OB Flashcards
A 39-year-old female, who is 35 weeks pregnant, presents with acute abdominal pain, irregular contractions, and vaginal bleeding. Her BP is 70/48 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. Her abdomen is tender to palpation and her uterus feels rigid. What should you suspect?
Abruptio placenta
Assessment of newborn reveals respiratory distress, diminished breath sounds on the left, and a sunken abdomen. What should you suspect?
Diaphragmatic hernia
Compared to adults, children can maintain their blood pressure longer following an injury because they have a:
proportionally larger blood volume
How do complex febrile seizures differ from simple febrile siezures?
Complex partial seizures are focal and have a longer duration
A 26-year-old woman has had abdominal pain since the end of her menstrual period approximately 10 days ago. She reports that the pain is in both lower quadrants, and she has a temperature of 100.5F. What should you suspect?
Pelvic inflammatory disease
A 4-year-old child presents with lethargy, poor skin turgor, and sunken eyes. You are unable to obtain a blood pressure. The cardiac monitor reveals a narrow-complex tachycardia at a rate of 190/min. What should you do?
Give a 20-mL/kg normal salione bolus
What should you do after completing care and transport of a child that you suspect has been physically abused?
Report your suspicions to the receiving physician and file a report with child protective services
While caring for a child who is ill, you notice that he has a gastrostomy tube. You should recall that this is used for what purpose?
Instill nutrition and medications directly into the stomach
During your assessment of a woman in labor, she tells you that she was diagnosed with gestational diabetes and polyhydramnios. Which of the following is she at increased risk for?
Prolapsed umbilical cord
Shortly after initiating bag-mask ventilation on a 3-year-old boy, you note that his radial pulses are absent, his carotid pulse has become weak and rapid, and his skin has turned pale. Vascular access has been established. What should you do?
Ausculate his breath sounds
Which of the following is the MOST common cause of cardiopulmonary arrest in infants and children?
Respiratory failure
Which of the following statements regarding isoimmunization (Rh disease) is correct?
Rh disease is most prominent with subsequent pregnancies and occurs when an Rh-negative mother becomes pregnant by a man with Rh-positive blood.
A 7-year-old, 20-kg child complains of dizziness.
Establish IV access and give 2mg adenosine
You are assessing the cardiac rhythm of a 9-year-old child who says his chest is “fluttering.” P waves are not visible, the QRS
Reentry supraventricular tachycardia
The Apgar scoring system is used to:
evaluate the adequacy of a newborn’s vital functions following birth
You have just delivered an ifant born at 27 weeks’ gestation. After drying and warming the infant, you assess him and note that his respirations are rapid and irregular, his pulse rate is 90 beats/min, and his face and trunk are cyanotic.
Give positive-pressure ventilations for 30 seconds and then reassess the newborn
You are triaging first-grade students at a school bush crash and encounter a small child who is unresponsive and apneic.
Assess for a palpable pulse
Which of the following clinical findings are associated with HELLP syndrome?
Low platelets and elevated liver enzymes
You are using a bag-mask device to ventilate a 4-year-old, 16-kg child in respiratory failure. The cardiac monitor reveals a wide-complex rhythm at a rate of 40/min that matches the palpable pulse. What should you do?
Being chest compressions
A 6-month-old infant prevents with lethargy, profound respiratory distress, and an oxygen saturation of 74%. Which of the following cardiac rhythms BEST matches this clinical presentation?
Bradycardia with or without AV block
You receive a call for a 2-year-old girl having a seizure. Upon arrival, you find the child lying in a bed.
Bacterial meningitis
A 4-year-old male presents with stridory, a barking cough, and increased work of breathing.
Let him assume a position of comfort, offer oxygen via the blow-by technique, and administer a 2.25% solution of racemic epinephrine via nebulizer
You are assisting in the delivery of a baby. As soon as the head delivers, you should:
check for the presence of a nuchal cord.
A 5-year-old boy presents with labored breathing, stridor, and high fever. His mother tells you that his symptoms rapidly progressed over the last few hours.
Epiglottitis
Which of the following is a sign of inadequate breathing in an infant?
Expiratory grunting
A 24-year-old woman, who is 12 weeks pregnant with her first child, presents with severe nausea and vomiting for the past 36 hours.
