EMT Chapter 37: Obstetrics and Care of the Newborn

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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


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