Chapter 32 Study
When performing chest compressions on a pregnant patient who has gone into cardiac arrest, what change do you need to make in the placement of your hands? A. 1 to 2 inches lower on the sternum B. 1 to 2 inches higher on the sternum C. 0.5 to 1 inch higher on the sternum D. 0.5 to 1 inch lower on the sternum
1 to 2 inches higher on the sternum
A premature infant is one who is born before how many weeks of the pregnancy? A. 34 B. 37 C. 28 D. 40
37
An infant's birth weight is considered low if it is less than ________ pounds. A. 2.5 B. 4.5 C. 3.5 D. 5.5
5.5
Normal maternal blood loss during delivery of an infant usually does not exceed how much? A. 250 cc B. 100 cc C. 500 cc D. 1,000 cc
500 cc
When clamping the umbilical cord, the clamp farthest from the baby should be approximately ________ inch(es) from the infant's body. A. 3 B. 12 C. 10 D. 1
10
The condition in which the placenta separates from the uterine wall is known as which of the following? A. Abruptio placentae B. Ectopic pregnancy C. Placenta previa D. Preeclampsia
Abruptio placentae
Your patient is an infant who has just been delivered 3 weeks before her due date. She is breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and chest. Which of the following interventions should be done first? A. Begin CPR with a compression rate of 120/minute. B. Place a neonatal nonrebreather mask on the infant's face. C. Administer blow-by oxygen. D. Perform ventilations with a bag-valve-mask device and supplemental oxygen.
Administer blow-by oxygen.
You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks you to wait because she feels the need to use the bathroom first. Which of the following is the BEST course of action? A. Tell the patient she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital. B. Advise the patient that this could be a sign of a serious complication, have her lie on her left side, apply high-concentration oxygen, and transport immediately. C. Allow the patient to use the bathroom because it will make transport, and also delivery, more comfortable. D. Advise the patient that this could be an indication that the baby is ready to be born, and you need to check to see if the baby's head is visible.
Advise the patient that this could be an indication that the baby is ready to be born, and you need to check to see if the baby's head is visible.
When assisting with a delivery in the field, which of the following should be done as the head begins to emerge from the vagina? A. Pull on the baby. B. Apply gentle, well-distributed pressure to the head with your gloved hand. C. Advise the mother not to push or strain. D. Check for crowning.
Apply gentle, well-distributed pressure to the head with your gloved hand.
Which of the following is NOT relevant in determining whether or not delivery is imminent for a woman in labor? A. Asking how long ago the contractions began B. Contacting medical direction C. Finding out how many pregnancies the patient has had D. Determining if the patient feels as if she needs to move her bowels
Contacting medical direction
By which of the following means does the fetus's blood pick up nourishment from the mother? A. Indirect circulation B. Diffusion C. Osmosis D. Direct circulation
Diffusion
The greatest danger to the pregnant woman and her fetus involved in trauma is which of the following? A. Distributive shock B. Neurogenic shock C. Supine hypotensive shock D. Hemorrhagic shock
Hemorrhagic shock
You are called to assess a pregnant woman who is approximately 7 months pregnant. She states that her pregnancy has been uneventful but she is experiencing intermittent headaches. Her vital signs are pulse 118, respirations 22, blood pressure 138/88, and blood sugar 148. She has a history of diabetes. Which of the following statements regarding this patient is TRUE? A. Her blood pressure should be higher during pregnancy. B. Her oxygen demand will be lower than normal. C. Her pulse rate should be lower than normal. D. Her diabetes may be made worse during pregnancy.
Her diabetes may be made worse during pregnancy.
Supine hypotensive syndrome may be prevented by transporting the pregnant female into which of the following positions? A. Tilted slightly onto the right side B. Supine, with the head lower than the hips C. Lying on her left side D. With her head down and pelvis elevated
Lying on her left side
Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding? A. Monitoring for hypovolemic shock B. Finding out if the patient is currently sexually active C. Preventing infection D. Obtaining a thorough gynecological history
Monitoring for hypovolemic shock
You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is in your estimation about 8 months pregnant. She tells you that she has been hiding her pregnancy. What would make you predict the need for neonate resuscitation with this patient, other than premature delivery? A. No prior prenatal care B. Labor induced by medical conditions C. Multiple births D. Labor induced by trauma
No prior prenatal care
Which of the following is NOT part of a basic obstetrics kit? A. Packet of suture material B. Baby blanket C. Umbilical cord clamps D. Surgical scissors
Packet of suture material
If assisting in a prehospital delivery while off-duty, which of the following would be the BEST choice for tying or clamping the umbilical cord? A. Section of wire coat hanger B. Clothespin C. Pair of shoelaces D. White cotton thread
Pair of shoelaces
Which of the following is indicated in the prehospital management of a prolapsed umbilical cord? A. Use your gloved hand to push the umbilical cord back up through the cervix. B. Immediately clamp the cord in two places and cut it between the clamps. C. Place the mother in a head-down position with pillows under her hips. D. Encourage the mother to push forcefully in order to speed delivery.
