CH32 Obstetrics and gynecologic emergencies

Which of the following is true concerning prehospital delivery of twins?
a There are always two placentas.
b The umbilical cord of the first infant must not be cut until the second infant is born.
c This is a true emergency and cannot be managed outside t

d The infants will probably be smaller than a single infant and need attention in keeping them warm.

Which of the following BEST describes the events that occur during the first stage of labor?
a Rupture of the amniotic sac
b Expulsion of the fetus through the birth canal
c Expulsion of the placenta
d Thinning and dilation of the cervix

d Thinning and dilation of the cervix

The muscular organ in which a baby develops during pregnancy is called the:
a fetal membrane.
b placenta.
c uterus.
d amniotic sac.

c uterus.

The condition in which the placenta separates from the uterine wall is known as which of the following?
a Abruptio placentae
b Placenta previa
c Ectopic pregnancy
d Preeclampsia

a Abruptio placentae

Which of the following is a cause of gynecological emergencies?
a Soft-tissue trauma to the external genitalia
b Sexual assault
c Disorders of the female reproductive organs
d All of the above

d All of the above

Which of the following is true concerning a stillborn baby?
a Infants born in cardiopulmonary arrest should not be resuscitated.
b The parents should never be allowed to see the baby, especially if it has begun to deteriorate.
c The death may occur weeks

c The death may occur weeks before delivery.

By definition, a premature infant is one who is born before how many weeks of the pregnancy?
40
37
34
28

37

Which of the following BEST describes placenta previa?
a The placenta prematurely separates from the uterine wall.
b The pregnancy is lost before the 20th week of gestation.
c The umbilical cord is the presenting part.
d The placenta is implanted over the

d The placenta is implanted over the opening of the cervix.

What is the temporary organ of pregnancy, which functions to supply the developing fetus with oxygen and nutrients?
a Cervix
b Uterus
c Amnion
d Placenta

d Placenta

When clamping the umbilical cord, the clamp closest to the baby should be approximately ________ inch(es) from the infant's body.
a 3
b 12
c 1
d 7

d 7

Which of the following is the correct technique to check for crowning in the assessment of a woman in labor?
a Ask the woman to "push" or "bear down" as you inspect the vaginal opening.
b Place your hand on the woman's abdomen, just above the umbilicus, a

c Cover her with a sheet, have her remove her underwear, wait for a contraction, and then visualize the vaginal opening.

Which of the following is true concerning trauma in the pregnant woman?
a The mother's body will preferentially protect the life of the fetus over that of the mother.
b She may lose up to 35 percent of her blood volume before exhibiting signs of shock.
c

b She may lose up to 35 percent of her blood volume before

Which of the following is true of premature infants?
a They are at risk for respiratory difficulty.
b They are more susceptible to infection.
c They can easily develop hypothermia.
d All of the above

d All of the above

Which of the following describes the normal appearance of amniotic fluid?
a A fluid containing blood and mucus
b Thin fluid, greenish-yellow in color
c Clear and colorless fluid
d Thick fluid, greenish-black in color

c Clear and colorless fluid

Which of the following may result from a woman in her third trimester of pregnancy lying in a supine position?
a Fetal compromise
b Maternal hypotension
c The mother's body attempting to compensate for shock
d All of the above

d All of the above

Which of the following is the correct way to time the frequency of contractions in the pregnant woman?
a From the beginning of a contraction to the end of the same contraction
b From the end of one contraction to the beginning of the next
c From the begin

c From the beginning of one contraction to the beginning of the next

You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as the head was delivered and again following complete delivery. The infant is not yet breathing. Which of the following is the correct sequence of interventions?
a P

c Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and check the pulse.

Normal maternal blood loss during delivery of an infant usually does not exceed how much?
a 100 cc
b 250 cc
c 1,000 cc
d 500 cc

d 500 cc

When delivering a baby, you should do all of the following EXCEPT:
a have someone stay at the mother's head if possible.
b suction the mouth first, then the nose.
c place your fingers in the armpit to assist with delivery of the shoulders.
d position your

c place your fingers in the armpit to assist with delivery of the shoulders.

While treating a patient of sexual assault, your treatment should follow which of the following sequences?
a Treat immediate life threats, treat psychological needs, and protect criminal evidence.
b Maintain scene safety, treat immediate life threats, and

c Maintain scene safety, treat immediate life threats, treat medical and psychological needs, and protect criminal evidence.

When assisting with a delivery in the field, which of the following should be done as the head begins to emerge from the vagina?
a Check for crowning.
b Advise the mother not to push or strain.
c Apply gentle pressure to the head with your gloved hand.
d

c Apply gentle pressure to the head with your gloved hand.

If the baby's umbilical cord is noted to be wrapped around his neck after the head is delivered, which of the following should be done?
a Clamp the cord in two places but do not cut it until the baby is delivered.
b Try to slip the cord over the baby's he

b Try to slip the cord over the baby's head and shoulder.

