an ovum in alternating months and releases it into the: A) vagina. B) uterus. C) cervix. D) fallopian tube.
Correct Response D) fallopian tube.
The most common presenting sign of pelvic inflammatory disease is: A) vaginal discharge. B) fever. C) nausea and vomiting. D) lower abdominal pain.
Correct Response D) lower abdominal pain.
When caring for a female patient who has been sexually assaulted, you should: A) ask the patient for a concise, detailed report of what happened to her. B) allow law enforcement to take her statement before you begin treatment. C) advise her that she will not be allowed to shower or change her clothes. D) place any bloodstained clothing or other articles in separate paper bags.
Correct Response D) place any bloodstained clothing or other articles in separate paper bags.
