Question 1

``` H-1) The lowest portion of the​ uterus, which must dilate to allow​ childbirth, is called​ the: A. uterine body. B. myometrium. C. cervix. D. fundus. ```

Accepted Answer

C. cervix. The cervix is the lowest and narrowest portion of the​ uterus, the neck of the uterus at the entrance to the birth canal. The cervix must thin and dilate to allow the fetus to pass from the uterus into the vagina.

Question 2

``` H-2) Under normal​ circumstances, the fertilized egg is implanted into and develops in​ the: A. cervix. B. placenta. C. fallopian tube. D. uterus. ```

Accepted Answer

D. uterus. The uterus is the structure in which a fertilized egg is implanted and develops into an​ embryo, and then a​ fetus, during pregnancy.

Question 3

``` H-3) During​ labor, the cervix​ typically: A. relaxes and expands. B. rotates and dilates. C. thickens and contracts. D. thins and dilates. ```

Accepted Answer

D. thins and dilates. The cervix thins and​ dilates, allowing the uterus to contract and push the fetus out.

Question 4

H-4) Which of the following statements about pregnancy is​ true? A. Although blood volume​ increases, the number of red blood cells decreases. B. The cardiovascular system responds to pregnancy by increasing blood​ volume, increasing cardiac​ output, and increasing heart rate. C. The blood pressure of a pregnant female is usually slightly increased. D. The vascularity of the uterus and related structures is decreased.

Accepted Answer

B. The cardiovascular system responds to pregnancy by increasing blood​ volume, increasing cardiac​ output, and increasing heart rate. The cardiovascular system responds to pregnancy by increasing blood​ volume, increasing cardiac​ output, and increasing heart rate. Although blood volume​ increases, the number of red blood cells remains the same. This causes a dilution of the​ blood, referred to as anemia​, and it should be remembered that although there is more​ blood, its​ oxygen-carrying capacity is actually decreased. The blood pressure of a pregnant female is usually slightly​ decreased, but high blood pressure can occur as well. There is also a massive increase in vascularity​ (presence of blood and blood​ vessels) in the uterus and related structures.

Question 5

H-5) Which of the following statements about fetal development is​ true? A. The uterus grows to reach the umbilicus by the third month. B. The 9 months of pregnancy are divided into three​ 3-month periods, or semesters. C. There is rapid uterine growth during the first trimester when the fetus is being formed. D. The uterus grows to reach the epigastrium by the seventh month.

Accepted Answer

D. The uterus grows to reach the epigastrium by the seventh month. The 9 months of pregnancy are divided into three​ 3-month periods, or trimesters. During the first​ trimester, the fetus is being formed. Since the fetus remains quite​ small, there is little uterine growth during this period. After the third​ month, the uterus grows​ rapidly, reaching the umbilicus​ (navel) by the fifth month and the epigastrium​ (upper abdomen) by the seventh month.

Question 6

``` H-6) Your pregnant patient is in the third trimester. You have ruled out possible cervical spine injury. How should you transport the​ patient? A. Prone B. On her left side C. Supine D. In the Trendelenburg position ```

Accepted Answer

B. On her left side To take the weight off the vena cava and counteract or avoid the possible drop in blood​ pressure, all​ third-trimester patients should be transported on their left sides. A pillow or rolled blanket should be placed behind the back to maintain proper positioning.

Question 7

H-7) You are caring for a pregnant trauma patient with a possible cervical spine injury. She is due to deliver within the next month. How should you transport the​ patient? A. With spinal​ precautions, as you would do normally B. Without spinal​ precautions, on her left side C. With spinal​ precautions, with patient and board tilted to the left as a unit D. Without spinal​ precautions, on her right side

Accepted Answer

C. With spinal​ precautions, with patient and board tilted to the left as a unit ​Third-trimester patients should be moved to a lateral position and transported on their left sides to take the weight off the vena​ cava, to counteract or avoid a possible drop in blood pressure. When spinal injury is​ involved, however, you must take spinal precautions while avoiding supine hypotensive syndrome. The patient is not able to be moved to a lateral position. She must be secured to a spine​ board, then the board and patient should be tipped to the left as a​ unit, relieving pressure on the abdominal organs and vena cava.

