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The EMT shows that he understands care of the post-delivery mother when he states: A. "If blood is observed coming from the vagina after the baby has been delivered, the mother should be placed in the shock position." B. "We should be concerned if there is any bleeding from the vagina following delivery." C. "Post-delivery hemorrhage can best be controlled by inserting a bulky dressing into the vagina." D. "Allowing the baby to nurse immediately after delivery can help to control uterine bleeding."
"Allowing the baby to nurse immediately after delivery can help to control uterine bleeding."
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. 0 B. 2 C. 1 D. 3
1
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
First stage
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. 3 B. 0 C. 1 D. 2
2
How many newborns will require a level of care that falls below the top tier of the neonatal resuscitation pyramid? A. 20 percent B. Approximately half C. One in twenty D. 80 percent
20 percent
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
20 weeks
The EMT is performing CPR on a neonate. What is the correct compression-to-ventilation ratio? A. 15 compressions to every 5 ventilations B. 30 compressions to every 2 ventilations C. 3 compressions to every 1 ventilation D. 5 compressions to every 2 ventilations
3 compressions to every 1 ventilation
By the time a fetus reaches full term, the tidal volume of the female has increased by: A. The tidal volume remains the same but the rate increases by 30 percent B. 15 percent C. 40 percent D. 25 percent
40 percent
When asked by a concerned newborn parent, the EMT should indicate that an acceptable respiratory rate for the newborn is: A. 52 breaths per minute B. 24 breaths per minute C. 70 breaths per minute D. 12 breaths per minute
52 breaths per minute
The EMT would recognize which neonate as premature? A. A baby weighing 7 pounds 4 ounces born at 36 weeks B. A baby weighing 6 pounds 2 ounces born at 38 weeks C. A baby weighing 8 pounds 6 ounces born at 39 weeks D. A baby weighing 8 pounds 6 ounces born at 41 weeks
A baby weighing 7 pounds 4 ounces born at 36 weeks
Which statement regarding limb presentation is true during childbirth? A. There is little danger unless the umbilical cord is also protruding B. A cesarean section birth will likely be required C. The EMT can try one time to deliver the baby D. The baby is premature
A cesarean section birth will likely be required
The EMT should recognize a full-term pregnancy has occurred in which patient? A. A 21-year-old woman who is 39 weeks pregnant and feeling dizzy B. A 33-year-old woman who is pregnant with twins and in the eighth month of pregnancy C. A 40-year-old woman beginning her third trimester but whose water just broke D. A 25-year-old woman who is 220 days into pregnancy and complaining of back pain
A 21-year-old woman who is 39 weeks pregnant and feeling dizzy
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. Massage the abdomen, provide high-concentration oxygen, and nonemergently transport the patient B. Administer high-concentration oxygen and immediately transport the patient C. Place the patient in a supine position and immediately transport her D. Provide low-concentration oxygen and nonemergently transport the patient
Administer high-concentration oxygen and immediately transport the patient
Despite the increase in maternal blood volume, the pregnant patient is typically: A. Bradycardic B. Anemic C. Prone to early signs of shock D. Hypertensive
Anemic
What would the expected preductal SpO2 reading be at 5 minutes after birth? A. Over 94% B. 70% to 75% C. At least 80% D. 85% to 90%
At least 80%
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
At the level of the xiphoid process
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. Stop the delivery and transport C. Contact medical direction for directions D. Clamp and cut the cord to prevent strangulation of the newborn
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 32-year-old woman, in the third trimester, passing foul-smelling and bloody vaginal discharge B. A 38-year-old woman, 36 weeks pregnant, having abdominal pain with painless vaginal bleeding C. A 21-year-old woman, 6 weeks pregnant, passing vaginal blood clots D. A 16-year-old woman, 24 weeks pregnant, with painless contractions
A 21-year-old woman, 6 weeks pregnant, passing vaginal blood clots
Which action shows that the EMT is properly caring for the umbilical cord after delivery? A. The cord is cut 1 inch from the baby's abdomen B. A 6-inch segment of cord is still connected to the baby C. The cord is clamped but not cut until arrival at the hospital D. The clamps are removed from the cord after cutting
A 6-inch segment of cord is still connected to the baby
In a normal fertilization, the egg and the sperm meet in which structure? A. Cervix B. Uterus C. Fallopian tube D. Vaginal canal
Fallopian tube
A newborn's first Apgar score was 6. His second Apgar score is 9. What does this information mean to the EMT? A. Need for extensive resuscitation B. Total score of 15 C. Poor heart and lung function D. Improvement
Improvement
When do most women experience a decrease in the nausea and vomiting associated with hyperemesis gravidarum? A. Between 14 and 20 weeks B. About 2 weeks postpartum C. During the first trimester D. At term
Between 14 and 20 weeks
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. Place the patient on her left side B. Call for another EMS crew C. Provide blow-by oxygen to the baby D. Place the patient on the stretcher for transport
