Chapter 34 - (BASIC) Obstetrics & Neonatal Care Flashcards
A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should:
Select one:
A. administer oral glucose for presumed hypoglycemia and transport.
B. insert an oral airway and ventilate her with a bag-valve-mask.
C. elevate her legs to improve brain perfusion and keep her warm.
D. place her on her side, administer high-flow oxygen, and transport.
D. place her on her side, administer high-flow oxygen, and transport.
A history of pelvic inflammatory disease or tubal ligations increases a woman’s risk for:
Select one:
A. preeclampsia.
B. placenta previa.
C. gestational diabetes.
D. an ectopic pregnancy.
D. an ectopic pregnancy.
A mother who is pregnant with her first baby is typically in the first stage of labor for approximately:
Select one:
A. 10 hours.
B. 4 hours.
C. 16 hours.
D. 8 hours.
C. 16 hours.
A nuchal cord is defined as an umbilical cord that:
Select one:
A. is wrapped around the baby’s neck.
B. is lacerated due to a traumatic delivery.
C. has separated from the placenta.
D. has abnormally developed blood vessels.
A. is wrapped around the baby’s neck.
A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because:
Select one:
A. pregnant patients can dramatically increase their heart rate.
B. blood is shunted to the uterus and fetus during major trauma.
C. pregnant patients have an overall increase in blood volume.
D. pregnancy causes vasodilation and a lower blood pressure.
C. pregnant patients have an overall increase in blood volume.
By the 20th week of pregnancy, the uterus is typically at or above the level of the mother’s:
Select one:
A. xiphoid process.
B. superior diaphragm.
C. pubic bone.
D. belly button.
D. belly button.
Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT:
Select one:
A. some form of tactile stimulation.
B. thorough drying with a towel.
C. positive-pressure ventilations.
D. suctioning of the upper airway.
C. positive-pressure ventilations.
During your visual inspection of a 25-year-old woman in labor, you see the baby’s head crowning at the vaginal opening. What should you do?
Select one:
A. Apply gentle pressure to the baby’s head as it delivers.
B. Place your fingers in the vagina to assess for a nuchal cord.
C. Maintain firm pressure to the head until it completely delivers.
D. Tell the mother not to push and transport her immediately.
A. Apply gentle pressure to the baby’s head as it delivers.
Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should:
Select one:
A. elevate her legs 6 to 8 inches and cover her with a blanket.
B. carefully insert a sterile trauma dressing into her vagina.
C. place her legs together and position her on her left side.
D. firmly massage the uterine fundus with a circular motion.
D. firmly massage the uterine fundus with a circular motion.
From what internal female organ is the fetus expelled during delivery?
Select one:
A. Perineum
B. Uterus
C. Vagina
D. Cervix
B. Uterus
If a baby is born at 7:52, the second Apgar score should be calculated at:
Select one:
A. 8:00.
B. 7:57.
C. 7:53.
D. 7:59.
B. 7:57.
The amniotic fluid serves to:
Select one:
A. transfer oxygen to the fetus.
B. insulate and protect the fetus.
C. remove viruses from the fetus.
D. assist in fetal development.
B. insulate and protect the fetus.
The presence of meconium in the amniotic fluid indicates:
Select one:
A. that the baby’s airway may be obstructed.
B. that full newborn resuscitation will be needed.
C. an expected finding in full-term infants.
D. that the fetus is at least 4 weeks premature.
A. that the baby’s airway may be obstructed.
Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect:
Select one:
A. pulmonary embolism.
B. spontaneous pneumothorax.
C. intrauterine bleeding.
D. acute pulmonary edema.
A. pulmonary embolism.
When determining the frequency of contractions, you should time the contractions from the:
Select one:
A. end of one to the end of the next.
B. end of one to the start of the next.
C. start of one to the end of the next.
D. start of one to the start of the next.
D. start of one to the start of the next.
When preparing a pregnant patient for delivery, you should position her:
Select one:
A. in a supine position with her legs spread.
B. on a firm surface with her hips elevated 2 to 4 inches.
C. on her left side with the right leg elevated.
D. in a sitting position with her hips elevated 12 inches.
B. on a firm surface with her hips elevated 2 to 4 inches.
Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes?
Select one:
A. “Do you feel the need to push?”
B. “When are you due?”
C. “Is this your first baby?”
D. “Have you had a sonogram?”
D. “Have you had a sonogram?”
You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should:
Select one:
A. respect the patient’s wishes, ensure that the appropriate documentation is completed, and transport the patient.
B. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management.
C. call for the police to ensure that patient assessment is carried out.
D. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome.
A. respect the patient’s wishes, ensure that the appropriate documentation is completed, and transport the patient.
You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should:
Select one:
A. ask more detailed questions and press the issue until you have a more detailed understanding of the incident.
B. immediately remove the patient from the environment and transport.
C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.
D. contact police and remain at the scene until they arrive and escort you to the hospital.
C. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care.
Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant’s leg is protruding from the vagina. Appropriate management of this situation includes:
Select one:
A. placing the mother supine with her head down and pelvis elevated.
B. gently pulling on the infant’s leg in an attempt to facilitate delivery.
C. placing the mother in a recumbent position and rapidly transporting.
D. carefully attempting to push the infant’s leg off of the umbilical cord.
A. placing the mother supine with her head down and pelvis elevated.
What is a reason a fetus may be in trouble before the mother presents signs of shock?
If the mother has severe trauma, the blood supply to the fetus often reduces.
Which of the following is not true regarding delivery with a nuchal cord?
Select One
A. gently slip the cord over the infant’s head or shoulder
B. clamp the cord and cut it before delivering the infant
C. clamp the cord, then suction the airway before cutting the cord
D. Clamp the cord and cut it, then gently unwind it from around the neck if wrapped around more than once
C. clamp the cord, then suction the airway BEFORE cutting the cord
Which of the following refers to greenish or foul-smelling amniotic fluid?
Select One
A. nuchal rigidity
B. meconium staining
C. placenta previa
D. bloody show
B. meconium staining
Which of the following is not performed immediately following delivery of the infant?
Select One
A. wrap the infant in a towel and place it on one side with head lowered
B. be sure the head is covered and keep the neck in a neutral position
C. use a sterile gauze pad to wipe the infant’s mouth, then suction again
D. obtain an Apgar score
D. obtain an Apgar score
The Apgar score should be calculated at 1 minute and again at 5 minutes after birth. Most newborns will have a score of 7 or 8 at 1 minute and is for 8 to 10 at 5 minutes. (Page 1205)
You may help control bleeding by massaging the _________ after delivery of the placenta.
Select One
A. perineum
B. fundus
C. lower back
D. inner thighs
B. fundus
The Apgar score should be calculated at ___________ minutes after birth.
Select One
A. 1 and 5
B. 3 and 7
C. 2 and 10
D. 4 and 8
A. 1 and 5
Once the infant is delivered, feel for a brachial pulse or the pulsations in the umbilical cord. If the pulse rate is below ________ beats/min, begin assisted ventilations.
Select One
A. 60
B. 80
C. 100
D. 120
C. 100
When assisting ventilations in a newborn with a bag-mask device, the rate is ________ breaths/min.
Select One
a. 20-30
b. 30-50
c. 35-45
d. 40-60
d. 40-60
When performing CPR on a newborn, a compression to ventilation ratio of 3:1 should be used; this will yield a total of ________ “actions” per minute.
Select One
A. 90
B. 100
C. 110
D. 120
D. 120
You cannot successfully deliver a _________ presentation in the field.
Select One
A. limb
B. breech
C. vertex
D. cephalic
A. limb
Which of the following is not performed when caring for a mother with a prolapsed cord?
Select One
A. clamp and cut the cord
B. provide high-flow oxygen and rapid transport
C. use your fingers to physically hold the infant’s head off the cord
D. position the mother to keep the weight of the infant off the cord
A. clamp and cut the cord
A prolapse of the umbilical cord is a representation that must be treated in the hospital. The situation is dangerous because the fetus had will compress the cord during birth and cut off circulation, depriving the fetus of oxygenated blood. Your job is to try to keep the fetus’s head from compressing the cord. (Pages 1207-1208)
When handling a delivery involving a drug- or alcohol-addicted mother, your first concern should be for:
Select One
A. the mother’s airway
B. your personal safety
C. the infant’s airway
D. the need for CPR for the infant
B. your personal safety
Which of the following is not a stage of labor?
Select One
A. rupture of amniotic fluid
B. expulsion of the baby
C. delivery of the placenta
D. dilation of the cervix
A. rupture of amniotic fluid
The first stage of labor begins with the onset of contractions and ends when:
Select One
A. the infant is born
B. the cervix is fully dilated
C. the water breaks
D. the placenta is delivered
B. the cervix is fully dilated
Which of the following is not a sign of the beginning of labor?
Select One
A. bloody show
B. contractions of the uterus
C. crowning
D. rupture of the amniotic sac
C. crowning
The second stage of labor begins when the cervix is fully dilated and ends when:
Select One
A. the infant is born
B. the water breaks
C. the placenta is delivered
D. the uterus stops contracting
A. the infant is born
The third stage of labor begins with the birth of the infant and ends with the:
Select One
A. release of milk from the breasts
B. cessation of uterine contractions
C. delivery of the placenta
D. cutting of the umbilical cord
C. delivery of the placenta
The difference between preeclampsia and eclampsia is the onset of:
Select One
A. seeing spots
B. seizures
C. swelling in the hands and feet
D. headaches
B. seizures
You should consider the possibility of a(n) ___________ in women who have missed a menstrual cycle and complain of a sudden stabbing and usually unilateral pain in the lower abdomen.
Select One
A. PID
B. ectopic pregnancy
C. miscarriage
D. placenta abruptio
B. ectopic pregnancy