OBGYN, Neonatology TH Quiz
If the amniotic sac has not ruptured before the delivery of the infant's head you should: A. Continue with the delivery; the sac does not present a problem B. Have the mother pant and stop pushing; this is a true emergency C. Puncture the sac and remove it from around the infant's head D. Immediately cross clamp the cord and deliver the infant
C. Puncture the sac and remove it from around the infant's head
You are preparing to deliver a baby that is 34 weeks gestation. What should you be prepared for in this case? A. Normal full-term delivery B. Fetal death C. Risk of hypothermia D. Transposition of the great vessels
C. Risk of hypothermia
You are treating a 23-year-old woman who complains of diffuse abdominal pain, low-grade fever, and vaginal discharge. She walks with a shuffle, taking short, slow steps. In addition to pain felt when walking, the patient also reports pain with: A. Bending her legs B. Urination C. Sexual intercourse D. Menstruation
C. Sexual intercourse
Seizures present in the newborn that involve eye deviation, paddling movements of the legs, and sucking are called: A. Multifocal B. Focal clonic C. Subtle D. Myoclonic
C. Subtle
The placenta has not delivered within 5 minutes of the infant's birth. You should: A. Gently pull on the placenta to speed delivery B. Wait on scene until the placenta delivers C. Transport the patient and be prepared for placental delivery D. Administer Pitocin to speed delivery of the placenta
C. Transport the patient and be prepared for placental delivery
Vaginal bleeding should be controlled with: A. Administration of Pitocin B. Uterine massage C. Trauma dressings or sanitary pads D. Vaginal packing or tampons
C. Trauma dressings or sanitary pads
Symptoms that are associated with hypoglycemia in the newborn include: A. Lethargy and hyperpnea B. Eye-rolling and hyperactivity C. Twitching and a high-pitched cry D. Eye-rolling and Biot's respirations
C. Twitching and a high-pitched cry p 1631
Which of the following is true of umbilical veins and arteries? A. There are two umbilical veins and one umbilical artery B. An umbilical vein is larger than an umbilical artery C. Umbilical veins have thin walls compared to umbilical arteries D. Umbilical veins spasm and close soon after birth, but arteries remain open
C. Umbilical veins have thin walls compared to umbilical arteries
You are caring for a woman in labor. She has had three previous deliveries and states that her contractions are approximately 3 minutes apart. Physical exam reveals a bulging of tissue at the vaginal opening with each contraction; however, the baby's head is not yet visible. You should: A. perform an internal exam to see how much the cervix is dilated. B. place the mother in the knee-chest position. C. encourage the mother to breathe and ready her for transport. D. prepare for imminent delivery.
C. encourage the mother to breathe and ready her for transport.
Mittelschmerz is characterized by pain: A. Centered around the cervix B. Lasting more than 1 week C. Midcycle in the menstrual period D. During menstruation
C. Midcycle in the menstrual period
The medical history of a woman in her thirty-third week of gestation includes the use of magnesium sulfate and terbutaline. You expect her to have a history of: A. Multiple gestation B. Bacterial vaginosis C. Premature labor D. Placenta previa
C. Premature labor
Which of these events would be the best determinant of whether you stay on the scene and prepare to deliver or transport? A. Strong uterine contractions B. History of previous quick delivery C. Presence of crowning D. Ruptured membranes
C. Presence of crowning
Gestational diabetes is related to: A. Type 1 diabetes in the mother's childhood B. Type 2 diabetes before pregnancy C. Gaining too much weight during pregnancy D. Inability to metabolize carbohydrates
D. Inability to metabolize carbohydrates
The neonate you are caring for has a heart rate of 52 at 30 seconds after delivery. You should first: A. Begin CPR B. Suction vigorously C. Infuse 20 mL of fluid D. Initiate positive-pressure ventilations
D. Initiate positive-pressure ventilations
A newly fertilized ovum is called a: A. Blastocyst B. Morula C. Embryo D. Zygote
D. Zygote
The presence of meconium in amniotic fluid is more common in : A. Infants who develop fetal distress during labor and delivery B. Infants of full-term gestation C. Neonatal death D. Premature delivery
A. Infants who develop fetal distress during labor and delivery
An IUD is a: A. Type of birth control device B. Surgical procedure C. Medication that regulates menstrual cycles D. Disease of the endometrium
A. Type of birth control device
Which of the following describes the appropriate administration of intravenous fluids in a newborn? A. 10 percent dextrose in water, 20 mL/kg, slow IV push B. Normal saline or lactated Ringer's solution 40 mL/kg using a pressure infuser C. Normal saline, 10 mL/kg, slow IV push D. 5 percent dextrose in 0.45 percent saline solution, 30 mL/kg
C. Normal saline, 10 mL/kg, slow IV push
Naloxone is: A. A first-line medication in neonatal resuscitation B. Given only if the mother is addicted to opioids C. Not recommended for initial resuscitation of the newborn D. Given to the neonate through the ET tube for fast absorption
C. Not recommended for initial resuscitation of the newborn
A predisposing factor for ectopic pregnancy is: A. Oral contraceptive use B. Hypertension C. PID D. Previous cesarean delivery
C. PID p 1151
A 37-year-old, obviously pregnant woman complains of sharp, tearing abdominal pain. She reports that she is pregnant with her fifth child, but states she cannot remember the exact due date. The patient has a history of drug use and states that she last smoked crack cocaine approximately 30 minutes ago. You suspect: A. abruptio placentae. B. spontaneous abortion. C. placenta previa. D. false labor.