An infant's birth weight is considered low if it is less than ________ pounds.
a 4.5
b 2.5
c 5.5
d 3.5

c 5.5

Seizures due to complications of pregnancy generally occur during which of the following time periods?
a In the first trimester
b In the second trimester
c Before the mother even knows she is pregnant
d Late in pregnancy

d Late in pregnancy

You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all extremities. What is the newborn's APGAR score?
a 7
b 10
c 9
d 8

c 9

Which of the following conditions should be present before the umbilical cord is cut?
a The infant is breathing on her own.
b The cord is no longer pulsating.
c The cord is clamped in two places.
d All of the above

d All of the above

Which of the following is indicated in the prehospital management of a prolapsed umbilical cord?
a Immediately clamp the cord in two places and cut it between the clamps.
b Encourage the mother to push forcefully in order to speed delivery.
c Use your glo

d Place the mother in a head-down position with pillows under her hips.

In which of the following situations should the mother be transported immediately?
a The mother experiences a severe, tearing sensation in her abdomen during labor and the outline of the fetus can be felt through the abdominal wall.
b The infant's arm is

d All of the above

Which of the following is NOT relevant in determining whether or not delivery is imminent for a woman in labor?
a Determining if the patient feels as if she needs to move her bowels
b Finding out how many pregnancies the patient has had
c Phoning the pati

c Phoning the patient's obstetrician for advice

By which of the following means does the fetus's blood pick up nourishment from the mother?
a Direct circulation
b Indirect circulation
c Diffusion
d Osmosis

c Diffusion

You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks you to wait because she feels the need to use the bathroom fi

d Advise the patient that this could be an indication that the baby is ready to be born and you need to check to see if the baby's head is visible.

You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds with increasing pain. The patient states that she feels the urge to push. These signs indicate which stage of delivery?
a Third stage
b Second stage
c Fourth sta

d First and second stage

Traditionally an APGAR score is taken at what time intervals after birth?
a 5 and 10 minutes
b 2 and 7 minutes
c 1 and 5 minutes
d 1 and 6 minutes

c 1 and 5 minutes

Which of the following is an appropriate question to ask while evaluating a woman in labor?
a Do you know who the father is and what is his medical history?
b When was the last time you were sexually active?
c Is this your first pregnancy?
d None of these

c Is this your first pregnancy?

Which of the following is the highest priority to the EMT in delivery of an infant with meconium-stained amniotic fluid?
a Checking for fever
b Vigorously rubbing the infant's back immediately upon delivery to stimulate breathing
c Being prepared to sucti

c Being prepared to suction the infant immediately before he takes a breath

If the baby's head is delivered with the amniotic sac still intact, which of the following should be done first?
a Use your fingers to tear the sac away from the baby's face.
b Leave the sac intact until the entire body is delivered.
c Use the scissors in

a Use your fingers to tear the sac away from the baby's face.

All of the following are signs of adequate breathing and circulation in the newborn EXCEPT:
a heart rate greater than 100.
b relaxation of the extremities.
c cyanosis of only the hands and feet.
d vigorous crying.

b relaxation of the extremities.

The greatest danger to the pregnant woman and her fetus involved in trauma is which of the following?
a Neurogenic shock
b Distributive shock
c Hemorrhagic shock
d Supine hypotensive shock

c Hemorrhagic shock

Which of the following is NOT part of a basic obstetrics kit?
a Umbilical cord clamps
b Surgical scissors
c A baby blanket
d A packet of suture material

d A packet of suture material

Which of the following is NOT advisable following complete birth of the infant?
a Dry the infant and wrap him in a blanket.
b Keep the infant at the level of the mother's vagina until the cord is clamped and cut.
c Place the infant on his side with his he

d Hold the infant by the ankles to allow the airway to drain

Which of the following is a common sign of a pre-delivery emergency?
a Contractions become more intense and closer together.
b The amniotic sac ruptures.
c The placenta fails to deliver within 20 minutes of the infant's birth.
d There is profuse vaginal b

d There is profuse vaginal bleeding.

During which stage of labor is the baby born?
a Ninth
b First
c Second
d Third

c Second

When caring for a premature baby, which of the following is appropriate?
a Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90�F and 100�F
b Deeply suctioning the airway with a rigid tonsil-tip
c Ap

a Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90�F and 100�F

Which of the following describes a breech presentation?
a The infant presents buttocks first.
b The infant presents with both feet first.
c The infant presents face first.
d Both A and B

d Both A and B

If assisting in a prehospital delivery while off-duty, which of the following would be the BEST choice for tying or clamping the umbilical cord?
a A section of wire coat hanger
b A pair of shoelaces
c White cotton thread
d A clothespin

b A pair of shoelaces

Your patient is an infant who has just been delivered 3 weeks before her due date. She is breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and chest. Which of the following interventions should be done first?
a

b Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute.

