OB/GYN Practice Exam Annotated Answer Key

1.  

Reading Level: 9.3	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.25

A:	Create an area that is sterile and free of any germs.
B:	Instruct her to lie on her side when she has an urge to push.
C:	Tell the patient to use the bathroom while you are setting up.
D:	Have the patient remove her pants and cover her legs with a sheet.
Treating the patient with kindness and respecting her dignity will be a big part of your treatment. The other distracters are impossible to create or potentially dangerous.

2.  

Reading Level: 7	Bloom Level: 4	Cut Score: 0.9
Provider: EMT-P	National Registry: OB18	Objective: 5-14.26

A:	It will protect the rescuers from civil liability later.
B:	Relatives can serve as legal witneseses for the EMS run form.
C:	If needed, relatives or friends could be able to assist with the delivery.
D:	Calling a friend or relative could comfort the patient.
Delivery of a new baby can be stressful for a new mom. Calling for a friend or family member could make her feel better during this stressful time. Our job requires us to think about the emotions of a patient.

3.  

Reading Level: 9.7	Bloom Level: 2	Cut Score: 0.36
Provider: EMT-P	National Registry: OB17	Objective: 5-14.2

A:	The delivery of the placenta after a baby has been born.
B:	A small mixture of blood and mucous that preceeds delivery.
C:	A Large flow of bright red fluid indicating the placenta has ruptured.
D:	The tearing of the tissue between the vagina and rectum during delivery of a large baby.
A bloody show indicates that the cervix is dilating and active labor is in progress. Delivery of the placenta is “after birth” and a large flow of bright red fluid does not match the typical description of a bloody show.

4.  

Reading Level: 9.9	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB20	Objective: 5-13.8

A:	Examine the vaginal area.
B:	Place bloody articles in paper bags.
C:	Question the patient about the incident.
D:	Remove the patient’s clothing and place in separate bags for evidence.
You should place any bloody articles in a paper bag to preserve the evidence. You should avoid examining the vaginal area in this situation unless you suspect severe bleeding. The other two choices should not be performed.

5.  

Reading Level: 8.9	Bloom Level: 5	Cut Score: 0.45
Provider: EMT-P	National Registry: OB18	Objective: 5-14.11

A:	Create a setting that is as private as possible for the patient where she is found.
B:	Tell the manager that you are not allowed to move patients without EMS help.
C:	Pressure the patient to consider moving to the restroom as requested by the staff.
D:	Suggest to the manager he close the restaurant down and ask everyone to leave.
The BEST answer is to place the interest of your patient as your highest priority. Creating a setting that is as private as possible is the best answer. Pressuring the patient to move or offering advice to the manager is not your responsibility.

6.  

Reading Level: 10.4	Bloom Level: 4	Cut Score: 0.9
Provider: EMT-P	National Registry: OB16	Objective: 5-13.6

A:	Gall stones.
B:	Kidney stones.
C:	Endometriosis.
D:	Ectopic pregnancy.
Our greatest concern would be that the patient may have an ectopic pregnancy which is a life-threatening condition. The other conditions listed are not life-threatening.

7.  

Reading Level: 6.7	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: OB23	Objective: 5-14.4

A:	Dilation.
B:	Contraction.
C:	Expulsion.
D:	Placental.
The expulsion stage is the stage when the baby is delivered. The placental stage is when the placenta is delivered. The dilation stage occurs prior to delivery. There is no contraction stage.

8.  

Reading Level: 5.8	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.1

A:	Uterus.
B:	Cervix.
C:	Placenta.
D:	Amniotic Sac.
The organ that holds the fetus is the uterus. The amniotic sac is not an organ.

9.  

Reading Level: 9.7	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.5

A:	Limb.
B:	Breech.
C:	Cephalic.
D:	Transverse.
The description provided is that of a breech presentation.

10.  