Place the mother in a head-down position with pillows under her hips.
Which of the following BEST describes crowning? A. Discharge of bloody mucus B. Complete dilation of the cervix C. Delivery of the head during a breech birth, completing delivery D. Presenting part of the baby being visible at the vaginal opening
Presenting part of the baby being visible at the vaginal opening
Which of the following statements concerning the physiologic changes of pregnancy is FALSE? A. The growing uterus displaces the GI tract. B. Respirations become easier. C. Oxygen demand increases but lung capacity decreases. D. Blood volume and heart rate increase.
Respirations become easier.
You are transporting a pregnant patient with a seizure on her left side. You have opened the patient's airway and are administering high-concentration oxygen. What other intervention would be inappropriate? A. Keep the patient warm. B. Revive the patient by hard slaps to the back. C. Contact ALS for immediate assistance. D. Have suction ready.
Revive the patient by hard slaps to the back.
You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as the head was delivered and again following complete delivery. The infant is not yet breathing. Which of the following is the correct sequence of interventions? A. Transport without further intervention. B. Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse. C. Perform a series of back blows and chest thrusts interposed with mouth-to-mouth ventilation. D. Begin bag-valve-mask ventilations, suction the airway with a rigid tonsil tip, and begin CPR.
Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse.
During which stage of labor is the baby born? A. First B. Primary C. Third D. Second
Second
Which of the following is the highest priority for the EMT in delivery of an infant with meconium-stained amniotic fluid who requires resuscitation after birth? A. Checking for fever B. Transporting the infant C. Vigorously rubbing the infant's back immediately upon delivery to stimulate breathing D. Suctioning the infant's oropharynx immediately before he takes a breath
Suctioning the infant's oropharynx immediately before he takes a breath
What is key to providing proper emotional support to the mother in the event of a miscarriage? A. Talk with the patient to gain her confidence. B. Refer to the miscarriage as a spontaneous abortion. C. Provide high-concentration oxygen. D. Delay transport if signs of shock are present.
Talk with the patient to gain her confidence.
Which of the following statements concerning a stillborn baby is TRUE? A. The death may occur weeks before delivery. B. The parents should never be allowed to see the baby, especially if it has begun to deteriorate. C. Resuscitation must always be attempted. D. Infants born in cardiopulmonary arrest should not be resuscitated.
The death may occur weeks before delivery.
Which of the following statements regarding ectopic pregnancies is TRUE? A. It usually occurs during the second trimester. B. The fallopian tubes cannot stretch to accommodate a fetus. C. It may cause painless bright red bleeding. D. The fertilized egg usually implants in the wall of the uterus.
The fallopian tubes cannot stretch to accommodate a fetus.
Which of the following BEST describes the events that occur during the first stage of labor? A. Thinning and dilation of the cervix B. Expulsion of the fetus through the birth canal C. Expulsion of the placenta D. Rupture of the amniotic sac
Thinning and dilation of the cervix
Which of the following statements concerning prehospital delivery of twins is TRUE? A. This is a true emergency and cannot be managed outside the hospital setting without additional help. B. The umbilical cord of the first infant must not be cut until the second infant is born. C. The infants will probably be smaller than a single infant and need special care to keep them warm. D. There are always two placentas.
The infants will probably be smaller than a single infant and need special care to keep them warm.
Which of the following BEST describes placenta previa? A. The placenta is implanted over the opening of the cervix. B. The umbilical cord is the presenting part. C. The pregnancy is lost before the twentieth week of gestation. D. The placenta prematurely separates from the uterine wall.
The placenta is implanted over the opening of the cervix.
Which of the following statements regarding umbilical cord care is FALSE? A. Protect your eyes when cutting the umbilical cord. B. The proximal clamp on the umbilical cord should be 7 inches from the distal clamp. C. Apply one clamp or tie to the umbilical cord about 10 inches from the baby. D. Dry the infant and wrap him in a blanket.
The proximal clamp on the umbilical cord should be 7 inches from the distal clamp.
Which of the following statements concerning trauma in the pregnant woman is TRUE? A. With hemorrhage, 48 percent blood loss must occur before signs or symptoms of shock appear. B. The pregnant patient's vital signs tend to be lower than the nonpregnant female's. C. The uterus is frequently injured in automobile collisions. D. The uterus provides generally inadequate protection for the baby even from minor trauma.
