EMT Ch 33 Obstetrics and Neonatal Care

The correct answer is: place her on her side, administer high-flow oxygen, and transport.

A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should: Select one: A. elevate her legs to improve brain perfusion and keep her warm. B. place her on her side, administer high-flow oxygen, and transport. C. administer oral glucose for presumed hypoglycemia and transport. D. insert an oral airway and ventilate her with a bag-valve mask.

The correct answer is: place her in a left lateral recumbent position.

A 33-year-old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. You should: Select one: A. carefully place sterile gauze into her vagina. B. place her in a left lateral recumbent position. C. position her supine and elevate her legs 12 inches. D. ventilate her with a bag-valve mask.

The correct answer is: an ectopic pregnancy.

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

The correct answer is: 16 hours.

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

The correct answer is: is wrapped around the baby's neck.

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

The correct answer is: the placenta prematurely separates from the uterine wall.

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

The correct answer is: belly button.

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

The correct answer is: positive-pressure ventilations.

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

The correct answer is: pregnant patients have an overall increase in blood volume.

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

The correct answer is: Apply gentle pressure to the baby's head as it delivers.

During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? Select one: A. Maintain firm pressure to the head until it completely delivers. B. Tell the mother not to push and transport her immediately. C. Place your fingers in the vagina to assess for a nuchal cord. D. Apply gentle pressure to the baby's head as it delivers.

The correct answer is: profound tachycardia.

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

The correct answer is: firmly massage the uterine fundus with a circular motion.

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: Select one: A. elevate her legs 6 to 8 inches and cover her with a blanket. B. carefully insert a sterile trauma dressing into her vagina. C. firmly massage the uterine fundus with a circular motion. D. place her legs together and position her on her left side.

The correct answer is: these actions simulate the production of oxytocin and cause uterine contraction.

Following 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: Select one: A. uterine massage increases blood flow to the uterus. B. a portion of the placenta was retained in the uterus. C. breastfeeding causes uterine blood vessels to dilate. D. these actions simulate the production of oxytocin and cause uterine contraction.

The correct answer is: Uterus

From what internal female organ is the fetus expelled during delivery? Select one: A. Perineum B. Vagina C. Uterus D. Cervix

The correct answer is: 7:57.

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

The correct answer is: may not present with heavy vaginal bleeding.

In contrast to abruptio placenta, placenta previa: Select one: A. may present without significant abdominal pain. B. is typically associated with severe abdominal pain. C. is caused by hypertension or abdominal trauma. D. may not present with heavy vaginal bleeding.

The correct answer is: weighs less than 5 lb or is born before 36 weeks' gestation.

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

The correct answer is: development of the placenta over the cervical opening.

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

The correct answer is: a portion of the spinal cord or meninges protrudes outside of the vertebrae.

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

The correct answer is: breech presentation and prolapsed umbilical cord.

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

The correct answer is: insulate and protect the fetus.

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

The correct answer is: on a firm surface with her hips elevated 2 to 4 inches.

When preparing a pregnant patient for delivery, you should position her: Select one: A. on a firm surface with her hips elevated 2 to 4 inches. B. in a sitting position with her hips elevated 12 inches. C. in a supine position with her legs spread. D. on her left side with the right leg elevated.

The correct answer is: Increased respiratory rate and decreased respiratory reserve

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy? Select one: A. Increased respiratory depth and decreased respiratory rate B. Increased respiratory rate and decreased respiratory reserve C. Increased respiratory reserve and decreased oxygen demand D. Decreased respiratory rate and increased minute volume

The correct answer is: Return of contractions following delivery of the baby

Which of the following is NOT generally considered an obstetrical emergency? Select one: A. Return of contractions following delivery of the baby B. Failure of the placenta to deliver after 30 minutes C. More than 500 mL of blood loss before placental delivery D. Significant bleeding after delivery of the placenta

The correct answer is: "Have you had a sonogram?"

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? Select one: A. "Do you feel the need to push?" B. "Is this your first baby?" C. "When are you due?" D. "Have you had a sonogram?"

The correct answer is: In some cases, women with gestational diabetes require insulin injections.

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

The correct answer is: 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.

Which of the following statements regarding the placenta is correct? Select one: A. 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. B. The placenta 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 for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus.

The correct answer is: respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient.

You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: Select one: A. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome. B. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient. C. call for the police to ensure that patient assessment is carried out. D. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management.

The correct answer is: continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.

You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should: Select one: A. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care. B. contact police and remain at the scene until they arrive and escort you to the hospital. C. immediately remove the patient from the environment and transport. D. ask more detailed questions and press the issue until you have a more detailed understanding of the incident.

The correct answer is: placing the mother supine with her head down and pelvis elevated.

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: Select one: A. carefully attempting to push the infant's leg off of the umbilical cord. B. placing the mother supine with her head down and pelvis elevated. C. placing the mother in a recumbent position and rapidly transporting. D. gently pulling on the infant's leg in an attempt to facilitate delivery.

The correct answer is: that the baby's airway may be obstructed.

The presence of meconium in the amniotic fluid indicates: Select one: A. that full newborn resuscitation will be needed. B. that the fetus is at least 4 weeks premature. C. that the baby's airway may be obstructed. D. an expected finding in full-term infants.

The correct answer is: carries oxygen to the baby via the umbilical vein.

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

The correct answer is: pulmonary embolism.

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: Select one: A. spontaneous pneumothorax. B. acute pulmonary edema. C. intrauterine bleeding. D. pulmonary embolism.

The correct answer is: attempt to slip the cord gently over the infant's head.

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

The correct answer is: start of one to the start of the next.

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