OB PED Unit Exam Flashcards

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1
Q

20-year-old female is pregnant for the first time with twins. What is she considered?

A

Primigravida

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2
Q

2-year-old is restless, irritable, and febrile with a distinct cough. The parent states that the child is calmer in a steam shower. You should suspect?

A) Influenza
B) Bronchitis
C) Croup
D) Epiglottitis

A

Croup

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3
Q

2-year-old patient has a respiratory rate of 30 breaths per minute. This is considered.

A

Normal

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4
Q

A 10-year-old patient was injured while skating, upon assessment you note a visible deformity of the
forearm. The fingers are pale and cool without a palpable pulse. You should apply?

A rigid splint
gentle manual traction
a cold pack and rapid transport
significant traction until pulse returns

A

gentle manual traction

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5
Q

A 13-month-old lying supine in crib, crying. Fever of 104.5, rash on body and some spots are purple. You
should?

Transport
put on surgical mask
open airway
apply high-flow oxygen

A

put on surgical mask

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6
Q

A 14-year-old jumped off a 4-foot wall, landing on her feet. She is complaining of tingling below waist,
lower back pain, and cramping in both feet. Vital signs are BP 106/74, P 112, and R 20. You should

a. Immobilize to a long spine board
b. Transport in a position of comfort
c. Apply bilateral soft splints to lower extremities
d. Coach her to slow her breathing

A

Immobilize to a long spine board

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7
Q

A 20-year-old female feels faint and has severe pain between her shoulder blades. Her skin is cool
and clammy. Vital signs are BP 82/48, P 134, R 22, and SPO2 92%. What should you suspect?

Sexual transmitted infection
spontaneous abortion
pelvic inflammatory disease
rupture ectopic pregnancy

A

rupture ectopic pregnancy

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8
Q

A 24-year-old female in her second trimester of pregnancy presents with mild contractions. There is no
regular pattern to the contractions, and they have not increased in intensity since they began. She
denies vaginal bleeding or any other symptoms. This patient is most likely experiencing.

Braxton Hicks contractions
premature labor
placenta previa
threatened abortion

A

Braxton Hicks contractions

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9
Q

A 24-year-old woman presents with vaginal bleeding following sexual assault, controlling bleeding would best be done by

A) Packing a vaginal canal with gauze
B) Apply direct pressure
C) Placing a dressing @ the vaginal opening
D) Bending the patient’s legs upward

A

Placing a dressing @ the vaginal opening

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10
Q

A 2-year-old child presents with a fever, lethargy, and screaming upon neck flexion. You should
suspect?

A

Meningitis

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11
Q

A 2-year-old female is lethargic to respond. She has dry mucous membranes and a tearless cry. What should you suspect?

A) Hypoxia
B) hypoglycemia
C) morning hypovolemia
D) hypothermia

A

morning hypovolemia

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12
Q

A 32-week pregnant female complaining of facial swelling, headache, vomiting, and experiencing
visual disturbances last 12 hours. You should suspect?

Gestational diabetes
eclampsia
severe migraine
pre eclampsia

A

pre-eclampsia

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13
Q

A 33-year-old female was in a motor vehicle collision. She is 36 weeks pregnant. First responders
have removed the patient from the vehicle and immobilized her and they cannot obtain a blood
pressure. You should?

A) Load and go to the nearest trauma center
B) tilt the backboard to the left immediately
C) loosen the backboard straps as soon as possible
D) apply oxygen and call for helicopter transport

A

tilt the backboard to the left immediately

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14
Q

A 35-week pregnant woman. Following scenarios most life threatening?

A) Hypertension and experiencing visual disturbances
B) fever and pain on urination
C) sharp lower abdominal pain
D) contracts with mucous discharge

A

Hypertension and experiencing visual disturbances

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15
Q

A 37-week pregnant woman with tearing abdominal pain and weak, vitals are 90/60, 140, and 26 with
pale, cool, diaphoretic skin, you should suspect?

