EMT Chapter 37: Obstetrics and Care of the Newborn
By the time a fetus reaches full term, the tidal volume of the female has increased by: A. 25 percent B. 15 percent C. The tidal volume remains the same but the rate increases by 30 percent D. 40 percent
D. 40 percent
Despite the increase in maternal blood volume, the pregnant patient is typically: A. Hypertensive B. Prone to early signs of shock C. Bradycardic D. Anemic
D. Anemic
A female patient tells you that she is 38 weeks pregnant. Where would you expect to palpate the top of the uterus during your exam? A. At the level of the umbilicus B. At the level of the iliac crest C. At the level of the twelfth rib D. At the level of the xiphoid process
D. At the level of the xiphoid process
You have been called for a 35-year-old female who is experiencing vaginal spotting. The patient states that she has noted the discharge of blood from her vagina and is concerned because she is 36 weeks pregnant. She has also experienced some abdominal pain, which she describes as "sharp." Your assessment reveals bleeding as noted and tenderness on palpation just right to the midline of her abdomen. Her pulse is 122 beats/min, respirations are 22 breaths/min, blood pressure is 118/82 mmHg, SpO2 is 96%, and oral temperature is 97.3degrees F. Based on this presentation, you would: A. Administer high-concentration oxygen and immediately transport the patient B. Place the patient in a supine position and immediately transport her C. Provide low-concentration oxygen and nonemergently transport the patient D. Massage the abdomen, provide high-concentration oxygen, and nonemergently transport the patient
A. Administer high-concentration oxygen and immediately transport the patient
Assessment of a newborn indicates that she has slow and irregular respirations with a weak cry. You should award her how many points according to the Apgar scoring system? A. 1 B. 0 C. 3 D. 2
A. 1
The EMT is performing CPR on a neonate. What is the correct compression-to-ventilation ratio? A. 3 compressions to every 1 ventilation B. 5 compressions to every 2 ventilations C. 15 compressions to every 5 ventilations D. 30 compressions to every 2 ventilations
A. 3 compressions to every 1 ventilation
The EMT would recognize which neonate as premature? A. A baby weighing 7 pounds 4 ounces born at 36 weeks B. A baby weighing 8 pounds 6 ounces born at 39 weeks C. A baby weighing 8 pounds 6 ounces born at 41 weeks D. A baby weighing 6 pounds 2 ounces born at 38 weeks
A. A baby weighing 7 pounds 4 ounces born at 36 weeks
What would the expected preductal SpO2 reading be at 5 minutes after birth? A. At least 80% B. 70% to 75% C. 85% to 90% D. Over 94%
A. At least 80%
While delivering a baby, you note that the umbilical cord is wrapped around the baby's neck. You would: A. Attempt to slip the cord over the baby's shoulders or head B. Contact medical direction for directions C. Stop the delivery and transport D. Clamp and cut the cord to prevent strangulation of the newborn
A. Attempt to slip the cord over the baby's shoulders or head
Which patient should the EMT be most suspicious of having a spontaneous abortion? A. A 21-year-old woman, 6 weeks pregnant, passing vaginal blood clots B. A 16-year-old woman, 24 weeks pregnant, with painless contractions C. A 38-year-old woman, 36 weeks pregnant, having abdominal pain with painless vaginal bleeding D. A 32-year-old woman, in the third trimester, passing foul-smelling and bloody vaginal discharge
A. A 21-year-old woman, 6 weeks pregnant, passing vaginal blood clots
You have been called to a residence for a 21-year-old female in labor. On arrival, you immediately see that the head of the baby is out of the vagina. While delivering the head, the mother tells you that she is having twins. The EMT should immediately: A. Call for another EMS crew B. Place the patient on the stretcher for transport C. Place the patient on her left side D. Provide blow-by oxygen to the baby
A. Call for another EMS crew
You are in the process of performing a field delivery and have just delivered the baby's head. What should you do next? A. Check the neck for the umbilical cord B. Suction the baby's nose, and then the mouth C. Turn the baby clockwise and continue delivery D. Suction the baby's mouth, and then the nose
A. Check the neck for the umbilical cord
You are assessing a female patient who informs you that she has been pregnant four times before but delivered only once. What would be a correct way to document that information on the prehospital care report? A. Gravida IV; para I B. Para III; gravida I C. Para IV; gravida I D. Gravida III; para I
A. Gravida IV; para I
Which assessment finding best indicates that the newborn is significantly distressed? A. Heart rate of 92 beats per minute B. Respiratory rate of 50 breaths per minute C. Apgar score of 8 D. Loud crying
A. Heart rate of 92 beats per minute
The components of the Apgar scoring system include: A. Heart rate, spontaneous activity, and respirations B. Grimace, movement, and skin moisture C. Airway, breathing, and level of consciousness D. Airway, breathing, and circulation
