Ch 33 Obstetrics and Neonatal Care
By the end of pregnancy the pregnant patient heart rate increases up to 20% or about ____________ beats per minute
20
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 she has been complaining of a headache for the past few days. You should: A place on her side, administer high flow O2 and transport B insert an oral airway and ventilate her with a bag valve mask C elevate her legs to improve brain perfusion and keep her warm D administer oral glucose for pursumed hypoglycemia and transport
A
A 33-year-old woman who is 36 weeks' pregnant is experiencing scant vaginal bleeding. During transport, you note that she suddenly becomes diaphoretic, tachycardic, and hypotensive. In addition to administering 100% oxygen, you should A place her in the left lateral recumbent position B position her supine and elevate her legs 12 inches C carefully place sterile gauze into her vagina D ventilate her with a bag valve mask
A
Are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. Patient has apparently fall 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: A continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care B immediately remove the patient from the environment and transport C ask more detailed questions and press the issue until you have more detailed understanding of the incident D contact police and remain at the scene until they arrive and escort you to the hospital
A
Determine the Apgar score in the following scenario: You arrive at the scene of a home delivery. Upon entering the scene, the father appears upset and hands you a limp baby. The child has a weak cry, is completely cyanotic, and has a pulse of 70 beats/min. Respirations are slow. Select one: A. 3 B. 9 C. 2 D. 7
A
From what internal female organ is the fetus expelled during delivery? A uterus B vagina C cervix Dperineum
A
Placenta previa is defined as: A development of the placenta over the cervical opening B abnormal development and functioning of the placenta C delivery of a portion of the placenta before the baby D premature placental separation from the uterine wall
A
When determining the frequency of contractions, you should time the contractions from the: A start of one to the start of the next B end of one to the end of the next C end of one to the start of the next D start of one to the end of the next
A
Which of the following statements is not true? A the leading cause of abruptly placenta is in an ectopic pregnancy B as pregnancy progresses the uterus and larges and rises out of the pelvis C some cultures may not permit male EMTs to examine a female patient D gestational diabetes will clear up in most woman after delivery
A
You have just delivered a premature baby. Your assessment reveals that he is breathing adequately; however his heart rate is 90 bpm you should: A keep him warm and ventilate with a BVM B clamp and cut the umbilical cord and keep him warm C assess his skin color and give free flow oxygen as needed D give chest compressions and reassess in 30 seconds
A
___________ is heralded by the onset of convulsions, or seizures, resulting from severe hypertension in the pregnant woman. a. eclampsia b. placenta previa c. placenta abruptio d. supine hypotensive syndrome
A
Amniotic sac
A fluid filled, bag like membrane inside the uterus that grows around the developing fetus
A risk of pelvic inflammatory disease or tubal ligations increase a woman's risk for: A preeclampsia B ectopic pregnancy C gestational diabetes D placenta previa
B
Baby is born at 7:50 to the Apgar score should be calculated at: A 8 o'clock B 7:57 C 7:59 D 7:53
B
Following delivery of the placenta, the mother is experiencing vaginal bleeding. After massaging her fundus and allowing the mother to breast feed, the bleeding stops. This occurred because: A breast-feeding causes uterine blood vessels to dilate B these actions stimulate the production of oxytocin and cause uterine contraction C a portion of the placenta was retained in the uterus D uterine massage increases blood flow to the uterus
B
Premature separation of the placenta from the wall of the uterus is known as: A placenta previa B abruptio placenta C prolapsed cord D eclampsia
B
Upon delivery of an infants head, you know that the umbilical cord is wrapped around it's neck. You should: A give high flow oxygen to the mother and transport B attempt to slip the core gently over the infants had C provide free flow oxygen to the infant and transport D immediately clamp and cut the umbilical cord
B
When preparing a pregnant patient for delivery, you should position her: A on her left side with the right leg elevated B on a farm flat surface with her hips elevated 2 to 4 inches C in a sitting position with their hips elevated 12 inches D in a supine position with her legs spread
B
Which of the following questions is at least pronounce when determining whether a mother will deliver her baby with in the next few minutes? A "when are you due? " B "have you had a sonogram? " C "do you feel the night need to push? " D "is this your first baby? "
B
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: A placing the mother and a recumbent position and rapidly transporting B placing the mother supine with her head down and pelvis elevated C. Gently pulling on the infants leg in an attempt to facilitate delivery D carefully attempting to push the infants leg off of the umbilical cord
B
20th week of pregnancy, the uterus is typically at or above the level of the mothers: A superior diaphragm B. Xipoid process C bellybutton D pubic bone
C
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: A carefully insert a sterile trauma dressing into her vagina B Place your legs together and position her on her left side C massage the uterine fundus with a circular motion D elevate her legs 6 to 8 inches and cover with a blanket
C
Once the infant's head has been delivered: Select one: A. suction the infant's nose, and then the mouth. B. apply oxygen over the mother's vagina. C. suction the infant's mouth, then the nose. D. apply a nasal cannula at 3 L/min to the infant.