Diphenhydramine
While assessing a woman in labor; you note that a loop of the umbilical cord is protruding from her vagina.
Ensure that the umbilical cord continues to pulsate
According to current resusciation guidelines, when should epinephrine be administered to an infant or child who is in ventricular fibrillation?
After the second shock
What is the appropriate second dose of adenosine for a 4-year-old child with supraventricular tachycardia?
3.2 mg
A 25-year-old female presents with abdominal pain, vaginal bleeding, and amenorrhea. What should you suspect?
Ectopic pregnancy
A 1-year-old child presents with lethargy, bradypnea, cyanosis, and a heart rate of 50 beats/min. What should you do?
Ventilate with a bag-mask device
Which of the following conditions is a woman at risk for if she does not take prenatal vitamins throughout her pregnancy?
Anemia
A 3-year-old child presents with a heart rate of 190 beats/min. Which of the following findings would make a diagnosis of reentry supraventricular tachycardia less likley?
History of a high fever, vomiting, and diarrhea
A 20-kg child requires amiodarone for refractory ventricular fibrillation. Amiodarone is supplied as 150 mg in 3 mL.
2 mL
Which of the following findings should increase your suspicion that a 4-year-old child has an intentionally injury?
The injury occurred several hours before EMS was called.
A 7-month-old infant has partial-thickness burns to the entire anterior aspect of the leg.
6.75%
Regarding labor and delivery, what is meant by the term lightening?
Relief of pressure in the upper abdomen and a simulataneous increase of pressure in the pelvis
A newborn has central cyanosis and a pulse rate of 70 beats/min. What should you do?
Ventilate with a bag-mask device
A 3-year-old child has had a low-grade fever and a cough for the last 2 days. Today, he has respiratory distress. What should you suspect?
Croup
You and your team are performing CPR on a 8-year-old female who is in cardiac arrest
Defib and immediately resume CPR
A 29-year-old female complains of bilateral lower abdominal quadrant pain. Which of the following findings
Intrauterine device use
You are assessing the cardiac rhythm of a 6-year-old child.
Ventricular tachycardia
A 19-year-old woman, who is 28 weeks pregnant with her first baby, presents with a headache, edema to her ankles and hands
Start an IV line and monitory her for seizures
Following a viral illness, an 8-year-old child presents acutely with pallor, palpitations, chest pain not influenced by breathing or position
Myocarditis
A 4-year-old unresponsive child presents with weak intercostal retractions and a heart rate of 70 beats/min.
Ventilate the child with high-flow oxygen
A 9-month-old infant presents with increased work of breathing. The infant is active and has moderate retractions.
Bronchiolitis
As you are assessing the skin color and condition of a newborn, you note that it is red and abnormally warm to the touch.
this is an uncommon finding and suggests a serious illness
Which of the following medications can be used to control postpartum hemorrhage?
Oxytocin
A 30-kg child presents with a regular, monomophic, wide-complex tachycardia at 190 beats/min. He tells you that his chest feels funny, but otherwise has no other symptoms.
Adenosine, 3 mg
Which of the following is consistent with a foreign body upper airway obstruction in a child?
Acute dyspnea without a fever
How should you maintain neutral alignment of an 18-month-old child’s airway structures?
Place padding under the shoulders
A 7-year-old child is in ventricular tachycardia. He has a weak pulse and cool, pale skin.
Cardiovert with 20 joules
Which of the following clinical signs is common with a brief resolved unexplained event in an infant?
Cyanosis
Which of the following statements regarding fetal circulation in utero is correct?
The ductus arteriosus and foremen ovale divert blood flow away from the fetus’s lungs
When should tracheal suctioning be performed in the newborn?
Meconium is present in the amniotic fluid an the infant is not vigorous
A 5-year-old, 20-kg child has a heart rate of 45 beats/min with poor perfusion despite oxygenation and vetilation. It is possible that the child’s bradycardia is caused by increased vagal tone. What should you do?
Begin chest compressions
A patient who is in her third trimester of pregnancy has a vaginal bleeding.
Establish an IV with normal saline
A woman who is 37 weeks pregnant fell and injured her hip.
