Chapter 36

Traditionally an APGAR score is taken at what time intervals after birth?

1 and 5 minutes

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?

1 to 2 inches higher on the sternum

By definition, a premature infant is one who is born before how many weeks of pregnancy?

37

An infant's birth weight is considered low if it is less than ________ pounds

5.5

Normal maternal blood loss during delivery of an infant usually does not exceed how much?

500cc

When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body.

7

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?

9

The condition in which the placenta separates from the uterine wall is known as which of the following?

Abruptio placentae

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. Which of the following is the best course of action?

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

Which of the following is a cause of gynecological emergencies?

All of the above

Which of the following may result from a woman in her third trimester of pregnancy lying in a supine position?

All of the above

Which of the following should be done when the infant's head has been delivered?

All of the above

Which of the following should the EMT do to control maternal bleeding after delivery of the baby?

All of the above

When assisting with a delivery in the field, which of the following should be done as the baby's head begins to emerge from the vagina?

Apply gentle pressure to the head with your gloved hand.

While treating a pregnant patient in cardiac arrest, which of the following is the best way to keep the fetus alive

Attempt to resuscitate the patient as you would any other cardiac arrest patient

Which of the following is the highest priority for the EMT when delivering an infant with meconium-stained amn

Being prepared to suction the infant immediately before he takes a breath

Which of the following describes a breech presentation?

Both A (The infant presents buttocks first.) and B (The infant presents with both feet first)

Which of the following describes the normal appearance of amniotic fluid?

Clear and colorless fluid

Which of the following is the correct technique to check for crowning in the assessment of a woman in labor?

Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening.

Which of the following is true regarding a pregnant woman?

Diabetes may be made worse during pregnancy.

By which of the following means does the fetal blood pick up nourishment from the mother?

Diffusion

Which of the following is the correct way to time the frequency of contractions in the pregnant woman?

From the beginning of one contraction to the beginning of the next

Which of the following poses the greatest danger to the pregnant woman and her fetus when trauma occurs?

Hemorrhagic shock

Which of the following is not advisable following complete birth of the infant?

Hold the infant by the ankles to allow the airway to drain.

Seizures due to complications of pregnancy generally occur during which of the following time periods?

Late in pregnancy

Supine hypotensive syndrome is easily prevented by transporting all third-trimester patients in which of the following positions?

Lying on the left side

While treating a patient of sexual assault, which of the following sequences should your treatment follow?

Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence

Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleed

Monitoring for hypovolemic shock

Which of the following is an appropriate question to ask while evaluating a woman in labor?

None of the above

Which of the following is not part of a basic obstetrics kit?

Packet of suture material

Which of the following is not relevant in determining whether or not delivery is imminent for a woman in labor?

Phoning the patient's obstetrician for advice

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?

Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute

Which of the following is indicated in the prehospital management of a prolapsed umbilical cord?

Place the mother in a head-down position with pillows under her hips

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?

Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse.

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?

Section of wire coat hanger

Which of the following is true concerning trauma in the pregnant woman?

She may lose up to 35 percent of her blood volume before exhibiting signs of shock

What term is used to describe delivery of the fetus and placenta before the 20th week of pregnancy?

Spontaneous abortion

Which of the following is true concerning a stillborn baby?

The death may occur weeks before delivery

Which of the following is true regarding ectopic pregnancies?

The fallopian tubes cannot stretch to accommodate a fetus.

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?

The infant must be breathing on his or her own before you cut the cord.

Which of the following is true concerning prehospital delivery of twins?

The infants will probably be smaller than a single infant and special attention should be paid to keeping them warm

You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is, by 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 indicate that there may be a need for neonatal resuscitation?

The mother has not had prenatal care

Which of the following best describes placenta previa?

The placenta is implanted over the opening of the cervix

Which of the following is a common sign of a pre-delivery emergency?

There is profuse vaginal bleeding

Which of the following best describes the events that occur during the first stage of labor?

Thinning and dilation of the cervix

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?

Try to slip the cord over the baby's head and shoulder

If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first?

Use your fingers to tear the sac away from the baby's face

The muscular organ in which a baby develops during pregnancy is called the:

Uterus

Which of the following is appropriate when caring for a premature baby?

Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F

Which of the following conditions should be present before the umbilical cord is cut?

all of the above

Which of the following is true of premature infants?

all of the above

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:

ectopic pregnancy

The term for a baby developing inside the mother's womb after 8 weeks is:

fetus

You are assessing a patient in labor. Her contractions are 2 minutes apart, lasting 30 seconds with increasing pain. She states that she does not yet feel the urge to push. These signs indicate she has reached which stage of delivery?

first stage

The muscle contraction mechanism that moves an egg down the fallopian tube toward the uterus is the same mechanism that moves:

food from the esophagus to the stomach

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:

getting to the hospital.

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:

having the mother squeeze her legs together to provide direct pressure

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:

keep the baby off of the cord.

When delivering a baby, you should do all of the following except

place your fingers in the armpit to assist with delivery by pulling on the baby

What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients

placenta

You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8 months pregnant and has moderate, bright red bleeding with no abdominal pain. She says that her doctor was concerned about the location of the placenta. This condition is known as:

placenta previa

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:

prepare to deliver the baby on-scene.

Which of the following best describes the term crowning?

presenting part of the baby being visible at the vaginal opening

All of the following are signs of adequate breathing and circulation in the newborn except:

relaxation of the extremities.

During which stage of labor is the baby born?

second

You have been called for a young female in labor. She is lying on the floor in obvious distress from 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:

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:

time her contractions