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. Suction the baby's nose, and then the mouth B. Check the neck for the umbilical cord C. Turn the baby clockwise and continue delivery D. Suction the baby's mouth, and then the nose
Check the neck for the umbilical cord
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. Prepare her for the possibility that she may have miscarried the baby B. Provide rapid transport in a supine position C. Collect all towels with blood and transport them with the patient D. Clean the outside of the vagina with sterile water and peroxide
Collect all towels with blood and transport them with the patient
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
Continue to monitor the mother and baby
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. Check the baby's breath sounds B. Clamp and cut the cord C. Administer high-concentration oxygen to the baby D. Dry the baby with a warm towel
Dry the baby with a warm towel
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. Placenta previa B. Ectopic pregnancy C. Appendicitis D. Abruptio placentae
Ectopic pregnancy
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. Mittelschmerz C. Abruptio placentae D. Ectopic pregnancy
Ectopic pregnancy
When should the EMT instruct his partner to cut the umbilical cord? A. After the 1-minute Apgar score has been obtained B. Immediately after delivery of the placenta C. Following delivery and after the baby has been dried off D. Just prior to passage of the legs through the vaginal canal
Following delivery and after the baby has been dried off
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 eye protection should be worn for both the patient with HIV and the noninfectious patient B. Gloves are needed for a noninfectious patient in labor; goggles and gloves must be worn for the patient with HIV C. Gloves, a gown, and goggles will be used for this patient; only gloves and a gown are required for a healthy patient in labor D. A HEPA filter mask should be used for the patient with HIV, but not for the noninfectious patient
Gloves, a gown, and eye protection should be worn for both the patient with HIV and the noninfectious patient
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. Para IV; gravida I B. Gravida IV; para I C. Gravida III; para I D. Para III; gravida I
Gravida IV; para I
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 inserts the bulb syringe deep into the oropharynx to get thick secretions B. He suctions the nose first, followed by the mouth C. He squeezes the bulb syringe prior to placing it in the baby's nose D. He uses the portable suction unit on the "high" setting
He squeezes the bulb syringe prior to placing it in the baby's nose
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. Respirations of 28 breaths per minute D. Heart rate of 140 beats per minute
Heart rate of 140 beats per minute
Which assessment finding best indicates that the newborn is significantly distressed? A. Heart rate of 92 beats per minute B. Apgar score of 8 C. Loud crying D. Respiratory rate of 50 breaths per minute
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
Heart rate, spontaneous activity, and respirations
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
Hemorrhage
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. Maternal shock B. Fluid loss C. Infection D. Hypoxia
Hypoxia
As soon as the baby is delivered from the vaginal canal, it is critical that the EMT immediately: A. Initiate drying and warming of the newborn B. Clamp and cut the umbilical cord C. Obtain a pulse oximetry reading from the newborn's right hand D. Perform the Apgar assessment
Initiate drying and warming of the newborn
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. Intermittent vaginal bleeding B. Increased weight over the past month C. Several painless contractions D. Increased desire to eat
Intermittent vaginal bleeding
During a continuing education session on OB/GYN topics, the EMT would recognize which statement about the umbilical cord as true? A. It detoxifies blood before its delivery to the baby B. It produces hormones for the baby C. It connects the placenta and the uterus D. It contains one vein and two arteries
It contains one vein and two arteries
Why is the uterus essential to a healthy pregnancy and childbirth? A. It powerfully contracts to force the fetus from the mother's body following gestation B. It manufactures specific blood cells needed for fetal immunity C. It permits the excretion of waste from the baby to the mother D. It protects abdominal organs during fetal growth
It powerfully contracts to force the fetus from the mother's body following gestation
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. Family history of diabetes B. Increased urination C. Last period nine weeks ago D. Periods irregular in nature
Last period nine weeks ago
When cutting the umbilical cord, how should the baby be positioned? A. Upright and on the mother's chest (if possible) B. Prone and in a head-down position C. Level with the mother's uterus D. Six inches below the vaginal opening
Level with the mother's uterus
When should the EMT use the Apgar scoring system on a newborn? A. Before and after the baby is dried and warmed B. Ten minutes after birth and then at 20 minutes, if needed C. Just prior to delivery and then five minutes after delivery D. One and five minutes after the baby has been delivered