A. Heart rate, spontaneous activity, and respirations
A newborn's first Apgar score was 6. His second Apgar score is 9. What does this information mean to the EMT? A. Improvement B. Need for extensive resuscitation C. Total score of 15 D. Poor heart and lung function
A. Improvement
During a continuing education session on OB/GYN topics, the EMT would recognize which statement about the umbilical cord as true? A. It contains one vein and two arteries B. It connects the placenta and the uterus C. It detoxifies blood before its delivery to the baby D. It produces hormones for the baby
A. It contains one vein and two arteries
When cutting the umbilical cord, how should the baby be positioned? A. Level with the mother's uterus B. Prone and in a head-down position C. Six inches below the vaginal opening D. Upright and on the mother's chest (if possible)
A. Level with the mother's uterus
When should the EMT use the Apgar scoring system on a newborn? A. One and five minutes after the baby has been delivered B. Ten minutes after birth and then at 20 minutes, if needed C. Just prior to delivery and then five minutes after delivery D. Before and after the baby is dried and warmed
A. One and five minutes after the baby has been delivered
It has been 30 minutes and the placenta has yet to deliver. The EMT should: A. Apply gentle traction to the protruding umbilical cord B. Place the mother in a knee-chest position C. Move the mother into a side-lying position D. Continue to monitor the mother and baby
D. Continue to monitor the mother and baby
Assessment of a pregnant patient in labor reveals what appears to be the baby's buttocks presenting at the vaginal opening. The EMT would immediately: A. Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen B. Put the patient in semi-Fowler's position on the stretcher and immediately transport C. Lay the patient on her left side and administer high-concentration oxygen D. Place both hands on the abdomen and attempt to turn the baby into a head-down position
A. Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen
Five minutes after delivering a baby, the mother feels the sudden urge to push and a gush of blood comes from the vagina. Given that the mother is not delivering twins, which stage of labor should the EMT recognize? A. Placental B. Fourth C. Expulsion D. Second
A. Placental
During which abnormal birth presentation is it permissible for the EMT to place a gloved hand into the vaginal canal? A. Prolapsed umbilical cord B. Multiple birth delivery C. Limb presentation D. Placenta previa
A. Prolapsed umbilical cord
You are delivering a baby in the patient's house. As the baby's head appears at the opening of the vagina, you notice that the amniotic membrane is still intact. You would: A. Rip open the amniotic sac with your fingers B. Cut the sac with the sterile scissors in the OB kit C. Transfer the patient to the stretcher for immediate transport D. Continue with the delivery of the baby
A. Rip open the amniotic sac with your fingers
You have been called to a home for a female in labor. On scene, the family tells you that the 37-year-old patient is 42 weeks pregnant and wanted to have her baby at home naturally. The patient has been in labor for more than 24 hours, but suddenly began complaining of severe and tearing abdominal pain. Which condition should the EMT suspect? A. Ruptured uterus B. Ectopic pregnancy C. Placenta previa D. Preeclampsia
A. Ruptured uterus
While delivering a baby in the field, the EMT notices that the baby is covered with a green-brown liquid. The EMT should immediately recognize that: A. The baby was distressed and may be hypoxic B. There is an infection in the amniotic membrane and fluid C. The amniotic sac has yet to rupture D. The baby is premature and covered with vernix
A. The baby was distressed and may be hypoxic
The Apgar scoring system is useful in determining: A. The newborn's overall condition B. The maturity of the newborn's heart and lungs C. The precise age of gestation D. The type of resuscitation needed
A. The newborn's overall condition
The EMT shows that he understands care of the post-delivery mother when he states: A. "Allowing the baby to nurse immediately after delivery can help to control uterine bleeding." B. "Post-delivery hemorrhage can best be controlled by inserting a bulky dressing into the vagina." C. "We should be concerned if there is any bleeding from the vagina following delivery." D. "If blood is observed coming from the vagina after the baby has been delivered, the mother should be placed in the shock position."
A. "Allowing the baby to nurse immediately after delivery can help to control uterine bleeding."
You are transporting a female patient who is seven months pregnant. She has been diagnosed with preeclampsia and is currently hypertensive. Which statement made by the patient indicates she may be transitioning from preeclampsia to eclampsia? A. "I feel like I am going to have a seizure." B. "My legs and feet are more swollen." C. "I have gained 10 pounds just this month." D. "I think that I may have to vomit."