Supine hypotensive syndrome
imminent delivery
abruptio placentae
placenta previa

A

abruptio placentae

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16
Q

A 37-year-old female in the later stages of pregnancy has been experiencing abdominal pain and
vomiting for the last two days. She responds to verbal stimulus. Vital signs are BP 100/70, P 116 R 24, skin
cool and dry, how should you position her?

In Fowler’s position on the stretcher
● Semi Fowlers with knees bent
● Left lateral recumbent with knees bent
● Supine with a pillow under her knees

A

Left lateral recumbent with knees bent

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17
Q

A 38-year-old female reports left sided abdominal pain that radiates to the back. Vitals are 90/64, 118,
20. You should suspect?

Pelvic inflammatory disease
kidney stones
ruptured ectopic emergency
cholecystitis

A

a ruptured ectopic emergency

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18
Q

A 3-year-old child involved in a motor vehicle collision needs to be secured on an adult backboard.
You should?

Secure the feet first, then the torso
secure the head first, then the torso
place padding under the child’s head
place padding under the child’s torso

A

place padding under the child’s torso

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19
Q

A 3-year-old is unresponsive and apneic on the floor of a restaurant. He was choking, turned blue, and
collapsed. What should you do?

a. Begin chest compressions
b. Perform a blind finger sweep
c. Give 5 abdominal thrusts
d. Give 5 back blows

A

Begin chest compressions

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20
Q

A 4-year-old is having trouble breathing. He is drooling and sitting forward in a chair with his mouth
wide open. He has a 103.2 temp. you should suspect.

Epiglottitis
croup
hyperthermia
asthma attack

A

Epiglottitis

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21
Q

A 4-year-old male is sitting upright and drooling. He has swallowed a marble that is completely
blocking his airway. What should you do?

A

perform abdominal thrusts

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22
Q

A 4-year-old patient has sustained blunt trauma to the chest. Based on the MOI you should suspect

Good chest rise with no diaphragmatic breathing
● Minimal external signs with serious internal injury
● Multi rib fractures due to fragile bone structure
● Dark ecchymosis around the umbilical area

A

Minimal external signs with serious internal injury

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23
Q

A 50-year-old fell from her bicycle after hitting a bump in the road. She is now bleeding from her
vagina. You should

Gently pack the vagina with sterile dressing
transport the patient with legs elevated
transport patient in the left lateral recumbent
apply external sterile bulky dressing

A

apply external sterile bulky dressing

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24
Q

A 5-year-old is actively seizing, his respirations are slow, and skin is pale. His parents say he had
seized several times in the last 15 minutes without waking up. You should suspect that the?

A) Seizure is about to end and you should wait to treat him
B) child will become postictal and will
regain consciousness
C) child is in status epilepticus and medication is required
D) child is in diabetic ketoacidosis and medication is required

A

child is in status epilepticus and medication is required

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25
Q

A 6-month-old is febrile, cyanotic, and grunting with labored breathing. You should?

A) *Assist ventilations via bvm
B) sponge the infant with tepid water
C) apply blow by 02 and trans
D) perform a rapid medical assessment

A

apply blow by 02 and transport

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26
Q

A 6-year-old is shy and withdrawn. He has multiple contusions in various stages of healing. His mother
states “he fell on the playground.” What should you suspect?

a. Sexual abuse
b. Emotional abuse
c. Neglect
d. Physical abuse

A

Physical abuse

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27
Q

A 7-year-old presents with a pencil in his left cheek, you should?

Remove the pencil
stabilize the pencil
check for airway patency
control bleeding

A

check for airway patency

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28
Q

A child is postictal. You should?

Note length of seizure
administer blow by o2
ensure open airway
protect patient from injury

A

ensure open airway

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29
Q

A conscious child has a significant airway obstruction due to an illness. You should?

Insert OPA
examine the upper airway for white spots
place the child in a supine position
give o2 and transport immediately

A

give o2 and transport immediately

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30
Q

A cord is wrapped around a baby’s neck during childbirth. This is called

A

Nuchal cord

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31
Q

A maternal condition that occurs when the placenta separates from the uterine wall and is a cause
of pre-birth bleeding is?

Abruptio placenta
uterine rupture
placenta previa
ectopic pregnancy

A

Abruptio placenta

32
Q

To relieve pressure on the vena cava when transporting a pregnant patient, you should?