A. abruptio placentae
When amniotic fluid is stained with meconium and the infant is not vigorous, you should: A. Apply cricoid pressure to prevent aspiration B. Initiate CPR C. Perform ET intubation and endotracheal suctioning immediately after birth D. Place the infant on the side and provide suction with a bulb syringe
C. Perform ET intubation and endotracheal suctioning immediately after birth
How does a history of cesarean delivery affect subsequent pregnancies? A. A woman has greater difficulty getting pregnant following a cesarean delivery B. Previous cesarean delivery may indicate future high-risk pregnancies C. Women who deliver by cesarean cannot have more children D. Multiple births are more common following cesarean delivery
B. Previous cesarean delivery may indicate future high-risk pregnancies
"Newborn" would be the appropriate term for a child who is: A. 2 hours old B. 2 days old C. 2 weeks old D. 2 months old
A. 2 hours old
Which of the following describes an abnormal menstrual period? A. 250 to 500 mL of blood flow B. 4 to 6 days in duration C. Repeats on a 28-day cycle D. Fairly constant duration and cycle from month to month
A. 250 to 500 mL of blood flow
How many days after ovulation is the endometrium ready to receive the developing embryo if fertilization has occurred? A. 7 B. 10 C. 15 D. 21
A. 7
The most common cause of vaginal bleeding during pregnancy is: A. Abortion B. Placenta previa C. Abruptio placentae D. Uterine rupture
A. Abortion
You are treating a pregnant patient in her thirty-fifth week of gestation with her first child. She called 911 for sudden-onset abdominal pain, vaginal bleeding, and contractions. You suspect this patient has: A. Abruptio placentae B. Placenta previa C. Uterine rupture D. Ruptured ectopic pregnancy
A. Abruptio placentae
A 24-year-old female complains of a sudden onset of right-sided abdominal pain. It began as a cramping sensation, but is steady and severe now. She is pale and cool, and her vital signs are: BP 104/76 mmHg, P 128 bpm, R. 20/min. SaO2 97%. She takes no medicines on a daily basis. She has spotty vaginal bleeding and states her last normal menstrual period was 8 weeks ago. You initiate an IV of normal saline. Which intervention should you perform next? A. Administer oxygen 15 lpm by non-rebreather mask B. Give morphine 2-4 mg slow IV for pain relief C. Measure her blood glucose level D. Place her in the modified Trendelenburg position
A. Administer oxygen 15 lpm by non-rebreather mask
A baby girl is born with: A. Approximately 2 million primary oocytes B. 400 primary oocytes C. 10 primary oocytes, which continue to divide until menopause D. No oocytes - they develop during puberty
A. Approximately 2 million primary oocytes
The concern for an infant with a prolapsed cord is that the cord will: A. Be compressed and cut off circulation to the infant B. Become contaminated by the outside environment C. Be too short for an appropriate delivery D. Obstruct the vaginal opening and interfere with delivery
A. Be compressed and cut off circulation to the infant
Status epilepticus in a newborn is generally treated with: A. Benzodiazepines B. Barbiturates C. Neuroleptics D. Paralytics
A. Benzodiazepines
Premature infants have an increased risk for mortality. This could be due to: A. Difficulty in maintaining normothermia B. An inclination for an increased risk of meningitis C. The probability of DIC during the delivery process D. Hyperventilation syndrome, which depletes their oxygen supplies
A. Difficulty in maintaining normothermia
Gender is differentiated during the _____ month of gestation. A. Fourth B. Fifth C. Sixth C. Seventh
A. Fourth
While assisting a woman in labor, she tells you that her baby is expected to weigh more than 10 pounds. The head delivers normally and then pulls back tightly against the perineum. The baby does not deliver after several strong contractions. You should: A. Guide the head downward and attempt to slip the anterior shoulder under the symphysis pubis B. Put the mother in a knee-chest position and transport immediately C. Administer Pitocin to strengthen uterine contractions D. Reach into the vagina past the baby's head to determine what is obstructing delivery
A. Guide the head downward and attempt to slip the anterior shoulder under the symphysis pubis
The most common cause of bradycardia in a newborn is: A. Hypoxia B. Increased intracranial pressure C. Hypothyroidism D. Acidosis
A. Hypoxia
Which of the following are likely to occur when suctioning a newborn's airway? A. Hypoxia, bradycardia B. Vagal stimulation, tachycardia C. Hypoxia, ventricular fibrillation D. Hypoxia, tachycardia
A. Hypoxia, bradycardia p 1621
The goal of treatment in the field for a woman with abdominal pain and vaginal bleeding is to: A. Identify life-threatening conditions and transport rapidly B. Determine the cause of the bleeding C. Rule out ectopic pregnancy D. Aggressively manage the cause of the bleeding
A. Identify life-threatening conditions and transport rapidly
Vomiting in a newborn who is 18 hours old is suggestive of: A. Increased intracranial pressure B. Haemophilus influenzae C. Oxygen toxicity D. Hypoglycemia
A. Increased intracranial pressure
Which of the following statements is TRUE of prehospital newborn care? A. Low-birth-weight babies are much more likely to require immediate assistance after delivery. B. It is impossible to anticipate which deliveries may result in the need for newborn resuscitation. C. Sixty percent of newborns delivered outside a hospital require some form of resuscitation. D. Newborns weighing over 2,500 grams are at higher risk of respiratory compromise.
