Question 1

Which of the following is the highest priority to the EMT in delivery of an infant with meconium-stained amniotic fluid?

Accepted Answer

Meconium-stained amniotic fluid can be a sign of fetal distress and can potentially block the infant's airway if aspirated. Therefore, the highest priority for the EMT is to be prepared to suction the infant immediately before he takes a breath. Checking for fever and vigorously rubbing the infant's back are not as high a priority in this situation.

Question 2

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

Accepted Answer

A premature infant is defined as one who is born before 37 weeks of the pregnancy have been completed. Normal gestation is around 40 weeks, so any birth before 37 weeks is considered premature.

Question 3

In which of the following situations should the mother be transported immediately?

Accepted Answer

All the situations described are obstetric emergencies that require immediate medical attention. A severe tearing sensation with the fetus outline visible suggests uterine rupture, an infant's arm presenting first indicates a malpresentation, and painless, bright red bleeding could be a sign of placental abruption or placenta previa, all of which necessitate urgent transport to a medical facility.

Question 4

Which of the following conditions should be present before the umbilical cord is cut?

Accepted Answer

All of the above conditions should be present before the umbilical cord is cut. It is important for the infant to be breathing on their own as this signifies that they have transitioned to life outside of the womb. The cord needs to stop pulsating as it indicates that the baby has received adequate blood supply from the placenta. Lastly, the cord should be clamped in two places to prevent bleeding from both the baby and the placenta.

Question 5

Normal maternal blood loss during delivery of an infant usually does not exceed how much?

Accepted Answer

Normal maternal blood loss during delivery of an infant usually does not exceed 500 cc. This is considered to be a normal range and anything higher may indicate postpartum hemorrhage.

Question 6

Which of the following is a common sign of a pre-delivery emergency?

Accepted Answer

Profuse vaginal bleeding is a common sign of a pre-delivery emergency and can indicate a number of serious conditions such as placenta previa or placental abruption. It is important to seek immediate medical attention in these cases. Contractions becoming more intense and closer together (A) and the amniotic sac rupturing (B) are both normal signs of labor and not necessarily emergencies. The placenta failing to deliver within 20 minutes of the infant's birth (C) is a post-delivery emergency known as retained placenta.

Question 7

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 100/76.Which of the following is true regarding ectopic pregnancies?

Accepted Answer

Ectopic pregnancies occur when the fertilized egg implants outside of the uterus, often in the fallopian tubes. The fallopian tubes are not designed to accommodate a growing fetus, which can lead to severe abdominal pain and other complications. Option B is incorrect because in a normal pregnancy, the fertilized egg implants in the uterine wall. Option C is also incorrect, as ectopic pregnancies are typically diagnosed and treated prior to the second trimester. Option D is incorrect because ectopic pregnancies often cause abdominal pain and vaginal bleeding, but the bleeding is usually not painless and is often dark or brown in color.

Question 8

Which of the following is true of premature infants?

Accepted Answer

Premature infants have underdeveloped organs and immune systems, making them more susceptible to respiratory difficulty and infection. They also have difficulty regulating their body temperature and can easily become hypothermic. Therefore, all of the above options are true of premature infants.

Question 9

Which of the following is indicated in the prehospital management of a prolapsed umbilical cord?

Accepted Answer

In the prehospital management of a prolapsed umbilical cord, the best course of action is to place the mother in a head-down position with pillows under her hips. This helps to relieve pressure on the cord and prevent further compression, which could cause fetal distress. Option A is not recommended as it can further compromise blood flow to the fetus. Option B should not be encouraged as it can worsen the situation. Option C can cause further injury to the cord and is not recommended.