A

Place on left side

33
Q

A mother has just delivered a newborn with central cyanosis. The newborns vitals are P 82, R 30. You should?

A) Initiate active warming
B) begin positive pressure ventilations
C) administer blow by O2
D) suction the airway and stimulate

A

begin positive pressure ventilations

34
Q

A pale 2-year-old male turns his face away and hides when you approach. Vital signs are P 150 R 32 with audible wheezing what should you be most concerned about?

A) Heart rate
B) skin color
C) respiratory rate
D) breath sounds

A

skin color

35
Q

A patient is in labor and has a strong urge to push. The baby’s head is not yet visible, but the umbilical cord is protruding, you should?

A) Clamp the cord in 2 places and cut between them
B) place her in knee-chest position and transport
C) cover the cord with a dry sterile dressing
D) encourage her to bear down and push

A

place her in knee-chest position and transport

36
Q

A woman is 36 weeks pregnant and complaining of painless vaginal bleeding. The most likely cause
is?

Abruptio placenta
placenta previa
spontaneous abortion
bloody show

A

placenta previa

37
Q

Alert & oriented 4-year-old patient has possible head injury from a fall. Vitals are P 120, R 18. How should you transport?

A) Fully immobilize with towel under his scapulae
B) fully immobilize in Trendelenburg position
C) secure child’s safety seat to the stretcher
D) allow the patient to sit on his mother’s lap

A

Fully immobilize with towel under his scapulae

38
Q

Assess on infant. Which artery should you take for pulse?

Brachial
radial
carotid
femoral

A

Brachial

39
Q

Assisting a home birth and baby’s head just delivered. You should?

A) Examine for nuchal
B) guide and rotate
C) turn face up and suction

A

Examine for nuchal

40
Q

Before assessing the respiratory adequacy of an unconscious infant or child, you should

● Routinely suction the mouth to remove oral secretions
● Insert and OPA or an NPA
● Ensure that his or her head is in a hyperextended position
● Ensure the airway is patent and clear of obstructions

A

Ensure the airway is patent and clear of obstructions

41
Q

Compared to adults in shock, pediatric patients?

Stay in compensated shock longer
do not require treatment as quickly
are less likely to become hypovolemic
become hypertensive sooner

A

Stay in compensated shock longer

42
Q

During assessment of a crying infant, you discover a sunken fontanelle. Your next question should
be?

Birth defects
fallen recently
how many wet diapers has the baby produced

A

how many wet diapers the baby has produced

43
Q

Febrile seizures in children are most often the result of a/an:

A) Abrupt rise in body temp
B) life threatening infection
C) temp greater than 100 fahrenheit
D) inflammatory process

A

Abrupt rise in body temp

44
Q

If a patient presents vaginal bleeding within the first 20 weeks of pregnancy you should suspect?

A

Spontaneous abortion

45
Q

In centimeter what is the correct depth of chest compressions for a 7-year-old child?

A) 1.5
B) 6
C) 5
D) 2

A

5

46
Q

Initiate CPR on infant if heart rate is less than?

A

60

47
Q

Nausea, vomiting, vaginal discharge, irregular periods and abdominal pain are signs and symptoms
of?

Pelvic inflammatory disease
ruptured ectopic pregnancy
endometriosis
cystitis

A

Pelvic inflammatory disease

48
Q

Neonatal 2-week-old female is dyspneic and lethargic to respond. Vitals are P 58, R 4 and irregular. What should you be concerned about?

A) Altered mental status
B) cerebral hypoxia
C) respiratory acidosis
D) cardiac arrest

A

Cardiac Arrest

49
Q

Normal response for a healthy 9-month-old infant

A

Gaze follows parents

50
Q

One sign of respiratory distress in a neonate?

Grunting
increased activity
barrel chest
tachycardia

A

Grunting

51
Q

Painless bright red vaginal bleeding late in the third trimester. You should suspect?