A. Low-birth-weight babies are much more likely to require immediate assistance after delivery.
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar003-1.jpg, P 84, R 20. If the patient begins to seize, medical direction may order administration of: A. Magnesium sulfate B. Calcium gluconate C. Naloxone D. Morphine
A. Magnesium sulfate
You are treating a 23-year-old woman who complains of diffuse abdominal pain, low-grade fever, and vaginal discharge. She walks with a shuffle, taking short, slow steps. The causative agent for this condition is most commonly this sexually transmitted disease: A. N. gonorrhoeae B. Staphylococci C. Streptococci D. N. syphilis
A. N. gonorrhoeae
You are examining a woman in her eighth month of pregnancy and discover that her blood pressure is 100/70, her heart rate is 90, and her respirations are 20. These vital signs indicate: A. Normal changes during pregnancy B. Moderate hypovolemia at this stage of pregnancy C. Severe dehydration D. The patient is hypoxic
A. Normal changes during pregnancy
As she is pushing, your patient, who is at 34 weeks' gestation, states that the baby is coming. You notice a cord protruding from the vagina. You should: A. Place the mother in the knee-chest position B. Deliver the infant as quickly as possible C. Replace the cord into the vagina D. Cut and clamp the cord
A. Place the mother in the knee-chest position
The term "gravida" refers to the number of: A. Pregnancies B. Live births C. Weeks of gestation D. Weeks until delivery
A. Pregnancies
Which of the following is the initial step in neonatal assessment and management ? A. Prevent heat loss and avoid hypothermia B. Position the infant C. Provide tactile stimulation and initiate breathing if necessary D. Suction the airway
A. Prevent heat loss and avoid hypothermia
The term for a first-time pregnant patient is: A. Primigravida B. Nullipara C. Gravidapara D. Unogravida
A. Primigravida
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar003-1.jpg, P 84, R 20. The classic presentations of this syndrome are hypertension, excessive weight gain, and: A. Proteinuria B. Seizures C. Hypoglycemia D. Increased intracranial pressure
A. Proteinuria
A newborn has just been delivered. You notice a greenish-brown substance on the infant, and observe a vigorous cry and active movement. What is the appropriate way to manage this patient? A. Rub the infant with a dry towel and place on the mother's chest. B. Lay the infant supine and place padding behind the shoulders. C. Prepare to suction the trachea with an endotracheal tube and meconium aspirator. D. Using a bulb syringe, suction the nose and then the mouth.
A. Rub the infant with a dry towel and place on the mother's chest.
If a pregnant patient informs you that her membranes ruptured 5 days ago, what problem should you anticipate? A. Sepsis B. Hypovolemia C. Uterine rupture D. Placenta previa
A. Sepsis
The placenta is a(n): A. Specialized structure of pregnancy that is not present in the nonpregnant uterus B. Uterine organ that is present from birth C. Organ that develops during puberty and is shed during menopause D. Fetal organ that is absorbed into the embryo by the fifth month
A. Specialized structure of pregnancy that is not present in the nonpregnant uterus
You are treating a 30-year-old woman who is 6 weeks pregnant with her first child. She has severe abdominal pain centered in the left lower quadrant. She reports vaginal spotting that began an hour ago. The usual treatment for this condition is: A. Surgery B. Antibiotic therapy C. Removal of the uterus following delivery D. Hormone therapy
A. Surgery
Hysterectomy is most often performed to treat what condition? A. Symptomatic fibroid tumors B. Heavy menstrual bleeding C. Pelvic inflammatory disease D. Endometriosis
A. Symptomatic fibroid tumors
A 30-year-old woman complains of swelling in both of her legs. She is 32 weeks pregnant, and states that she has also developed varicose veins over the past few weeks. Which of the following BEST explains the cause of this patient's signs and symptoms? A. The gravid uterus compresses the pelvic and femoral vessels, decreasing venous return and causing venous stasis. B. The gravid uterus compresses the superior vena cava, decreasing venous return to the heart. C. Changes in kidney function alter the normal electrolyte balance, causing tissue edema in the legs and feet. D. Changes in the endocrine system cause peripheral edema during the late stages of pregnancy.
A. The gravid uterus compresses the pelvic and femoral vessels, decreasing venous return and causing venous stasis.
The preferred technique for neonatal CPR is: A. The use of two thumbs, with the hands encircling the chest B. Two-finger chest compression C. Alternate positive-negative pressure compression D. Compression supplied by an automatic pumping device
A. The use of two thumbs, with the hands encircling the chest
The best position in which to transport a pregnant trauma patient with possible spinal injury is with cervical spine immobilization and a long backboard: A. Tilted to the left B. Flat on the stretcher C. With the head elevated 30 degrees D. Raised several inches at the feet
A. Tilted to the left
While assisting in the delivery of twins, you note an arm protruding from the vagina. This is the only visible part of the infant. You should: A. Transport immediately B. Attempt to turn the infant C. Deliver the anterior shoulder D. Position the mother on her side to promote stronger contractions
A. Transport immediately
A 29-year-old woman is 28 weeks pregnant. She complains of nausea, abdominal pain, and right shoulder pain. She states she vomited once, which caused temporary relief; however, the pain returned shortly afterward. She has no pertinent medical history or allergies, has stable vital signs, and states that she ate a cheeseburger about 20 minutes prior to the start of her pain. The most likely cause of this patient's presentation is: A. cholecystitis. B. appendicitis. C. food poisoning. D. hyperemesis gravidarum.