A. "I feel like I am going to have a seizure."
Which statement regarding the placenta, made by your EMT partner while reviewing the OB/GYN protocols, is most accurate? A. "The placenta typically delivers itself within 20 minutes of the birth of the baby." B. "The EMT must deliver the placenta by applying gentle pressure to the abdomen after the baby has been born." C. "It is essential that the mother not be moved until the placenta has been delivered." D. "The placenta is full of bacteria and should not be transported in the ambulance near the baby."
A. "The placenta typically delivers itself within 20 minutes of the birth of the baby."
The EMT shows she has a proper understanding of Braxton-Hicks contractions when he says: A. "They are often irregular and less painful than labor contractions, but they should still be evaluated by the hospital." B. "They can be differentiated from labor contractions by the presence of vaginal discharge." C. "They are painless, but are capable of delivering the baby very quickly." D. "They often are called false contractions and do not require hospital evaluation."
A. "They are often irregular and less painful than labor contractions, but they should still be evaluated by the hospital."
Which action shows that the EMT is properly caring for the umbilical cord after delivery? A. The cord is clamped but not cut until arrival at the hospital B. The cord is cut 1 inch from the baby's abdomen C. The clamps are removed from the cord after cutting D. A 6-inch segment of cord is still connected to the baby
D. A 6-inch segment of cord is still connected to the baby
You have been dispatched for a young female in labor. On arrival, you find an arm protruding from the vagina. What should you do next? A. Have the mother push when she feels a contraction B. Place the mother in a knee-chest position C. Insert a gloved hand into the vagina to locate the baby's head D. Attempt to replace the arm into the vaginal canal
B. Place the mother in a knee-chest position
Assessment of a newborn indicates that his heart rate is 120 beats per minute. How many points should he be awarded according to the Apgar scoring system? A. 1 B. 2 C. 3 D. 0
B. 2
Which statement regarding limb presentation is true during childbirth? A. The EMT can try one time to deliver the baby B. A cesarean section birth will likely be required C. There is little danger unless the umbilical cord is also protruding D. The baby is premature
B. A cesarean section birth will likely be required
The EMT should recognize a full-term pregnancy has occurred in which patient? A. A 40-year-old woman beginning her third trimester but whose water just broke B. A 21-year-old woman who is 39 weeks pregnant and feeling dizzy C. A 25-year-old woman who is 220 days into pregnancy and complaining of back pain D. A 33-year-old woman who is pregnant with twins and in the eighth month of pregnancy
B. A 21-year-old woman who is 39 weeks pregnant and feeling dizzy
When do most women experience a decrease in the nausea and vomiting associated with hyperemesis gravidarum? A. During the first trimester B. Between 14 and 20 weeks C. At term D. About 2 weeks postpartum
B. Between 14 and 20 weeks
You arrive at the side of a pregnant patient in her third trimester who has had vaginal bleeding for several hours. Observation reveals several blood-soaked towels on the bed. She is alert and oriented with a patent airway and adequate breathing. Her pulse is 88 beats per minute and her blood pressure is 104/66 mmHg. In caring for this patient you would: A. Clean the outside of the vagina with sterile water and peroxide B. Collect all towels with blood and transport them with the patient C. Provide rapid transport in a supine position D. Prepare her for the possibility that she may have miscarried the baby
B. Collect all towels with blood and transport them with the patient
A young female complains of sharp pain to the left lower quadrant of her abdomen. She states that her last period was seven weeks ago. With this information, the EMT should be suspicious of: A. Appendicitis B. Ectopic pregnancy C. Abruptio placentae D. Placenta previa
B. Ectopic pregnancy
In a normal fertilization, the egg and the sperm meet in which structure? A. Cervix B. Fallopian tube C. Uterus D. Vaginal canal
B. Fallopian tube
When should the EMT instruct his partner to cut the umbilical cord? A. Just prior to passage of the legs through the vaginal canal B. Following delivery and after the baby has been dried off C. After the 1-minute Apgar score has been obtained D. Immediately after delivery of the placenta
B. Following delivery and after the baby has been dried off
After the EMT observes that secretions are interfering with the baby's breathing, which action indicates that the EMT is properly suctioning the newborn? A. He uses the portable suction unit on the "high" setting B. He squeezes the bulb syringe prior to placing it in the baby's nose C. He suctions the nose first, followed by the mouth D. He inserts the bulb syringe deep into the oropharynx to get thick secretions
B. He squeezes the bulb syringe prior to placing it in the baby's nose