Reading Level: 6.7	Bloom Level: 2	Cut Score: 0.9
Provider: EMT-P	National Registry: OB23	Objective: 5-14.9

A:	Scalpel.
B:	Bulb syringe.
C:	Placental bag.
D:	Umbilical clamps.
The most important piece of equipment listed is the bulb syringe as it allows us to provide a clear airway for the newborn.

11.  

Reading Level: 12	Bloom Level: 1	Cut Score: 0.45
Provider: EMT-P	National Registry: OB17	Objective: 5-14.7

A:	Nuchal cord.
B:	Prolapsed cord.
C:	Placenta previa.
D:	Limb presentation.
Placenta previa is a pre-delivery emergency. The other emergencies listed occur during the delivery process.

12.  

Reading Level: 10.7	Bloom Level: 6	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.8

A:	Crowning.
B:	Braxton Hicks contractions.
C:	Labor pains which are 10 minutes apart.
D:	The mother indicates she has an urge to defecate.
The best indication of those listed would be crowning. The next best would be the mother's indication for an urge to defecate.

13.  

Reading Level: 7	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.10

A:	Administer high-flow oxygen.
B:	Tilt the board onto the patient’s left side.
C:	Place an oral airway and begin ventilating.
D:	Place the patient in a trendelenburg position.
The patient is showing signs of supine hypotension disorder and needs to be immediately tilted to the left to take pressure off of the vena cava.

14.  

Reading Level: 10.1	Bloom Level: 2	Cut Score: 0.45
Provider: EMT-P	National Registry: OB23	Objective: 5-14.11

A:	On a table.
B:	On her bed.
C:	On the floor.
D:	On the stretcher.
The stretcher would be the best place to position the mother so if there are complications of delivery, you are immediately prepared to transport.

15.  

Reading Level: 12	Bloom Level: 3	Cut Score: 0.9
Provider: EMT-P	National Registry: OB23	Objective: 5-14.12

A:	Gown.
B:	Gloves.
C:	Face shields and masks.
D:	All of the above.
Childbirth is messy and you should use all of the BSI materials available.

16.  

Reading Level: 6.8	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.13

A:	Immediately transport the mother.
B:	Cut the sac open with your scalpel.
C:	Use your fingers to puncture the sac.
D:	Continue with the delivery as this is normal.
You should first attempt to puncture the sac with your fingers. If this fails, carefully using your scalpel would be your next option.

17.  

Reading Level: 6.1	Bloom Level: 3	Cut Score: 0.9
Provider: EMT-P	National Registry: OB23	Objective: 5-14.13

A:	Clamp and cut the cord.
B:	Suction the mouth then the nose.
C:	Dry the head to prevent heat loss.
D:	Pull the baby’s head down to delivery the shoulders.
As soon as the head is delivered you should suction the mouth then nose. You should also assess for a nuchal cord at this time.

18.  

Reading Level: 3.9	Bloom Level: 2	Cut Score: 0.9
Provider: EMT-P	National Registry: OB23	Objective: 5-14.15

A:	Prior to pulsations stopping and before clamping the cord.
B:	After pulsations have stopped and prior to clamping the cord.
C:	Prior to pulsations stopping and after you have clamped the cord.
D:	After pulsations have stopped and after you have clamped the cord.
The cord should not be cut until pulsations have stopped and you have clamped the cord.

19.  

Reading Level: 9.7	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.16

A:	It usually takes the placenta about 20 minutes to deliver.
B:	You should delay transport until the placenta has delivered.
C:	You should have the mother nurse to facilitate placental delivery.
D:	You should gently massage the uterus to facilitate placental delivery.
It usually takes about 20 minutes for the placenta to deliver. You do not need to delay transport for placental delivery. The other two deal with controlling post-partum bleeding and not placental delivery.

20.  

