Module test #11 (34-38) OBGYN
Which of these steps is included in the emergency care of a pediatric patient with epiglottitis? A. Avoid agitating the child with unnecessary assessment and treatment B. Suctioning the airway as needed C. Inserting an oropharyngeal airway D. Positioning the child in a supine position
A. Avoid agitating the child with unnecessary assessment and treatment
Which of the following structures serves as the division between the thoracic and abdominal cavities? A. Diaphragm B. Visceral peritoneum C. Parietal pleura D. Pleural lining
A. Diaphragm
You have arrived on the scene of a child with reported difficulty breathing. The patient is a 4-year-old male child who is sitting on the floor, putting together a puzzle with his mother. One of the FIRST things that you notice is that the child is grunting with each expiration. Which choice is the cause of the grunting that you should suspect? A. He is having difficulty keeping his lower airways open B. He is absorbed in play C. Sinus drainage D. He is not toilet trained
A. He is having difficulty keeping his lower airways open
What mechanism accounts for about half of all traumas in pregnancy? A. Motor vehicle crashes B. Falls C. Domestic violence D. Burns
A. Motor vehicle crashes
When assessing a child's appearance in the Pediatric Assessment Triangle, what is meant by assessing the patient's tone? A. Muscle tone and movement B. Apparent mood or emotion C. Pitch of the voice or cry D. Skin color
A. Muscle tone and movement
As a review of the anatomy of the abdominal cavity, which of the following is TRUE? A. Solid organs include the pancreas and kidneys. B. The visceral peritoneum adheres to the walls of the abdominal cavity. C. Organs that lie in the upper portion of the abdomen are called retroperitoneal. D. The gallbladder and spleen are examples of solid organs.
A. Solid organs include the pancreas and kidneys. This is the correct answer.
When faced with the possibility of delivering twins, the EMT must remember that: A. The second infant may be born breech B. Twins are typically born after 40 weeks' gestation, making them larger C. There will be only one umbilical cord that needs to be cut D. Both babies are typically in the vaginal canal at the same time
A. The second infant may be born breech
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. Tilt the long spine board to the left B. Transport her on her right side C. Transport her to her obstetrician's office D. Transport her in a supine position without a cervical collar in place
A. Tilt the long spine board to the left
The appearance part of the pediatric assessment triangle refers to the child's A. mental status. B. skin temperature. C. facial grimacing. D. skin color.
A. mental status.
The EMT shows that he can accurately differentiate placenta previa from abruptio placentae when he states: A. "Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless." 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. "The blood lost with placenta previa is dark red; the color of blood associated with abruptio placentae is bright red."
A. "Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless."
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. "I have gained 10 pounds just this month." C. "I think that I may have to vomit." D. "My legs and feet are more swollen."
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. "It is essential that the mother not be moved until the placenta has been delivered." C. "The placenta is full of bacteria and should not be transported in the ambulance near the baby." D. "The EMT must deliver the placenta by applying gentle pressure to the abdomen after the baby has been born."
A. "The placenta typically delivers itself within 20 minutes of the birth of the baby."
What is the typical duration of the FIRST stage of labor in first-time mothers? A. 1 to 2 days B. 8 to 10 hours C. 5 to 7 hours D. 12 to 15 hours
B. 8 to 10 hours
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 III; para I B. Gravida IV; para I C. Para III; gravida I D. Para IV; gravida I
B. Gravida IV; para I
A 74-year-old female complains of abdominal pain after falling down five stairs off her front porch and striking her abdomen and left hand on a mailbox at the bottom. The patient also reports pain in her left wrist and right ankle, both of which show obvious deformity. She is alert and oriented, and her abdomen is free of bruising but tender in the left upper and lower quadrants. Her vital signs are pulse, 132 beats/min; respirations, 22 breaths/min; blood pressure, 106/86 mmHg; and initial SpO2, 93% on room air. Oxygen has been applied, and the patient has full spine motion restriction precautions in place. Advanced life support has been requested and is 12 minutes away from your current location. What is your next action? A. Apply ice to the wrist and ankle while awaiting arrival of the ALS unit B. Initiate immediate transport and intercept with the ALS unit C. Secure the wrist and ankle to board splints, initiate transport, and cancel the ALS unit D. Monitor the patient and wait for ALS assistance
B. Initiate immediate transport and intercept with the ALS unit
During a continuing education session on OB/GYN topics, the EMT would recognize which statement about the umbilical cord as true? A. It connects the placenta and the uterus B. It contains one vein and two arteries C. It detoxifies blood before its delivery to the baby D. It produces hormones for the baby
B. It contains one vein and two arteries
Which statement BEST describes the cervix? A. It is the inner lining of the uterus. B. It is the narrow, lower end, or "neck" of the uterus. C. It is the opening at the junction of the uterus and fallopian tube. D. It is the duct through which an egg released from the ovary travels to the uterus.
