My EMT w Chpt 36
Which of the following is the process in which heat is lost from the body as wind passes over it? a. Convection b. Hydrodynamic cooling c. Exposure d. Condensation
A
When actively rewarming a frostbitten extremity in warm water, you should change the water when the temperature falls below ________ °F. a. 115-120 b. 100-105 c. 85-95 d. 80-90
B
A patient who is lying on cold ground is losing the most amount of heat by what mechanism? a. Radiation b. Convection c. Conduction d. Shivering
C
In a hypothermic patient the coldest blood is found in what part of the patient's body? a. Intestines b. Heart and lungs c. Head d. Extremities
D
The term gangrene means tissue: a. damage. b. discoloration. c. infection. d. death.
D
Which of the following should be done when the infant's head has been delivered? A. Check to see if the umbilical cord is around the neck. B. Suction the mouth. C. Suction the nose. D. All of the above
D
By which of the following means does the fetus's blood pick up nourishment from the mother? A. Diffusion B. Direct circulation C. Indirect circulation D. Osmosis
A
In which of the following situations would a person lose heat by conduction? a. Sitting on cold metal bleachers at a football game b. Wearing wet clothing in windy weather c. Breathing d. Going outside without a coat during a cold but calm day
A
Rough handling of a patient with severe hypothermia may result in which of the following? a. Ventricular fibrillation b. Seizures c. Heart attack d. Rewarming shock
A
The term blanching, used to describe localized cold injury, means the tissue has turned to which of the following colors? a. White or lighter b. Blue or purple c. Red d. Black
A
Traditionally an APGAR score is taken at what time intervals after birth? A. 1 and 5 minutes B. 5 and 10 minutes C. 1 and 6 minutes D. 2 and 7 minutes
A
When delivering a baby, you should do all of the following except: A. place your fingers in the armpit to assist with delivery of the shoulders. B. have someone stay at the mother's head if possible. C. position your gloved hands at the vaginal opening. D. suction the mouth first, then the nose.
A
Which of the following BEST describes a localized cold injury with a clear line of demarcation of its limits? a. Early frostnip b. Late frostbite c. Immersion foot d. Deep frostnip
A
Which of the following describes the condition of having an abnormally high body temperature? a. Hyperthermia b. Septic shock c. Hyperdynamic state d. Heat shock
A
Which of the following does NOT make infants and children more prone to hypothermia? a. Inefficient metabolism b. Large body surface area c. Small muscle mass d. Little body fat
A
Which of the following is NOT a classification of localized cold injury? a. Hypothermia b. Frostbite c. Frostnip d. All of the above are localized cold injuries
A
Which of the following is NOT part of a basic obstetrics kit? A. Packet of suture material B. Surgical scissors C. Umbilical cord clamps D. Baby blanket
A
Which of the following is an appropriate question to ask while evaluating a woman in labor? A. Is this your first pregnancy? B. When was the last time you were sexually active? C. Do you know who the father is and what is his medical history? D. None of the above
A
Which of the following is the correct way to time the frequency of contractions in the pregnant woman? A. From the beginning of one contraction to the beginning of the next B. After counting the number of contractions in a 15-minute period, multiply by 4 C. From the end of one contraction to the beginning of the next D. From the beginning of a contraction to the end of the same contraction
A
Which of the following is true concerning trauma in the pregnant woman? A. She may lose up to 35% of her blood volume before exhibiting signs of shock. B. The mother's body will preferentially protect the life of the fetus over that of the mother. C. The increase in blood volume during pregnancy makes shock an unlikely cause of death. D. She may lose up to 15% of her blood volume before exhibiting signs of shock.
A
Why is it important to keep patients at rest when they are hypothermic? a. Since the blood is warmest in the extremities, exercise or unnecessary movement could quickly circulate the warm blood and raises the core body temperature. b. Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and drop the blood pressure. c. Since the blood is coldest in the extremities, exercise or unnecessary movement could quickly circulate the cold blood and lower the core body temperature. d. None of the above
A
You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8 months pregnant and has moderate, bright red bleeding. She says that her doctor was concerned about the location of the placenta. This condition is known as: A. placenta previa. B. placenta disruption. C. abruptio placenta. D. unstable placenta.