Reading Level: 7.6	Bloom Level: 4	Cut Score: 0.45
Provider: EMT-P	National Registry: OB22	Objective: 5-14.18

A:	Administer oxygen.
B:	Begin chest compressions.
C:	Suction the mouth then nose.
D:	Begin bag-valve-mask ventilation.
Ensuring a clear airway should be your first action. You would then administer oxygen, assist ventilations, and finally begin compressions.

21.  

Reading Level: 7.9	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.19

A:	Clamp and cut the cord.
B:	Continue with the delivery as this is normal.
C:	Attempt to slide the cord around the head or shoulders.
D:	Place your gloved hand into the vagina and lift the head up until the cord begins pulsating.
You should lift the head off the cord to relieve the pressure from the cord. Attempting to slide the cord around the shoulders or head is the correct answer for a nuchal cord issue, not a prolapsed cord.

22.  

Reading Level: 11.7	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.19

A:	Nuchal cord.
B:	Prolapsed cord.
C:	Limb presentation.
D:	Transverse presentation.
Of the choices listed, a prolapsed cord would be the only correct answer. The only other time it is appropriate for an EMS provider to place a gloved hand into the birth canal is a delayed breech delivery.

23.  

Reading Level: 9.4	Bloom Level: 4	Cut Score: 0.45
Provider: EMT-P	National Registry: OB22	Objective: 5-14.23

A:	One of the infants may be a breech presentation.
B:	Paying special attention to keeping the infants warm.
C:	The delivery will be especially difficult due to the size of the infants.
D:	Not clamping the cord of the first child until the second child has delivered.
Twins are typically born early and can not protect themselves from heat loss as well as a full-term newborn. Twins are usually smaller than a full-term so the breech concerns will not occur. The clamping of cord is not a concern.

24.  

Reading Level: 10.4	Bloom Level: 3	Cut Score: 0.9
Provider: EMT-P	National Registry: OB22	Objective: 5-14.22

A:	Begin ventilations immediately.
B:	Suction before stimulating the infant.
C:	Wipe off the child thoroughly before any other action.
D:	Perform chest thrusts to remove any foreign obstructions.
You should suction immediately to prevent aspiration of the meconium.

25.  

Reading Level: 9.9	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB22	Objective: 5-14.23

A:	Keeping the infant warm.
B:	Performing an APGAR assessment.
C:	Placing the infant on a non-rebreather.
D:	Suctioning the nose then mouth with a flexible suction catheter.
Heat loss is a significant issue with the premature infant. We should suction the mouth first not the nose.

26.  

Reading Level: 8.2	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB20	Objective: 5-13.6

A:	Placing the patient on her right side.
B:	Looking for signs of imminent delivery.
C:	Controlling any bleeding from the vagina.
D:	Administering high-concentration oxygen.
This patient is showing signs of an ectopic pregnancy and needs high-concentration oxygen. The location of the pain does not indicate imminent delivery. Ectopic pregnancies do not usually cause vaginal bleeding.

27.  

Reading Level: 9.7	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.3

A:	An elevated blood pressure.
B:	A blood loss of 30% with no signs of shock.
C:	A respiratory rate which is greater than her normal.
D:	A pulse rate that is 10-15 beats faster that her normal.
An elevated blood pressure is not a normal sign in the last trimester and indicates the potential development of pre-eclampsia.

28.  

Reading Level: 8.5	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.24

A:	Providing low-concentration oxygen.
B:	Providing her with high-concentration oxygen.
C:	Placing her in a trendelenburg position to treat for shock.
D:	Assisting with normal delivery as her signs are appropriate for her condition.
You should immediately provide this patient with high concentration oxygen as this is the only way to treat the fetus who, given the mechanism, is probably suffering from hypoxia.

29.  

Reading Level: 8.6	Bloom Level: 6	Cut Score: 0.45
Provider: EMT-P	National Registry: OB20	Objective: 5-13.8

A:	Providing care for the patient.
B:	Preventing destruction of evidence.
C:	Maintaining the patient’s modesty and privacy.
D:	Providing accurate and complete documentation.
Though all are important, providing care for the patient is our highest priority.