B. It is the narrow, lower end, or "neck" of the uterus.
The mother of a 4-year-old boy states that he fell off the top bunk bed and hit his head. After falling, he appeared to seize for approximately 30 seconds. Currently, he has nonpurposeful movement to painful stimuli, with a patent airway and slow respirations. His radial pulse is intact, and his skin is warm and dry. You note urinary incontinence. After taking manual spine motion restriction precautions, what should you do next? A. Perform a head-tilt, chin-lift maneuver and administer high-concentration oxygen B. Perform a jaw-thrust maneuver and start positive pressure ventilation C. Apply oxygen, provide full spinal motion restriction precautions, and then initiate rapid transport D. Insert an oropharyngeal airway and provide high-concentration oxygen
B. Perform a jaw-thrust maneuver and start positive pressure ventilation
A 78-year-old male pedestrian was struck by a car at a convenience store. The patient is conscious but confused, and has sustained multisystem trauma. What would represent the best sequence of care for this patient? A. Primary assessment, oxygen, secondary assessment, cervical collar, and all other care en route to the hospital B. Primary assessment, oxygen, secondary assessment, spine motion restriction precautions, and all other care en route to the hospital C. Primary assessment, spine motion restriction, and all other care en route to the hospital D. Primary assessment, oxygen, secondary assessment, and all other care en route to the hospital
B. Primary assessment, oxygen, secondary assessment, spine motion restriction precautions, and all other care en route to the hospital
Which of the following is the correct definition of Kehr sign? A. Abdominal distention due to a ruptured diaphragm B. Referred pain to the shoulder caused by abdominal bleeding C. Bruising around the umbilicus D. Increased gastric sounds due to intraperitoneal injury
B. Referred pain to the shoulder caused by abdominal bleeding
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. Placenta previa B. Ruptured uterus C. Preeclampsia D. Ectopic pregnancy
B. Ruptured uterus
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. Suction the nose and mouth B. Start external chest compressions C. Attach an AED with pediatric pads D. Continue positive pressure ventilation
B. Start external chest compressions
How can blunt abdominal trauma to the pregnant female cause fetal death? A. The head of the fetus will flex, causing airway occlusion. B. The placenta tears away from the uterus. C. It will cause the umbilical cord to burst D. The baby will sustain long bone fractures.
B. The placenta tears away from the uterus.
What type of abdominal organ is the vena cava? A. Hollow B. Vascular C. Cutaneous D. Solid
B. Vascular
The mother of a 3-year-old boy has called 911 because her son has a low-grade fever and difficulty breathing. On scene, the mother tells you that she is a licensed practical nurse (LPN), and that she suspects her son is suffering from croup. Which statement made by the mother would reinforce this suspicion? A. "When I turn the air conditioner on, he becomes more short of breath." B. "At night, he seems to get a barking-like cough." C. "There are times when he continually drools." D. "When he is short of breath, his heart rate increases."