A. cholecystitis.
You are caring for a 42-year-old woman who is 32 weeks pregnant with twins. She is complaining of a severe headache and blurred vision, and lives in a rural area approximately 30 miles from the nearest ED. Your physical exam reveals significant peripheral edema and the following vital signs: heart rate 98, blood pressure 156/98 mmHg, respirations 18. The patient states she has a history of hypertension, but has not taken her prescribed medications because "they aren't safe for the babies." Appropriate treatment for this patient includes: A. intravenous magnesium sulfate and rapid transport. B. administration of aspirin and a prehospital stroke assessment. C. intravenous calcium chloride and 12-lead ECG. D. administration of nitroglycerine and delayed transport.
A. intravenous magnesium sulfate and rapid transport.
What modifications of the usual management of cardiac arrest should be made for a pregnant patient? A. Deliver low-flow oxygen to prevent fetal oxygen toxicity B. Administer vasopressors at double the usual dose C. Perform cardiac compressions higher on the sternum D. Deliver small boluses of crystalloids to prevent fetal pulmonary edema
C. Perform cardiac compressions higher on the sternum
Painless vaginal bleeding during pregnancy is most likely related to: A. Abruptio placentae B. Placenta previa C. Uterine rupture D. Ruptured ectopic pregnancy
B. Placenta previa
You have recently intubated a neonate. After about 10 minutes, you notice that the patient's heart rate is 82, you have poor compliance while ventilating, and there is acrocyanosis. You suspect: A. Tracheal atresia B. Pneumothorax C. Pierre Robin syndrome D. Respiratory acidosis
B. Pneumothorax
The correct dose of fluids for treating hypovolemia in a neonate is: A. 10 mL every 5 minutes B. 10 mL/kg over 5-10 minutes, then reassess C. Repeated boluses of 1 mL/kg until perfusion improves D. 100 mL, then reassess
B. 10 mL/kg over 5-10 minutes, then reassess
At what age does menarche usually occur? A. 10 years B. 13 years C. 47 years D. 50 years
B. 13 years
A pregnant patient can't remember how many weeks she is into her pregnancy. On exam, you feel the fundus of the uterus at the level of the umbilicus, leading you to conclude that she has been pregnant for: A. 12 weeks B. 18 weeks C. 24 weeks D. 30 weeks
B. 18 weeks
The ventilation-to-compression ratio for a newborn is: A. 1:1 B. 1:3 C. 1:5 D. 1:7
B. 1:3
A woman who is gravida 4, para 3, has been pregnant: A. 7 times B. 4 times C. 3 times D. 1 time
B. 4 times
Which of the following is considered normal after the delivery of a newborn? A. Central cyanosis B. Acrocyanosis C. Methocyanosis D. Periumbilical cyanosis
B. Acrocyanosis
You are treating a 23-year-old woman who complains of diffuse abdominal pain, low-grade fever, and vaginal discharge. She walks with a shuffle, taking short, slow steps. The usual definitive treatment for this condition is: A. Antiviral therapy B. Antibiotic therapy C. Surgery to remove affected tissues D. Complete hysterectomy
B. Antibiotic therapy
You have just assisted in the delivery of a 34-week-gestation infant in the office of a methadone clinic. After 30 seconds of drying and stimulation, the infant remains limp and cyanotic, with a pulse of 50. Which of the following is the most appropriate action to take at this point? A. Continue to warm and dry the infant for an additional 30 seconds, while preparing to intubate. B. Begin CPR at a rate of 3 compressions to 1 ventilation. C. Begin bag-valve-mask ventilations and establish intravenous access. D. Intubate the trachea, ventilate, reassess, and prepare to transport to a NICU.
B. Begin CPR at a rate of 3 compressions to 1 ventilation.
While suctioning a neonate, you should watch for: A. Ventricular arrhythmias B. Bradycardia C. Hypothermia D. Reflex tachycardia
B. Bradycardia
The greatest risk factor for birth injuries is: A. Uncontrolled explosive delivery B. Breech delivery C. Strong uterine contractions D. Prolonged delivery time
B. Breech delivery
The ductus venosus allows blood to: A. Circulate directly from the mother to the fetus B. Bypass the immature fetal liver C. Travel through the nonfunctional fetal lungs D. Transverse directly from the right atrium to the right ventricle
B. Bypass the immature fetal liver
A fissure in the roof of the mouth that runs along its midline is: A. Cleft lip B. Cleft palate C. Choanal atresia D. Pierre Robin syndrome
B. Cleft palate
During the first 8 weeks of pregnancy, the developing ovum is known as a(n): A. Oocyte B. Embryo C. Fetus D. Zygote
B. Embryo
The most serious complication of a ruptured ovarian cyst is: A. Ectopic pregnancy B. Hemorrhage C. Infection D. Loss of future ovarian function
B. Hemorrhage
Abruptio placentae is often associated with: A. Teen pregnancy, trauma B. Hypertension, preeclampsia C. Trauma, preterm labor D. Preterm labor, hypertension
B. Hypertension, preeclampsia
A fetal heart rate of 80 indicates: A. Fetal pain B. Hypoxia C. Maternal dehydration D. A normal finding
B. Hypoxia
Many patients with pain caused by gynecological complaints prefer to be transported: A. Sitting on the bench seat B. In a left-lateral recumbent position C. Lying prone D. Lying supine with legs extended
B. In a left-lateral recumbent position
When treating a patient who was sexually assaulted: A. Assess a thorough history of the assault for reporting purposes B. Limit the history of the event to elements necessary for care C. Genital examination is mandatory for accurate assessment D. Allow the patient to express feelings with no fear that his or her words will be reported
B. Limit the history of the event to elements necessary for care