C
The amniotic fluid serves to: A remove viruses from the fetus B assist in fetal development C insulate and protect the fetus D transfer oxygen to the fetus
C
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: A acute pulmonary edema B spontaneous pneumothorax C pulmonary embolism D intra-uterine bleeding
C
When assisting ventilations in a newborn with a bag valve mask, the rate is ____________ breaths per minute A 35 to 45 B 20 to 30 C 40 to 60 D 30 to 50
C
Which of the following is not generally considered an obstetrical emergency? A significant bleeding after delivery of the placenta B failure of the placenta to deliver after 30 minutes C return of contractions following delivery of the baby D more than 500 mL of blood loss before placenta delivery
C
Which of the following is not performed immediately following delivery of the infant? A use a sterile gauze pad to wile the infants mouth, then suction again B be sure the head is covered and keep the neck in a neutral position C obtain an Apgar score D wrap the infant in a towel and place it on one side with head lowered
C
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 pregnant women. You should: A call for the police to ensure the patient assessment carried out B insist that the patient requires proper care and that requires an adequate physical assessment that you cannot be responsible for the outcome C respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient D inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management
C
Umbilical cord
Connects mother and infant
A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A eight hours B 10 hours B 4 hours D 16 hrs.
D
A nuchal cord is defined as an umbilical cord that: A is lacerated due to traumatic delivery B has separated from the placenta C has abnormally developed blood vessels D is wrapped around the baby's neck
D
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A pregnant patients can dramatically increase their heart rate B pregnancy causes vasodilation and a lower blood pressure C blood is shunted to the uterus and fetus during major drama D. Pregnant patients have an overall increase in blood volume
D
An infant is considered to be premature if it: A. Is born before 38 weeks' gestation or weighs less than 6 pounds. B. Weighs less than 5.5 pounds or is born before 37 weeks' gestation. C. Is born before 40 weeks' gestation or weighs less than 7 pounds. D. Weighs less than 5 pounds or is born before 36 weeks' gestation.
D
Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A thorough drying with a towel B some form of tactile stimulation C suctioning of the upper airway D positive pressure ventilation's
D
During your visual inspection of a 25-year-old woman in labor, you see the babies head crowning of the vagina opening. What should you do? A Place your fingers in the vagina to assess for a nuchal cord B tell the mother not to push and transport her immediately C maintain firm pressure to the head until it completely delivers D apply gentle pressure to the babies head as it delivers
D
The only indications for placing your glove finger in the vagina during delivery are: A Nuchal cord and presentation of an arm and a leg B. Limb presentation and severe vaginal hemorrhage C vertex presentation and delivery of the placenta D breech presentation and prolapsed umbilical cord
D
The presence of meconium in the amniotic fluid indicates: Select one: A. an expected finding in full-term infants. B. that the fetus is at least 4 weeks premature. C. that full newborn resuscitation will be needed. D. that the baby's airway may be obstructed.
D
Which of the following statements regarding the placenta is correct? The placenta provides oxygen and nutrients to the fetus and is expelled from the vagina about 30 minutes before the baby is born B the placenta barrier consists of two layers of cells and allows the mothers blood that contains high concentrations of oxygen to directly mix with the blood of the fetus C the placenta allows for the transfer of oxygen and carbon dioxide between the mother and fetus but prevents most medications from passing between the mother and fetus D 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
D
The leading cause of maternal death in the first trimester is internal hemorrhage into the abdomen following rupture of a ____________
Ectopic pregnancy
Placenta
Tissue that develops on the wall of the uterus and is connected to the fetus
____________ is a developmental defect in which a portion of the spinal cord portraits outside the vertebrae
spina bifida