You arrive at the residence of a physician who informs you that his pregnant wife requires immediate transport to the hospital because she is bleeding and has a history of abruptio placentae. As a knowledgeable EMT, you should recognize that the greatest threat to the baby is: A. Fluid loss B. Hypoxia C. Maternal shock D. Infection
B. Hypoxia
You have completed the assessment of a 32-year-old patient who is starting her seventh month of pregnancy. During your assessment, which finding should you be most concerned about? A. Increased weight over the past month B. Intermittent vaginal bleeding C. Several painless contractions D. Increased desire to eat
B. Intermittent vaginal bleeding
A female patient has acute onset of right-sided abdominal pain, describes it as sharp, and rates it as 9/10. The primary survey reveals no life threats, but her skin is cool and diaphoretic. She states that she has been going to the bathroom more and is worried because her father has diabetes. Her last period was nine weeks ago, and she has a history of irregular periods. Her heart rate is 122 beats/min, respirations are 20 breaths/min, blood pressure is 138/68 mmHg, and SaO2 is 97%. In this scenario, which bit of information is of most concern to the EMT? A. Periods irregular in nature B. Last period nine weeks ago C. Family history of diabetes D. Increased urination
B. Last period nine weeks ago
After delivery, you note blood still escaping from the mother's vagina. The sanitary pads that you placed earlier between her legs continue to become soaked. Your next action would be to: A. Place the mother on her left side B. Perform a uterine massage C. Insert sterile gauze into the vaginal canal D. Transport with lights and sirens
B. Perform a uterine massage
You have been called to assist another crew with the birth of a baby. On scene, another EMT informs you that the mother's perineum tore and is bleeding heavily. You would: A. Insert sterile gauze into the vagina and leave it in place until the bleeding stops B. Place a sterile dressing between the mother's vagina and rectum C. Place a cold pack on the mother's abdomen just below the umbilicus D. Apply a sterile gauze dressing with gentle pressure above the vagina
B. Place a sterile dressing between the mother's vagina and rectum
You have arrived at the side of a 35-year-old female who is 37 weeks pregnant and in labor. Your exam reveals crowning with contractions 60 seconds apart. Your immediate action would be to: A. Obtain vital signs, and then move the patient to the ambulance for a nonemergency transport B. Place the patient on her back, and then open and prepare the OB kit C. Have the patient hold her legs together, and then move her to the ambulance for delivery of the baby D. Place the patient on the cot in the left lateral recumbent position, and then proceed with emergency transport
B. Place the patient on her back, and then open and prepare the OB kit
A 22-year-old female, who is eight months pregnant, calls 911 for vaginal bleeding. Your primary assessment reveals no acute life threats, but the patient does have some evidence of blood in her underwear. The patient denies abdominal pain. Her vital signs are normal. Given these findings, the EMT should be suspicious of: A. Ectopic pregnancy B. Placenta previa C. Uterine rupture D. Pelvic inflammatory disease
B. Placenta previa
If the placenta attaches over the cervix, the patient and fetus would be at risk for which condition? A. Ectopic pregnancy B. Placenta previa C. Placental abruption D. Uterine tear
B. Placenta previa
After successfully delivering a baby, the EMT notes that the protruding umbilical cord is lengthening and a small gush of blood came out of the vagina. The appropriate action would be to: A. Massage the patient's uterus B. Prepare for delivery of the placenta C. Open the vaginal canal using obstetric forceps D. Apply a sanitary pad over the vaginal opening
B. Prepare for delivery of the placenta
While en route for a call involving a pregnant patient, an Emergency Medical Responder (EMR) on scene contacts you and reports that the patient is actively seizing. The EMR reports that she is seven months pregnant and has not been feeling well for the past three days (per family). Which instruction is critical for you to relay to the EMR? A. Place a tongue blade in the patient's mouth B. Provide oxygen at 15 liters per minute C. Restrain the patient on her back or left side D. Determine if the patient has a seizure history
B. Provide oxygen at 15 liters per minute
You are completing the delivery of a near term baby boy when you notice that the fluid expelled with the baby is greenish-brown. At this point you should: A. Administer high-concentration oxygen B. Quickly suction the nose and mouth only if the newborn's condition is depressed C. Suction the nose and mouth D. Immediately begin positive pressure ventilation
B. Quickly suction the nose and mouth only if the newborn's condition is depressed
You are by the side of a 19-year-old female who is 36 weeks pregnant. When assessing this patient, which finding best indicates that she is in preterm labor? A. Feeling nauseated with each contraction B. Rupture of the amniotic sac C. Complaint of lower back pain D. Contractions 12 minutes apart
