Obstertics Flashcards
Just before an infant is delivered, the fetal scalp can be seen at the vaginal opening during each contraction. This is referred to as:
Question 1 options:
A)
dilation.
B)
crowning.
C)
effacement.
D)
presentation.
crowning
The blood-rich structure that serves as a lifeline for the developing fetus is called the:
Question 2 options:
A)
placenta.
B)
uterus.
C)
amniotic sac.
D)
cervix.
placenta
The medically appropriate term for the projected birth date of a baby is:
Question 3 options:
A)
probable date of delivery.
B)
estimated date of confinement.
C)
predicted delivery date.
D)
expected date of labor.
estimated date of confinement
The term “puerperium” refers to:
Question 4 options:
A)
the delivery of the afterbirth.
B)
a specific fertility treatment.
C)
a technique used to delay contractions.
D)
the time surrounding delivery.
the time surrounding delivery
You are caring for a woman who is 32 weeks pregnant. While assessing her breathing, you notice that her rib cage expands visibly with each breath and that her tidal volume appears to be deep. You recognize:
Question 5 options:
A)
an increase in oxygen demand due to an obstetrical emergency.
B)
signs of a severe respiratory condition requiring immediate intervention.
C)
an increase in tidal volume that is normal during pregnancy.
D)
signs of obstructive shock.
increase in tidal volume that is normal during pregnancy
A 27-year-old pregnant woman was the restrained driver of a vehicle that hit the guardrail at a high rate of speed. She sustained a large laceration to the upper thigh and has lost a significant amount of blood. Vital signs are: heart rate 102, blood pressure 118/78 mmHg, respirations 18, and her skin is pale and clammy. Which of the following BEST explains this patient’s presentation?
Question 6 options:
A)
Maternal vital signs remain normal following trauma to ensure the survival of the developing fetus.
B)
Fetal oxygen demand increases after trauma, causing maternal blood pressure and heart rate to increase immediately after injury.
C)
Maternal blood volume decreases during pregnancy, amplifying the effects of epinephrine and allowing for the maintenance of blood pressure.
D)
Maternal blood volume increases during pregnancy, allowing vital signs to remain normal despite significant blood loss.
maternal blood volume increases during pregnancy allowing vital signs to remain normal despite significant blood loss
A 30-year-old woman complains of swelling in both of her legs. She is 32 weeks pregnant, and states that she has also developed varicose veins over the past few weeks. Which of the following BEST explains the cause of this patient’s signs and symptoms?
Question 7 options:
A)
Changes in kidney function alter the normal electrolyte balance, causing tissue edema in the legs and feet.
B)
Changes in the endocrine system cause peripheral edema during the late stages of pregnancy.
C)
The gravid uterus compresses the pelvic and femoral vessels, decreasing venous return and causing venous stasis.
D)
The gravid uterus compresses the superior vena cava, decreasing venous return to the heart.
the gravid uterus compresses the pelvic and femoral vessels decreasing venous return and causing venous stasis
During which period of development is the fetus most susceptible to damage from maternal exposure to toxins, such as alcohol and tobacco?
Question 8 options:
A)
20-40 weeks
B)
1-8 weeks
C)
8-12 weeks
D)
16-20 weeks
8-12 weeks
Which structure allows oxygenated maternal blood to bypass the uninflated lungs of the developing fetus?
Question 9 options:
A)
Ductus arteriosus
B)
Umbilical artery
C)
Foramen ovale
D)
Ductus venosus
Ductus venosus
A 38-year-old pregnant woman called 911 after she developed a “splitting headache” unrelieved by over-the-counter analgesics. She states that she has a previous diagnosis of diabetes that is typically well controlled with insulin injections. This patient’s history of diabetes makes her more likely to develop which of the following pregnancy-related conditions?
Question 10 options:
A)
Congestive heart failure
B)
Preeclampsia
C)
Cerebral aneurysm
D)
Stroke
preeclampsia
A 29-year-old woman is 28 weeks pregnant. She complains of nausea, abdominal pain, and right shoulder pain. She states she vomited once, which caused temporary relief; however, the pain returned shortly afterward. She has no pertinent medical history or allergies, has stable vital signs, and states that she ate a cheeseburger about 20 minutes prior to the start of her pain. The most likely cause of this patient’s presentation is:
Question 11 options:
A)
cholecystitis.
B)
appendicitis.
C)
food poisoning.
D)
hyperemesis gravidarum.
cholecystitis
You are caring for a 42-year-old woman who is 32 weeks pregnant with twins. She is complaining of a severe headache and blurred vision, and lives in a rural area approximately 30 miles from the nearest ED. Your physical exam reveals significant peripheral edema and the following vital signs: heart rate 98, blood pressure 156/98 mmHg, respirations 18. The patient states she has a history of hypertension, but has not taken her prescribed medications because “they aren’t safe for the babies.” Appropriate treatment for this patient includes:
Question 12 options:
A)
intravenous calcium chloride and 12-lead ECG.
B)
intravenous magnesium sulfate and rapid transport.
C)
administration of nitroglycerine and delayed transport.
D)
administration of aspirin and a prehospital stroke assessment.
