EMT Chapter 24 Gynecologic Emergencies
Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? A. Chlamydia B. Genital herpes C. Ectopic pregnancy D. Ovarian cysts
A. Chlamydia
In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. becomes engorged with blood. B. thins and begins to separate. C. sheds and is expelled externally. D. diverts blood flow to the vagina.
A. becomes engorged with blood
General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: A. carefully removing any foreign bodies from the vagina. B. supplemental oxygen and keeping the patient supine. C. treating external lacerations with sterile compresses. D. refraining from placing any dressings into the vagina.
A. carefully removing any foreign bodies from the vagina
If a woman with vaginal bleeding reports syncope, the EMT should assume that she: A. is in shock. B. has an infection. C. has an ectopic pregnancy. D. is pregnant.
A. is in shock
The physical examination of a sexual assault victim should be: A. limited to a brief survey for life-threatening injuries. B. deferred until the patient can be evaluated by a physician. C. performed in the presence of at least two police officers. D. as detailed as possible so all injuries can be documented.
A. limited to a brief survey for life-threatening injuries
Bacterial vaginosis is a condition that occurs when: A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. B. numerous bacteria enter the uterus through the cervix and cause severe tissue damage. C. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes. D. abnormal bacteria enter the vagina and cause damage without causing any symptoms.
A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms
When caring for a female patient who has been sexually assaulted, you should: A. place any bloodstained clothing or other articles in separate paper bags. B. allow law enforcement to take her statement before you begin treatment. C. advise her that she will not be allowed to shower or change her clothes. D. ask the patient for a concise, detailed report of what happened to her.
A. place any bloodstained clothing or other articles in separate paper bags
Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. ask her if there is anyone you can contact, such as a friend or relative. C. advise her that she cannot clean herself up because this will destroy evidence. D. defer any physical assessment so that you do not destroy potential evidence.
A. provide emotional support and visually assess her for obvious trauma
Injury to the labia would most likely occur following: A. sexual abuse. B. a motor-vehicle crash. C. strenuous exercise. D. a significant fall
A. sexual abuse
When a female has reached menarche: A. she is capable of becoming pregnant. B. she can no longer produce an ovum. C. she usually requires hormone therapy. D. menstrual periods become less frequent.
A. she is capable of becoming pregnant
Which of the following statements regarding rape is correct? A. Only a licensed physician can make a diagnosis of rape. B. Rape is a legal term, not a medical diagnosis. C. Rape causes more physical than emotional harm. D. The EMT should try to determine if rape occurred.
B. Rape is a legal term, not a medical diagnosis
It is common for young females who experience their first menstrual period to: A. have a false positive home pregnancy test result. B. experience abdominal cramping, which may be misinterpreted. C. become so emotionally distraught that they contemplate suicide. D. lose up to 500 mL of blood within the first 24 hours.
B. experience abdominal cramping, which may be misinterpreted
Each ovary produces an ovum in alternating months and releases it into the: A. uterus. B. fallopian tube. C. vagina. D. cervical os.
B. fallopian tube
The most common presenting sign of pelvic inflammatory disease (PID) is: A. vomiting. B. generalized lower abdominal pain. C. foul-smelling vaginal discharge D. nausea.
B. generalized lower abdominal pain
When documenting a call in which a female was sexually assaulted, you should: A. only use quotation marks when recording any statements made by witnesses. B. keep the report concise and record only what the patient stated in her own words. C. record your opinion only if you have reasonable proof to justify the statement. D. translate the patient's words or statements using proper medical terminology.
B. keep the report concise and record only what the patient stated in her own words
Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? A. Pain around the umbilicus, low-grade fever, and generalized weakness B. Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge C. Upper abdominal cramping, severe headache, and heavy vaginal bleeding D. Left lower quadrant pain, referred pain to the left shoulder, and fever
B. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge
When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. ask questions related to her gynecologic history. B. maintain her ABCs and transport without delay. C. determine the underlying cause of her problem. D. keep assessment and treatment to a minimum.
B. maintain her ABCs and transport without delay
Potentially life-threatening consequences of pelvic inflammatory disease (PID) include: A. ovarian cysts and gonorrhea. B. ovarian abscess and ectopic pregnancy. C. bacterial vaginosis and chlamydia. D. uterine rupture with severe bleeding.
B. ovarian abscess and ectopic pregnancy
Which of the following statements regarding gonorrhea is correct? A. Symptoms of gonorrhea usually appear within 3 months after being infected. B. Painful urination is a common symptom of gonorrhea in men and women. C. Most men who are infected with gonorrhea do not experience symptoms. D. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.
B. painful urination is a common symptoms of gonorrhea in men and women
EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I can't remember anything, but I know I was raped." The EMTs should suspect that: A. an underlying head injury is causing her amnesia. B. the patient was given a drug prior to the incident. C. the traumatic experience has created a mental block. D. the patient knew her attacker, but is afraid to say.
