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? Select one: A. "When are you due?" B. "Is this your first baby?" C. "Have you had a sonogram?" D. "Do you feel the need to push?"

C. "Have you had a sonogram?"

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

D. start of one to the start of the next.

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. Select one: A. 3 B. 9 C. 2 D. 7

A. 3

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. Apply gentle pressure to the baby's head as it 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. Maintain firm pressure to the head until it completely delivers.

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

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

A. belly button.

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

A. placing the mother supine with her head down and pelvis elevated.

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

B. Uterus

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. firmly massage the uterine fundus with a circular motion. C. carefully insert a sterile trauma dressing into her vagina. D. place her legs together and position her on her left side.

B. firmly massage the uterine fundus with a circular motion.

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

B. insulate and protect the fetus.

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

B. is wrapped around the baby's neck.

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. intrauterine bleeding. B. pulmonary embolism. C. acute pulmonary edema. D. spontaneous pneumothorax.

B. pulmonary embolism.

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. call for the police to ensure that patient assessment is carried out. B. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient. C. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome. D. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management.

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

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

B. that the baby's airway may be obstructed.

Which of the following statements is NOT true? Select one: A. Gestational diabetes will clear up in most women after delivery. B. The leading cause of abruptio placenta is an ectopic pregnancy. C. As pregnancy progresses, the uterus enlarges and rises out of the pelvis. D. Some cultures may not permit male EMTs to examine a female patient.

C. As pregnancy progresses, the uterus enlarges and rises out of the pelvis.

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

C. positive-pressure ventilations.

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

C. pregnant patients have an overall increase in blood volume.

Once the infant's head has been delivered: Select one: A. suction the infant's nose, and then the mouth. B. apply oxygen over the mother's vagina. C. suction the infant's mouth, then the nose. D. apply a nasal cannula at 3 L/min to the infant.

C. suction the infant's mouth, then the nose.

Which of the following is NOT performed immediately following delivery of the infant? Select one: A. Wrap the infant in a towel and place it on one side with head lowered. B. Be sure the head is covered and keep the neck in a neutral position. C. Use a sterile gauze pad to wipe the infant's mouth, then suction again. D. Obtain an Apgar score.

D, Obtain an Apgar score.

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

D. 16 hours.

When assisting ventilations in a newborn with a bag-valve mask, the rate is _____ breaths/min. Select one: A. 20 to 30 B. 30 to 50 C. 35 to 45 D. 40 to 60

D. 40 to 60

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

D. an ectopic pregnancy.

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. immediately remove the patient from the environment and transport. B. contact police and remain at the scene until they arrive and escort you to the hospital. C. ask more detailed questions and press the issue until you have a more detailed understanding of the incident. D. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.

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

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

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

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. administer oral glucose for presumed hypoglycemia and transport. C. insert an oral airway and ventilate her with a bag-valve mask. D. place her on her side, administer high-flow oxygen, and transport.

D. place her on her side, administer high-flow oxygen, and transport. Correct