B. Rupture of the amniotic sac
You are responding to a low-income apartment complex for a 16-year-old female who is five weeks pregnant with vaginal bleeding. When mentally reviewing possible causes of hemorrhage for this patient, which condition are you most likely to encounter given the information provided thus far? A. Dysfunctional placenta B. Spontaneous abortion C. Ruptured uterus D. Drug addiction
B. Spontaneous abortion
Assessment indicates that a term newborn's respiratory rate is 38 breaths per minute and his heart rate is 80 beats per minute after administration of supplemental blow-by oxygen. The EMT should: A. Start chest compressions at a rate of 120 compressions per minute B. Start positive pressure ventilation with supplemental oxygen C. Continue to monitor the baby for another 30 seconds D. Administer high-concentration oxygen via a pediatric nonrebreather mask
B. Start positive pressure ventilation with supplemental oxygen
According to the neonatal resuscitation pyramid, which level of care will most newborns require? A. Suctioning of the nose and mouth B. Tactile stimulation and drying C. Blow-by oxygen D. Nursing
B. Tactile stimulation and drying
When faced with the possibility of delivering twins, the EMT must remember that: A. There will be only one umbilical cord that needs to be cut B. The second infant may be born breech C. Both babies are typically in the vaginal canal at the same time D. Twins are typically born after 40 weeks' gestation, making them larger
B. The second infant may be born breech
The EMT would use the sterile scissors found in the OB kit to cut: A. Towels to create a sterile field B. The umbilical cord C. The patient's clothing D. The amniotic sac if it is not yet ruptured
B. The umbilical cord
You have been called to a crisis shelter for a patient possibly having a baby. On scene, you find an older female patient who is developmentally challenged and cannot communicate normally. Staff states that the patient just came to the shelter and they know nothing about her, other than that she is pregnant. Assessment reveals crowning, and you proceed to deliver what appears to be a healthy baby boy. When assessing the mother after delivery, which finding should increase your suspicion that the woman may be carrying twins? A. The woman's abdomen becomes soft and boggy following delivery B. The mother's abdomen remains large after delivery of the first baby C. The mother continues to bleed vaginally D. A large placenta is delivered within seconds of the first baby
B. The mother's abdomen remains large after delivery of the first baby
The EMT shows that he understands the seriousness of a prolapsed umbilical cord when he states: A. "A baby can bleed to death inside the uterus if the cord is compressed for more than 10 minutes." B. "A prolapsed cord that is pinched can stop the flow of oxygen to the baby and must be addressed immediately." C. "If the cord is observed protruding from the vagina, it should be clamped and cut immediately." D. "The priority when treating a patient with a prolapsed umbilical cord is keeping the cord moist."
B. "A prolapsed cord that is pinched can stop the flow of oxygen to the baby and must be addressed immediately."
A woman informs you that she is eight months pregnant and fatigues easily. She is apprehensive because when she lies down, she gets dizzy and feels as though she is going to vomit. What is the EMT's best response? A. "We really need to get to the hospital right away to make sure that your baby is okay. This does not sound good." B. "Check with your obstetrician, but you may want to rest and sleep on your left or right side." C. "You should really call your doctor. During the eighth month of pregnancy, energy levels usually increase." D. "As long as the baby is still moving, you are okay. Just try to get through one more month."
B. "Check with your obstetrician, but you may want to rest and sleep on your left or right side."
Which statement by the patient best indicates that the patient is in the second stage of labor? A. "I think that my water just broke." B. "I feel like I have to move my bowels." C. "The contractions are beginning to hurt now." D. "It feels good not to have to push anymore."
B. "I feel like I have to move my bowels."
The EMT shows an understanding of newborn resuscitation when she states: A. "The EMT must use high-concentration oxygen sparingly because it can be toxic to a baby." B. "Interventions in a newborn should be performed for 30 seconds followed by reassessment." C. "Most newborns require aggressive resuscitation immediately after birth." D. "CPR should be provided only when the baby is unresponsive, apneic, and pulseless."
B. "Interventions in a newborn should be performed for 30 seconds followed by reassessment."
A 25-year-old female presents with abdominal pain. She appears thin and healthy, but in obvious distress. Of the many questions the EMT may ask, which one should the EMT ask early during the patient interview? A. "Are you having any vaginal discharge?" B. "Is there any possibility you are pregnant?" C. "Are your menstrual periods regular?" D. "How many times have you been pregnant?"