The uterus is frequently injured in automobile collisions.
If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first? A. Leave the sac intact until the entire body is delivered. B. Use the scissors in the obstetrics kit to cut the sac away from the baby's head. C. Use your fingers to tear the sac away from the baby's face. D. Call medical control before taking action.
Use your fingers to tear the sac away from the baby's face.
Which of the following is appropriate in all cases when caring for a premature baby? A. Encouraging family members to hold the infant B. Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F C. Deeply suctioning the airway with a rigid tonsil-tip D. Applying high-concentration oxygen with a neonatal nonrebreather mask
Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F
All of the following are signs of adequate breathing and circulation in the newborn EXCEPT: A. vigorous crying. B. cyanosis of only the hands and feet. C. heart rate greater than 100. D. blue coloration to the torso.
blue coloration to the torso.
While treating a patient of sexual assault, preserving the crime scene does NOT involve: A. limiting the number of providers who access the scene. B. avoiding cutting the victim's clothes. C. maintaining the position of items on the scene. D. documenting the situation objectively.
documenting the situation objectively.
You are called for a woman with severe abdominal pain. During your assessment and interview, she tells you that she is sexually active and there is a chance she could be pregnant. Her vital signs are pulse 122, respirations 22, blood pressure 96/62, and skin cool and pale. You should immediately suspect: A. a seizure. B. appendicitis. C. ectopic pregnancy. D. placenta previa.
ectopic pregnancy.
You have delivered a newborn and wrapped the baby in a dry blanket. During your reassessment of the mother, you note continued moderate vaginal bleeding. Care for this bleeding may involve all of the following EXCEPT: A. lowering the mother's feet. B. massaging the uterus to control bleeding. C. placing a sanitary napkin over the vaginal opening. D. encouraging the mother to use the bathroom if possible.
encouraging the mother to use the bathroom if possible.
The term for a baby developing inside the mother's womb after week 8 is: A. neonate. B. embryo. C. fetus. D. infant.
fetus.
You have been called for a 32-year-old female who is in active labor. During your assessment and interview, you note that she is 37 weeks along, this is her first child, and her contractions are 5 minutes apart. She also tells you that her pregnancy is considered "high risk." Your first concern should be: A. calling for a back-up unit. B. getting to the hospital. C. assembling your delivery kit. D. completing a thorough secondary exam.
getting to the hospital.
You respond for an imminent delivery of a baby in the breech position. As you examine the mother, you see that the umbilical cord is protruding from the opening of the cervix. You realize that the most important care you can provide for this baby is to: A. keep the baby off of the cord. B. cut the cord. C. gently push the cord back into the vaginal space. D. lower the mother's hips.
keep the baby off of the cord.
What is a small, round organ located on either side of most women's lower abdominal quadrants that produces many of the hormones necessary for the process of reproduction? A. uterus. B. ovary. C. amnion. D. cervix.
ovary.
When delivering a baby, you should do all of the following EXCEPT: A. place your fingers in the armpits and pull to assist with delivery of the shoulders. B. have someone stay at the mother's head if possible. C. if necessary, suction the mouth first, then the nose. D. position your gloved hands at the vaginal opening.
place your fingers in the armpits and pull to assist with delivery of the shoulders.
You respond to a call for a patient in active labor with her second child. Your interview with the patient shows that she is 40 weeks pregnant and has been in active labor for several hours. You determine that her vital signs are all within normal limits. After your physical exam, you determine the baby is crowning. You should next: A. delay delivery until arrival at the hospital. B. prepare to deliver the baby on-scene. C. contact ALS for intercept. D. begin transport and plan to deliver in the ambulance.
prepare to deliver the baby on-scene.
You have been called for a young female in labor. She is lying on the floor in obvious distress from the labor pains. While you are assessing her for crowning, your partner is getting a set of vital signs. The patient tells you that she is getting dizzy and nauseated. Vital signs are pulse rate 120, respiratory rate 22, and blood pressure 98/62. You should be concerned that the patient has: A. Braxton-Hicks contractions. B. placenta previa. C. contracted food poisoning. D. supine hypotensive syndrome.
supine hypotensive syndrome.
You have responded to a woman who has possible premature labor. She is 8 months pregnant and is experiencing labor pains. During your assessment, you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You should next: A. time her contractions. B. complete a set of vital signs. C. check for cervix dilation. D. check the level of the fundus.
time her contractions.
The muscular organ in which a baby develops during pregnancy is called the: A. fetal membrane. B. uterus. C. amniotic sac. D. placenta.
uterus.