Chapter 33: Obstetrics and Neonatal Care

Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?

"Have you had a sonogram?".

A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:

16 hours.

Determine the Apgar score in the following scenario: You arrive at the scene of a home delivery. Upon entering the scene, the father appears upset and hands you a limp baby. The child has a weak cry, is completely cyanotic, and has a pulse of 70 beats/min. Respirations are slow.

3.

When assisting ventilations in a newborn with a bag-valve mask, the rate is _____ breaths/min.

40 to 60.

If a baby is born at 7:52, the second Apgar score should be calculated at:

7:57.

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:

8.

Spina bifida is a developmental defect in which:

A portion of the spinal cord or meninges protrudes outside of the vertebrae.

Premature separation of the placenta from the wall of the uterus is known as:

Abruptio placenta.

Braxton-Hicks contractions are characterized by:

Alleviation of pain with movement or changing positions.

A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for:

An ectopic pregnancy.

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?

Apply gentle pressure to the baby's head as it delivers.

Upon delivery of an infant's head, you note that the umbilical cord is wrapped around its neck. You should:

Attempt to slip the cord gently over the infant's head.

By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's:

Belly button.

The vagina and the neck of the uterus comprise the:

Birth canal.

Which of the following is NOT a component of the Apgar score?

Body size.

The ONLY indications for placing your gloved fingers in the vagina during delivery are:

Breech presentation and prolapsed umbilical cord.

The umbilical cord:

Carries oxygen to the baby via the umbilical vein.

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:

Continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.

The onset of labor begins with:

Contractions of the uterus.

Placenta previa is defined as:

Development of the placenta over the cervical opening.

After the fetus has descended into the pelvis at the end of the third trimester, many mothers experience:

Easier breathing.

_____ is heralded by the onset of convulsions, or seizures, resulting from severe hypertension in the pregnant woman.

Eclampsia.

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:

Firmly massage the uterine fundus with a circular motion.

A precipitous labor and delivery is MOST common in women who:

Have delivered a baby before.

Signs and symptoms of preeclampsia include:

Headache and edema.

Which of the following statements regarding gestational diabetes is correct?

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

Which of the following are normal physiologic changes that occur in the mother's respiratory system during pregnancy?

Increased respiratory rate and decreased respiratory reserve.

The amniotic fluid serves to:

Insulate and protect the fetus.

A nuchal cord is defined as an umbilical cord that:

Is wrapped around the baby's neck.

You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however, his heart rate is 90 beats/min. You should:

Keep him warm and ventilate with a BVM.

In contrast to abruptio placenta, placenta previa:

May not present with heavy vaginal bleeding.

Which of the following statements regarding twins is correct?

Most twins are born within 45 minutes of each other.

Which of the following is NOT performed immediately following delivery of the infant?

Obtain an Apgar score.

When preparing a pregnant patient for delivery, you should position her:

On a firm surface with her hips elevated 2 to 4 inches.

Most medical models base a pregnant woman's due date:

On the first day of her last menstrual cycle.

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:

Place her in a left lateral recumbent position.

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:

Place her on her side, administer high-flow oxygen, and transport.

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:

Placing the mother supine with her head down and pelvis elevated.

Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:

Positive-pressure ventilations.

A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:

Pregnant patients have an overall increase in blood volume.

Fetal complications associated with drug- or alcohol-addicted mothers include all of the following, EXCEPT:

Profound tachycardia.

Following delivery of a pulseless and apneic infant who has a foul odor, skin sloughing, and diffuse blistering, you should:

Provide emotional support to the mother.

If a newborn's heart rate is less than 60 beats/min following delivery, you should:

Provide ventilations for 30 seconds.

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:

Pulmonary embolism.

While examining a woman in labor, you see the umbilical cord protruding from the vagina. You should:

Push the infant's head away from the cord.

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:

Respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient.

Which of the following is NOT generally considered an obstetrical emergency?

Return of contractions following delivery of the baby.

When determining the frequency of contractions, you should time the contractions from the:

Start of one to the start of the next.

Once the infant's head has been delivered:

Suction the infant's mouth, then the nose.

Which of the following statements regarding suctioning of a newborn's mouth and oropharynx is correct?

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

When the mother is experiencing a contraction, you should instruct her to:

Take quick short breaths.

The presence of meconium in the amniotic fluid indicates:

That the baby's airway may be obstructed.

Which of the following statements is NOT true?

The leading cause of abruptio placenta is an ectopic pregnancy.

Which of the following statements regarding the placenta is correct?

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.

bruptio placenta occurs when:

The placenta prematurely separates from the uterine wall.

Supine hypotensive syndrome occurs when:

The pregnant uterus compresses the inferior vena cava.

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:

These actions simulate the production of oxytocin and cause uterine contraction.

Which of the following occurs during true labor?

Uterine contractions become more regular.

From what internal female organ is the fetus expelled during delivery?

Uterus.

An infant is considered to be premature if it:

Weighs less than 5 lb or is born before 36 weeks' gestation.