B. "At night, he seems to get a barking-like cough."
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 97.3 degrees °F. Based on this presentation, you would: A. Provide low-concentration oxygen and nonemergently transport the patient B. Massage the abdomen, provide high-concentration oxygen, and nonemergently transport the patient C. Administer high-concentration oxygen and immediately transport the patient D. Place the patient in a supine position and immediately transport her
C. Administer high-concentration oxygen and immediately transport the patient
You observe a traumatically injured 3-year-old female patient being secured to a long spine board with no padding behind the neck, shoulders, or back during a spine motion restriction intervention. What is the main concern with this oversight? A. Extension of the cervical spine B. Bruising to the back C. Airway compromise D. Pain and discomfort
C. Airway compromise
An unrestrained female patient, who was involved in a minor motor vehicle collision, refuses EMS care or transport. She is seven months pregnant and is alert and oriented. When asked, she denies any complaint. Your best action would be to: A. Have her follow up with her obstetrician B. Have the police witness her signing the refusal-of-care form C. Contact medical direction for instructions D. Make contact with her obstetrician
C. Contact medical direction for instructions
You have been called for a male patient who was shot with a rifle. Assessment reveals an entrance wound to the left lower quadrant of the abdomen. A hemorrhaging exit wound to the left lower back is also located. What should you do immediately? A. Place a cervical collar on the patient B. Cover the abdominal wounds with dry sterile gauze dressings C. Cover the entrance wound with a gloved hand D. Auscultate the patient's breath sounds
C. Cover the entrance wound with a gloved hand
Which of these guidelines apply when examining and caring for an infant? A. Ask the caregiver to lay the infant on a flat surface and undress him so you can examine him. B. For an infant who is alert and in no immediate distress, begin your assessment with the head and end with the feet. C. Form a general impression as you approach the patient, before reaching his side. D. Let the infant hold and play with equipment before you use it on him.
C. Form a general impression as you approach the patient, before reaching his side.
Which condition should be suspected when a patient who is 32 weeks pregnant presents with a complaint of headache, right upper quadrant abdominal pain, nausea, hypertension, and swelling of the face, hands, and feet? A. Ectopic pregnancy B. Hyperemesis gravidarum C. Preeclampsia D. Gestational diabetes
C. Preeclampsia
You arrive on the scene of a home birth to find a vigorous infant who is crying and in NO distress, and his 35-year-old mother, who experienced a sudden onset of sharp, localized chest pain, and shortness of breath. Her skin is mottled and cool, she is in severe respiratory distress, hypotensive, and tachycardic. With which condition is the mother's signs and symptoms MOST consistent? A. Uterine rupture B. Postpartum hemorrhage C. Pulmonary embolism D. Septic shock
C. Pulmonary embolism
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. Continue with the delivery of the baby B. Cut the sac with the sterile scissors in the OB kit C. Rip open the amniotic sac with your fingers D. Transfer the patient to the stretcher for immediate transport
C. Rip open the amniotic sac with your fingers
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. Contractions 12 minutes apart B. Feeling nauseated with each contraction C. Rupture of the amniotic sac D. Complaint of lower back pain
C. Rupture of the amniotic sac
Which mechanism accounts for supine hypotensive syndrome? A. Compression of the umbilical cord between the fetus and the uterine wall results in decreased fetal cardiac output and hypotension. B. The weight of the enlarged uterus and fetus compress the vagus nerve, which slows the heart rate and decreases cardiac output. C. The weight of the enlarged uterus and fetus presses on the inferior vena cava, causing inadequate blood return to the heart. D. The weight of the enlarged uterus and fetus compresses the descending aorta, restricting blood flow to the rest of the body.
C. The weight of the enlarged uterus and fetus presses on the inferior vena cava, causing inadequate blood return to the heart.
A 22-year-old pregnant female patient complains of severe nausea and vomiting. The patient's skin is pale and clammy. Her vital signs are HR 126, R 24, BP 88/70, and SpO2 is 94% on room air. You should apply oxygen via a A. simple mask at 6 liters per minute. B. nasal cannula at 2 liters per minute. C. nonrebreather mask at 15 liters per minute. D. bag-valve mask at 15 liters per minute.
C. nonrebreather mask at 15 liters per minute.
You have been called to a nursing home for a confused 91-year-old male patient who became dizzy and fell, striking his head on the floor. Which statement made by the nurse should be of most concern to you? A. "He did not have any of his medications today." B. "I just checked his blood sugar and it is 154 mg/dL, but it was 243 at last shift change." C. "He has a heart valve problem and takes Coumadin to help prevent his blood from clotting." D. "He is normally confused, and his family just made him a DNR."
