EMT Chapter 23 Gynecologic Emergencies

A patient with vaginal bleeding _________. Select one: A. will have profound and obvious signs of shock B. may not have obvious signs of shock even if she has experienced significant blood loss C. may want to stand, rather than sit or lie on the stretcher D. will have a weak and rapid pulse but not pale or diaphoretic skin

B. may not have obvious signs of shock even if she has experienced significant blood loss

When caring for a female patient who has been sexually assaulted, you should: Select one: A. allow law enforcement to take her statement before you begin treatment. B. place any bloodstained clothing or other articles in separate paper bags. C. ask the patient for a concise, detailed report of what happened to her. D. advise her that she will not be allowed to shower or change her clothes.

B. place any bloodstained clothing or other articles in separate paper bags.

Left untreated, _____ can lead to premature birth or low birth weight in pregnant women. A. chlamydia B. gonorrhea C. bacterial vaginosis D. vaginal bleeding

C. bacterial vaginosis

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease? Select one: A. A shuffling gait when walking B. Bright red blood in the urine C. A history of ectopic pregnancy D. Vaginal passage of blood clots

A. A shuffling gait when walking

Which of the following statements regarding rape is correct? A. Rape is a legal diagnosis, not a medical diagnosis. B. Only a licensed physician can make a diagnosis of rape. C. The EMT should try to determine if rape occurred. D. Rape causes more physical harm than emotional harm.

A. Rape is a legal diagnosis, not a medical diagnosis.

Which of the following signs/symptoms is considered particularly significant in gynecological emergencies? Select one: A. Syncope B. Abdominal cramping C. Painful urination D. Vaginal bleeding

A. Syncope

Often the most important intervention for a sexual assault patient is _____ and transport to a facility with a staff specially trained to deal with this scenario. A. comforting reassurance B. excellent assessment skills C. bandaging skills D. emotional sympathy

A. comforting reassurance

Each ovary produces an ovum in alternating months and releases it into the: A. fallopian tube B. cervix C. uterus D. vagina

A. fallopian tube

The sperm typically fertilizes the egg in the _________. Select one: A.fallopian tube B. vagina C. uterus D. ovary

A. fallopian tube

As a woman approaches menopause: Select one: A. her menstrual periods may become irregular and vary in severity. B. she cannot become pregnant because of fluctuating hormone levels. C. she usually experiences abdominal cramping without vaginal bleeding. D. her risk of developing pelvic inflammatory disease lowers significantly.

A. her menstrual periods may become irregular and vary in severity.

The physical examination of a sexual assault victim should be: Select one: A. limited to a brief survey for life-threatening injuries. B. as detailed as possible so all injuries can be documented. C. performed in the presence of at least two police officers. D. deferred until the patient can be evaluated by a physician.

A. limited to a brief survey for life-threatening injuries.

In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: Select one: A. may be relatively painless. B. is typically not as severe. C. can be controlled in the field. D. often presents with acute pain.

A. may be relatively painless.

Bacterial vaginosis is a condition that occurs when: A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. B. numerous bacteria enter the uterus through the cervix and cause severe tissue damage. C. abnormal bacteria enter the vagina and cause damage without causing any symptoms. D. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

A. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms.

When a female has reached menarche: Select one: A. she is capable of becoming pregnant. B. she can no longer produce an ovum. C. she usually requires hormone therapy. D. menstrual periods become less frequent.

A. she is capable of becoming pregnant.

The EMT should perform a "rapid scan" to determine if the patient is __________ during the __________. Select one: A. stable or unstable; primary assessment B. breathing or not breathing; primary assessment C. complaining of vaginal bleeding; history taking D. pregnant; secondary assessment

A. stable or unstable; primary assessment

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I cannot remember anything, but I know I was raped." The EMTs should suspect that: Select one: A. the patient was given a drug prior to the incident. B. the patient knew her attacker, but is afraid to say. C. an underlying head injury is causing her amnesia. D. the traumatic experience has created a mental block.