A
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. 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. 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. Tell the patient she needs to be transported immediately and using the bathroom will have to wait until she arrives at the hospital. D. Allow the patient to use the bathroom as it will make transport, and also delivery, more comfortable.
A
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. Which of the following is true regarding a pregnant woman? A. Diabetes may be made worse during pregnancy. B. Her pulse rate should be lower than normal. C. Her blood pressure is usually higher during pregnancy. D. Her respirations usually remain the same during pregnancy.
A
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. Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse. B. Transport without further intervention. C. Begin bag-valve-mask ventilations, suction the airway with a rigid tonsil tip, and begin CPR. D. Perform a series of back blows and chest thrusts interposed with mouth-to-mouth ventilation.
A
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. She 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 she has: A. supine hypotensive syndrome. B. contracted food poisoning. C. Braxton-Hicks contractions. D. placenta previa.
A
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. check the level of the fundus. C. complete a set of vital signs. D. check for cervix dilation.
A
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. Administer blow-by oxygen. B. Begin CPR with a compression rate of 120/minute. C. Perform ventilations with a bag-valve-mask device and supplemental oxygen. D. Place a neonatal nonrebreather mask on the infant's face.
A
Allowing a patient's body temperature to increase by preventing further heat loss is referred to as which of the following? a. Core rewarming b. Passive rewarming c. Active rewarming d. Natural rewarming
B
An infant's birth weight is considered low if it is less than ________ pounds. A. 3.5 B. 5.5 C. 4.5 D. 2.5
B
Applying an external source of heat to the patient's body to rewarm him is called ________ rewarming. a. central b. active c. endogenous d. peripheral
B
By definition, a premature infant is one who is born before how many weeks of the pregnancy? A. 28 B. 37 C. 40 D. 34
B
Heat cramps occur due to loss of which of the following substances? a. Water b. Salt c. Magnesium d. Water and potassium
B
Normal maternal blood loss during delivery of an infant usually does not exceed how much? A. 1,000 cc B. 500 cc C. 250 cc D. 100 cc
B
The greatest danger to the pregnant woman and her fetus involved in trauma is which of the following? A. Neurogenic shock B. Hemorrhagic shock C. Supine hypotensive shock D. Distributive shock
B
The technique for central rewarming requires the application of heat to which of the following areas of the patient's body? a. Chest, back, neck, and armpits b. Lateral chest, neck, armpits, and groin c. Head, neck, chest, and back d. Head, neck, chest, and groin
B
What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients? A. Uterus B. Placenta C. Amnion D. Cervix
B
Which of the following BEST describes placenta previa? A. The placenta prematurely separates from the uterine wall. B. The placenta is implanted over the opening of the cervix. C. The umbilical cord is the presenting part. D. The pregnancy is lost before the 20th week of gestation.
B
Which of the following describes the normal appearance of amniotic fluid? A. Thin fluid, greenish-yellow in color B. Clear and colorless fluid C. A fluid containing blood and mucus D. Thick fluid, greenish-black in color
B
Which of the following is NOT advisable following complete birth of the infant? A. Place the infant on his side with his head slightly lower than his body. B. Hold the infant by the ankles to allow the airway to drain. C. Keep the infant at the level of the mother's vagina until the cord is clamped and cut. D. Dry the infant and wrap him in a blanket.
B
Which of the following is the most significant way in which the body cools itself? a. Respiration b. Perspiration c. Radiation d. Vasoconstriction
B
While treating a pregnant trauma patient, which of the following is the BEST way to keep the fetus alive? A. Transport the patient to the closest pediatric center. B. Treat the patient as any other trauma patient. C. Do an emergency cesarean section of the fetus. D. Do not put the patient on a spine board to prevent supine hypotensive syndrome.
B
You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds with increasing pain. The patient states that she feels the urge to push. These signs indicate which stage of delivery? A. Third stage B. First and second stage C. Fourth stage D. Second stage
B
You have just delivered a full-term baby girl and she is doing well. You have dried her off and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the following is normally true regarding cutting the umbilical cord? A. You should hold the baby above the level of the mother when cutting the cord. B. The infant must be breathing on his or her own before you cut the cord. C. The cord should be cut immediately following delivery. D. You must try to cut the cord before it stops pulsating.