C. "He has a heart valve problem and takes Coumadin to help prevent his blood from clotting."
Of which of these situations should you be aware in the assessment and treatment of pediatric patients? A. Despite their small body size, the diameter of a child's trachea reaches adult size by the age of 5 years. B. Children have a lower body surface to mass ratio than adults. C. Children's increased metabolic rate creates greater oxygen demand. D. A child lacks any capacity to compensate for blood or fluid loss.
C. Children's increased metabolic rate creates greater oxygen demand.
Despite the increase in maternal blood volume, the pregnant patient is typically: A. Prone to early signs of shock B. Hypertensive C. Bradycardic D. Anemic
D. Anemic
You are transporting an elderly female who fell in a nursing home and displays outward rotation of her left leg. She has a lengthy medical history, including dementia. Currently, she is very quiet and receiving oxygen through a nasal cannula at 6 liters per minute. She also is secured to a long spine board. During your reassessment, you note her to be alert but confused, with slightly accelerated respirations and a strong radial pulse. You also note that her SpO2 has dropped from 97% on scene to 91%. You should: A. Start positive pressure ventilation B. Perform a head-tilt, chin-lift maneuver C. Request ALS assistance D. Apply supplemental oxygen
D. Apply supplemental oxygen
At the scene of a motor vehicle accident, a car has extensive front-end damage and a deformed steering wheel. The restrained driver, who was self-extricated, is in the care of EMRs, who have applied a cervical collar and continue to maintain spine motion restriction precautions. The patient's airway is patent and respirations adequate. His radial pulse is rapid and weak, and his skin is cool and diaphoretic. The EMRs report the following vital signs: pulse, 136 beats/min; respirations, 20 breaths/min; blood pressure, 100/68 mmHg; and SpO2, 95% with supplemental O2 being administered. The right forearm is deformed, and the head, chest, and upper back are uninjured according to your assessment. Your next action would be to: A. Change the nonrebreather mask to a nasal cannula B. Repeat the vital signs C. Start positive pressure ventilation D. Check the abdomen for injury
D. Check the abdomen for injury
The EMT is correctly assessing the perfusion status of a 10-month-old when she: A. Obtains a blood pressure B. Looks for cyanosis in the extremities C. Observes the characteristics of the fontanelles D. Feels for a brachial pulse
D. Feels for a brachial pulse
When should the EMT instruct his partner to cut the umbilical cord? A. After the 1-minute Apgar score has been obtained B. Just prior to passage of the legs through the vaginal canal C. Immediately after delivery of the placenta D. Following delivery and after the baby has been dried off
D. Following delivery and after the baby has been dried off
Why is the uterus essential to a healthy pregnancy and childbirth? A. It protects abdominal organs during fetal growth B. It manufactures specific blood cells needed for fetal immunity C. It permits the excretion of waste from the baby to the mother 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
If a patient has severe retroperitoneal bleeding from an organ located within this cavity, she has most likely injured her: A. Large intestine B. Liver C. Stomach D. Kidney
D. Kidney
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. Put the patient in semi-Fowler's position on the stretcher and immediately transport B. Lay the patient on her left side and administer high-concentration oxygen C. Place both hands on the abdomen and attempt to turn the baby into a head-down position D. Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen
D. Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen
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 EMT can palpate the cervix to measure the contractions that the mother is having during the third trimester C. The "bloody show" comes from the cervix and confirms pregnancy in the first 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
Which of the following statements explains why brain injury secondary to trauma is increased in the geriatric population? A. The elderly strike their heads more often. B. The elderly are less able to brace themselves in a fall. C. The elderly are less able to prepare themselves for impending trauma. D. The loss of brain mass allows more room for movement within the skull.
D. The loss of brain mass allows more room for movement within the skull.
Severe abdominal trauma and blood loss may cause signs and symptoms of shock, which include: A. a decreased heart rate. B. hypertension. C. flushed skin. D. an increased heart rate.
D. an increased heart rate.
General emergency medical care for the patient with an abdominal injury includes: A. administering oxygen at 6 lpm by nasal cannula. B. applying and inflating the abdominal section of the PASG to control internal abdominal bleeding. C. placing the patient in the prone position with knees bent. D. covering an evisceration with a moist dressing and occlusive dressing.
D. covering an evisceration with a moist dressing and occlusive dressing.