30.  

Reading Level: 10	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB20	Objective: 5-13.6

A:	Cystitis.
B:	Endometritis.
C:	Ruptured ovarian cyst.
D:	Pelvic inflammatory disease.
The unilateral pain and tha absence of any sign of infection indicate that this patient has a ruptured ovarian cyst. The other processes listed would produce a fever and would not be unilateral in nature.

31.  

Reading Level: 11	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB20	Objective: 5-13.6

A:	Endometritis.
B:	Endometriosis.
C:	Ectopic pregnancy.
D:	Pelvic inflammatory disease.
The signs and symptoms as well as the history of sexually transmitted diseases should lead you to suspect this patient has pelvic inflammatory disease. Endomitritis would be a good wrong answer.

32.  

Reading Level: 12	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: OP5	Objective: 5-14.12

A:	Gloves only.
B:	Gloves and booties.
C:	Gloves, gowns, and booties.
D:	Gloves, gown, and goggles.
OSHA mandates that gloves, a gown, and goggles are the appropriate BSI precautions for delivery of a fetus.

33.  

Reading Level: 11.7	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.6

A:	Abruptio placenta.
B:	Placenta previa.
C:	Spontaneous abortion.
D:	Pre-eclampsia.
Abruptio placenta, placenta previa, and pre-eclampsia occur in the 2nd and 3rd trimesters, while spontaneous abortions usually occur between 12 and 13 weeks.

34.  

Reading Level: 10.2	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB22	Objective: 5-14.14

A:	Cutting the umbilical cord.
B:	Suctioning the mouth then nose.
C:	Drying, warming and stimulating.
D:	Assisting ventilations with a bag-valve-mask.
Drying, waming, and stimulating the newborn is done partially to encourage the newborn to breathe. As such, it is important to make sure the newborn has a clear airway before this occurs. If spontaneous breathing does not occur after suctioning and stimulating, providing ventilations will become necessary. Cutting the umbilical cord is a low priority.

35.  

Reading Level: 9.2	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: OB20	Objective: 5-13.5

A:	Packing the vagina with sterile gauze.
B:	Initiating intravenous access for fluid replacement.
C:	Rapid transport to a surgical center.
D:	High-flow oxygen via a non-rebreather.
One should never pack the vagina as a means to control bleeding for any reason.

36.  

Reading Level: 10.5	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.3

A:	When did you get pregnant?
B:	When is your due date?
C:	How many babies have you had?
D:	Have you been confined to bed rest?
The estimated date of confinement (EDC), is also known as the due date. It is calculated by taking the first day of the last menstrual period and adding 280 days.

37.  

Reading Level: 5.6	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.12

A:	Initiate intravenous access.
B:	Don body substance isolation precautions.
C:	Drape the mother with sterile towels.
D:	Move the patient to a position of comfort.
You should first take appropriate body substance isolation.

38.  

Reading Level: 10.1	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.6

A:	The newborn will probably be apneic.
B:	The newborn will be smaller than normal.
C:	The newborn will be larger than normal.
D:	The newborn will have its spinal cord exposed.
Gestational diabetes statistically has a direct correlation with producing larger than normal babies.

39.  

Reading Level: 10.7	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.8

A:	The mother's urge to move her bowels.
B:	Contractions that are 3-5 minutes apart.
C:	Rupture of the bag of waters.
D:	Contractions lasting approximately 30 seconds.
The mother's urge to push or move her bowels and the presence of crowning absolutely indicate imminent delivery.

40.  

Reading Level: 11.6	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: N/A	Objective: 5-13.2

A:	The secretory phase.
B:	The ovulation phase.
C:	The proliferative phase.
D:	The ischemic phase.
The proliferative phase is dominated by estrogen to prepare the uterus for a fertilized egg.

