Quiz 1- Wk1-4

Question 1

You are faced with a non-imminent birth however the umbilical cord is visible, aspects of patient management include?
Select one:
a. Minimise cord handling, ensure the cord is pulsating, place mother in Exaggerated Sims position
b. Handle the cord with warm saline packs, ensure that that it is kept warm and moist and make sure that the presenting part is not putting pressure on the cord.
c. Transport without intervention and advise the hospital of your expected arrival time
d. Minimise cord handling and ensure that that it is kept warm and moist

Answer 1

You are faced with a non-imminent birth however the umbilical cord is visible, aspects of patient management include?

a. Minimise cord handling, ensure the cord is pulsating, place mother in Exaggerated Sims position

Question 2

Paramedics are assessing a woman who is in her eighth month of pregnancy and discover that her blood pressure is 100/70, her heart rate is 90, and her respiratory rate is 20. What do these vital signs most likely indicate?
Select one:
a. Normal changes during pregnancy
b. Severe dehydration
c. The patient is hypoxic.
d. Moderate hypovolemia at this stage of pregnancy

Answer 2

Paramedics are assessing a woman who is in her eighth month of pregnancy and discover that her blood pressure is 100/70, her heart rate is 90, and her respiratory rate is 20. What do these vital signs most likely indicate?

a. Normal changes during pregnancy

Question 3

When assessing a patient with possible pre-eclampsia a common patient complaint may be:
Select one:
a. Itchy abdomen
b. Headache
c. Increased urge to urinate
d. Blurred vision in isolation

Answer 3

When assessing a patient with possible pre-eclampsia a common patient complaint may be:

b. Headache

Question 4

What paramedic management is required to assist the delivery of the placenta in the pre-hospital environment?
Select one:
a. Perform fundal massage to assist with the deliver of the placenta, administer uterotonic drugs and storage of the placenta into a clinical waste bag for review at hospital
b. Administration of uterotonic drugs, active cord traction and storage of the placenta into a clinical waste bag for review at hospital
c. Active cord traction, administration of uterotonic drugs and storage of the placenta into a clinical waste bag for review at hospital
d. Let the placenta deliver without active intervention, monitor the women for ongoing blood loss and storage of the placenta into a clinical waste bag for review at hospital and monitor the woman for ongoing blood loss

Answer 4

What paramedic management is required to assist the delivery of the placenta in the pre-hospital environment?

d. Let the placenta deliver without active intervention, monitor the women for ongoing blood loss and storage of the placenta into a clinical waste bag for review at hospital and monitor the woman for ongoing blood loss

Question 5

In the setting of a footling breech presentation the paramedic should (multiple answers):
Select one or more:
a. Undertake a ‘hands-off’ approach
b. Attempt to deliver using the Lovset’s maneouvre
c. Prepare a polyethylene bag regardless of gestation age.
d. Use the McRobert’s position

Answer 5

In the setting of a footling breech presentation the paramedic should (multiple answers):

a. Undertake a ‘hands-off’ approach
b. Attempt to deliver using the Lovset’s maneouvre

Question 6

During the assessment of a pregnant woman, paramedics discover the baby is crowning. The contractions are 1 minute apart. The patient is a gravida 3, para 2. How should the paramedics proceed?
Select one:
a. Stay on scene and prepare to assist with the birth of the baby
b. Reassure the mother that she will not birth her baby for at least an hour
c. Transport immediately
d. Prepare for delivery, while traveling to hospital under emergency driving conditions

Answer 6

During the assessment of a pregnant woman, paramedics discover the baby is crowning. The contractions are 1 minute apart. The patient is a gravida 3, para 2. How should the paramedics proceed?

a. Stay on scene and prepare to assist with the birth of the baby

Question 7

How does the McRobert’s position work to assist the delivery in a suspected shoulder dystocia?
a. Opens the pelvis diameter
b. Allows the mother to push harder with contractions
c. Allows the baby’s pelvis and legs to restitute in the correct position.
d. Prevents nuchal cord