Question 8

``` H-8) Which of the following events reliably occurs during the second stage of​ labor? A. The infant is delivered. B. The mucus plug is lost. C. The placenta is delivered. D. The bag of waters breaks. ```

Accepted Answer

A. The infant is delivered. The second stage of labor is defined as the period from complete cervical dilation through delivery of the infant.

Question 9

``` H-9) During which stage of labor does the cervix reach full​ dilation? A. First stage B. Third stage C. Braxton-Hicks stage D. Second stage ```

Accepted Answer

A. First stage The end of the first stage of labor is marked by complete dilation of the cervix.

Question 10

``` H-10) To assess your pregnant patient for​ crowning, you​ must: A. wait for ALS personnel to arrive. B. place the patient in the ambulance. C. obtain online medical direction. D. visualize the vaginal opening. ```

Accepted Answer

D. visualize the vaginal opening.

Question 11

``` H-11) Your pregnant patient is​ contracting, and delivery appears imminent. Part of your care for the mother must​ include: A. vitals every 5 minutes. B. immediate transport. C. emotional support. D. orthostatic vitals. ```

Accepted Answer

C. emotional support. Emotional support for the mother is an important part of your care during the delivery process.

Question 12

H-12) Which of the following situations is most likely when a woman who is experiencing labor pain states that she needs to go to the bathroom to move her​ bowels? A. She is in early​ labor, with adequate time for transport. B. She is in false labor ​(Braxton-Hicks ​contractions). C. The bag of waters is about to break. D. Birth is imminent.

Accepted Answer

D. Birth is imminent. (page 1063) When the baby is in the birth​ canal, it often puts pressure on the​ rectum, causing the sensation that the mother needs to move her bowels. This is an indication that birth is imminent.

Question 13

H-13) Your pregnant patient is contracting. Which of the following questions is most important in determining whether delivery is​ imminent? A. ​"Are you​ crowning?" B. ​"Are you experiencing uterine​ contractions?" C. ​"When did the labor pains​ start?" D. ​"Do you feel the urge to​ push?"

Accepted Answer

D. ​"Do you feel the urge to​ push?" As delivery gets​ close, the mother will feel the urge to push. This signals you to check for crowning and prepare for delivery.

Question 14

H-14) When predicting the need for neonatal​ resuscitation, what is the significance of a pregnant patient in​ labor's not having seen an​ obstetrician? A. The patient has likely not received prior prenatal care. B. The labor was probably induced by drug use. C. There probably are underlying medical conditions. D. This indicates a history of problems with pregnancy.

Accepted Answer

A. The patient has likely not received prior prenatal care. If the pregnant patient in labor has not seen an obstetrician for her​ pregnancy, she probably​ hasn't received any prior prenatal care.

Question 15

H-15) Your pregnant patient is contracting. She denies any prenatal care. Why is this a​ concern? A. The patient likely knows little about her health or that of her baby. B. The patient is likely uninsured. C. The patient must be transported to a county or state hospital. D. The patient is likely not being truthful.

Accepted Answer

A. The patient likely knows little about her health or that of her baby.

Question 16

H-16) If you cannot loosen or slip the umbilical cord over the​ baby's head,​ then: A. the delivery must proceed with the cord in place. B. push the baby backward gently until you can create enough slack to loosen the cord. C. pull the baby forward gently until you can create enough slack to loosen the cord. D. clamp the cord in two places and cut the cord between the clamps.

Accepted Answer

D. clamp the cord in two places and cut the cord between the clamps. If you cannot loosen or slip the cord over the​ baby's head, the baby cannot be delivered.​ Therefore, immediately clamp the cord in two places using the clamps provided in the obstetrics kit. Be very careful not to injure the baby. With extreme​ care, cut the cord between the two clamps. Gently unwrap the ends of the cord from around the​ baby's neck and proceed with the delivery.

Question 17

H-17) What is NOT typically included in an obstetrics​ kit? A. One pair of surgical scissors B. Several individually wrapped sanitary napkins C. A scalpel D. Several pairs of sterile surgical gloves

Accepted Answer

C. A scalpel

Question 18

H-18) At which of the following intervals should you assess an APGAR score on a​ newborn? A. 5 minutes and 10 minutes after birth B. 1 minute after birth and every 5 minutes thereafter C. Every 5 minutes for an unstable newborn and every 15 minutes for a stable infant D. 1 minute and 5 minutes after birth

Accepted Answer

D. 1 minute and 5 minutes after birth

Question 19

H-19) What is NOT a reason for keeping a baby​ warm? A. Ensuring the​ baby's blood can properly carry oxygen B. Maintaining the​ baby's glucose levels C. Keeping the baby comfortable D. Maintaining the airway

Accepted Answer

D. Maintaining the airway The most important aspect of caring for a neonate is keeping the baby warm. Newly born babies rapidly lose heat. This heat loss not only impacts their comfort but also can drop their glucose levels and even impact their ability to carry oxygen in their blood. For these​ reasons, you must consider heat retention a high priority. Keeping a baby​ warm, however, does not do anything specifically to maintain the airway.