B. the patient was given a drug prior to the incident
The outermost cavity of a woman's reproductive system, which forms the lowest part of the birth canal, is called the: A. cervix. B. vagina. C. uterus. D. perineum.
B. vagina
Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. The most common presenting symptom of PID is generalized upper abdominal pain. B. PID most commonly affects women who have had an ectopic pregnancy in the past. C. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. D. The most severe cases of PID occur in women who are not sexually active.
C. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy
A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: A. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. B. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly.
C. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay
The most frequently used date rape drug is: A. Xanax. B. Ecstasy. C. alcohol. D. ketamine.
C. alcohol
The onset of menstruation usually occurs in females who are: A. between 8 and 10 years of age. B. between 18 and 23 years of age. C. between 11 and 16 years of age. D. between 25 and 28 years of age.
C. between 11 and 16 years of age
When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A. ascertains if the patient was ever pregnant. B. has obtained a complete set of vital signs. C. has gathered patient history information. D. has formed a general impression of the patient.
C. has gathered patient history information
Which of the following findings should make the EMT especially suspicious that a woman was sexually assaulted? A. The odor of alcohol on her breath B. A prescription for alprazolam (Xanax) C. Inability to remember the event D. Signs of shock on assessment
C. inability to remember the event
Pelvic inflammatory disease (PID) typically does NOT affect the: A. uterus. B. fallopian tubes. C. urinary bladder. D. ovaries.
C. urinary bladder
A 24-year-old woman complains of an ache in her abdomen that gets worse when she walks. She has a fever and chills and tells you that it burns when she urinates. Which of the following should you suspect? A. Chlamydia B. Gonorrhea C. Ectopic pregnancy D. Pelvic inflammatory disease
D. Pelvic inflammatory disease
Which of the following drugs is commonly referred to as "roofies"? A. Ketamine B. MDMA C. GHB D. Rohypnol
D. Rohypnol
You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease? A. Vaginal passage of blood clots B. Bright red blood in the urine C. A history of ectopic pregnancy D. A shuffling gait when walking
D. a shuffling gait when walking
During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: A. perform a visual assessment of her vaginal area. B. perform a rapid secondary assessment. C. assess her blood pressure and elevate her legs. D. assist her ventilations with a bag-mask device.
D. assist her ventilations with a bag-mask device
During your assessment of a 30-year-old woman with abdominal pain, she tells you that she has been experiencing vaginal bleeding. Her vital signs are stable, and there are no signs of shock. What should you do? A. Carefully pack her vagina with a sterile multi-trauma dressing. B. Position her supine, elevate her legs, and keep her warm. C. Visualize her vaginal area to assess the degree of bleeding. D. Defer the vaginal examination until she is at the hospital.
D. defer the vaginal examination until she is at the hospital
Whenever possible, a female sexual assault victim should be: A. thoroughly assessed, even if no signs of injury exist. B. encouraged to take a shower and change her clothes. C. asked to provide a brief description of the perpetrator. D. given the option of being treated by a female EMT.
D. given the option of being treated by a female EMT
As a woman approaches menopause: A. she cannot become pregnant because of fluctuating hormone levels. B. her risk of developing pelvic inflammatory disease lowers significantly. C. she usually experiences abdominal cramping without vaginal bleeding. D. her menstrual periods may become irregular and vary in severity.
D. her menstrual periods may become irregular and vary in severity
Pregnant women with bacterial vaginosis might have: A. babies that deliver after 42 weeks. B. secondary cervical cancer. C. hypertension later in life. D. low birth weight babies.
D. low birth weight babies
In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. often presents with acute pain. B. is typically not as severe. C. can be controlled in the field. D. may be relatively painless.
D. may be relatively painless
When caring for a female patient who has been sexually assaulted, you should: A. ask the patient for a concise, detailed report of what happened to her. B. advise her that she will not be allowed to shower or change her clothes. C. allow law enforcement to take her statement before you begin treatment. D. place any bloodstained clothing or other articles in separate paper bags.
D. place any bloodstained clothing or other articles in separate paper bags
Injuries to the vagina and external genitalia are serious because: A. external injury is always associated with internal injury. B. severe infection occurs in nearly all cases of external injury. C. most injuries to these areas are unnoticed by the patient. D. these areas are rich with blood vessels and nerves.
D. these areas are rich with blood vessels and nerves
Which of the following statements regarding pelvic inflammatory disease (PID) is correct? A. PID is a life-threatening condition that is associated with shock. B. PID is an infection of the lower female reproductive organs. C. The majority of women with PID never develop symptoms. D. Untreated PID can lead to an ectopic pregnancy or an abscess.
D. untreated PID can lead to an ectopic pregnancy or abscess