B
Your pregnant patient is in active labor. You note that her contractions are getting closer together and much stronger as the baby moves deeper into the birth canal. The muscle contraction mechanism that moves the baby toward birth is the same mechanism that moves: A. fluid into and out of the cell. B. food from the esophagus to the stomach. C. air down the bronchial tubes to the alveoli. D. sweat to the surface of the skin.
B
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. relaxation of the extremities. D. heart rate greater than 100.
C
Heat stroke is caused by which of the following mechanisms? a. Blockage of blood flow to the brain b. Extreme dilation of all the blood vessels c. Failure of temperature regulation mechanisms d. Heat-induced swelling of brain tissue
C
If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first? A. Call medical control before taking action. 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. Leave the sac intact until the entire body is delivered.
C
If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done? A. Clamp the cord in two places, but do not cut it until the baby is delivered. B. Immediately cut the cord before delivering the baby. C. Try to slip the cord over the baby's head and shoulder. D. Transport emergently without further intervention.
C
In which of the following ways does the body produce heat in response to being cold? a. Excreting more urine b. Burning fewer calories c. Shivering d. Increasing the respiratory rate
C
Localized cold injury occurs due to vasoconstriction and: a. chemical imbalance in the tissues. b. blood clots. c. ice crystal formation in the tissues. d. loss of calcium.
C
The condition in which the placenta separates from the uterine wall is known as which of the following? A. Placenta previa B. Preeclampsia C. Abruptio placentae D. Ectopic pregnancy
C
To assess skin temperature for a possibly hypothermic patient, the EMT should place the back of his hand against which part of the patient's body? a. Forehead b. Cheek c. Abdomen d. Inner wrist
C
When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body. A. 12 B. 1 C. 10 D. 3
C
When performing chest compressions on a pregnant patient that has gone into cardiac arrest, what change do you need to make in the placement of your hands? A. 0.5 to 1 inch lower on the sternum B. 0.5 to 1 inch higher on the sternum C. 1 to 2 inches higher on the sternum D. 1 to 2 inches lower on the sternum
C
Which of the following BEST describes the events that occur during the first stage of labor? A. Expulsion of the fetus through the birth canal B. Expulsion of the placenta C. Thinning and dilation of the cervix D. Rupture of the amniotic sac
C
Which of the following BEST describes the term crowning? A. Delivery of the head during a breech birth, completing delivery B. Discharge of bloody mucus C. Presenting part of the baby being visible at the vaginal opening D. Complete dilation of the cervix
C
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. Determining if the patient feels as if she needs to move her bowels C. Phoning the patient's obstetrician for advice D. Finding out how many pregnancies the patient has had
C
Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding? A. Preventing infection B. Finding out if the patient is currently sexually active C. Monitoring for hypovolemic shock D. Obtaining a thorough gynecological history
C
Which of the following is the correct technique to check for crowning in the assessment of a woman in labor? A. Place your hand on the woman's abdomen, just above the umbilicus, and check for the firmness of the uterus during contractions. B. Ask the woman to "push" or "bear down" as you inspect the vaginal opening. C. Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening. D. None of the above
C
Which of the following is the highest priority to the EMT in delivery of an infant with meconium-stained amniotic fluid? A. Checking for fever B. Vigorously rubbing the infant's back immediately upon delivery to stimulate breathing C. Being prepared to suction the infant immediately before he takes a breath D. None of the above
C
Which of the following is true concerning a stillborn baby? A. Resuscitation must always be attempted. B. Infants born in cardiopulmonary arrest should not be resuscitated. C. The death may occur weeks before delivery. D. The parents should never be allowed to see the baby, especially if it has begun to deteriorate.
C
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. internal bleeding. B. placenta previa. C. ectopic pregnancy. D. appendicitis.
C
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. completing a thorough secondary exam. B. calling for a back-up unit. C. getting to the hospital. D. assembling your delivery kit.