A blood glucose level in an infant of 35 mg/dL indicates: A. Normal blood glucose B. Low blood glucose C. Elevated blood glucose D. Dangerously high blood glucose
B. Low blood glucose
When amniotic fluid is stained with meconium and the infant is vigorous, you should: A. Initiate positive-pressure ventilation B. Manage the airway in the normal fashion since no special care is required C. Intubate and suction the trachea D. Position the infant head down to facilitate drainage
B. Manage the airway in the normal fashion since no special care is required
When newborns are hypothermic, the demand on the body to maintain temperature can cause: A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D.Metabolic alkalosis
B. Metabolic acidosis
Termination of a pregnancy by any cause prior to 20 weeks' gestation is termed: A. Abortion B. Miscarriage C. Preterm delivery D. Incomplete gestation
B. Miscarriage
Dysmenorrhea means that a woman experiences: A. Irregular menstrual cycles B. Pain with menstruation C. No menstrual period D. Very small blood loss with each menstrual period
B. Pain with menstruation
Fever of 101° F in a newborn: A. Is likely due to rebound hyperthermia B. Requires evaluation by a physician C. Generally results from aspiration pneumonia D. Is no cause for concern if resolved within 24 hours
B. Requires evaluation by a physician
A woman who recently suffered a miscarriage now has endometritis, which is typically caused by: A. Infection resulting from instruments B. Retained placental tissue C. Hormone imbalance D. Uterine contractions
B. Retained placental tissue
Your pregnant patient's baby is crowning. Her contractions are 1 minute apart. She is a gravida 3, para 2. You should: A. Transport immediately B. Stay and prepare to assist delivery C. Prepare for delivery, while traveling with lights and sirens D. Reassure the mother that she will not deliver for about 60 minutes
B. Stay and prepare to assist delivery
Secondary apnea means the neonate: A. Stops breathing after resuscitation, but begins again spontaneously B. Stops breathing and does not begin again spontaneously C. Has an apneic event that occurs 24 hours after birth D. Has a self-limited condition that is common after birth
B. Stops breathing and does not begin again spontaneously
D and C is a: A. Type of birth-control device B. Surgical procedure C. Medication that regulates menstrual cycles D. Disease of the endometrium
B. Surgical procedure
You have just delivered a newborn at 38 weeks of gestational age. As you assess this patient, you discover a scaphoid abdomen and unusual sounds in the left lower chest. The neonate is exhibiting mild respiratory distress. Definitive care for this patient includes: A. Long-term positive-pressure ventilation B. Surgical repair C. Rest, with adequate nutrition D. Needle decompression
B. Surgical repair
Immediately after birth, which of these things happens for the first time? A. The heart begins to beat B. The alveoli open C. Blood is circulated D. Maternal blood bypasses the fetal lungs
B. The alveoli open
If a pregnant woman loses 30% of her blood volume, you would expect the mother: A. And fetus to tolerate this loss well B. To show minimal changes, but the fetus will be distressed C. To show signs of extreme hypoperfusion but the fetus to tolerate the loss well D. And fetus to be gravely hypoxic
B. To show minimal changes, but the fetus will be distressed
Analgesic therapy for abdominal pain should be: A. Administered orally B. Withheld until after physician evaluation C. Given intravenously D. Given by IM or SQ injection
B. Withheld until after physician evaluation
You are caring for a woman who is 32 weeks pregnant. While assessing her breathing, you notice that her rib cage expands visibly with each breath and that her tidal volume appears to be deep. You recognize: A. signs of obstructive shock. B. an increase in tidal volume that is normal during pregnancy. C. an increase in oxygen demand due to an obstetrical emergency. D. signs of a severe respiratory condition requiring immediate intervention.
B. an increase in tidal volume that is normal during pregnancy.
A woman late in her pregnancy is in cardiac arrest. When resuscitating this patient, it is appropriate to: A. compress at a rate of at least 120 per minute. B. lift and push the gravid uterus to the left. C. use a mechanical compression device. D. assess for imminent delivery.
B. lift and push the gravid uterus to the left.
Oxygenated blood is delivered to the fetus via: A. two umbilical veins B. one umbilical vein C. two umbilical arteries D. one umbilical artery
B. one umbilical vein
You are caring for a patient who is 36 weeks pregnant. She states that she has been experiencing vaginal bleeding after intercourse, and denies any associated pain. Vital signs are: heart rate 84, respirations 18, blood pressure 102/72 mmHg, and warm, dry skin. The most likely cause of this patient's vaginal bleeding is: A. false labor. B. placenta previa. C. abruptio placentae. D. spontaneous abortion.
B. placenta previa.
Immediately after delivery, a neonate is crying and moving his arms and legs, but is centrally cyanotic. You recognize: A. signs of a congenital heart abnormality. B. signs of a normal, healthy infant. C. the need for supplemental oxygen. D. the need to prevent further heat loss.
B. signs of a normal, healthy infant.
You can estimate the amount of vaginal blood lost by asking the patient: A. "Is there more or less blood than during your normal period?" B. "How much blood have you lost?" C. "How many pads or tampons were soaked per hour?" D. "For how many hours have you been bleeding?"