Question 20

``` H-20) Which of the following is the threshold for beginning chest compressions in a​ newborn? A. Heart rate​ < 60 per minute B. Respiratory rate​ < 60 per minute C. SpO2 ​< 80% one minute after birth D. Heart rate < 100 per minute ```

Accepted Answer

A. Heart rate​ < 60 per minute A heart rate of less than 60 in a newborn indicates severe bradycardia and inadequate cardiac output. Begin chest compressions in a newborn with a heart rate less than 60.

Question 21

H-21) You have just​ delivered, dried, and warmed a newborn. The newborn has​ slow, gasping respirations. You​ should: A. begin chest compressions. B. provide​ blow-by oxygen. C. provide ventilations at 10-12 per minute. D. provide ventilations at 40-60 per minute.

Accepted Answer

D. provide ventilations at 40-60 per minute. page 1076

Question 22

H-22) To find the​ mother's uterus to initiate uterine massage as a means of managing postpartum uterine​ bleeding, palpate the abdomen until you​ note: A. an object about the size and shape of a banana. B. a​ grapefruit-sized object. C. a​ square-shaped area just beneath the diaphragm. D. a soft spot toward the lower half of the abdomen.

Accepted Answer

B. a​ grapefruit-sized object. Massaging the uterus will help it contract. This will help control the bleeding. Feel the​ mother's abdomen until you note a​ grapefruit-sized object. This is her uterus. Rub this area lightly with a circular motion. It should contract and become​ firm, and the bleeding should diminish.

Question 23

``` H-23) Afterbirth tissues should​ be: A. saved and properly identified. B. disposed of in a biohazard container. C. thrown into any standard wastebasket. D. left where they​ are, for later disposal. ```

Accepted Answer

A. saved and properly identified. Save all afterbirth tissues. The attending physician will want to examine the placenta and other tissues for​ completeness, since any afterbirth tissues remaining in the uterus pose a serious threat of infection and prolonged bleeding to the mother. Try to catch the afterbirth in a container. Place the container in a plastic​ bag, or wrap it in a​ towel, paper, or plastic. If no container is​ available, catch the afterbirth in a​ towel, paper, or a plastic bag. Label this material​ "placenta," and include the name of the mother and the time the tissues were expelled.

Question 24

``` H-24) As you inspect the perineum of a woman in labor to check for​ crowning, the water breaks. You note that it is pea green in color. What does that finding​ indicate? A. Meconium staining B. Stillbirth C. Preterm labor D. Multiple birth ```

Accepted Answer

A. Meconium staining ​Meconium, the first stool to be passed by an​ infant, can be present in the amniotic fluid if the fetus had a hypoxic event.

Question 25

H-25) If you notice that the patient has a prolapsed cord when you are examining for​ crowning, what should you​ do? A. Elevate the​ patient's hips, administer​ oxygen, wrap the cord using a sterile​ towel, and use your hand to prevent the fetal head from compressing the cord B. Have the patient assume a squatting position over an area that you have prepared with sterile towels C. Place the patient in​ Fowler's position D. Position the patient as for a breech delivery and proceed with the delivery

Accepted Answer

A. Elevate the​ patient's hips, administer​ oxygen, wrap the cord using a sterile​ towel, and use your hand to prevent the fetal head from compressing the cord Instruct the patient not to​ push, so as to avoid compression on the cord. Position the mother with her head down and pelvis raised with a blanket or​ pillow, using gravity to lessen pressure on the birth canal. Administer oxygen to the mother by nonrebreather mask. Wrap the cord with a sterile towel from the obstetrics kit. Insert a​ sterile, gloved hand in the​ vagina, and gently push the presenting part of the fetus​ (head or​ buttocks) up,​ back, or away from the pulsating cord.

Question 26

H-26) Which of the following descriptions characterizes an ectopic​ pregnancy? A. A fertilized ovum is implanted outside the uterine cavity and begins to develop into an embryo. B. A pregnancy that continues past the expected due date C. A​ "hidden" pregnancy that ​is, one that is not discovered until the mother goes into labor D. The fetus presents in the birth canal feet​ down, rather than head down.

Accepted Answer

A. A fertilized ovum is implanted outside the uterine cavity and begins to develop into an embryo. An ectopic pregnancy is when implantation of the fertilized egg is not in the body of the​ uterus, occurring instead in the fallopian tube​ (oviduct), cervix, or abdominopelvic cavity.

Question 27

``` H-27) Which of the following signs and symptoms is associated with​ eclampsia? A. Seizures B. Hyperglycemia C. Painless vaginal bleeding D. Supine hypotensive syndrome ```

Accepted Answer

A. Seizures Eclampsia is characterized by​ hypertension, edema, and proteinuria​ (preeclampsia) that have progressed to seizures​ (eclampsia).