41.  

Reading Level: 8.4	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB20	Objective: 5-13.6

A:	Cystitis.
B:	Endometritis.
C:	Endometriosis.
D:	Ruptured ovarian cyst.
You should suspect this patient is suffering from endometritis. A ruptured ovarian cyst would be unilateral. Cystitis involves the bladder and would affect urination, and endometriosis would not cause a foul-smelling vaginal discharge.

42.  

Reading Level: 9.8	Bloom Level: 1	Cut Score: 0.45
Provider: EMT-P	National Registry: OB16	Objective: 5-13.4

A:	Mittelschmerz.
B:	Pelvic inflammatory disease.
C:	Endometriosis.
D:	Ectopic pregnancy.
PID, or pelvic inflammatory disease is the overwhelming number one cause of non-traumatic abdominal pain, occurring in approximately 2% of all women in the United States at some point.

43.  

Reading Level: 6.9	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.5

A:	A maternal blood loss of 1500 ml.
B:	A decrease in fetal heart rate during contractions.
C:	The fetus presenting head first face down.
D:	Vaginal and perineal tearing.
The normal amount of blood loss during labor typically does not exceed 1 pint or 500 ml.

44.  

Reading Level: 7.7	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.19

A:	Clamp and cut the cord immediately.
B:	Gently lift the cord over the baby's head.
C:	Transport the infant to the nearest obstetric facility.
D:	Request medical control permission for a caesarean section.
This is a nuchal cord situation. Usually there is enough room to gently slide the umbilical cord over the infant's head.

45.  

Reading Level: 9.1	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.3

A:	Dusting and cleaning.
B:	Dilation and curettage.
C:	Dyspareunia and coitus.
D:	Dysmenorrhea and cervicalitis.
The medical term represented by D&C is dilation and curetage. The term often is mentioned as dusting and cleaning.

46.  

Reading Level: 11.8	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.3

A:	P3, G2, AB1.
B:	G3, P2, AB1.
C:	G2, P2, AB1.
D:	P5, G2, AB1.
Gravida is the number of times a female has been pregnant (G3), Para or Parity is the number of times she has delivered (P2), and (AB1) represents the number of abortions.

47.  

Reading Level: 9.1	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.3

A:	The fallopian tubes spasm preventing fertilization.
B:	Estrogen and progesterone inhibit the release of the egg.
C:	The uterine wall is not capable of maintaining a pregnancy.
D:	Chemicals are released that destroy the sperm prior to fertilization.
Oral contraceptives cause estrogen and progesterone to inhibit the release of the ovum. Spermicides destroy the sperm.

48.  

Reading Level: 8	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.3

A:	Amenorrhea.
B:	Dyspareunia.
C:	Dysmenorrhea.
D:	Premenstrual syndrome.
Dysmenorrhea is the name for pain during menstruation. Dyspareunia is the term for pain during intercourse. Amenorrhea means without menstruation.

49.  

Reading Level: 8.5	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	Period.
B:	Puberty.
C:	Menarche.
D:	Menopause.
A female's first menstrual period is called menarche.

50.  

Reading Level: 8.3	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	Testosterone.
B:	Progesterone.
C:	Leutenizing hormone.
D:	Follicle stimulating hormone.
Progesterone is secreted by the ovaries. Testosterone is screted by the testicles. The leutenizing hormone and the follicle stimulating hormone are secreted by the anterior pituitary gland.

51.  

Reading Level: 9.7	Bloom Level: 1	Cut Score: 0.45
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	Epimetrium.
B:	Perimetrium.
C:	Myometrium.
D:	Endometrium.
The myometrium is the middle layer made up of smooth muscles. The endometrium is the inner lining. The perimetrium is the outer wall of the uterus.

52.  

Reading Level: 8.3	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	Prepuce.
B:	Perineum.
C:	Peritoneum.
D:	Episiotoneum.
The perineum is the area between the vagina and the anus. The prepuce is the area that covers the clitoris. The peritoneum is located in the abdomen.