Compromised venous return
You are assessing an 18-month-old female with a high fever. The child is crying, and is tachypneic and tachycardic.
Remove her clothing to minimize heat retention, give ibuprofen, and transport
Following delivery, a newb orn has a thicl, dark-green substance around their mouth. The newborn has a strong cry, peripheral cyanosis, and a pulse rate of 120 beats/min. What should you do?
Administer blow-by oxygen and continue your assessment
A 3-year-old girl with respiratory distress is listless and pale and has a pulse rate of 60 beats/min. What should you do?
A 3-year-old girl with respiratory distress is listless and pale and has a pulse rate of 60 beats/min. What should you do?
A 30-year-old woman who is 34 weeks pregnant with twins complains of intense itching to her hands and feet and right upper quadrant abdominal pain.
Cholestasis
You are assessing a 3-year-old boy who was diagnosed with croup last night. Today, he is lethargic, fatigued, and experiencing severe respiratory distress, and has stridor.
Subglottic edema
Which of the following clinical findings would indicate obstruction of a ventricular shunt in a child?
Bradycardia and hypertension
Treatment for a 7-year-old child with suspected anemia and a respiratory rate of 24 breaths/min should include which of the following?
Supplemental oxygen
An infant born at 40 weeks has central cyanosis and a heart rate of 80 beats/min. What should you do?
Ventilate with room air
Which of the following is a clear sign of respiratory failure in a child?
Bradypnea
Which of the following female hormones stimulates ovulation?
Luteinizing hormone
Which of the following is an obvious sign of decompensated shock in an infant?
Weak brachial pulses
What injury pattern would you expect to encounter if a small child accidentally pulled a pot of boiling water off of the stovetop?
A downward splash pattern of superficial and partial-thickness burns to the anterior aspect of the body
A 2-year-old girl has had a high fever for the past 2 days and screams every time her mother tries to pick her up. What should you suspect?
Meningitis
A woman who is 38 weeks pregnant tells you that this is her third pregnancy. Which of the following terms describes her obstetric history?
Multigravida
A 23-year-old oman who is 35 weeks pregnant complains of right upper quadrant abdominal pain, bruising to her arms, a severe headache, and pain to her right shoulder.
HELLP syndrome
An 8-year-old remains in ventricular fibrillation despite three shocks, epinephrine, and high-quality CPR. What should you do next?
Give 120 mg amiodarone
Treatment for an infant born at 34 weeks gestation, regardless of their appearance at birth, includes which of the following?
Taking extra measures to prevent rapid heat loss
A 2-year-old child fell from a second-story window. You should suspect that the primary impact occurred to which of the following body parts?
Head
During assessment of a woman in labor, you observe the baby’s arm protruding from the patient’s vagina.
Begin transport immediately
During delivery of a baby, you note that a loop of the umbilical cord is protruding from the vagina, just ahead of the presenting part of the fetus. What should you do?
Elevate the woman’s hips, instruct her to pant which each contraction, and gently push the baby back up into the vagina
A 9-month-old male has had numerous episodes of vomiting and diarrhea. On assessment, the infant is listless. He has unlabored tachypnea; absent radial pulses and a weak brachial pulses
Severe dehydration with decompensated shock
An infant or child with cardiogenic shock
often presents with increased work of breathing and an enlarged liver
Which of the following signs and symptoms would you expect to encounter in an infant with meningitis?
Fever, paradoxical irritability, and poor feeding
A febrile seizure would MOST likley occur in a child
with a fever that acutely spikes
Which of the following interventions is ONLY performed at the end of the third stage of labor?
Massaging the uterine fundus in a circular motion
A 7-month-old infant fell out of his father’s arms and off a second-floor balcony. Given the mechanism of injury and the child’s age, which of the following would be a clinically significant findings?
Bulging anterior fontanelle
A 29-year-old female presents with lower abdominal pain and minor vaginal bleeding. She recently had a dilation and curettage
Endometritis
Compared to an adult, an infant or child has
proportionately large tongue
Pregnant women with hyperemesis gravidarum are at risk for which of the following?
Mallory-Weiss syndrome
When should initial suctioning of a newborn’s mouth and nose occur?