B. "Is there any possibility you are pregnant?"
Which statement made by a pregnant patient in labor should be of most concern to the EMT? A. "I have terrible pains in my lower back." B. "My water broke two days ago." C. "I just passed a lot of blood and mucus." D. "The contractions seem to last about 30 seconds."
B. "My water broke two days ago."
When asked, a young female with abdominal pain replies that she is not sure if she is pregnant. Given this response, which question would provide the best information to determine if the patient may be pregnant? A. "Does it feel like the last time you were pregnant?" B. "When was your last normal menstrual period?" C. "Do you feel pressure in your belly area?" D. "Have you been vomiting in the morning?"
B. "When was your last normal menstrual period?"
While examining a pregnant patient who has not received prenatal medical care, you note that you can palpate the uterine fundus at the level of the umbilicus. What is the approximate gestational age of the fetus? A. 12 weeks B. You cannot estimate fetal age using this method C. 20 weeks D. 38 weeks
C. 20 weeks
When asked by a concerned newborn parent, the EMT should indicate that an acceptable respiratory rate for the newborn is: A. 12 breaths per minute B. 24 breaths per minute C. 52 breaths per minute D. 70 breaths per minute
C. 52 breaths per minute
Upon arrival at the home of a woman in labor, a midwife on scene tells you the patient is 7 cm dilated and is complaining of painful contractions. Which stage of labor should the EMT identify? A. Expulsion B. Uterine C. First stage D. Third stage
C. First stage
Which single assessment finding is most consistent with a stable newborn? A. Heart rate of 100 beats per minute B. Facial grimace when irritated C. Heart rate of 140 beats per minute D. Respirations of 28 breaths per minute
C. Heart rate of 140 beats per minute
When treating a patient whom you believe has an ectopic pregnancy, you know that the primary threat to the patient's life is: A. Pelvic organ damage B. Infection C. Hemorrhage D. Severe pain
C. Hemorrhage
As soon as the baby is delivered from the vaginal canal, it is critical that the EMT immediately: A. Obtain a pulse oximetry reading from the newborn's right hand B. Perform the Apgar assessment C. Initiate drying and warming of the newborn D. Clamp and cut the umbilical cord
C. Initiate drying and warming of the newborn
Prior to delivery, the EMT prepares to create a sterile field around the patient's vaginal opening. This is best accomplished by: A. Using towels from the patient's residence to wrap each leg and cover her abdomen B. Placing sheets from the OB kit over both the patient's legs and her abdomen C. Placing a sheet from the OB kit under the patient's hips and another over her abdomen and legs D. Using a sheet from the patient's bed to cover her abdomen and groin
C. Placing a sheet from the OB kit under the patient's hips and another over her abdomen and legs
You have been called for a 27-year-old female who is 32 weeks pregnant. She states that she is experiencing uterine contractions but feels no pain with them, just a tightening in her abdomen. The contractions began three days ago and seem to be increasing in frequency today. She denies discharge or rupture of her membranes. Given this presentation, you should recognize: A. Possible placental abruption, and immediately must transport the patient with lights and sirens B. Probable false labor, and should have the patient follow up with her obstetrician C. Probable false labor, but have the patient transported to the hospital for evaluation D. True labor, so you should assess the vaginal canal for possible crowning
C. Probable false labor, but have the patient transported to the hospital for evaluation
A female patient is described as primigravida. Consequently, the EMT would recognize that: A. She has only one child B. She has been pregnant before but miscarried C. She is pregnant for the first time D. She has never been pregnant
C. She is pregnant for the first time
Despite positive pressure ventilation, a term newborn's heart rate has decreased from 80 beats per minute to 40 beats per minute. He is breathing spontaneously but shallowly at 40 breaths per minute and has a mottled appearance. Your next action would be to: A. Continue positive pressure ventilation B. Attach an AED with pediatric pads C. Start external chest compressions D. Suction the nose and mouth
C. Start external chest compressions
After positive pressure ventilation, a newborn's heart rate increases from 80 to 120 beats per minute. The EMT should: A. Insert an oral airway and resume positive pressure ventilation B. Contact medical direction for instructions C. Stop positive pressure ventilation and provide blow-by oxygen D. Continue positive pressure ventilation with less oxygen use
C. Stop positive pressure ventilation and provide blow-by oxygen
You have been called for a 16-year-old female with vaginal bleeding. On scene, you determine the patient to be pregnant and bleeding for 3 hours. Which statement would indicate proper care of the patient? A. "I know that it is uncomfortable, but try to keep your legs apart so the blood can flow out of your body." B. "I am going to place this piece of sterile gauze into your vagina to try to stop the bleeding." C. "I am going to put this sanitary napkin between your legs to collect the blood." D. "I am going to insert my gloved hand into your vagina and apply pressure to try to stop the bleeding from the inside."