Question 28

H-28) When abruptio placentae causes excessive prebirth​ bleeding, you​ should: A. Push a bulky dressing into the​ vagina, to stem the flow of blood. B. mop up the blood with bulky dressings that you discard. C. place a sanitary napkin over the vaginal opening. D. carefully dispose of​ blood-soaked tissue in biohazard containers.

Accepted Answer

C. place a sanitary napkin over the vaginal opening. For excessive prebirth​ bleeding, place a sanitary napkin over the vaginal opening. Note the time of napkin placement. Do not place anything in the vagina. Replace pads as they become​ soaked, but save all pads for use in evaluating blood loss. Save all tissue that is passed.

Question 29

``` H-29) You suspect that your pregnant patient may be experiencing preeclampsia. Which of the following signs or symptoms is the patient likely​ experiencing? A. Hypotension B. Weight loss C. Hypoglycemia D. Hypertension ```

Accepted Answer

D. Hypertension Seizures in​ pregnancy, sometimes caused by a condition called eclampsia​, tend to occur late in pregnancy. The seizures are typically a result of a condition called preeclampsia. This condition is often related to​ pregnancy-induced hypertension, and may be well known to the patient. Preeclampsia can be recognized by altered mental​ status; swollen​ hands, feet,​ and/or face; and high blood pressure. Seizures in pregnancy pose a serious threat to both the mother and unborn baby.

Question 30

H-30) You suspect that your patient has been sexually assaulted. You​ should: A. document who likely committed the assault. B. ask the patient to notify law enforcement. C. fulfill any locally mandated reporting requirements. D. ask the patient to describe exactly what happened.

Accepted Answer

C. fulfill any locally mandated reporting requirements. You should document the situation objectively and fulfill any reporting requirements that are locally mandated.

Question 31

``` H-31) In providing care for a patient with vaginal​ bleeding, which of the following steps is​ last? A. Ensure an adequate airway. B. Take Standard Precautions. C. Administer oxygen. D. Transport. ```

Accepted Answer

D. Transport. Transporting the patient would follow taking Standard​ Precautions, ensuring an adequate​ airway, and administering​ high-concentration oxygen by nonrebreather mask if signs of shock were present or shock were suspected.

Question 32

PT-1) When should the EMT initiate chest compressions on an​ infant? A. When respirations are labored or gasping B. When the heart rate is below 60 beats per minute C. Anytime the heart rate is below 100 beats per minute D. Only when there is no brachial pulse

Accepted Answer

B. When the heart rate is below 60 beats per minute

Question 33

``` PT-2) When is it appropriate to massage the​ patient's uterus? A. After delivery of the placenta B. During labor C. Anytime before delivery of the baby D. Only when ALS providers are present ```

Accepted Answer

A. After delivery of the placenta (Page 1079) Will help it to contract and help control bleeding

Question 34

PT-3) Which of the following statements about​ pregnancy-related changes for the mother is​ true? A. Respiratory rate decreases. B. Cardiac output decreases. C. Digestion slows. D. Musculoskeletal ligaments lose elasticity.

Accepted Answer

C. Digestion slows.

Question 35

``` PT-4) A newborn has a pink body but blue hands and feet 1 minute after birth. Which of the following is the correct notation of this​ finding? A. ​"1" for appearance B. ​"0" for appearance C. ​"1" for respiration D. ​"0" for respiration ```

Accepted Answer

A. ​"1" for appearance

Question 36

PT-5) Your patient is in active​ labor, and admits to abusing prescription narcotics. You should​ expect: A. an uncomplicated​ delivery, if vital signs are normal. B. the newborn to be Tachycardic on delivery. C. the possible need for neonatal resuscitation. D. a more rapid delivery.