A. the patient was given a drug prior to the incident.

Signs and symptoms of bacterial vaginosis typically include _________. Select one: A. blood associated with vaginal intercourse B. "fishy," foul-smelling discharge C. low back pain D. rectal pain and discharge

B. "fishy," foul-smelling discharge

The onset of menstruation usually occurs in women who are: A. 8 and 10 years B. 11 and 16 years C. 16 and 18 years D. 17 and 20 years

B. 11 and 16 years

Which of the following statements regarding pelvic inflammatory disease (PID) is correct? Select one: A. The most severe cases of PID occur in women who are not sexually active. B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. C. PID most commonly affects women who have had an ectopic pregnancy in the past. D. The most common presenting symptom of PID is generalized upper abdominal pain.

B. PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy.

Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following? Select one: A. Chlamydia B. Pelvic inflammatory disease C. Gonorrhea D. Bacterial vaginosis

B. Pelvic inflammatory disease

During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: Select one: A. perform a rapid secondary assessment. B. assist her ventilations with a BVM. C. assess her blood pressure and elevate her legs. D. perform a visual assessment of her vaginal area.

B. assist her ventilations with a BVM.

In anticipation of receiving a fertilized ovum, the lining of the uterine wall: Select one: A. diverts blood flow to the vagina. B. becomes engorged with blood. C. thins and begins to separate. D. sheds and is expelled externally.

B. becomes engorged with blood.

It is common for young females who experience their first menstrual period to: Select one: A. have a false positive home pregnancy test result. B. experience abdominal cramping, which may be misinterpreted. C. lose up to 500 mL of blood within the first 24 hours. D. become so emotionally distraught that they contemplate suicide.

B. experience abdominal cramping, which may be misinterpreted.

Painful urination associated with burning and a yellowish discharge is associated with: A. chlamydia B. gonorrhea C. endometriosis D. syphilis

B. gonorrhea

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: A. has obtained a complete set of vital signs. B. has gathered patient history information. C. ascertains if the patient was ever pregnant. D. has formed a general impression of the patient.

B. has gathered patient history information.

If a patient with vaginal bleeding presents with a rapid pulse and pale or cool skin, you should: A. attempt to locate the source of bleeding and correct it B. place the patient in a supine position with her legs elevated C. consider this to be a normal sign in a menstruating woman D. inquire about recent problems with urination

B. place the patient in a supine position with her legs elevated

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: Select one: A. advise her that she cannot clean herself up because this will destroy evidence. B. provide emotional support and visually assess her for obvious trauma. C. ask her if there is anyone you can contact, such as a friend or relative. D. perform a limited hands-on assessment to detect life-threatening injuries.

B. provide emotional support and visually assess her for obvious trauma.

Menstrual flow will typically last approximately _________. Select one: A. 1 day B. 3 days C. 1 week D. 1 month

C. 1 week

While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age. Select one: A. 10; 40 B. 20; 60 C. 11; 50 D. 10; 70

C. 11; 50

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? Select one: A. Genital herpes B. Ectopic pregnancy C. Chlamydia D. Ovarian cysts

C. Chlamydia

What is typically the most important intervention that an EMT can provide to the victim of sexual assault? Select one: A. Control of vaginal bleeding B. Calling for ALS personnel C. Comfort and reassurance D. High-flow oxygen therapy

C. Comfort and reassurance

______________ may be a cause of vaginal bleeding in a patient who states that she is NOT pregnant. Select one: A. Bacterial vaginosis B. Hypotension C. Ectopic pregnancy D. Menopause

C. Ectopic pregnancy

Which of the following infections, when left untreated, may lead to infection of the blood and brain? Select one: A. Pelvic inflammatory disease B. Bacterial vaginosis C. Gonorrhea D. Chlamydia

C. Gonorrhea

Which of the following statements regarding gonorrhea is correct? A. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever. B. Symptoms of gonorrhea usually appear within 3 months after being infected. C. Painful urination is a common symptom of gonorrhea in men and women. D. Most men who are infected with gonorrhea do not experience symptoms.

C. Painful urination is a common symptom of gonorrhea in men and women.

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: Select one: A. supplemental oxygen and keeping the patient supine. B. refraining from placing any dressings into the vagina. C. carefully removing any foreign bodies from the vagina. D. treating external lacerations with sterile compresses.