Answer 7

How does the McRobert’s position work to assist the delivery in a suspected shoulder dystocia?

a. Opens the pelvis diameter

Question 8

Signs of shoulder dystocia may include (select all that apply):
a. Post partum haemorrhage
b. Failure of shoulders to descend
c. A ‘footling’ presentation
d. Failure of the baby to undergo restitution
e. Prolonged delivery time of body > 1 min

Answer 8

Signs of shoulder dystocia may include (select all that apply):

b. Failure of shoulders to descend
d. Failure of the baby to undergo restitution
e. Prolonged delivery time of body > 1 min

Question 9

Third stage labour should last no longer than…
Select one:
a. Ten hours
b. Three hours
c. One hour
d. Six hours

Answer 9

Third stage labour should last no longer than…
Select one:

c. One hour

Question 10

The definition of an antepartum haemorrhage is:
Select one:
a. Any significant blood loss occurring within six weeks post birth
b. Any internal or external bleeding occurring throughout a pregnancy prior to birth/labour
c. Greater than 500mls of blood loss within 24 hours post birth
d. The rupture of membranes

Answer 10

The definition of an antepartum haemorrhage is:
Select one:

b. Any internal or external bleeding occurring throughout a pregnancy prior to birth/labour

Question 11

The first manoeuvre to use when faced with a should dystocia is?
Select one:
a. McRobert’s
b. Lovset’s
c. All-fours
d. Mauriceau-Smellie-Viet

Answer 11

The first manoeuvre to use when faced with a should dystocia is?
Select one:
a. McRobert’s

Question 12

At what gestation age do you need to use a polyethylene bag with a preterm baby to keep them warm?
Select one:
a. <30
b. <32
c. <34
d. <28

Answer 12

At what gestation age do you need to use a polyethylene bag with a preterm baby to keep them warm?

d. <28

Question 13

When assessing visible blood loss, what volume needs to be present for a paramedic to confirm primary post-partum haemorrhage:
Select one:
a. >250mls
b. >500mls
c. <500mls
d. >1000mls

Answer 13

When assessing visible blood loss, what volume needs to be present for a paramedic to confirm primary post-partum haemorrhage:

b. >500mls

Question 14

You are attempting to manage an imminent birth with a breech presentation. The mother is resting with her buttocks on the edge of the bed and the baby’s buttocks are visible as the presenting part. To safely facilitate the birth from this position the baby’s back should be:
Select one:
a. Maintained in a lateral but neutral position until the nape of the neck is visible
b. Uppermost toward the paramedic with the baby’s face toward the sacrum
c. Maintained in a lateral position until the nape of the neck is visible
d. Back facing away from the treating paramedic with the baby’s face toward the mothers abdomen

Answer 14

You are attempting to manage an imminent birth with a breech presentation. The mother is resting with her buttocks on the edge of the bed and the baby’s buttocks are visible as the presenting part. To safely facilitate the birth from this position the baby’s back should be:

b. Uppermost toward the paramedic with the baby’s face toward the sacrum

Question 15

If during a breech presentation the baby’s arms don’t birth by themselves, the paramedic should perform the:
Select one:
a. Gaskin manoeuvre
b. Lovsetts manoeuvre
c. Suprapubic pressure
d. McRobert’s manoeuvre

Answer 15

If during a breech presentation the baby’s arms don’t birth by themselves, the paramedic should perform the:

b. Lovsetts manoeuvre

Question 16

Fill the blanks- Positioning the pregnant patient supine should be avoided, as this can lead to obstruction of the _____ causing a ____ in cardiac output and subsequent _____

Answer 16

Positioning the pregnant patient supine should be avoided, as this can lead to obstruction of the inferior vena cava causing a decrease in cardiac output and subsequent hypotension

Question 17

Fundal massage should be applied to:
Select one:
a. A firm, compacted and central fundus associated with visible blood loss
b. To assist the delivery of the placenta post birth of the baby
c. A soft, boggy fundus that is associated with visible blood loss
d. To assist the uterus to correctly expel the placenta in the shortest timeframe possible post birth

