Question 1

When assessing a 27-year-old patient who is eight months pregnant, which one of the following statements should the EMT be most concerned about?

Accepted Answer

The fact that the patient has not been able to see a doctor during her pregnancy is concerning as she may not have received adequate prenatal care and there may be potential complications that have gone unnoticed.

Question 2

You have been called to assist another crew with the birth of a baby. On scene another EMT informs you that the mother's perineum tore and is bleeding heavily. You would:

Accepted Answer

Placing a sterile dressing between the mother's vagina and rectum is appropriate for managing a torn perineum and controlling bleeding, as it applies direct pressure to the area without inserting anything into the vagina, which could cause further harm.

Question 3

A female patient is described as primigravida. Consequently, the EMT would recognize that:

Accepted Answer

Primigravida means a woman who is pregnant for the first time.

Question 4

Which of the following statements best indicates that the patient is in the second stage of labor?

Accepted Answer

The feeling of having to move the bowels is a common sensation during the second stage of labor, as the baby moves down the birth canal and puts pressure on the rectum. This is known as the "pushing stage" and is characterized by strong contractions and the urge to push. The other statements may occur earlier in labor or during later stages.

Question 5

The EMT should recognize a full-term pregnancy in which one of the following patients?

Accepted Answer

A patient who is 39 weeks pregnant is considered full-term, which means the fetus has reached its complete development inside the womb. The other options are not full-term pregnancies. B) Although the patient is in her third trimester, the fact that her water broke indicates that she is in labor, which means the fetus has not completed its development inside the womb. C) 220 days into pregnancy would only be approximately 31 weeks, which is not full-term. D) Although the patient is in her eighth month of pregnancy, the fact that she is pregnant with twins means that the fetuses are likely smaller and still developing, which means they may not be full-term yet.

Question 6

A 25-year-old female presents with abdominal pain. She appears thin and healthy, but in obvious distress. What question should the EMT ask first?

Accepted Answer

Asking about the possibility of pregnancy is important because it can affect the diagnostic and treatment plan for the patient. It is important to rule out pregnancy as a potential cause for abdominal pain. The other questions may be relevant but are not as crucial to ask first.

Question 7

A female patient who is eight and a half months pregnant states that she does not feel well and is weak with clammy skin. She denies chest pain, shortness of breath, and dizziness. She states that she did vomit earlier in the morning and still feels somewhat nauseated. She is alert and oriented and has a patent airway. She is breathing 18 times per minute and has a heart rate of 88 beats per minute. Her blood pressure is 116/70 mmHg and SpO₂ reading of 95% on room air. The most appropriate care for this patient should include:

Accepted Answer

The answer of A female patient who is eight and...

Question 8

You have been dispatched to a residence for a female patient who is dizzy and "passing out." An Emergency Medical Responder meets you at the door and reports that the patient is lying in bed and is nine months pregnant. Her pulse rate is 112 and her blood pressure is 84/50 mmHg. Respirations are 24 per minute and she has a room air pulse oximetry reading of 97%. Which one of the following should you do as soon as you reach the patient's side?

Accepted Answer

The patient's low blood pressure and high pulse rate suggest that she may be experiencing hypovolemia or shock. Rolling her onto her side can help improve blood flow to the heart and brain and prevent aspiration in case she is vomiting or nauseous. This maneuver can provide immediate benefits to the patient and should be done before any further assessment or intervention. Rechecking the blood pressure may be indicated after the patient has been repositioned and stabilized. Determining any complications of the pregnancy can also be important but may not be immediately necessary in this critical situation. Starting positive pressure ventilation may not be indicated unless the patient's breathing becomes inadequate or compromised.

Question 9

Why is the uterus essential to a healthy pregnancy?

Accepted Answer

The answer of Why is the uterus essential to a...

Question 10

Prior to delivery, the EMT prepares to create a sterile field around the patient's vaginal opening. This is best accomplished by:

Accepted Answer

Placing a sheet from the OB kit under the patient's hips and another over her abdomen and legs creates a sterile field around the vaginal opening. Using towels from the patient's residence or a sheet from the patient's bed may not provide adequate sterile coverage. Placing sheets from the OB kit over both the patient's legs and her abdomen may be cumbersome and difficult to maintain during delivery.

Question 11

Which of the following lists the stages of labor in the order in which they occur?

Accepted Answer

The stages of labor occur in the following order: dilation (cervix opening), expulsion (delivery of the baby), and placental (delivery of the placenta).

Question 12

You are assessing a female patient who informs you that she has been pregnant four times before but only delivered once. Which one of the following shows how you should document that information on the prehospital care report?