C. carefully removing any foreign bodies from the vagina.

Your _____ is the best tool to gain the patient's confidence to seek medical help. A. professionalism B. content knowledge C. compassion D. empathy

C. compassion

The _____________ connect(s) each ovary with the uterus. Select one: A. abdomen B. egg C. fallopian tubes D. cervix

C. fallopian tubes

The __________ and _________ are folds of tissue that surround the urethral and vaginal openings. Select one: A. fallopian tubes; uterus B. perineum; anus C. labia majora; labia minora D. vagina; cervix

C. labia majora; labia minora

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? A. left lower quadrant pain, referred pain to the left shoulder, and fever B. upper abdominal cramping, severe headache, and heavy vaginal bleeding C. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge D. pain around the umbilicus, low-grade fever, and generalized weakness

C. lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge

If fertilization has not occurred in approximately 14 days postovulation: Select one: A. the ovum will begin to travel to the uterus. B. another egg will be released. C. menstruation will begin. D. All of these answers are correct.

C. menstruation will begin.

Chlamydia, bacterial vaginosis, and gonorrhea are all examples of _________. Select one: A. "women's conditions" B. diseases that can cause scarring of the fallopian tubes C. sexually transmitted diseases D. causes of vaginal bleeding

C. sexually transmitted diseases

The EMT should ensure that vaginal bleeding is _________. Select one: A. controlled directly by the patient B. not caused by traumatic injury C. taken seriously and the patient is transported for gynecologic evaluation D. severe enough to warrant transport

C. taken seriously and the patient is transported for gynecologic evaluation

Causes of vaginal bleeding include which of the following? Select one: A. Ectopic pregnancy B. Vaginal trauma C. Spontaneous abortion D. All of these answers are correct.

D. All of these answers are correct.

During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following? Select one: A. The amount of time since of the patent's last menstrual cycle B. The possibility that the patient may be pregnant C. If the patient is sexually active D. All of these answers are correct.

D. All of these answers are correct.

In cases of sexual assault, it is important to ensure that you do which of the following? Select one: A. Immediately write down your observations of the scene before assessing the patient. B. Call for a female EMT or ALS care provider. C. Discuss with law enforcement any suspicions that you may have about the perpetrator. D. All of these answers are correct.

D. All of these answers are correct.

What is (are) the primary female reproductive organ(s) called? Select one: A. Uterine tubes B. Uterus C. Vagina D. Ovaries

D. Ovaries

Which of the following drugs is commonly referred to as "roofies"? Select one: A. Ketamine B. GHB C. MDMA D. Rohypnol

D. Rohypnol

A patient with pelvic inflammatory disease will typically complain of _________. Select one: A. aches and fever associated with urination B. bleeding associated with stress C. nausea and vomiting associated with intercourse D. abdominal pain associated with menstruation

D. abdominal pain associated with menstruation

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: Select one: A. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. B. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. C. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. D. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

D. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay.

When prioritizing care for the victim of a sexual assault, the EMT should focus on _________ first. Select one: A. preserving evidence B. relaying the patient's account of the event to law enforcement C. soft-tissue injuries D. life-threatening injuries

D. life-threatening injuries

Whenever possible, a female sexual assault victim should be: A. deferred until the patient can be evaluated by a physician. B. all injuries can be documented. C. performed in the presence of at least two police officers. D. limited to a brief survey for life-threatening injuries.

D. limited to a brief survey for life-threatening injuries.

The most common presenting sign of pelvic inflammatory disease is: A. vaginal discharge B. fever C. nausea and vomiting D. lower abdominal pain

D. lower abdominal pain

When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: A. determine the underlying cause of her problem. B. her gynecologic history. C. keep assessment and treatment to a minimum. D. maintain her ABCs and transport without delay.

D. maintain her ABCs and transport without delay.

Some women experience ___________ during ovulation. Select one: A. hypotension B. severe bleeding C. severe abdominal pain D. slight cramping

D. slight cramping

Pelvic inflammatory disease (PID) typically does NOT affect the: A. ovaries. B. uterus. C. fallopian tubes. D. urinary bladder.

D. urinary bladder.