A) placenta previa
B) abruptio placentae
C) ectopic pregnancy
D) spontaneous abortion

A

placenta previa

52
Q

Pediatric airways differ from adult airways in that

Trachea is more rigid
child’s tongue takes up less space
oral airways devices cannot be used on children
all structures are smaller and can be more easily obstructed

A

all structures are smaller and can be more easily obstructed

53
Q

Placenta previa occurs when the placenta

A) Separates from the uterus
B) is abnormally positioned
C) separates from umbilical cord
D) disrupted

A

is abnormally positioned

54
Q

Pre- eclampsia becomes eclampsia when

A

A seizure occurs

55
Q

Scald injuries to a child’s lower extremity can be indicative of?

A

Abuse

56
Q

A 3-year-old drank some drain cleaner. It would be most helpful to?

A

transport immediately

57
Q

Shortly after delivery, a mother experiences dyspnea and becomes hypotensive. No excessive
bleeding is noted, and the uterus seems firm. You should suspect?

Abruptio placenta
pulmonary embolism
post delivery trauma
uterine rupture

A

pulmonary embolism

58
Q

Signs or symptoms of a pre delivery emergency?

A) Hypertension
B) Back pain
C) crowning
D) gush of amniotic fluid

A

Hypertension

59
Q

The cessation of menses with associated decrease of estrogen secretion is called.

Menopause
menarche
myometrium
mitted schmerz

A

Menopause

60
Q

The period of time during which intrauterine fetal development occurs is called

A) Gravidity
B) Gestation
C) Parity
D) Primi gravity

A

Gestation

61
Q

What effect can excessive traction have on the umbilical cord during placental delivery?

Uterine rupture
umbilical bleeding
abruptio placentae

A

abruptio placentae

62
Q

What is the proper method for suctioning a newborn’s airway with a bulb syringe?

a. Squeeze after placing the bulb syringe in the nose
b. Squeeze before placing the bulb syringe in the nose
c. Squeeze after placing the bulb syringe in the mouth
d. Squeeze before placing the bulb syringe in the mouth

A

Squeeze before placing the bulb syringe in the mouth

63
Q

What is the proper way to size an OPA for a child?

A

corner of mouth to the angle of the mandible

64
Q

When assessing distal circulatory function in a 3-year-old, a reliable indicator is?

A) Pulse ox
B) BP
C) Cap refill
D) Skin temp

A

Cap Refill

65
Q

When inserting an OPA in a child you should?

A

Hold the tongue in position

66
Q

Where should you apply pressure to access for uterine contractions?

A) Left and right upper quadrants
B) abdomen below the navel
C) abdomen above the navel
D) left and right flan

A

abdomen above the navel

67
Q

Which may indicate that a fetus was in distress before delivery?

A

Presence of a greenish material in the amniotic fluid, meconium (dark green substance, forming the first feces of a newborn infant)

68
Q

Which of the following indicates decompensated shock in a pediatric patient?

A) Shallow breathing
B) *rapid heart rate
C) pale cool and diaphoretic
D) loss of consciousness

A

loss of consciousness

69
Q

Which signs and symptoms most suggest pre-eclampsia?

A

Hypertension and excessive water retention

70
Q

With pediatric patient, your assessment should begin

A

At first sight

71
Q

You are assisting a vaginal delivery and the mom is crowning. The infant’s head suddenly disappears, and the mother begins to complain of sharp, intense, constant abdominal pain. You should suspect?

A) Placenta previa
B) multiple births
C) Uterine Rupture
D) transition to phase III of delivery

A

Uterine Rupture

72
Q

You are treating a 3-month-old, apneic patient with a pulse of 110. In preparing to ventilate this infant, you should.

A

place a small towel under their shoulders

73
Q

You have assisted a mother in delivering a premature newborn. Assessment after 5 minutes shows
newborn has central cyanosis and heart rate of 90. What should you do?

A

Provide ventilatory assistance

74
Q

You have just delivered a baby girl who remains cyanotic and is not responding to stimulation and
oxygen therapy. Heart rate is 90. You should

A

Begin positive pressure ventilations

75
Q

Your neighbor has asked you to check on her 2-month-old baby. The baby is sleeping, and vitals are
P 130, R 40, and he continues to sleep even when you try to wake him up. What should you do?

A

Call for EMS