EMT Chapter 33: Obstetrics and Neonatal Care

Signs and symptoms of preeclampsia include:

headache and edema.

Braxton-Hicks contractions are characterized by:

alleviation of pain with movement or changing positions.

The presence of meconium in the amniotic fluid indicates:

that the baby's airway may be obstructed.

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?"

The Apgar score should be calculated at ____ minutes after birth

1 and 5

After delivery, if the infant does not begin breathing after ____ seconds, you should begin resuscitation efforts

10-15

Which of the following is NOT a reason for delivery of the fetus at the scene?

The amniotic sac has ruptured

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.

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

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

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

The amniotic fluid serves to:

insulate and protect the fetus

A nuchal cord is defined as an umbilical cord that:

is wrapped around teh 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.

You cannot successfully deliver a ___ presentation in the field.

limb

In contrast to abruptio placenta, placenta previa:

may not present with heavy vaginal bleeding.

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

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

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.

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.

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

Eclampsia

Fertilization usually occurs when the egg is inside the:

Fallopian tube

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

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

16 hours

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

Which of the following is NOT performed when caring for a mother with a prolapsed cord?

Clamp and cut the cord

Which of the following is NOT true regarding deliver with a nuchal cord?

Clamp the cord, then suction the airway before cutting the cord

Which of the following is NOT considered a possible effect to the fetus when the mother is a known substance abuser?

Spina bifida

Which of the following statements is FALSE:

The leading cause of abruptio placenta is an ectopic pregnancy

Which of the following statements regarding multiple gestations is FALSE:

There is only one placenta with the birth of twins

Spina bifida is a developmental defect in which:

a portion of the spinal cord or meninges protrudes outside of the vertebrae

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

an ectopic pregnancy

The onset of labor begins with:

contractions of the uterus

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

easier breathing.

You should consider the possibility of a ____ in women who have missed a menstrual cycle and complain of a sudden stabbing and usually unilateral pain in the lower abdomen.

ectopic pregnancy

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

on the first day of her last menstrual cycle.

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

positive-pressure ventilations

The first stage of labor begins with the onset of contractions and ends when:

the cervix is fully dilated

The second stage of labor begins when the cervix is fully dilated and ends when:

the infant is born

Abruptio placenta occurs when:

the placenta prematurely separates from the uterine wall

An infant is considered to be premature if it:

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

When handling a delivery involving a drug or alcohol addicted mother, your first concern should be for:

your personal safety

Once the infant is delivered, feel for a brachial pulse or the pulsations of the umbilical cord. If the pulse rate is below _____ beats/min, begin assisted ventilations

100

Approximately ______ of deliveries are complicated by the presence of meconium in the amniotic fluid

12-16%

When performing CPR on a newborn, a compression to ventilation ratio of 3:1 should be used; this will yield a total of ___ "actions" per minute

120

In situations where assisted ventilation is required, you should use a newborn BVM and ventilate with high flow oxygen at a rate of ____ breaths/min

40-60

Bleeding that exceeds approximately ___ mL is considered excessive

500

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

Which of the following is NOT a sign of the beginning of labor?

Crowning

Which of the following refers to green or foul-smelling amniotic fluid?

Meconium staining

Which of the following statements regarding twins is correct?

Most twins are born within 45 minutes of each other.

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

take quick short breaths

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

Return of contractions following delivery of the baby

Which of the following is NOT a stage of labor?

Rupture of amniotic fluid

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.

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 third stage of labor begins with the birth of the newborn and ends with the:

delivery of the placenta

Placenta previa is defined as:

development of the placenta over the cervical opening.

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.

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 for 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 dmbolism

If the baby is crowning and the amniotic sac has not yet ruptured, you should:

puncture the sac away from the head and then push the sac away from the infant's face

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.

The difference between preeclampsia and eclampsia is the onset of:

seizures

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

start of one to the start of the next.