Accepted Answer

C. the possible need for neonatal resuscitation.

Question 37

``` PT-6) Which of the following statements about​ pregnancy-related changes in the​ mother's cardiovascular system is​ true? A. There is an increased lung capacity. B. The blood volume decreases. C. There is an increased oxygen demand. D. There is a decreased oxygen demand. ```

Accepted Answer

C. There is an increased oxygen demand.

Question 38

PT-7) If a newborn is not breathing upon​ delivery, your first action should be​ to: A. begin​ bag-valve-mask ventilations. B. begin chest compressions and ventilations. C. give​ blow-by oxygen. D. rub the​ newborn's back as you dry the newborn.

Accepted Answer

D. rub the​ newborn's back as you dry the newborn.

Question 39

PT-8) After delivery of the​ placenta, you observe an unusual amount of heavy bleeding. You​ should: A. apply the PASG. B. ask the mother to stop​ breast-feeding. C. pack the vagina with gauze. D. massage the uterus.

Accepted Answer

D. massage the uterus.

Question 40

``` PT-9) When ovulation​ occurs, the fallopian tubes move the​ egg, or​ ovum, toward the uterus with waves of muscular contraction​ called: A. hydrolysis. B. urinalysis. C. neuralgia. D. peristalsis. ```

Accepted Answer

D. peristalsis.

Question 41

PT-10) Your pregnant patient is contracting. You have determined that delivery is imminent. You​ should: A. determine the​ mother's preference. B. transport immediately. C. do nothing until ALS personnel arrive. D. prepare to deliver on scene.

Accepted Answer

D. prepare to deliver on scene.

Question 42

``` PT-11) Which of the following conditions would most likely result from trauma to the abdomen in a pregnant patient in the second or third​ trimester? A. Abruptio placentae B. Placenta previa C. Ectopic pregnancy D. Eclampsia ```

Accepted Answer

A. Abruptio placentae

Question 43

PT-12) Your female patient has trauma to the external genitalia. For this type of​ call, you should​ always: A. direct the patient to document exactly what happened. B. notify law enforcement. C. consider the possibility of assault. D. fully expose the patient.

Accepted Answer

C. consider the possibility of assault.

Question 44

PT-13) Which of the following steps is included in proper emergency medical care of a patient who is in active labor in which a normal delivery is​ anticipated? A. Support the​ infant's head as it delivers in the birth canal. B. Have the mother lie flat on her back and place her hands behind her​ knees, to pull them back toward her shoulders as far as possible. C. As the​ baby's shoulders begin to​ emerge, guide the baby gently upward to deliver the lower shoulder first. D. Position the mother on her left side with her right hip and knee flexed.

Accepted Answer

A. Support the​ infant's head as it delivers in the birth canal.

Question 45

PT-14) Which of the following statements best describes the​ cervix? A. It is the opening at the junction of the uterus and the fallopian tube. B. It is the​ narrow, lower​ end, or​ "neck," of the uterus. C. It is the duct through which an egg released from the ovary travels to the uterus. D. It is the inner lining of the uterus.

Accepted Answer

B. It is the​ narrow, lower​ end, or​ "neck," of the uterus.

Question 46

``` PT-15) What is the typical duration of the first stage of labor in​ first-time mothers? A. Less than 6 hours B. About 16 hours C. About 2 hours D. At least 24 hours ```

Accepted Answer

B. About 16 hours

Question 47

PT-16) Your patient has been sexually assaulted. Law enforcement is on the scene. You​ should: A. be conscious of the​ patient's likely need for personal space. B. withhold treatment until law enforcement has left the scene. C. expose the patient and document your findings. D. ask the patient to describe exactly what happened.

Accepted Answer

A. be conscious of the​ patient's likely need for personal space.

Question 48

``` PT-17) The female reproductive structure that houses the fetus during development is​ the: A. fallopian tube. B. cervix. C. uterus. D. ovary. ```

Accepted Answer

C. uterus.

Question 49

PT-18) If it is necessary to begin chest compressions on a​ newborn, what is the correct depth of chest​ compression? A. 1/2 - 1 inch B. About​ two-thirds the depth of the chest C. About​ one-third the depth of the chest D. 2 - 2 1/2 inches

Accepted Answer

C. About​ one-third the depth of the chest

Question 50

PT-19) Which of the following signs is LEAST associated with seizures in​ pregnancy? A. Hypotension B. Altered mental status C. Swelling of the​ face, hands,​ ankles, and feet D. Weight gain

Accepted Answer

A. Hypotension

Question 51

``` PT-20) As you are assessing your pregnant patient and preparing for​ delivery, which of the following will NOT help you make a transport​ decision? A. A series of questions B. A determination of vital signs C. An examination for crowning D. A sense of urgency ```

Accepted Answer

D. A sense of urgency

Question 52

``` PT-21) Traditional methods of treating shock will not be effective​ with: A. hemorrhagic shock. B. hypovolemic shock. C. anaphylaxis. D. supine hypotensive syndrome. ```

Accepted Answer

D. supine hypotensive syndrome

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CH 36 Obstetric and Gynecologic Emergencies Flashcards

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