Answer 17

Fundal massage should be applied to:

c. A soft, boggy fundus that is associated with visible blood loss

Question 18

The most effective pharmacological agent available to paramedics to assist in the control of PPH is:
Select one:
a. Oral misoprostol
b. IM oxytocin
c. Oral oxytocin
d. IV misoprostol

Answer 18

The most effective pharmacological agent available to paramedics to assist in the control of PPH is:

b. IM oxytocin

Question 19

An APGAR assessment should be performed by the treating paramedic at:
Select one:
a. 3 and 7 minutes post birth
b. 2 and 6 minutes post birth
c. At least once in the first 10 minutes post birth
d. 1 and 5 minutes post birth

Answer 19

An APGAR assessment should be performed by the treating paramedic at:

d. 1 and 5 minutes post birth

Question 20

Appropriate positioning of the pregnant women can be of assistance with her underlying perfusion during transport. The recommended position and gestational age where this becomes relevant are:
Select one:
a. Semi-recumbent with legs elevated 15 degress when gestational age >25 weeks
b. Left lateral tilt of 20 degrees when gestational age >16 weeks
c. Left lateral tilt of 15- 30 degrees when gestational age >20 weeks
d. Semi-recumbent with legs elevated 15 degress when gestational age >20 weeks

Answer 20

Appropriate positioning of the pregnant women can be of assistance with her underlying perfusion during transport. The recommended position and gestational age where this becomes relevant are:

c. Left lateral tilt of 15- 30 degrees when gestational age >20 weeks

Question 21

Care of the vigorous newborn includes:
Select one:
a. Place newborn on a flat surface and commence CPR/ventilation
b. Dry newborn, immediately cut the umbilical cord, wrap newborn in a towel and allow father to have a cuddle
c. Suction newborn’s mouth and nose, administer high flow oxygen and dry head
d. Dry newborn thoroughly, place newborn naked on mother’s chest with skin-to-skin contact, dry newborn’s head, cover newborn and mother with warm blankets/towels

Answer 21

Care of the vigorous newborn includes:

d. Dry newborn thoroughly, place newborn naked on mother’s chest with skin-to-skin contact, dry newborn’s head, cover newborn and mother with warm blankets/towels

Question 22

The most common type of breech presentation is:
Select one:
a. Complete breech
b. Breech with flexed legs
c. Frank breech
d. Footling breech

Answer 22

The most common type of breech presentation is:

c. Frank breech

Question 23

Paramedics are attending a female patient who is 30 weeks gestation with her second child. She has had a mechanical fall from standing height and landed on her stomach. There was no head strike or loss of consciousness. She is now complaining of severe abdominal pain. What is the correct management of this patient?
Select one:
a. Transport to the maternity unit where patient is booked in
b. Advise patient to follow up with GP
c. Give patient two paracetamol tablets and leave them at home
d. Administer effective analgesia and transport to highest level trauma centre (preferably with an attached obstetrics facility) within state specific time frame

Answer 23

Paramedics are attending a female patient who is 30 weeks gestation with her second child. She has had a mechanical fall from standing height and landed on her stomach. There was no head strike or loss of consciousness. She is now complaining of severe abdominal pain. What is the correct management of this patient?

d. Administer effective analgesia and transport to highest level trauma centre (preferably with an attached obstetrics facility) within state specific time frame

Question 24

Signs of placental separation in third stage labour do not include:
Select one:
a. Uterus becoming rounder, firmer, smaller
b. Lengthening of cord
c. Spontaneous rupture of membranes
d. Cramping/contractions return

Answer 24

Signs of placental separation in third stage labour do not include:

c. Spontaneous rupture of membranes

Question 25

An assessment finding that indicates that an imminent birth may be about to occur include:
Select one:
a. Sharp generalised abdominal pain
b. Passing of mucosal plug
c. Crowning of fetal head
d. Intermittent contractions that are brief in nature

Answer 25

An assessment finding that indicates that an imminent birth may be about to occur include:

c. Crowning of fetal head