Which of the following BEST describes the term crowning?
a Complete dilation of the cervix
b The presenting part of the baby being visible at the vaginal opening
c The delivery of the head during a breech birth, completing delivery
d A discharge of bloody

b The presenting part of the baby being visible at the vaginal opening

Which of the following should be done when the infant's head has been delivered?
a Check to see if the umbilical cord is around the neck.
b Suction the mouth.
c Suction the nose.
d All of the above

d All of the above

Which of the following is of greatest concern for the EMT in the prehospital care of a woman with vaginal bleeding?
a Finding out if the patient is currently sexually active
b Monitoring for hypovolemic shock
c Obtaining a thorough gynecological history
d

b Monitoring for hypovolemic shock

Which of the following should the EMT do to control maternal bleeding after delivery of the baby?
a Apply direct pressure with a sanitary napkin over any perineal lacerations.
b Allow the infant to nurse, if possible.
c Massage the uterus until it is firm

d All of the above

While treating a pregnant trauma patient, which of the following is the BEST way to keep the fetus alive?
a Transport the patient to the closest pediatric center.
b Treat the patient as any other trauma patient.
c Do not put the patient on a spine board t

b Treat the patient as any other trauma patient.

Supine hypotensive syndrome is easily prevented by transporting the pregnant female in which of the following positions?
a Supine, with the head lower than the hips
b Lying on her left side
c On her hands and knees with her hips elevated
d Tilted slightly

b Lying on her left side

The term for a baby developing inside the mother's womb after week 8 is:
a infant.
b chorion.
c fetus.
d neonate.

c fetus.

You have been called for a 32-year-old female who is in active labor. During your assessment and interview, you note that she is 37 weeks along, this is her first child, and her contractions are 5 minutes apart. She also tells you that her pregnancy is co

c. getting to the hospital.

You are called for a woman with severe abdominal pain. During your assessment and interview, she tells you that she is sexually active and there is a chance she could be pregnant. Her vital signs are pulse 122, respirations 22, blood pressure 96/62, and s

b. ectopic pregnancy.

Your patient is a 26-year-old female with a history of ectopic pregnancies. She has called 911 for extreme abdominal pain and she is concerned that she has another ectopic pregnancy. Her vital signs are pulse 118, respirations 20, and blood pressure 100/7

a. The fallopian tubes cannot stretch to accommodate a fetus.

Your pregnant patient is in active labor. You note that her contractions are getting closer together and much stronger as the baby moves deeper into the birth canal. The muscle contraction mechanism that moves the baby toward birth is the same mechanism t

d. food from the esophagus to the stomach.

You are called to assess a pregnant woman who is approximately 7 months pregnant. She states
that her pregnancy has been uneventful but she is experiencing intermittent headaches. Her vital
signs are pulse 118, respirations 22, blood pressure 138/88, and

d. Diabetes may be made worse during pregnancy.

You have been called for a young female in labor. She is lying on the floor in obvious distress from the labor pains. While you are assessing her for crowning, your partner is getting a set of vital signs. She tells you that she is getting dizzy and nause

b. supine hypotensive syndrome.

Your pregnant patient is in active labor. She has been lying on her back throughout her labor and is experiencing signs and symptoms of shock. Her vital signs are pulse rate 118, respirations 22, blood pressure 96/62, and skin cool and diaphoretic. The be

c. place a rolled blanket under her left hip to displace the uterus

You are called for a women who is about to deliver. During the labor process, your patient's water breaks. She experiences a rush of warm water and an increase in uterine contractions. The purpose of the amniotic fluid is to:
a. provide lubrication during

d. All of the above are functions of amniotic fluid.

You have responded to a woman who has possible premature labor. She is 8 months pregnant and
is experiencing labor pains. During your assessment, you note that the baby is not yet crowning. You need to determine whether delivery is imminent or not. You sh

a. time her contractions.

You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds with increasing pain. The patient states that she feels the urge to push. These signs indicate which stage of delivery?
a. Third stage
b. Second stage
c. Fourth

d. First and second stage

You respond to a call for a patient in active labor with her second child. Your interview with the patient shows that she is 40 weeks pregnant and has been in active labor for several hours. You determine that her vital signs are all within normal limits.

b. prepare to deliver the baby on-scene.

You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is in your estimation about 8 months pregnant. She tells you that she has been hiding her pregnancy. You are especially concerned about problems she might have during

c. A young mother who has not had prenatal care

You have just delivered a full-term baby girl and she is doing well. You have dried her off and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the following is normally true regarding cutting the umbilical cord?
a. Th

b. The infant must be breathing on his own before you cut the cord.

You have delivered a newborn and wrapped the baby in a dry blanket. During your reassessment of the mother, you note continued moderate vaginal bleeding. Care for this bleeding may involve all of the following except:
a. applying firm pressure with a sani

c. having the mother squeeze her legs together to provide direct pressure.

You respond for an imminent delivery of a baby in the breech position. As you examine the mother, you see that the umbilical cord is protruding from the opening of the cervix. You realize that the most important care you can provide for this baby is to:
a

a. keep the baby off of the cord.

You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8 months pregnant and has moderate, bright red bleeding. She says that her doctor was concerned about the location of the placenta. This condition is known as:
a. placent

d. placenta previa.

You have responded to a woman who has possible premature labor. She is 8 months pregnant and
is experiencing labor pains. During your assessment, you note that the baby is not yet crowning.
You need to determine whether delivery is imminent or not. You sh

c. check for cervix dilation.

pdf version

http://www.montgomerycountymd.gov/mcfrs-psta/Resources/Files/EMTMod7/Mod7OBGYN.pdf