C. "How many pads or tampons were soaked per hour?"
Tidal volume and minute ventilation increase during pregnancy by: A. 10 to 20% B. 20 to 30% C. 30 to 40% D. 40 to 50%
C. 30 to 40%
On 1-minute evaluation of a newborn infant, you note the infant has blue arms and legs, a pink trunk, and a heart rate of 120. He is crying loudly and moving all extremities. The patient sneezes when stimulated. This patient's APGAR score is: A. 7 B. 8 C. 9 D. 10
C. 9
After cutting the umbilical cord, you note that the cord is bleeding below one clamp. You should: A. Not be concerned, because this is normal after delivery B. Transport the mother and child to the hospital rapidly C. Add a second clamp below the bleeding site D. Remove the clamp and move it to a lower place on the cord
C. Add a second clamp below the bleeding site
Stage II labor ends when the: A. Cervix is fully dilated B. The baby enters the birth canal C. Baby is delivered D. Placenta is delivered
C. Baby is delivered
After assisting with delivery, you dry, suction, and stimulate the newborn. He is still not breathing. You should: A. Administer epinephrine and atropine B. Administer chest compressions C. Begin positive-pressure ventilation D. Give blow-by oxygen
C. Begin positive-pressure ventilation
Hypothermia has the following effect on a newborn: A. Alkalosis B. Hypercarbia C. Bradycardia D. Hyperglycemia
C. Bradycardia
A fertilized oocyte secretes _____ to keep the corpus luteum from degenerating. A. Estrogen B. Progesterone C. Chorionic gonadotropin D. Follicle-stimulating hormone
C. Chorionic gonadotropin
Endometriosis is most common in women who: A. Have more than one child B. Begin menstruating at a young age C. Defer pregnancy D. Take oral contraceptives
C. Defer pregnancy
You are treating an apneic neonate with a heart rate of 110. Her mother is an opium addict. If apnea persists, you should administer: A. Epinephrine B. Naloxone C. Dextrose D. Flumazenil
C. Dextrose
You have just delivered a newborn at 38 weeks of gestational age. As you assess this patient, you discover a scaphoid abdomen and unusual sounds in the left lower chest. The neonate is exhibiting mild respiratory distress. Based on this presentation, you suspect: A. Tension pneumothorax B. Choanal atresia C. Diaphragmatic hernia D. Gastrothorax syndrome
C. Diaphragmatic hernia
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP 174/104, P 84, R 20. If this patient developed seizures or coma, the condition would be called: A. Essential hypertension B. Gestational hypertension C. Eclampsia D. Preeclampsia
C. Eclampsia
You are treating a 30-year-old woman who is 6 weeks pregnant with her first child. She has severe abdominal pain centered in the left lower quadrant. She reports vaginal spotting that began an hour ago. The most serious condition that could explain this presentation is: A. Endometriosis B. Ruptured ovarian cyst C. Ectopic pregnancy D. PID
C. Ectopic pregnancy
A neonate's heart rate is 50 after 30 seconds of positive-pressure ventilation and effective chest compressions. You should administer: A. An IV bolus of sodium bicarbonate B. Glucagon C. Epinephrine D. Naloxone
C. Epinephrine
What hormone stimulates the endometrium to grow and increase in thickness, preparing the uterus for the implantation of a fertilized ovum? A. Luteinizing hormone B. Progesterone C. Estrogen D. Chorionic gonadotropin
C. Estrogen
Sperm normally fertilize a mature ovum in the: A. Ovary B. Ovarian follicle C. Fallopian tube D. Uterus
C. Fallopian tube
What stimulates the development of the follicle, including the cells that produce estrogen? A. Luteinizing hormone B. Progesterone C. Follicle-stimulating hormone D. Chorionic gonadotropin
C. Follicle-stimulating hormone
IV access for patients with gynecological complaints: A. Should be initiated prior to transport B. Can wait until transport begins C. Is usually unnecessary D. Can be detrimental to the patient
C. Is usually unnecessary
If bag-mask ventilations are ineffective and tracheal intubation has failed, you should consider: A. Surgical cricothyrotomy B. Combitube insertion C. LMA insertion D. Digital intubation
C. LMA insertion
A 42-year-old woman is 38 weeks pregnant and in active labor. While assessing for crowning, you notice that although the top of the baby's head is visible, a loop of the umbilical cord is protruding from the vagina. You should: A. gently attempt to reinsert the cord into the vaginal canal. B. clamp and cut the presenting section of the umbilical cord. C. insert two fingers to raise the head of the baby off the cord. D. encourage the mother to push while gently pulling traction.