One and five minutes after the baby has been delivered
Which action demonstrates that the EMT is correctly performing uterine massage? A. She uses the lower palms of both hands to firmly press downward on the uterus B. She places her hands on the upper abdomen and pushes the uterus toward the pelvis C. One hand cups the top of the uterus, with one of the hands positioned just above the symphysis pubis D. Both hands are positioned at the symphysis pubis and she pushes with an upward motion
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. Oxygen at 15 lpm via a nonrebreather face mask B. Rapid transport to a hospital with specialized obstetric services C. Refusal-of-transport form signed with suggested follow-up with her obstetrician D. Quiet and calm transport in the supine position
Oxygen at 15 lpm via a nonrebreather face mask
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. Perform a uterine massage B. Insert sterile gauze into the vaginal canal C. Place the mother on her left side D. Transport with lights and sirens
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. Apply a sterile gauze dressing with gentle pressure above the vagina B. Place a cold pack on the mother's abdomen just below the umbilicus C. Insert sterile gauze into the vagina and leave it in place until the bleeding stops D. Place a sterile dressing between the mother's vagina and rectum
Place a sterile dressing between the mother's vagina and rectum
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. Place the mother in a knee-chest position B. Insert a gloved hand into the vagina to locate the baby's head C. Have the mother push when she feels a contraction D. Attempt to replace the arm into the vaginal cana
Place the mother in a knee-chest position
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. Place a saline-soaked dressing over the cord B. Carefully place the cord back inside the vagina C. Place the patient in a knee-chest position D. Gently pull the cord to assist in delivery
Place the patient in a knee-chest position
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. Put the patient in semi-Fowler's position on the stretcher and immediately transport B. Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen C. Place both hands on the abdomen and attempt to turn the baby into a head-down position D. Lay the patient on her left side and administer high-concentration oxygen
Place the patient in supine, head-down position, with hips elevated, and administer supplemental oxygen
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
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. Placenta previa B. Uterine rupture C. Pelvic inflammatory disease D. Ectopic pregnancy
Placenta previa
If the placenta attaches over the cervix, the patient and fetus would be at risk for which condition? A. Placental abruption B. Placenta previa C. Uterine tear D. Ectopic pregnancy
Placenta previa
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. Expulsion B. Placental C. Fourth D. Second
Placental
Prior to delivery, the EMT prepares to create a sterile field around the patient's vaginal opening. This is best accomplished by: A. Using a sheet from the patient's bed to cover her abdomen and groin B. Using towels from the patient's residence to wrap each leg and cover her abdomen C. Placing a sheet from the OB kit under the patient's hips and another over her abdomen and legs D. Placing sheets from the OB kit over both the patient's legs and her abdomen
Placing a sheet from the OB kit under the patient's hips and another over her abdomen and legs
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. Start external chest compressions B. Attach an AED with pediatric pads C. Suction the nose and mouth D. Continue positive pressure ventilation
Start external chest compressions
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. Apply a sanitary pad over the vaginal opening B. Open the vaginal canal using obstetric forceps C. Massage the patient's uterus D. Prepare for delivery of the placenta
Prepare for delivery of the placenta
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. Probable false labor, and should have the patient follow up with her obstetrician B. 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 D. Possible placental abruption, and immediately must transport the patient with lights and sirens
Probable false labor, but have the patient transported to the hospital for evaluation
During which abnormal birth presentation is it permissible for the EMT to place a gloved hand into the vaginal canal? A. Placenta previa B. Prolapsed umbilical cord C. Limb presentation D. Multiple birth delivery
Prolapsed umbilical cord
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. Provide oxygen at 15 liters per minute B. Restrain the patient on her back or left side C. Determine if the patient has a seizure history D. Place a tongue blade in the patient's mouth
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. Suction the nose and mouth B. Quickly suction the nose and mouth only if the newborn's condition is depressed C. Administer high-concentration oxygen D. Immediately begin positive pressure ventilation
Quickly suction the nose and mouth only if the newborn's condition is depressed
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. Cut the sac with the sterile scissors in the OB kit B. Continue with the delivery of the baby C. Rip open the amniotic sac with your fingers D. Transfer the patient to the stretcher for immediate transport