Question 10

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 skin cool and pale.You should immediately suspect:

Accepted Answer

The combination of severe abdominal pain, vital signs indicating shock (tachycardia, tachypnea, hypotension, cool and pale skin) and a history of sexual activity warrant immediate suspicion of an ectopic pregnancy, which is a medical emergency. Placenta previa may cause vaginal bleeding, but usually not severe abdominal pain. Appendicitis typically does not cause shock symptoms. Internal bleeding could be a possibility but given the patient's history, ectopic pregnancy should remain the top differential diagnosis.

Question 11

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:

Accepted Answer

Having the mother squeeze her legs together will not provide sufficient pressure to control the bleeding. The other options (A, B, and D) are all appropriate measures to control vaginal bleeding after childbirth.

Question 12

An infant's birth weight is considered low if it is less than ________ pounds.

Accepted Answer

An infant's birth weight is considered low if it is less than 5.5 pounds (2,500 grams).

Question 13

Traditionally an APGAR score is taken at what time intervals after birth?

Accepted Answer

The APGAR score is typically taken at 1 and 5 minutes after birth to assess the newborn's overall health and well-being. While there may be variations in practice, this is the standard protocol.

Question 14

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?

Accepted Answer

The first intervention that should be done is to place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute to improve oxygenation and reduce the cyanosis. This can be followed by other interventions as needed, but providing oxygen is the most important initial step. Ventilations with a bag-valve-mask device or a nonrebreather mask may be needed if the infant's respiratory effort is inadequate despite supplemental oxygen. CPR is not indicated as the infant has a heart rate of 140 beats per minute.

Question 15

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?

Accepted Answer

The best action is to try to slip the cord over the baby's head and shoulder to relieve any possible compression. If successful, the baby can be safely delivered. If the cord cannot be slipped over, then A or D may be necessary, depending on the situation. However, it is important to avoid unnecessary clamping or cutting of the cord before the baby is delivered as it may lead to fetal distress. Immediate transport is not recommended until the cord issue is addressed.

Question 16

Which of the following should the EMT do to control maternal bleeding after delivery of the baby?

Accepted Answer

All of the options listed are appropriate steps for an EMT to take in order to control maternal bleeding after the delivery of a baby. Applying direct pressure helps manage bleeding from perineal lacerations, allowing the infant to nurse can stimulate uterine contractions, and massaging the uterus until it is firm helps prevent postpartum hemorrhage by encouraging the uterus to contract.

Question 17

Which of the following is true concerning prehospital delivery of twins?

Accepted Answer

Prehospital delivery of twins can occur and the infants may be smaller than a single infant, requiring warmth and attention. While it is ideal to have additional help and transport to a hospital setting, it is not always possible and delivery efforts should be focused on ensuring the safety and health of the infants and mother. There may or may not be two placentas, and it is important to not cut the umbilical cord until the second infant is born to avoid potential complications. However, choice D is the only true statement about prehospital delivery of twins.

Question 18

Which of the following is appropriate when caring for a premature baby?

Accepted Answer

Premature babies have a hard time regulating their own body temperature and are more susceptible to hypothermia, so it is important to keep them warm during transport. Wrapping the infant in a blanket, covering his head, and keeping the temperature in the ambulance between 90°F and 100°F is appropriate. Choice B is not appropriate because deep suctioning can damage fragile premature tissues. Choice C is not appropriate because high-concentration oxygen can cause oxygen toxicity in premature infants. Choice D may not be appropriate because premature infants are fragile and can be susceptible to infection, so contact with family members may need to be limited.

Question 19

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?

Accepted Answer

The newborn's APGAR score is 9, calculated as follows: 2 points for a pulse of over 100, 2 points for strong crying (respiratory effort), 2 points for good movement of all extremities (muscle tone), 2 points for a pink trunk (body color), and 1 point for blue extremities (acrocyanosis). The only deduction is for the blue extremities, which indicates not completely normal coloration.

Question 20

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:

Accepted Answer

The most important care is to relieve pressure on the umbilical cord to ensure adequate blood flow and oxygen delivery to the baby.

Quiz 32: Obstetric and Gynecologic Emergencies