Question 1

You are responding to a low-income apartment complex for a 16-year-old who is five weeks pregnant with vaginal bleeding. When mentally reviewing possible causes of hemorrhage for this patient, which of the following should you be prepared to encounter?

Accepted Answer

A 16-year-old who is five weeks pregnant with vaginal bleeding is likely experiencing a spontaneous abortion, which is also known as a miscarriage. While there are other possible causes of vaginal bleeding during pregnancy, such as a ruptured uterus or dysfunctional placenta, these are less common in early pregnancy. Drug addiction may be a contributing factor to the patient's bleeding, but it is not a direct cause.

Question 2

When cutting the umbilical cord, how should the baby be positioned?

Accepted Answer

The baby should be positioned level with the vaginal opening to ensure proper blood flow and prevent any complications during the cutting of the umbilical cord.

Question 3

You are transporting a young female who just had a miscarriage at home. During the transport the woman weeps continually. What statement is most appropriate given the situation?

Accepted Answer

The most appropriate statement in this situation is to offer help and support to the patient. Option D acknowledges the patient's emotional state and offers assistance, showing empathy and compassion. Options A and B are insensitive and dismissive, with Option A assuming the patient desires to have another child immediately and Option B suggesting that the patient should ignore her own emotions to focus on her other child. Option C offers a false sense of hope and is not helpful in the moment.

Question 4

A 31-year-old female in her third trimester of pregnancy lost her balance and fell down a flight of stairs. When treating her, the EMT should:

Accepted Answer

Immobilizing the patient and then tilting the long spine board to the left is the correct procedure to avoid supine hypotensive syndrome by relieving pressure from the inferior vena cava, which can be compressed by the gravid uterus in late pregnancy, potentially compromising venous return and affecting fetal and maternal circulation.

Question 5

Which statement indicates an understanding of the relationship between seizures and pregnancy?

Accepted Answer

Prolonged seizures can cause hypoxia in both the mother and fetus, making it a potentially life-threatening situation for both. It is important for the EMT to quickly recognize and manage seizures in pregnant patients.

Question 6

Which one of the following statements regarding the placenta after the baby has been born is accurate?

Accepted Answer

The placenta typically delivers itself within 20 minutes of the birth of the baby. Gentle pressure should not be applied to the abdomen to deliver the placenta, and the placenta should be transported with the baby as it is an important part of the postpartum assessment. While it is important for the mother to remain still, it is not necessary for her to stay in the same position until the placenta is delivered.

Question 7

You are assessing a 29-year-old who has signs of imminent delivery. Her past medical history includes HIV infection. Compared to a patient with no infectious disease, how will standard precautions differ for this patient?

Accepted Answer

Standard precautions, including the use of gloves, a gown, and goggles, are recommended for all patients regardless of their infectious status to prevent the transmission of infections. This approach applies equally to patients with HIV and those without any infectious diseases, especially during procedures like delivery where exposure to bodily fluids is highly likely.

Question 8

You are delivering a baby in the patient's house. As the baby's head appears at the opening of the vagina, you notice that the amniotic membrane is still intact. You would:

Accepted Answer

When the amniotic sac is still intact as the baby's head appears, it is appropriate to gently break open the sac with your fingers. This allows the baby to be delivered safely. Cutting the sac with scissors or delaying delivery for transport could pose unnecessary risks.

Question 9

While delivering a baby, you note that the umbilical cord is wrapped around the baby's neck. You would:

Accepted Answer

If the umbilical cord is wrapped around the baby's neck, the first step is to slip the cord over the baby's shoulders to avoid strangulation. Clamping and cutting the cord or stopping the delivery and transport could cause harm to the baby. Contacting medical direction is not necessary at this point as this is a common occurrence during delivery and can be managed by the provider on-site.

Question 10

You have been called for a 16-year-old female with vaginal bleeding. On scene you determine the patient to be pregnant and bleeding for 3 hours. What statement would indicate proper care of the patient?

Accepted Answer

Placing a sanitary napkin between the patient's legs is the appropriate action to slow down the bleeding. It is not appropriate to place a piece of sterile gauze or insert a gloved hand into the vagina, as this may cause more harm than good. In addition, the patient should not be instructed to keep her legs apart as this can cause further bleeding and discomfort.

