Chapter 22 Gynecologic Emergencies Flashcards
1
Q
35. Which of the following is NOT characteristic of the secondary stage of syphilis? A) The presence of a skin rash B) A single or multiple chancres C) Mucous membrane lesions D) Fever and swollen lymph glands
A
Ans: B. A single or multiple Chancres
Page: 1200
Type: General Knowledge
2
Q
- A ruptured ovarian cyst typically presents with:
A) a sudden onset of abdominal pain that can be related to the menstrual cycle.
B) chronic waxing and waning abdominal cramping between menstrual periods.
C) dull or aching epigastric pain that radiates to the shoulders or lower back.
D) a sudden onset of upper abdominal pain and nausea without vomiting.
A
Ans: A. A sudden onset of abdominal pain that can be related to the menstrual cycle
Page: 1197
Type: General Knowledge
3
Q
2. What part of the female genitalia is homologous to the glans penis of the male? A) Hymen B) Clitoris C) Urethra D) Vestibule
A
Ans: B. Clitoris
Page: 1185
Type: General Knowledge
4
Q
1. The external female genitalia are collectively referred to as the: A) vagina. B) pudendum C) external labia. D) mons veneris.
A
Ans: B pudendum
Page: 1185
Type: General Knowledge
5
Q
- Which of the following statements regarding toxic shock syndrome (TSS) is correct?
A) TSS is a condition that is exclusive to females.
B) Patients with TSS may show signs of liver failure.
C) Most cases of TSS occur in the absence of a fever.
D) Group B Streptococcus is a causative agent in TSS.
A
Ans: B. Patients with TSS may show signs of liver failure
Page: 1198
Type: General Knowledge
6
Q
16. Pelvic inflammatory disease commonly affects all of the following organs, EXCEPT the: A) uterus. B) ovaries. C) urinary bladder. D) fallopian tubes.
A
Ans: C. Urinary bladder
Page: 1195
Type: General Knowledge
7
Q
- A 30-year-old woman complains of an “achy” pain to both lower abdominal quadrants, which she states is made worse by walking. She further tells you that she recently finished her menstrual period. She has a fever of 101.9°F. Her blood pressure is 122/62 mm Hg, pulse rate is 84 beats/min and strong, and respirations are 14 breaths/min and unlabored. After gathering the rest of her medical history, you should:
A) provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
B) advise her that she can probably go to the hospital via personal vehicle since she is not showing signs of shock.
C) visually inspect her vagina for bleeding or discharge, start an IV line and set it to keep the vein open, and transport.
D) establish vascular access and give her a 250-mL normal saline bolus, consider analgesia for her pain, and transport.
A
Ans: A. provide emotional support, make her as comfortable as possible, and safely transport her to an appropriate hospital.
Page: 1195-1196
Type: Critical Thinking
8
Q
28. Initial signs and symptoms of toxic shock syndrome include all of the following, EXCEPT: A) myalgia. B) scleral injection. C) headache and fever. D) cardiac dysrhythmias.
A
Ans: D cardiac dysrhythmias
Page: 1198
Type: General Knowledge
9
Q
- Postmenopausal women:
A) often experience hot flashes and bradycardia.
B) tend to experience fewer urinary tract infections.
C) are usually over 35 years of age and tend. to be obese.
D) are more susceptible to atherosclerosis and osteoporosis.
A
Ans: D. Are more susceptible to atherosclerosis and osteoporosis
Page: 1187
Type: General Knowledge
10
Q
- In contrast to endometritis, endometriosis:
A) may present without abdominal pain.
B) is an inflammation of the uterine lining.
C) generally causes light menstrual periods.
D) is often the result of gynecologic surgery.
A
Ans: A. May present without abdominal pain
Page: 1194-1195
Type: General Knowledge
11
Q
- If a 17-year-old woman with a gynecologic problem answers your question, “Is there any possibility that you are pregnant?” with a firm “No way!” you should:
A) document the response and continue your assessment.
B) assume that she is pregnant and document this thoroughly.
C) ask her mother or father about the possibility of pregnancy.
D) ask the patient why she is sure that she is not pregnant.
A
Ans: D. Ask the patient why she is sure that she is not pregnant
Page: 1190
Type: General Knowledge
12
Q
- Law enforcement request that you respond to a local apartment complex for a young woman who was sexually assaulted. When you arrive at the scene, you find the patient sitting on her couch, clearly upset. You see a small amount of blood on her shorts, near the groin area. What is your initial priority in the care of this patient?