C. "I am going to put this sanitary napkin between your legs to collect the blood."
You have determined that you will need to perform a field delivery. Which instructions to the patient show that the EMT is properly positioning her? A. "I am going to place you on your left side with your legs up until the baby's head is visible." B. "Please lie back, and then elevate both legs into the air. Your husband will help you hold them up." C. "Please lie on your back, draw your knees upward, and spread your legs apart." D. "I'd like you to lie flat on the bed and bend your right leg while keeping your left leg straight."
C. "Please lie on your back, draw your knees upward, and spread your legs apart."
Which statement made by the EMT indicates an understanding of the relationship between seizures and pregnancy? A. "If the pregnant patient is seizing, the EMT must quickly make a decision to administer or withhold her antiseizure medications." B. "A short seizure in the pregnant female with a seizure history generally does not require transport." C. "Prolonged seizures can easily cause the mother and baby to become hypoxic." D. "Seizure activity in the pregnant female is typically not life threatening unless the patient has had seizures in the past."
C. "Prolonged seizures can easily cause the mother and baby to become hypoxic."
What would the minimum expected preductal SpO2 reading be at one minute after birth? A. 85% B. 80% C. 60% D. 94%
C. 60%
How many newborns will require a level of care that falls below the top tier of the neonatal resuscitation pyramid? A. Approximately half B. One in twenty C. 80 percent D. 20 percent
D. 20 percent
A female patient is 34 weeks pregnant, and you are delivering the baby. As soon as the baby is completely delivered, you should immediately: A. Administer high-concentration oxygen to the baby B. Check the baby's breath sounds C. Clamp and cut the cord D. Dry the baby with a warm towel
D. Dry the baby with a warm towel
A 32-year-old female complains of the sudden onset of sharp pain to the left side of her abdomen. She denies any medical history and when asked, admits to being sexually active. Her last menstrual period was two months ago. As an EMT, you should immediately suspect: A. Pelvic inflammatory disease B. Abruptio placentae C. Mittelschmerz D. Ectopic pregnancy
D. Ectopic pregnancy
Why is the uterus essential to a healthy pregnancy and childbirth? A. It permits the excretion of waste from the baby to the mother B. It protects abdominal organs during fetal growth C. It manufactures specific blood cells needed for fetal immunity D. It powerfully contracts to force the fetus from the mother's body following gestation
D. It powerfully contracts to force the fetus from the mother's body following gestation
The EMT recognizes the underlying pathophysiology associated with the most common type of ectopic pregnancy is a fertilized egg that is: A. Developing without a placenta B. Contaminated with abdominal bacteria C. Attached to the upper region of the uterus rather than to the lower region by the cervix D. Lodged in a fallopian tube
D. Lodged in a fallopian tube
Which action demonstrates that the EMT is correctly performing uterine massage? A. Both hands are positioned at the symphysis pubis and she pushes with an upward motion B. She places her hands on the upper abdomen and pushes the uterus toward the pelvis C. She uses the lower palms of both hands to firmly press downward on the uterus D. One hand cups the top of the uterus, with one of the hands positioned just above the symphysis pubis
D. One hand cups the top of the uterus, with one of the hands positioned just above the symphysis pubis
A female patient who is eight and a half months pregnant states that she does not feel well and is weak with clammy skin. She denies chest pain, shortness of breath, and dizziness. She states that she did vomit earlier in the morning and still feels somewhat nauseated. She is alert and oriented and has a patent airway. She is breathing 18 times per minute and has a heart rate of 88 beats per minute. Her blood pressure is 116/70 mmHg and her SpO2 reading is 95% on room air. The most appropriate care for this patient should include: A. Refusal-of-transport form signed with suggested follow-up with her obstetrician B. Rapid transport to a hospital with specialized obstetric services C. Quiet and calm transport in the supine position D. Oxygen at 15 lpm via a nonrebreather face mask
D. Oxygen at 15 lpm via a nonrebreather face mask
A 31-year-old female is in labor. After ensuring her airway, breathing, and circulation, you assess her perineum and observe the umbilical cord protruding from the vagina. However, the baby is not visible. Your next action would be to: A. Carefully place the cord back inside the vagina B. Gently pull the cord to assist in delivery C. Place a saline-soaked dressing over the cord D. Place the patient in a knee-chest position
D. Place the patient in a knee-chest position