C. insert two fingers to raise the head of the baby off the cord.
At what rate per minute should chest compressions be performed in a neonate? A. 60 B. 80 C. 100 D. 120
D. 120
You are instructed to administer 10% dextrose to a newborn patient. Your drug box contains an ampule of 50% dextrose. You will be able to prepare a solution of 10% dextrose by diluting 1 mL of 50% dextrose with _____ mL water. A. 1 B. 2 C. 3 D. 4
D. 4
Braxton-Hicks contractions: A. Signal the beginning of labor B. Occur after 35 weeks of gestation C. Subside with rest D. Are generally benign
D. Are generally benign
If your patient inverts her uterus immediately after delivery of the infant, it is important to: A. Quickly pull on the placenta to reduce bleeding B. Wrap the uterus and placenta in dry towels C. Soak the placenta in a saline bath to keep it from drying D. Attempt to reinsert it once, without removing the placenta
D. Attempt to reinsert it once, without removing the placenta
Two criteria that might be used to determine prematurity are length of pregnancy and: A. Length of femur B. Head size C. Development of abdominal organs D. Body weight
D. Body weight
When assessing the perineum of a woman in labor, you see the head of the infant bulging at the vaginal opening. This is called: A. Labor B. Stage II C. Expulsion D. Crowning
D. Crowning
You are treating a woman with a fever, chills, and lower abdominal pain. She tells you that she has been urinating frequently and feels the need to urinate urgently. Only a small amount of urine is passed each time, causing intense burning. These are classic symptoms of: A. Chlamydia B. PID C. Ovarian cyst D. Cystitis
D. Cystitis
After delivery of the infant, the mother continues to bleed briskly, losing approximately 1 L of blood. You should: A. Do nothing; this is normal after delivery B. Pack the vagina with sterile dressings and transport quickly C. Administer 1 to 2 g of magnesium sulfate D. Encourage the mother to breast-feed the infant and massage the uterus
D. Encourage the mother to breast-feed the infant and massage the uterus
Options for tactile stimulation of an infant include: A. Slapping the buttocks B. Administering a sternal rub C. Pinching the tendon above the clavicle D. Flicking the soles of the feet
D. Flicking the soles of the feet
Endometriosis occurs when: A. The walls of the uterus become inflamed B. The fallopian tubes become blocked C. An ovarian cyst ruptures D. Fragments of the endometrium grow in the peritoneal cavity
D. Fragments of the endometrium grow in the peritoneal cavity
As you are delivering an infant, you note that the cord is loosely wrapped around the infant's neck. You should: A. Delay delivery as long as possible B. Wrap the cord in warm moist dressings C. Cut the cord and remove it from around the infant's neck D. Gently slip the cord over the infant's head
D. Gently slip the cord over the infant's head
You have just delivered an infant at 33 weeks gestation. The infant is blue and limp and has a brachial pulse of 70 beats per minute. What is the appropriate sequence of care for this infant? A. Clamp and cut the cord, positive pressure ventilations, keep warm and dry. B. Keep warm and dry, chest compressions, clamp and cut the cord. C. Clamp and cut the cord, chest compressions, positive pressure ventilations. D. Keep warm and dry, clamp and cut the cord, positive pressure ventilations.
D. Keep warm and dry, clamp and cut the cord, positive pressure ventilations.
The best position in which to transport a pregnant patient with no traumatic injuries is: A. Right medial recumbent B. Supine C. Sitting up, leaning slightly forward D. Left lateral recumbent
D. Left lateral recumbent
A 27-year-old pregnant woman was the restrained driver of a vehicle that hit the guardrail at a high rate of speed. She sustained a large laceration to the upper thigh and has lost a significant amount of blood. Vital signs are: heart rate 102, blood pressure 118/78 mmHg, respirations 18, and her skin is pale and clammy. Which of the following BEST explains this patient's presentation? A. Fetal oxygen demand increases after trauma, causing maternal blood pressure and heart rate to increase immediately after injury. B. Maternal blood volume decreases during pregnancy, amplifying the effects of epinephrine and allowing for the maintenance of blood pressure. C. Maternal vital signs remain normal following trauma to ensure the survival of the developing fetus. D. Maternal blood volume increases during pregnancy, allowing vital signs to remain normal despite significant blood loss.
D. Maternal blood volume increases during pregnancy, allowing vital signs to remain normal despite significant blood loss.
The leading cause of maternal injury is: A. Interpersonal violence B. Falls C. Penetrating objects D. Motor vehicle crashes
D. Motor vehicle crashes
When using a bulb syringe to suction an infant just delivered, which of the following should you suction first? A. Trachea B. Pharynx C. Nose D. Mouth
D. Mouth
Abdominal pain in a woman that presents 1 week after menstruation is typical of: A. Mittelschmerz B. Ruptured ectopic pregnancy C. Ruptured ovarian cyst D. PID
D. PID
You are treating a 23-year-old woman who complains of diffuse abdominal pain, low-grade fever, and vaginal discharge. She walks with a shuffle, taking short, slow steps. This patient most likely has: A. Syphilis B. Endometriosis C. Ruptured ovarian cyst D. Pelvic inflammatory disease
D. Pelvic inflammatory disease
Correct positioning of a newborn includes: A. Flexing the neck B. Hyperextending the neck C. Placing padding under the patient's head D. Placing the head in the neutral and slightly extended position
D. Placing the head in the neutral and slightly extended position
A 38-year-old pregnant woman called 911 after she developed a "splitting headache" unrelieved by over-the-counter analgesics. She states that she has a previous diagnosis of diabetes that is typically well controlled with insulin injections. This patient's history of diabetes makes her more likely to develop which of the following pregnancy-related conditions? A. Cerebral aneurysm B. Stroke C. Congestive heart failure D. Preeclampsia
D. Preeclampsia
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar003-1.jpg, P 84, R 20. You suspect this patient has: A. Essential hypertension B. Gestational hypertension C. Eclampsia D. Preeclampsia