Question 11

As soon as the baby is delivered from the vaginal canal, it is critical that the EMT immediately:

Accepted Answer

Once the baby is delivered, the immediate priority is to dry and warm the newborn to prevent hypothermia and stimulate breathing. Clamping and cutting the umbilical cord, performing the APGAR assessment, and obtaining a pulse oximetry reading can be done after the baby is stabilized.

Question 12

When should the EMT instruct his partner to cut the umbilical cord?

Accepted Answer

Cutting the umbilical cord should be done after delivery and after the baby has been dried and suctioned. Cutting the cord too soon can result in loss of valuable blood and nutrients that the baby would have received from the placenta. Waiting until after the baby has been dried and suctioned reduces the risk of infection and promotes the normal process of placental transfusion.

Question 13

Which one of the following actions shows that the EMT is properly caring for the cord after delivery?

Accepted Answer

After delivery, the cord should be clamped and cut, leaving a segment of about 6 inches attached to the baby to prevent infection and allow for any necessary medical interventions.

Question 14

You have arrived at the side of a 35-year-old who is 37 weeks pregnant and in labor. Your exam reveals crowning with contractions 60 seconds apart. Your immediate action would be to:

Accepted Answer

In this scenario, the immediate action should be to prepare for delivery since the baby is crowning and contractions are very close together. Placing the patient on her back and preparing the obstetric (OB) kit is the appropriate response to facilitate delivery right there, as moving the patient could delay necessary immediate care.

Question 15

While en route for a pregnant patient who is seizing, an Emergency Medical Responder (EMR) on scene contacts you and reports that the patient is actively seizing. He continues by stating that she is seven months pregnant and has not been feeling well for the past three days (per family). What instruction is critical for you to relay to the EMR?

Accepted Answer

The most critical instruction to relay to the EMR is to provide oxygen at 15 liters per minute. Seizures can cause hypoxia, and hypoxia can be particularly dangerous for a pregnant patient and her unborn child. It is important to ensure the availability of oxygen for this patient. Restraint is not typically recommended during a seizure; placing a tongue blade in the patient's mouth is also not recommended as it can cause injury. While obtaining a seizure history may be helpful in determining the cause of the seizure, it is not as critical as ensuring the patient receives adequate oxygen.

Question 16

You are in the process of a field delivery and have just delivered the baby's head. Which one of the following should you do next?

Accepted Answer

Before continuing delivery, it is important to check for the presence of the umbilical cord around the baby's neck. This is a common occurrence and can be addressed by carefully unwrapping the cord from around the baby's neck before continuing with delivery.

Question 17

You have determined that you will need to perform a field delivery. What instructions to the patient show that the EMT is properly positioning her?

Accepted Answer

The correct positioning for a field delivery involves the patient lying on her back with her knees drawn upward and legs spread apart to facilitate the delivery process. This position provides the best access for the baby to be delivered safely.

Question 18

You arrive at the side of a pregnant patient in her third trimester who has been vaginally bleeding for several hours. Observation reveals several blood-soaked towels on the bed. She is alert and oriented with a patent airway and adequate breathing. Her pulse is 88 beats per minute and her blood pressure is 104/66 mmHg. In caring for this patient you would:

Accepted Answer

Collecting all towels with blood and transporting them with the patient can provide valuable information to the hospital staff about the amount of blood loss, which is crucial for assessing the patient's condition and determining the appropriate treatment.

Question 19

Which one of the following actions indicates that the EMT is properly suctioning the newborn?

Accepted Answer

Suctioning a newborn properly involves gently clearing the airway without causing harm. Squeezing the bulb syringe before placing it in the baby's nose and then releasing it allows for gentle suction of mucus without the risk of injuring the delicate nasal passages. Suctioning the mouth before the nose is recommended to prevent inhaling secretions into the lungs. Deep insertion of a bulb syringe or using a high suction setting can be harmful.

Question 20

What patient should the EMT be most suspicious of having a spontaneous abortion?

Accepted Answer

A patient who is experiencing vaginal bleeding and passing blood clots during the first trimester of pregnancy is most suspicious of having a spontaneous abortion. The other answer choices have symptoms that are not typical of a spontaneous abortion.

Quiz 37: Obstetrics and Care of the Newborn