Chapter 34

Which of the following statements regarding a breech presentation is correct?

A breech presentation occurs when the buttocks are the presenting part.

An abortion occurs when the fetus and placenta deliver before:

A. 20 weeks

During your visual inspection of a 25 year old woman in labor, you see the babies head crowning at the vaginal opening. What should you do?

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:

A. Belly button

The only indications for placing your gloved finger in the vagina during delivery are:

A. Breech presentation and prolapsed umbilical cord

833 year old woman who is 36 weeks pregnant is experiencing vaginal bleeding. During transport, you know that she suddenly becomes diaphoretic, tachycardia, and hypotensive. You should:

A. Place her in a left lateral recumbent position

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

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

Which of the following statements regarding the placenta is correct?

A. 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.

After a baby is born, it is important to:

A. ensure that it is thoroughly dried and warmed

In contrast to a full-term infant, a premature infant:

A. has an even proportionately larger head

Signs and symptoms of preeclampsia include:

A. headache and edema.

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:

A. keep him warm and ventilate with a bag-mask device.

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:

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

During delivery, it is MOST important to position your partner at the mother's head because:

A. the mother may become nauseated and vomit.

A bruptio placenta occurs when:

A. the placenta prematurely separates from the uterine wall.

The term "bloody show" is defined as:

A. the small amount of pink-tinged mucus that is discharged from the vagina after expulsion of the mucous plug.

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

B. 7:57

Which of the following is an indication of imminent birth?

B. Crowning of the baby's head

If a pregnant patient must be placed onto a backboard, you should:

B. Elevate the right side of the board with rolled towels or blankets

Following delivery of a full-term baby, you have properly cared for the baby and have clapped and cut the umbilical cord. During transport, you know that the mother is experiencing moderate vaginal bleeding. You should:

B. Firmly massage the uterine fundus with a circular motion

In contrast to abruptio placenta, placenta previa:

B. Might present without significant abdominal pain

Fatal complications associated with a drug or alcohol addicted mothers include all of the following, except:

B. Profound tachycardia

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 has tachycardia. The EMT should suspect:

B. Pulmonary embolism

Upon delivery of the babies head, you know that its face is encased in the unruptured amniotic sac. you should:

B. Puncture the sac and suction the babies mouth and nose

Braxton-Hicks contractions are characterized by:

B. alleviation of pain with movement or changing positions

Which of the following is a normal physiologic change that occurs in the mothers respiratory system during pregnancy?

B. increased respiratory rate and decreased respiratory reserve

The amniotic fluid serves to:

B. insulate and protect the fetus.

A nuchal cord is defined as an umbilical cord that:

B. is wrapped around the baby's neck.

CPR is in progress on a pulseless and apneic 29 year old woman who is 37 weeks pregnant. When treating this patient, the EMT should:

B. manually displace the patient's uterus to the left.

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

B. push the infant's head away from the cord

The presence of meconium in the amniotic fluid indicates:

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

Supine hypotensive syndrome occurs when:

B. the pregnant utems compresses the inferior vena cava.

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

B. uterus

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

C. "Have you had a sonogram?"

A newborn infant will usually begin breathing spontaneously within _______ seconds following birth.

C. 15-30

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 resist attempt to straighten his legs. His Apgar score is:

C. 8

You are assessing a 25 year old woman who is 39 weeks pregnant. She is experiencing regular contractions that are approximately three minutes apart and states that her amniotic sac broke two hours ago. After taking the standard precautions, you should:

C. Assess her for crowning

The umbilical cord:

C. Carries oxygen to the baby via the umbilical vein

You have just delivered a full-term infant. His respirations are rapid and irregular, and he has a strong cry. What should you do next?

C. Check the pulse rate at the brachial artery.

Which of the following statements regarding gestational diabetes is correct?

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

Which of the following statements regarding twins is correct?

C. Most twins are born within 45 minutes of each other.

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

C. Provide emotional support to the mother

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

C. Return of contractions following delivery of the baby

Eclampsia is most accurately defined as:

C. Seizures that result from severe hypertension

Which of the following processes occurs immediately after ovulation?

C. The inner lining of the uterus thickens in preparation for implantation

Which of the following occurs during truth labor?

C. Uterine contractions become more regular

A precipitous Labor and delivery is most common in women who:

C. have delivered a baby before

The leading cause of maternal death during the first trimester of pregnancy is:

C. internal bleeding caused by a ruptured ectopic pregnancy

The term primigravida refers to a woman who:

C. is pregnant for the first time.

Common interventions used to stimulate spontaneous respirations and the newborn include all of the following except:

C. positive-pressure ventilations.

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

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

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

C. take quick short breaths

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

D. 16 hours

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

D. An ectopic pregnancy

The vagina and the neck of the uterus compromise the:

D. Birth canal

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

D. Easier breathing

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

D. First attempt to slip the cord gently over the infants head

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

D. On the first day of her last menstrual cycle

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 has been complaining of a headache for the past few weeks. You should:

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

After delivering of the placenta, the mother is experiencing vaginal bleeding. After massaging the uterine fundus and allowing the mother to breast-feed, the bleeding stops. This occurred because:

D. The production of oxytocin caused uterine contraction

Spina bifida is a development defect in which:

D. a portion of the spinal cord or meninges protudes outside of the vertebrae

The third stage of labor begins when the:

D. baby is expelled from the vagina

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

D. body size

The onset of labor begins with:

D. contractions of the uterus

Placenta previa is defined as:

D. development of the placenta over the cervical opening

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

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

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

D. provide ventilations for 30 seconds.

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

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

An infant is premature if it:

D. weighs less than 5 pounds or is born before 36 weeks' gestation.

Pregnant women are advised to take iron supplements, such as prenatal vitamins, because:

pregnancy causes a decreased number of red blood cells, which predisposes the mother to anemia