53.  

Reading Level: 10.1	Bloom Level: 4	Cut Score: 0.9
Provider: EMT-P	National Registry: OB20	Objective: 5-13.9

A:	Have the Basic EMT attend on this call.
B:	Have the advanced provider attend on this call.
C:	Have the police transport the patient to the hospital.
D:	Call a supervisor and have them accompany the patient during transport.
As the patient is stable, having the female EMT attend on this call would be the most apporpriate action.

54.  

Reading Level: 12	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.6

A:	Postpartum hemorrhage.
B:	Meconium staining.
C:	Pulmonary embolism.
D:	Myocardial infarction.
Pulmonary embolism is one of the most common causes of maternal cardiac arrest before and after pregnancy.

55.  

Reading Level: 12	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: N/A	Objective: 5-14.1

A:	The cervix.
B:	The vagina.
C:	The uterus.
D:	The urethra.
The urethra is part of the urinary system and not actually a component of the reproductive system.

56.  

Reading Level: 4.7	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.4

A:	Delivery of the fetus.
B:	Delivery of the placenta.
C:	Complete dilatation and effacement.
D:	Contractions 2-3 minutes apart.
The first stage of labor ends with complete dilatation and effacement, while the third, or placental stage ends with expulsion of the placenta/afterbirth.

57.  

Reading Level: 7.6	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB22	Objective: 5-14.15

A:	Approximately 15 inches from the baby.
B:	Approximately 10 centimeters from the baby.
C:	Approximately 8 centimeters from the mother.
D:	Approximately 4 inches from the mother.
The first clamp should be placed approximately 10 centimeters, 4 inches, from the baby, and the second clamp another 5 centimeters or 2 inches from the first clamp.

58.  

Reading Level: 5.8	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	Reception of the penis during copulation.
B:	Provision of an outlet for menstrual blood and debris.
C:	A passageway during childbirth.
D:	Protection of the pelvic structures.
The vagina is an internal reproductive organ and does not provide any protection for the pelvic structures.

59.  

Reading Level: 8.2	Bloom Level: 3	Cut Score: 0.6
Provider: EMT-P	National Registry: OB17	Objective: 5-14.6

A:	Abruptio placenta.
B:	Ectopic pregnancy.
C:	Placenta previa.
D:	Gestational diabetes.
The onset of bright red, painless, vaginal bleeding is one of the hallmark signs of placenta previa.

60.  

Reading Level: 11.5	Bloom Level: 2	Cut Score: 0.9
Provider: EMT-P	National Registry: OB18	Objective: 5-14.21

A:	Pack the vagina with sterile dressings.
B:	Administer 10-20 units of Pitocin IV push.
C:	Administer Dopamine at 5 mcg/kg/min.
D:	Perform a fundal massage.
You should first perform a fundal massage to encourage the uterus to contract.

61.  

Reading Level: 9.4	Bloom Level: 1	Cut Score: 0.45
Provider: EMT-P	National Registry: N/A	Objective: 5-13.2

A:	Menses.
B:	Menarche.
C:	Mittelschmerz.
D:	Premenstrual syndrome.
Mittelschmerz is the name given for pain upon ovulation. Menarche is a female's first period. Menses is another term for menstruation.

62.  

Reading Level: 6.3	Bloom Level: 3	Cut Score: 0.9
Provider: EMT-P	National Registry: OB27	Objective: 5-14.17

A:	Pack the vagina with sterile gauze.
B:	Apply the pneumatic anti-shock garment.
C:	Place the mother in the trendelenburg position.
D:	Massage the uterus until you feel the uterus contract.
Your next action should be to massage the abdomen over the uterus to facilitate contraction. We should never pack the vagina. Trendelenburg and PASG are not necessary yet.

63.  