D. Preeclampsia
The single most common cause of respiratory distress and cyanosis in a newborn is: A. Hypothermia B. Small size for gestational age C. Narcotic depression D. WePrematurity
D. Prematurity
An intrapartum risk factor that may affect the need for neonatal resuscitation is: A. Postterm gestation B. Inadequate prenatal care C. Single gestation D. Prolapsed cord
D. Prolapsed cord
Supportive and kind care for a sexual assault patient includes: A. Allowing the patient to wash before transport B. Discarding the patient's clothes if they are bloody C. Cleaning and bandaging the patient's minor cuts and scratches D. Providing emotional support by a same-sex paramedic, if possible
D. Providing emotional support by a same-sex paramedic, if possible
A 26-year-old pregnant female complains of feeling faint. You find her supine on the floor of a shopping mall. Bystanders state she became very weak, vomited, and then they lowered her gently to the floor. Her due date is in two weeks. She is pale and cool and has a rapid, thready radial pulse. Which action should you take first? A. Assess her oxygen saturation B. Initiate two large bore IVs C. Measure a complete set of vital signs D. Roll her onto her left side
D. Roll her onto her left side
Which of the following is true of sexual assault? A. Boys are girls are assaulted in equal numbers B. Rape is a rare occurrence; 1 in 1000 women report rape C. Most crimes of rape are reported to authorities and require ambulance transport D. Supportive care is the usual EMS treatment
D. Supportive care is the usual EMS treatment
A breech birth is one in which the: A. Infant's head is face up instead of face down B. Cord precedes the head in the vaginal opening C. Shoulders have become lodged in the vaginal opening D. The head is delivered last
D. The head is delivered last
Your patient is a 40-year-old female, gravida 6, para 5. She is complaining that this labor is unlike her others. She has sharp, constant abdominal pain and vaginal bleeding, and she feels like something is "tearing." You suspect: A. Abruptio placentae B. Placenta previa C. Spontaneous abortion D. Uterine rupture
D. Uterine rupture
Feverish infants generally do not exhibit: A. A rise in temperature to more than 100.4° F B. Mental status changes C. Warm or hot skin D. Visible sweat on their bodies
D. Visible sweat on their bodies
A 24-year-old pregnant woman is actively seizing. Her partner reports that she complained of abdominal pain approximately 10 minutes ago, and then began seizing. He reports that the seizure activity has been consistent for the past 10 minutes, and that she has no significant medical history. You should: A. suction the airway, obtain IV access, and assess blood pressure. B. insert a nasal airway, administer midazolam, and obtain vital signs. C. apply a nasal cannula, assess blood glucose level, and transport in the left lateral position. D. apply high-flow oxygen, administer magnesium sulfate, and transport emergently.
D. apply high-flow oxygen, administer magnesium sulfate, and transport emergently. P 1586
You have just delivered a healthy newborn to a 35-year-old woman. There is a steady flow of blood from the vagina and her uterus feels soft upon palpation. Her vital signs are: heart rate 122, respirations 20, blood pressure 90/60 mmHg. Appropriate management of this patient includes: A. sanitary pads placed over the vagina and continued monitoring. B. Trendelenberg position and administration of magnesium sulfate. C. low-flow oxygen and position of comfort. D. two large-bore IVs and oxytocin administration.
D. two large-bore IVs and oxytocin administration.
Newborns are stimulated to breathe in response to chemical changes and changes in: A. Pressure B. Temperature C. Atmospheric lighting D. Ambient noise
Not A
Which of the following is an antepartum risk factor that may affect the need for neonatal resuscitation? A. Premature labor B. Mother younger than 16 or older than 35 C. Meconium staining D. Prolapsed cord
Not A
The initial management for a neonate with bradycardia is to: A. Suction the airway B. Begin positive-pressure ventilation C. Intubate the trachea D. Assess for upper airway obstruction
Not A or B
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar003-1.jpg, P 84, R 20. The cause of this condition is: A. Excessive sodium intake B. Fetal pressure on the vena cavae C. Genetic abnormality D. Unknown
Not A or B
You are responding to a call for a 17-year-old pregnant patient at 36 weeks' gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP nar003-1.jpg, P 84, R 20. The patients most likely to experience this condition are: A. First-time mothers B. Women with previous histories of hypertension C. Patients taking steroids D. Older patients
Not B
You are caring for a 19-year-old woman who states that she is 32 weeks pregnant. She is experiencing cramping abdominal pain every six to seven minutes and reports a brief period of fluid discharge from her vagina approximately 15 minutes ago. You should: A. administer ondansetron and reassess vital signs. B. provide routine BLS care and transport. C. apply oxygen and perform a physical exam. D. begin a fluid bolus and transport code 3.
Not B or C
A 56-year-old woman states she has been having severe cramping and vaginal bleeding for several days. She reports soaking 8 sanitary napkins in the past half hour. As you question her, you note a red stain begin to encircle the bed sheets beneath her. Her vital signs are: BP 78/58 mmHg, P 132 bpm, R. 20/min., Sa02 95%. Which of the following interventions is appropriate at this time? A. Administer ketoradol 60 mg IM to relieve cramping B. Give oxytocin 10 units IM to promote uterine contraction C. Pack her vagina with gauze to tamponade the bleeding D. Place her in the modified Trendelenburg position
Not D
At the 1-minute evaluation, a neonate's APGAR score is 5, indicating: A. A normal finding at 1 minute B. The infant requires no additional resuscitation C. The administration of oxygen and stimulation are needed D. Chest compressions and medication administration should be initiated
Not D
The primary danger to the fetus of a rapid, uncontrolled delivery of the fetal head is: A. Fetal asphyxiation B. Apnea C. Tearing of the umbilical cord D. Shoulder dystocia
Not D
Which type of seizure is not usually a concern for the neonatal age group? Subtle Febrile Status Focal
Not subtle