C
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. elevating the mother's feet. B. massaging the uterus to control bleeding. C. encourage the mother to use the bathroom if possible. D. Transport the mother has a high-priority patient.
C
Your pregnant patient is in active labor. She has been lying on her back throughout her labor and is experiencing signs and symptoms of shock. Her vital signs are pulse rate 118, respirations 22, blood pressure 96/62, and skin cool and diaphoretic. The BEST way to treat her is to: A. give her some fluids to drink to help elevate her blood pressure. B. cover her up with a blanket to maintain body heat. C. place a rolled blanket under her left hip to displace the uterus. D. elevate her legs to increase the blood return to the heart.
C
During which stage of labor is the baby born? A. Third B. First C. Primary D. Second
D
For which of the following reasons are newborns, infants, and the elderly more readily affected by the heat than other age groups? a. Faster metabolism b. Increased body mass c. Inadequate salt intake d. Poor ability to regulate body temperature
D
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. White cotton thread D. Pair of shoelaces
D
In cases of extreme hypothermia, you will find the patient unconscious, with no discernible vital signs, and skin cold to your touch with stiff joints as if they appear dead. What is the emergency care for these patients? a. Contact medical control for input into the best treatment for this patient. b. Call the coroner as indications are the patient is cold and deceased, which is a definitive sign of death. c. Check distal CSM, apply warming packs to the extremities, and transport the patient. d. Assess the carotid pulse for 30 to 45 seconds; if there is no pulse, start CPR immediately and prepare to apply the AED
D
In which of the following situations should the mother be transported immediately? A. Delivery is not imminent and there is about 500 cc of painless, bright red bleeding. B. The mother experiences a severe, tearing sensation in her abdomen during labor and the outline of the fetus can be felt through the abdominal wall. C. The infant's arm is the presenting part. D. All of the above
D
Seizures due to complications of pregnancy generally occur during which of the following time periods? A. In the second trimester B. In the first trimester C. Before the mother even knows she is pregnant D. Late in pregnancy
D
Supine hypotensive syndrome is easily prevented by transporting the pregnant female into which of the following positions? A. On her hands and knees with her hips elevated B. Tilted slightly onto the right side C. Supine, with the head lower than the hips D. Lying on her left side
D
What is the term for when the fetus and placenta deliver before the 28th week of pregnancy? A. Induced abortion B. Stillbirth C. Eclampsia D. Spontaneous abortion
D
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. Check for crowning. B. Pull on the baby. C. Advise the mother not to push or strain. D. Apply gentle pressure to the head with your gloved hand.
D
When resuscitating a hypothermic patient in cardiac arrest, resuscitation attempts must continue until the patient has: a. been ventilated for at least 30 minutes with an oropharyngeal airway in place. b. developed rigor mortis. c. been defibrillated a total of nine times. d. been rewarmed.
D
When the body is in water, how many times faster does it lose heat than when it is in still air? a. 2 b. 100 c. 10 d. 25
D
Which of the following conditions should be present before the umbilical cord is cut? A. The cord is no longer pulsating. B. The cord is clamped in two places. C. The infant is breathing on his or her own. D. All of the above
D
Which of the following describes a breech presentation? A. The infant presents buttocks first. B. The infant presents with both feet first. C. The infant presents face first. D. Both A and B
D
Which of the following is a cause of gynecological emergencies? A. Soft-tissue trauma to the external genitalia B. Sexual assault C. Disorders of the female reproductive organs D. All of the above
D
Which of the following is a common sign of a pre-delivery emergency? A. The placenta fails to deliver within 20 minutes of the infant's birth. B. The amniotic sac ruptures. C. Contractions become more intense and closer together. D. There is profuse vaginal bleeding.
D
Which of the following is acceptable when actively rewarming a hypothermic patient? a. Encouraging the patient to exercise b. Giving coffee or brandy to drink c. Warming the patient as quickly as possible d. Applying humidified oxygen
D
Which of the following is appropriate when caring for a premature baby? A. Deeply suctioning the airway with a rigid tonsil-tip B. Applying high-concentration oxygen with a neonatal nonrebreather mask C. Encouraging family members to hold the infant D. Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90degrees°F and 100degrees°F
D
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. Encourage the mother to push forcefully in order to speed delivery. C. Immediately clamp the cord in two places and cut it between the clamps. D. Place the mother in a head-down position with pillows under her hips.