Reading Level: 8.7	Bloom Level: 1	Cut Score: 0.9
Provider: EMT-P	National Registry: N/A	Objective: 5-13.1

A:	The fundus.
B:	The fallopian tubes.
C:	The cervix.
D:	The endometrium.
The fundus is the most superior portion. The endometrium is the inner lining of the uterus and the fallopian or uterine tubes connect the uterus and ovaries.

64.  

Reading Level: 8.6	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.3

A:	Just below the rib cage.
B:	At the level of the umbilicus.
C:	Just above the symphysis pubis.
D:	Midway between the symphysis pubis and umbilicus.
At five months you should expect the top of the uterus to be level with the umbilicus. At three months it is just above the symphysis pubis. At four months it is midway between the umbilicus and the pubic bone and at term it is just under the rib cage.

65.  

Reading Level: 3.7	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: OB23	Objective: 5-14.9

A:	Under the buttocks, below the vaginal opening, and across the lower abdomen.
B:	Under the buttocks, at the end of the stretcher, and behind the abdomen.
C:	Behind the head, at the end of the stretcher, and across the abdomen.
D:	Beneath the vaginal opening, across the abdomen, and on the floor of the ambulance.
Utilizing drapes is an attempt to maintain aseptic technique throughout delivery. Drapes should be placed in areas that will most protect the newborn and mother after delivery from infection.

66.  

Reading Level: 7.5	Bloom Level: 1	Cut Score: 0.6
Provider: EMT-P	National Registry: N/A	Objective: 5-14.2

A:	A woman who has delivered twins.
B:	The number of times a woman has been pregnant.
C:	A woman who has never been pregnant.
D:	The number of pregnancies carried to full term.
Parity refers to the number carried to full term. Nulligravida would refer to a woman who has never been pregnant.

67.  

Reading Level: 10.7	Bloom Level: 4	Cut Score: 0.6
Provider: EMT-P	National Registry: OB16	Objective: 5-13.7

A:	Do you take oral contraceptives?
B:	Are you, or could you, be pregnant?
C:	When was your last menstrual period?
D:	When did you last have sexual intercourse?
Asking when the patient last had sexual intercourse would not be appropriate. The other questions have a medical basis to rule out pregnancy or other related medical conditions.

68.  

Reading Level: 9.4	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.20

A:	Insert an OPA during the seizure and assist ventilations.
B:	Administer 1.0-2.0 mg Magnesium sulfate IV push.
C:	Administer 2.0-4.0 grams Magnesium sulfate IV push.
D:	Administer 1.0 mEq/kg Sodium bicarbonate IV push
The correct drug for treating eclampsia is magnesium sulfate and the correct dose is 2-4 grams.

69.  

Reading Level: 9.7	Bloom Level: 2	Cut Score: 0.6
Provider: EMT-P	National Registry: OB18	Objective: 5-14.6

A:	120/80.
B:	90/70.
C:	180/120.
D:	60/40.
Eclampsia is occurring here in which the patient is almost always hypertensive.

70.  

Reading Level: 11.7	Bloom Level: 3	Cut Score: 0.9
Provider: EMT-P	National Registry: OB18	Objective: 5-14.19

A:	Clamp and cut the cord immediately.
B:	Insert gloved fingers into the vagina and raise the fetus off the cord.
C:	Have the mother bear down and push aggressively.
D:	Administer magnesium sulfate to promote tocolysis.
The newborn must be given an airway as it is compressing its own lifeline, the umbilical cord.

71.  

Reading Level: 8.5	Bloom Level:	Cut Score: 0.9
Provider: EMT-P	National Registry: OB18	Objective: 5-14.19

A:	Breech presentation.
B:	Transverse presentation.
C:	Prolapsed cord.
D:	Nuchal cord.
Nuchal cord exists when the umbilical cord is wrapped around the infant's neck. The other situations are abnormal delivery presentations of the fetus.