As soon as the head delivers, but before the next contraction
Following birth, a newborn has a pink body, but blue hands an feet; a strong cry; a pulse rate of 110 beats/min;
8
which of the following questions would provide the MOST information when determining whether or not delivery of a baby is imminent
Do you feel the urge to push?
Which of the following cardiac rhythms would you expect to encounter in a 16-month-old child who is pulseless and apeniec following several days of respiratory distress?
Asystole
A 3-year-old child with a high fever experienced a seizure that lasted approximately 5 minutes. What should you do?
Monitor only and transport.
Which of the following drug-dose combinations is indicated for a 3-year-old child with asystole?
Epinephrine, 1.4 mL
You are transporting a mother and her newborn baby to the hospital. The mother suddenly becomes dyspneic and complains of a sharp pain to the right side of her chest.
Amniotic fluid embolism
An 8-year-old child who recently had myocarditis presents with a decreased level of consciousness, weak peripheral pulses, and skin mottling. Which of the following assessment findings would support a diagnosis of cardiogenic shock?
Difficulty breathing
Following a recent viral respiratory infection, a 5-year-old child presents with fever, stridor, and respiratory distress.
Bacterial tracheitis
A 4-year-old child has partial-thickness burns to the entire face and head, anterior torso, and both anterior upper extremities.
42%
During delivery, you note that the baby’s head retracts back into the birth canal after each contraction.
Shoulder dystocia
A 29-year-old female, who is 32 weeks pregnant, presents with a blood glucose level of 305 mg/dL. Which of the following would explain this?
Placental hormones blocking the action of insulin
A 29-year-old female, who is 32 weeks pregnant, presents with blood glucose level of 305 mg/dl.
Placental hormones blocking the action of insulin
Which of the following is an inflammation or swelling of the smaller airways in the lower respiratory tract due to a viral infection and is associated with wheezing?
Bronchiolitis
A 6-year-old boy fell off his bike and injured himself. His mother tells you that he was wearing a helmet at the time of the incident.
Kneel down beside him and ask him what his name is
A 24-year-old woman who is 36 weeks pregnant experienced a witnessed cardiac arrest and is in ventricular fibrillation. What should you do?
Displace her uterus to the left and obtain vascular access above the diaphragm
What sized cuffed ET tube should you select for a 4-year-old child?
4.5 mm
What is a low normal systolic blood pressure for a 7-year-old child?
80 to 85 mm Hg
Upon delivery of an infant’s head, you note that its face is encased in the amniotic sac and a nuchal cord is present. What should you do?
Clear the membrane away from the infant’s face and attempt to slip the cord from around the neck
Which of the following is an early sign of a shock in an 18-month-old child?
Delayed capillary refill
CPR is in progress on a 4-year-old child in asystole. Which of the following treatments has the highest priority?
Epinephrine
A 46-year-old woman was sexually assaulted. What should you do?
Place any clothing items in a paper bag
Why is an unresponsive pregnant woman at greater risk for vomiting and aspirations than a nonpregnant woman?
The enlarged uterus displaces the stomach and intestines upward and laterally
Following delivery, woman has continued vaginal bleeding. Her BP is 126/62, pulse rate is 90 beats/min, and respiratory rate is 18 breaths/min. What should you do?
Massage the fundus of her uterus
A 33-year-old female presents with a headache, extreme weakness, chills, and a high fever for the past 10 days. She denies vaginal discharge, urinary difficulty, or painful intercourse.
Cytomegalovirus
A 20-kg child has been running a fever for the past 2 days. Today, he is lethargic and his skin is pale. His heart rate is 190 beats/min and his respiratory rate is 40 breaths/min. What should you do?
Give a 400-mL normal saline bolus
When does the second stage of labor begin?
When the cervix is fully dilated
A 24-year-old pregnant woman has had a severe headache and blurred vision for the past week.
Edema and hypertension
Following delivery of a baby who was born at 38 weeks, you note the presence of thick particulate meconium in the amniotic fluid.
Ensure the newborn is warm and dry, suction its mouth and nose, and administer blow-by oxygen
A 20-month-old child is listless and pale. He has poor skin turgor, dry mucous membranes, delayed capillary refill, and a heart rate of 190 beats/min. Which of the following is appropriate IV fluid management?
20 mL/kg