Rip open the amniotic sac with your fingers
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. Recheck the blood pressure B. Start positive pressure ventilation C. Roll her onto her left side D. Determine any complications of the pregnancy
Roll her onto her left side
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. Rupture of the amniotic sac B. Contractions 12 minutes apart C. Complaint of lower back pain D. Feeling nauseated with each contraction
Rupture of the amniotic sac
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. Placenta previa B. Ruptured uterus C. Preeclampsia D. Ectopic pregnancy
Ruptured uterus
A female patient is described as primigravida. Consequently, the EMT would recognize that: A. She has been pregnant before but miscarried B. She has only one child C. She is pregnant for the first time D. She has never been pregnant
She is pregnant for the first time
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. Spontaneous abortion B. Drug addiction C. Dysfunctional placenta D. Ruptured uterus
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 positive pressure ventilation with supplemental oxygen B. Administer high-concentration oxygen via a pediatric nonrebreather mask C. Start chest compressions at a rate of 120 compressions per minute D. Continue to monitor the baby for another 30 seconds
Start positive pressure ventilation with supplemental oxygen
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
Stop positive pressure ventilation and provide blow-by 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. Nursing D. Blow-by oxygen
Tactile stimulation and drying
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 contains a fluid called Wharton's jelly that protects the baby while in the uterus B. The amniotic sac contains fluid and surrounds and protects the uterus C. The amniotic sac must rupture during the second trimester of pregnancy for the third trimester to progress D. The amniotic sac protects and insulates the baby during gestation
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 EMT can palpate the cervix to measure the contractions that the mother is having during the third trimester B. The "bloody show" comes from the cervix and confirms pregnancy in the first trimester C. The cervix constricts near the time of delivery to prevent a premature birth D. The cervix becomes plugged with mucus to prevent contamination of the uterus during gestation
The cervix becomes plugged with mucus to prevent contamination of the uterus during gestation
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. Twins are typically born after 40 weeks' gestation, making them larger C. The second infant may be born breech D. Both babies are typically in the vaginal canal at the same time
The second infant may be born breech
The EMT would use the sterile scissors found in the OB kit to cut: A. The patient's clothing B. The amniotic sac if it is not yet ruptured C. The umbilical cord D. Towels to create a sterile field
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 mother continues to bleed vaginally B. The mother's abdomen remains large after delivery of the first baby C. The woman's abdomen becomes soft and boggy following delivery D. A large placenta is delivered within seconds of the first baby
The mother's abdomen remains large after delivery of the first baby
The Apgar scoring system is useful in determining: A. The precise age of gestation B. The type of resuscitation needed C. The newborn's overall condition D. The maturity of the newborn's heart and lungs
The newborn's overall condition
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 to her obstetrician's office B. Transport her in a supine position without a cervical collar in place C. Tilt the long spine board to the left D. Transport her on her right side
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. Vaginal bleeding not associated with pain C. Recent onset of a fever of 99.3degrees°F D. Shortness of breath when lying flat
Vaginal bleeding not associated with pain
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. "The priority when treating a patient with a prolapsed umbilical cord is keeping the cord moist." C. "A prolapsed cord that is pinched can stop the flow of oxygen to the baby and must be addressed immediately." D. "If the cord is observed protruding from the vagina, it should be clamped and cut immediately."
"A prolapsed cord that is pinched can stop the flow of oxygen to the baby and must be addressed immediately."
The EMT recognizes the underlying pathophysiology associated with the most common type of ectopic pregnancy is a fertilized egg that is: A. Lodged in a fallopian tube B. Contaminated with abdominal bacteria C. Developing without a placenta D. Attached to the upper region of the uterus rather than to the lower region by the cervix
odged in a fallopian tube
The EMT shows that he can accurately differentiate placenta previa from abruptio placentae when he states: A. "Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless." B. "The blood lost with placenta previa is dark red; the color of blood associated with abruptio placentae is bright red." C. "Abruptio placentae rarely results in the death of the baby; the mortality rate of placenta previa is high." D. "Abruptio placentae typically occurs in the first and second trimesters; placenta previa occurs in the third trimester."
"Bleeding associated with abruptio placentae is typically associated with abdominal pain; bleeding associated with placenta previa is painless."