D
Which of the following is true concerning prehospital delivery of twins? A. This is a true emergency and cannot be managed outside the hospital setting without additional help. B. There are always two placentas. C. The umbilical cord of the first infant must not be cut until the second infant is born. D. The infants will probably be smaller than a single infant and need attention in keeping them warm.
D
Which of the following is true of premature infants? A. They are more susceptible to infection. B. They are at risk for respiratory difficulty. C. They can easily develop hypothermia. D. All of the above
D
Which of the following may result from a woman in her third trimester of pregnancy lying in a supine position? A. Compression of the inferior vena cava B. Supine hypotensive syndrome C. Fetal compromise D. All of the above
D
Which of the following should the EMT do during the treatment of localized cold injury? a. Encourage the patient to use the affected part. b. Rub the affected area with snow. c. Massage the affected area. d. Gradually warm the affected area
D
Which of the following should the EMT do to control maternal bleeding after delivery of the baby? A. Massage the uterus until it is firm and grapefruit-sized. B. Allow the infant to nurse, if possible. C. Apply direct pressure with a sanitary napkin over any perineal lacerations. D. All of the above
D
Which of the following terms describes the temperature of the surrounding air? a. Wind chill index b. Shell temperature c. Core temperature d. Ambient temperature
D
While treating a patient of sexual assault, your treatment should follow which of the following sequences? A. Maintain scene safety, treat immediate life threats, allow the patient to shower if the patient is capable to help treat psychological needs, and transport. B. Treat immediate life threats, treat psychological needs, and protect criminal evidence. C. Maintain scene safety, treat immediate life threats, and treat only the secondary injuries that may become life threats to protect criminal evidence. D. Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence.
D
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. You are especially concerned about problems she might have during the delivery. Which of the following are findings that may indicate the need for neonatal resuscitation? A. Patient with a blood pressure of 130/82 B. Mother who has had five previous births C. Patient whose water has already broken D. Young mother who has not had prenatal care
D
You arrive on the scene and find an unresponsive homeless man lying in the alleyway clutching a wine bottle. He is wearing a long-sleeved shirt, but does not have pants on. His skin feels cold to the touch. The week's temperatures have not been above 50°F. Which of the following should you do immediately after ensuring the patient has an adequate airway? a. Apply the AED. b. Provide manual stabilization of the cervical spine. c. Begin passive rewarming. d. Check the pulse.
D
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. wrap the cord to prevent heat loss. B. provide oxygen to the mother. C. gently push the cord back into the vaginal space. D. keep the baby off of the cord.
D
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. begin transport and plan to deliver in the ambulance. B. delay delivery until arrival at the hospital. C. contact medical direction for orders. D. prepare to deliver the baby on-scene.
D
Your patient is a 26-year-old female with a history of ectopic pregnancies. She has called 911 for extreme abdominal pain and she is concerned that she has another ectopic pregnancy. Her vital signs are pulse 118, respirations 20, and blood pressure 100/76. Which of the following is true regarding ectopic pregnancies? A. The fertilized egg usually implants in the wall of the uterus. B. It usually occurs during the second trimester. C. It may cause painless bright red bleeding. D. The fallopian tubes cannot stretch to accommodate a fetus.
D
The term for a baby developing inside the mother's womb after week 8 is: A. neonate. B. chorion. C. infant. D. fetus.
D
The muscular organ in which a baby develops during pregnancy is called the: A. placenta. B. fetal membrane. C. uterus. D. amniotic sac.
C
You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities. What is the newborn's APGAR score? A. 8 B. 7 C. 10 D. 9
D
You are called for a women who is about to deliver. During the labor process, your patient's water breaks. She experiences a rush of warm water and an increase in uterine contractions. The purpose of the amniotic fluid is to: A. provide lubrication during the delivery of the baby. B. allow the fetus to float during development. C. help maintain a constant fetal body temperature. D. All of the above
D