Accepted Answer

Gravida refers to the number of times a woman has been pregnant, regardless of the outcome, while Para refers to the number of viable births. Therefore, if a woman has been pregnant four times and delivered once, she would be Gravida IV, Para I.

Question 13

An EMT is presenting a continuing education class on the care of the pregnant female. When discussing the amniotic sac, he is correct to emphasize which of the following points?

Accepted Answer

The amniotic sac is a membrane that protects and insulates the baby during pregnancy. It contains amniotic fluid, which cushions the baby from shocks and allows for fetal movement. The sac typically ruptures during labor or delivery, but in some cases, it may rupture prematurely (known as premature rupture of membranes or PROM). Option A is incorrect because the amniotic sac is not surrounding and protecting the uterus, but rather the developing embryo/fetus. Option B is incorrect because Wharton's jelly is actually a gelatinous substance found in the umbilical cord, not the amniotic sac. Option C is incorrect because if the amniotic sac ruptures too early (before week 37 of pregnancy), it can pose risks to both mother and baby.

Question 14

A patient is 7 cm dilated and complaining of painful contractions. What stage of labor should the EMT identify?

Accepted Answer

At 7 cm dilation, the patient is in the first stage of labor, which is characterized by the gradual opening of the cervix and painful contractions. The second stage is expulsion, where the baby is delivered, followed by the third stage where the placenta is delivered, and the fourth stage, which involves the recovery period for the mother. The uterine stage is not a recognized stage of labor.

Question 15

When asked, a young female with abdominal pain replies that she is not sure if she is pregnant or not. Which one of the following questions provides the best opportunity to determine if the patient is pregnant?

Accepted Answer

Asking about the last menstrual period can help determine if the patient is pregnant, since pregnancy is based on the timing of periods and ovulation. The other questions do not specifically relate to pregnancy.

Question 16

The EMT would use the sterile scissors found in the OB kit to cut which of the following?

Accepted Answer

Sterile scissors found in the OB kit would be used to cut the umbilical cord during a delivery. They would not be used to cut towels or clothing, as regular scissors could be used for that purpose. In the case of an unruptured amniotic sac, the EMT would not use scissors to puncture it, as this could potentially harm the baby.

Question 17

A woman informs you that she is eight months pregnant and fatigues easily. She is apprehensive because when she lies down, she gets dizzy and feels as though she is going to vomit. Which one of the following is the best response?

Accepted Answer

The woman's symptoms may be indicative of a condition called supine hypotensive syndrome, which occurs when the weight of the uterus compresses a major blood vessel, causing a drop in blood pressure and resulting in dizziness and nausea. This can be alleviated by sleeping on her left or right side, which removes the pressure off the blood vessel. However, the woman should still check with her obstetrician to rule out any other potential concerns. Option A is an overreaction, as there is no indication that an emergency hospital visit is necessary. Option B is incorrect, as the woman's symptoms are cause for concern and should not be brushed off. Option D is inaccurate, as fatigue is a common symptom during pregnancy and energy levels don't necessarily increase in the eighth month.

Question 18

You have completed the assessment of a 32-year-old patient who is starting her seventh month of pregnancy. Which one of the following assessment findings should the EMT be most concerned about?

Accepted Answer

Intermittent vaginal bleeding during pregnancy can be a sign of a serious complication such as placenta previa or abruptio placentae, which require immediate medical attention. Painless contractions (Braxton Hicks contractions), increased appetite, and weight gain are all common and expected findings during pregnancy.

Question 19

Which statement regarding the role and function of the cervix during pregnancy is true?

Accepted Answer

During pregnancy, the cervix produces thick mucus that plugs the cervical canal and helps prevent bacteria or other pathogens from entering the uterus, which could potentially harm the developing fetus. This mucus plug may be expelled as the cervix begins to dilate during labor, often referred to as the "bloody show," but it does not confirm pregnancy in the first trimester. The EMT may palpate the cervix during labor to assess cervical dilation and effacement, but this is not a function of the cervix during pregnancy itself. While the cervix does play a role in preventing premature birth, it does so by remaining tightly closed and preventing the fetal membranes from rupturing too soon, rather than by constricting.

Question 20

Five minutes after delivering a baby, the mother feels the sudden urge to push and a gush of blood comes from the vagina. Given that the mother is not delivering twins, what stage of labor should the EMT recognize?

Accepted Answer

This is the Placental stage of labor, where the placenta is delivered. The sudden urge to push and gush of blood indicates that the placenta is detaching from the uterine wall and being expelled. The Fourth stage of labor is the period of time after the delivery of the placenta and the Second stage is the actual delivery of the baby.

Quiz 37: Obstetrics and Care of the Newborn