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. "You should really call your doctor. During the eighth month of pregnancy, energy levels usually increase." B. "As long as the baby is still moving, you are okay. Just try to get through one more month." C. "We really need to get to the hospital right away to make sure that your baby is okay. This does not sound good." D. "Check with your obstetrician, but you may want to rest and sleep on your left or right side."
"Check with your obstetrician, but you may want to rest and sleep on your left or right side."
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 am going to put this sanitary napkin between your legs to collect the blood." B. "I know that it is uncomfortable, but try to keep your legs apart so the blood can flow out of your body." C. "I am going to insert my gloved hand into your vagina and apply pressure to try to stop the bleeding from the inside." D. "I am going to place this piece of sterile gauze into your vagina to try to stop the bleeding."
"I am going to put this sanitary napkin between your legs to collect the blood."
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. "I think that I may have to vomit." C. "I have gained 10 pounds just this month." D. "My legs and feet are more swollen."
"I feel like I am going to have a seizure."
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. "It feels good not to have to push anymore." D. "The contractions are beginning to hurt now."
"I feel like I have to move my bowels."
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 was a drug addict when I was a teenager." C. "I had some belly cramps two weeks ago." D. "I have not been able to see the doctor this pregnancy at all."
"I have not been able to see the doctor this pregnancy at all."
You are caring for an emotionally distraught female who just suffered a miscarriage. During transport, which statement would be the most appropriate one for the EMT to make to the patient? A. "It is better to have this happen at five weeks instead of 25 weeks." B. "Maybe at some time in the future, you can get pregnant again and things will turn out okay." C. "I really do not know what to say, but let me know how I can help you." D. "Let's just think of the two beautiful children whom you have at home."
"I really do not know what to say, but let me know how I can help you."
The EMT shows an understanding of newborn resuscitation when she states: A. "Interventions in a newborn should be performed for 30 seconds followed by reassessment." B. "The EMT must use high-concentration oxygen sparingly because it can be toxic to a baby." C. "Most newborns require aggressive resuscitation immediately after birth." D. "CPR should be provided only when the baby is unresponsive, apneic, and pulseless."
"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. "Is there any possibility you are pregnant?" B. "Are you having any vaginal discharge?" C. "Are your menstrual periods regular?" D. "How many times have you been pregnant?"
"Is there any possibility you are pregnant?"
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. "Is there anything that I can do to help you right now?" C. "I think in the long run you will be okay and things will work out." D. "If you want another child, wait a few months and then get pregnant again."
"Is there anything that I can do to help you right now?"
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. "I just passed a lot of blood and mucus." C. "My water broke two days ago." D. "The contractions seem to last about 30 seconds."
"My water broke two days ago."
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. "Please lie on your back, draw your knees upward, and spread your legs apart." B. "Please lie back, and then elevate both legs into the air. Your husband will help you hold them up." C. "I'd like you to lie flat on the bed and bend your right leg while keeping your left leg straight." D. "I am going to place you on your left side with your legs up until the baby's head is visible."
"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. "Seizure activity in the pregnant female is typically not life threatening unless the patient has had seizures in the past." B. "Prolonged seizures can easily cause the mother and baby to become hypoxic." C. "If the pregnant patient is seizing, the EMT must quickly make a decision to administer or withhold her antiseizure medications." D. "A short seizure in the pregnant female with a seizure history generally does not require transport."
"Prolonged seizures can easily cause the mother and baby to become hypoxic."
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. "The placenta is full of bacteria and should not be transported in the ambulance near the baby." D. "It is essential that the mother not be moved until the placenta has been delivered."
"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 can be differentiated from labor contractions by the presence of vaginal discharge." B. "They are painless, but are capable of delivering the baby very quickly." C. "They often are called false contractions and do not require hospital evaluation." D. "They are often irregular and less painful than labor contractions, but they should still be evaluated by the hospital."
"They are often irregular and less painful than labor contractions, but they should still be evaluated by the hospital."
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. "Have you been vomiting in the morning?" B. "When was your last normal menstrual period?" C. "Do you feel pressure in your belly area?" D. "Does it feel like the last time you were pregnant?"
"When was your last normal menstrual period?"
What would the minimum expected preductal SpO2 reading be at one minute after birth? A. 85% B. 60% C. 94% D. 80%
60%
What are the stages of labor in the order in which they occur? A. Uterine, delivery, and recovery B. Uterine, expulsion, placental, and recovery C. Dilation, delivery, placental, and afterbirth D. Dilation, expulsion, and placental delivery
Dilation, expulsion, and placental delivery