You have been dispatched to a residence for a female patient who is dizzy and "passing out." An Emergency Medical Responder meets you at the door and reports that the patient is lying in bed and is nine months pregnant. Her pulse rate is 112 beats per minute and her blood pressure is 84/50 mmHg. Respirations are 24 breaths per minute and she has a room air pulse oximetry reading of 97%. What should you do as soon as you reach the patient's side? A. Start positive pressure ventilation B. Determine any complications of the pregnancy C. Recheck the blood pressure D. Roll her onto her left side
D. Roll her onto her left side
An EMT is presenting a continuing education class on the care of the pregnant female. When discussing the amniotic sac, he is correct to emphasize which point? A. The amniotic sac must rupture during the second trimester of pregnancy for the third trimester to progress B. The amniotic sac contains fluid and surrounds and protects the uterus C. The amniotic sac contains a fluid called Wharton's jelly that protects the baby while in the uterus D. The amniotic sac protects and insulates the baby during gestation
D. The amniotic sac protects and insulates the baby during gestation
Which statement regarding the role and function of the cervix during pregnancy is true? A. The cervix constricts near the time of delivery to prevent a premature birth B. The "bloody show" comes from the cervix and confirms pregnancy in the first trimester C. The EMT can palpate the cervix to measure the contractions that the mother is having during the third trimester D. The cervix becomes plugged with mucus to prevent contamination of the uterus during gestation
D. The cervix becomes plugged with mucus to prevent contamination of the uterus during gestation
A 31-year-old female in her third trimester of pregnancy lost her balance and fell down a flight of stairs. Treatment included spinal motion precautions and oxygen therapy. When transporting her, the EMT should: A. Transport her on her right side B. Transport her in a supine position without a cervical collar in place C. Transport her to her obstetrician's office D. Tilt the long spine board to the left
D. Tilt the long spine board to the left
Which finding is of greatest concern when assessing a 33-year-old female who is eight months pregnant? A. Daily contractions that are irregular and painful B. Shortness of breath when lying flat C. Recent onset of a fever of 99.3degrees F D. Vaginal bleeding not associated with pain
D. Vaginal bleeding not associated with pain
The EMT shows that he can accurately differentiate placenta previa from abruptio placentae when he states: A. "The blood lost with placenta previa is dark red; the color of blood associated with abruptio placentae is bright red." B. "Abruptio placentae rarely results in the death of the baby; the mortality rate of placenta previa is high." C. "Abruptio placentae typically occurs in the first and second trimesters; placenta previa occurs in the third trimester." D. "Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless."
D. "Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless."
When assessing a 27-year-old patient who is eight months pregnant, which statement made by the patient should the EMT be most concerned about? A. "My last baby came two weeks late." B. "I had some belly cramps two weeks ago." C. "I was a drug addict when I was a teenager." D. "I have not been able to see the doctor this pregnancy at all."
D. "I have not been able to see the doctor this pregnancy at all."
You are transporting a young female who just had a miscarriage at home. During the transport the woman weeps continually. Which statement is most appropriate given the situation? A. "It is best to stay strong; your other child needs your support." B. "If you want another child, wait a few months and then get pregnant again." C. "I think in the long run you will be okay and things will work out." D. "Is there anything that I can do to help you right now?"
D. "Is there anything that I can do to help you right now?"
What are the stages of labor in the order in which they occur? A. Dilation, delivery, placental, and afterbirth B. Uterine, delivery, and recovery C. Uterine, expulsion, placental, and recovery D. Dilation, expulsion, and placental delivery
D. Dilation, expulsion, and placental delivery
You are assessing a 29-year-old pregnant female who has signs of imminent delivery. Her past medical history includes HIV infection. Compared to a patient with no infectious disease, how will standard precautions differ for this patient? A. Gloves, a gown, and goggles will be used for this patient; only gloves and a gown are required for a healthy patient in labor B. A HEPA filter mask should be used for the patient with HIV, but not for the noninfectious patient C. Gloves are needed for a noninfectious patient in labor; goggles and gloves must be worn for the patient with HIV D. Gloves, a gown, and eye protection should be worn for both the patient with HIV and the noninfectious patient
D. Gloves, a gown, and eye protection should be worn for both the patient with HIV and the noninfectious patient