IV mag sulfate and rapid transport
A 24-year-old pregnant woman is actively seizing. Her partner reports that she complained of abdominal pain approximately 10 minutes ago, and then began seizing. He reports that the seizure activity has been consistent for the past 10 minutes, and that she has no significant medical history. You should:
Question 13 options:
A)
apply high-flow oxygen, administer magnesium sulfate, and transport emergently.
B)
suction the airway, obtain IV access, and assess blood pressure.
C)
insert a nasal airway, administer midazolam, and obtain vital signs.
D)
apply a nasal cannula, assess blood glucose level, and transport in the left lateral position.
apply high flow oxygen administer mag sulfate and transport emergently
A 25-year-old woman presents complaining of heavy vaginal bleeding accompanied by cramping abdominal pain and backache. She can’t stop crying and reports that she is 11 weeks pregnant with her first child. Your physical exam reveals what appears to be the fetus and umbilical cord passing through the vaginal opening; however, the placenta has not been passed. Appropriate care for this patient includes:
Question 14 options:
A)
clamping and cutting the umbilical cord, wrapping fetal material in linen, and providing emotional support for the patient.
B)
leaving the fetus untouched and transporting the patient in a position of comfort.
C)
oxygen, 1000 mL fluid bolus, and rapid transport.
D)
disposing of the fetal material in a biohazard bag, left lateral position, and providing emotional support for the patient.
clamping and cutting the umbilical cord, wrapping fetal material in linen and providing emotional support
You are caring for a patient who is 36 weeks pregnant. She states that she has been experiencing vaginal bleeding after intercourse, and denies any associated pain. Vital signs are: heart rate 84, respirations 18, blood pressure 102/72 mmHg, and warm, dry skin. The most likely cause of this patient’s vaginal bleeding is:
Question 15 options:
A)
spontaneous abortion.
B)
false labor.
C)
placenta previa.
D)
abruptio placentae.
placenta previa
A 37-year-old, obviously pregnant woman complains of sharp, tearing abdominal pain. She reports that she is pregnant with her fifth child, but states she cannot remember the exact due date. The patient has a history of drug use and states that she last smoked crack cocaine approximately 30 minutes ago. You suspect:
Question 16 options:
A)
abruptio placentae.
B)
false labor.
C)
placenta previa.
D)
spontaneous abortion.
abruptio placentae
A pregnant woman is complaining of a severe headache and “feeling ill.” Her vital signs are: heart rate 92, blood pressure 120/82 mmHg, and respiratory rate of 16. Which of the following questions would be most helpful in identifying a possible pregnancy-related emergency?
Question 17 options:
A)
“What has been a typical blood pressure for you during this pregnancy?”
B)
“Do you have a history of migraine headaches?”
C)
“Have you been experiencing morning sickness or excessive vomiting today?”
D)
“When was the last time you saw your doctor?”
what has been a typical blood pressure for you during this pregnancy
Which of the following techniques is an appropriate method of estimating the gestational age?
Question 18 options:
A)
Measure the height of the fundus; each centimeter corresponds to one week of pregnancy.
B)
Palpate the abdomen and estimate gestational age based on the size of the developing fetus.
C)
Palpate the abdomen; if fetal movement is felt then the pregnancy is at least 14 weeks.
D)
Measuring the circumference of the woman’s abdomen; each inch corresponds to one week of pregnancy.
measuring the height of the fundus; each centimeter corresponds to one week of pregnancy
When assessing the vital signs of a pregnant patient, it is generally most appropriate to have the patient in which position?
Question 19 options:
A)
Left lateral recumbent
B)
Supine
C)
Standing
D)
Semi-Fowler’s
left lateral recumbent
You are caring for a 19-year-old woman who states that she is 32 weeks pregnant. She is experiencing cramping abdominal pain every six to seven minutes and reports a brief period of fluid discharge from her vagina approximately 15 minutes ago. You should:
Question 20 options:
A)
apply oxygen and perform a physical exam.
B)
provide routine BLS care and transport.
C)
administer ondansetron and reassess vital signs.
D)
begin a fluid bolus and transport code 3.
begin a fluid bolus and transport code 3
The second stage of labor begins:
Question 21 options:
A)
at the rupture of membranes.
B)
at the onset of contractions.
C)
with the complete dilation of the cervix.
D)
when the baby is delivered.
with complete dilation of the cervix
You are caring for a woman in labor. She has had three previous deliveries and states that her contractions are approximately 3 minutes apart. Physical exam reveals a bulging of tissue at the vaginal opening with each contraction; however, the baby’s head is not yet visible. You should:
Question 22 options:
A)
place the mother in the knee-chest position.
B)
encourage the mother to breathe and ready her for transport.
C)
prepare for imminent delivery.
D)
perform an internal exam to see how much the cervix is dilated.
prepare for imminent delivery
What is the appropriate sequence of care for a newborn following a normal delivery?
Question 23 options:
A)
Suction the nose, dry the infant, and cut the cord.
B)
Dry the infant, cut the cord, and place infant on mother’s stomach.
C)
Apply oxygen, dry the infant, and give the infant to the mother.
D)
Suction the mouth, deliver the placenta, and cut the cord.
dry the infant, cut the cord and place the infant on the mothers stomach
A newborn has just been delivered. He is centrally pink with pale extremities, has a heart rate of 110, and is actively crying and moving. The appropriate APGAR score for this infant is:
Question 24 options:
A)
9.
B)
6.
C)
7.
D)
8.
9