A) Asking her if she recognized the perpetrator
B) Identifying and treating immediate life threats
C) Not allowing her to shower or use the restroom
D) Quickly assessing her blood pressure and pulse
A
Ans: B. Identifying and treating immediate life threats
Page: 1200-1201
Type: Critical Thinking
13
Q
31. Common signs and symptoms of infection with the cytomegalovirus include: A) prolonged high fever. B) lesions on the genitalia. C) enlargement of the liver. D) severe nausea and diarrhea.
A
Ans: A prolonged high fever
Page: 1198
Type: General Knowledge
14
Q
7. The onset of menses is called \_\_\_\_\_\_\_\_\_\_\_, and typically occurs between the ages of \_\_\_\_\_\_\_\_\_\_\_. A) menorrhea, 10 and 12 years B) menarche, 11 and 14 years C) menopause, 12 and 15 years D) the climacteric, 14 and 16 years
A
Ans: B. Menarche, 11 and 14
Page: 1187
Type: General Knowledge
15
Q
- There is evidence that a 21-year-old woman was given Rohypnol before being raped. She presents with alcohol on her breath, drowsiness, and memory loss. Her blood pressure is 98/68 mm Hg, pulse is 58 beats/min and weak, and respirations are decreased and shallow. You attempt to administer high-flow oxygen, but she resists. What should you do now?
A) Administer a sedative medication to facilitate her acceptance of the oxygen.
B) Consider administering naloxone in case she was also given a narcotic drug.
C) Start an IV line and administer 1 to 2 liters of an isotonic crystalloid solution.
D) Recognize that because the patient is of legal age, she can refuse EMS treatment.
A
Ans: B. Consider administering naloxone in case she was also given a narcotic drug
Page: 1203
Type: Critical Thinking
16
Q
4. In the average female, the menstrual cycle lasts \_\_\_ days. A) 21 B) 24 C) 28 D) 35
A
Ans: C. 28
Page: 1186
Type: General Knowledge
17
Q
- When conducting the scene size-up of a call involving a gynecologic emergency, it is MOST important to:
A) assess for danger because any scene should be considered volatile.
B) quickly ascertain if the patient’s problem is medical or trauma in nature.
C) take standard precautions because many of these calls involve a lot of blood.
D) quickly assess the need for additional resources and summon them early.
A
Ans: A. assess for danger because any scene should be considered volatile
Page: 1188
Type: General Knowledge
18
Q
- You are dispatched to a grocery store for a woman with severe abdominal pain. When you arrive, you find the patient lying on her side in the manager’s office. She is confused, is diaphoretic, and appears to be bleeding from her vagina. Her blood pressure is low, and her pulse and respiratory rates are elevated. You should:
A) administer 100% oxygen, elevate her legs 12 to 18 inches, keep her warm, establish vascular access and give a 500-mL fluid bolus, reassess her blood pressure, and transport at once with continuous monitoring en route to the hospital.
B) immediately place her in a supine position, firmly massage her uterine fundus to control the bleeding, establish two large-bore IV lines and run them wide open, transport at once, and apply high-flow oxygen en route to the hospital.
C) apply high-flow oxygen, visually inspect her vagina and cover it with sterile dressings, keep her warm, begin transport, establish at least one large-bore IV en route, and administer enough crystalloid fluid to maintain radial pulses.
D) assist her ventilations with a bag-mask device, carefully place a trauma dressing inside her vagina to control the bleeding, begin rapid transport, establish two large-bore IV lines en route, and administer 20-mL/kg fluid boluses as needed.
A
Ans: C. apply high-flow oxygen, visually inspect her vagina and cover it with sterile dressings, keep her warm begin transport, establish at least one large bore IV on route.
Page: 1191, 1193
Type: Critical Thinking
19
Q
- While caring for an unresponsive young woman who was apparently sexually assaulted, you note that her respirations are slow and shallow, her pulse is slow and weak, and her blood pressure is low. There is a small amount of dried blood on her thigh, but no grossly active bleeding. Immediate care for this patient involves:
A) establishing an IV line and administering 0.5 mg of atropine.
B) visualizing her vaginal area to assess for external bleeding.
C) maintaining her airway and providing ventilatory assistance.
D) elevating her lower extremities to improve her blood pressure.
A
Ans: C. Maintaining her airway and providing ventilatory assistance
Page: 1200-1201
Type: Critical Thinking
20
Q
26. The MOST common underlying cause of a tubo-ovarian abscess is: A) vaginitis. B) gonorrhea. C) an ectopic pregnancy. D) a ruptured ovarian cyst.
A
Ans: B. Gonorrhea
Page: 1197
Type: General Knowledge
