EMP 200

OB/GYN

Practice Exam

A pregnant female is showing signs she will be have her baby before EMS arrives. What concept should the first responders follow during preparation for a delivery?

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.

You and your partner are preparing to deliver a baby. The patient tells you this is her first pregnancy and she is frightened. Choose the BEST reason for asking the patient if she wants you to contact a relative or friend to be with her.

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.

The BEST explanation of a bloody show during pregnancy is described as:

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.

You have a conscious female patient who has been sexually assaulted. Which of the following is MOST correct regarding the assessment and management of this patient?

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 are dispatched to a restaurant for a woman sitting of the floor in labor. Delivery seems imminent and you prepare to assist her. While setting up your equipment a manager asks if you can move the patient to the bathroom, so the customers are not distracted. With this information, rescuers should.

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.

When we are assessing a young, adult female with abdominal pain, which of the following is our biggest concern?

A:	Gall stones.
B:	Kidney stones.
C:	Endometriosis.
D:	Ectopic pregnancy.

What is the name of the stage of delivery when the baby is delivered?

A:	Dilation.
B:	Contraction.
C:	Expulsion.
D:	Placental.

What is the name of the organ that holds the fetus during pregnancy?

A:	Uterus.
B:	Cervix.
C:	Placenta.
D:	Amniotic Sac.

As you are examining an expectant patient you identify that the infant’s legs and buttocks are already delivered. What is the name for this type of presentation?

A:	Limb.
B:	Breech.
C:	Cephalic.
D:	Transverse.

10.

Of the following, which is the MOST important piece of equipment in the OB kit?

A:	Scalpel.
B:	Bulb syringe.
C:	Placental bag.
D:	Umbilical clamps.

11.

Which of the following is a pre-delivery emergency?

A:	Nuchal cord.
B:	Prolapsed cord.
C:	Placenta previa.
D:	Limb presentation.

12.

Which of the following is the BEST indicator of an imminent delivery?

A:	Crowning.
B:	Braxton Hicks contractions.
C:	Labor pains which are 10 minutes apart.
D:	The mother indicates she has an urge to defecate.

13.

You have just placed a 9-month pregnant female on a back board. The patient was stable prior to this and was just complaining of back pain. She is now unresponsive, breathing rapidly, and has a weak rapid pulse. Which of the following is your MOST immediate priority?

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.

14.

Which of the following would be the BEST place to have the mother position herself as she prepares to delivery the child?

A:	On a table.
B:	On her bed.
C:	On the floor.
D:	On the stretcher.

15.

Which of the following would be the appropriate body substance isolation materials to use during the delivery of an infant?

A:	Gown.
B:	Gloves.
C:	Face shields and masks.
D:	All of the above.

16.

What should you do FIRST if the amniotic sac is still intact as the head is delivered?

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.

17.

The head of the baby has just delivered, which of the following should you do NEXT?

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.

18.

When should you cut the umbilical cord?

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.

19.

Which of the following is true regarding the delivery of the placenta?

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.

20.

You have a newborn that is breathing slowly and has a heart rate of 64. What is the FIRST step in neonatal resuscitation for this newborn?

A:	Administer oxygen.
B:	Begin chest compressions.
C:	Suction the mouth then nose.
D:	Begin bag-valve-mask ventilation.

21.

You are assessing a pregnant female who is about to give birth and you notice a prolapsed cord? Which of the following is the correct procedure for this situation?

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.

22.

Under which of the following abnormal deliveries is it appropriate for you to place your gloved hand into the birth canal?

A:	Nuchal cord.
B:	Prolapsed cord.
C:	Limb presentation.
D:	Transverse presentation.

23.

Which of the following is your biggest concern regarding the delivery of twins?

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.

24.

You have just delivered an infant and meconium was present. Which of the following describes the appropriate procedure for this situation?

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.

25.

Which of the following is your greatest concern regarding a newborn that was born prematurely?

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.

26.

You are treating a 27-year-old female complaining of severe abdominal pain. She describes the pain's location as just under the diaphragm on the left. She indicates that she could be pregnant. Which of the following is your primary concern in treating this patient?

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.

27.

Which of the following would be abnormal for a pregnant female in her last trimester of pregnancy?

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.

28.

You are called to the scene of a trauma involving a female who is 9-months pregnant and in labor. She was cut in her radial artery and you have controlled bleeding. Her pulse is 98, respirations are 26 and shallow, blood pressure is 100/70, her skin is slightly pale, and she is anxious. Which of the following is your primary concern?

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.

29.

You have been dispatched to the residence of a female patient who has been sexually assaulted. Which of the following should be your highest priority?

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.

30.

You are dispatched to the honeymoon suite of a local hotel. The husband called you as a result of his wife’s complaint of severe unilateral abdominal pain during intercourse. The patient appears nervous but all vital signs are within normal ranges and she does not have a fever. Which of the following is the MOST likely cause of the unilateral abdominal pain?

A:	Cystitis.
B:	Endometritis.
C:	Ruptured ovarian cyst.
D:	Pelvic inflammatory disease.

31.

You are dispatched to the residence of a 20-year-old female who appears very ill. She indicates that she has had a fever, foul-smelling vaginal discharge and she reports severe pain upon palpation of the lower abdomen. Her history indicates that she has been diagnosed with gonorrhea and chlamydia. Which of the following is MOST likely the cause of her abdominal discomfort?

A:	Endometritis.
B:	Endometriosis.
C:	Ectopic pregnancy.
D:	Pelvic inflammatory disease.

32.

Which of the following are the MOST appropriate body substance isolation precautions in preparation for childbirth?

A:	Gloves only.
B:	Gloves and booties.
C:	Gloves, gowns, and booties.
D:	Gloves, gown, and goggles.

33.

Which of the following complications of pregnancy occurs during the first trimester?

A:	Abruptio placenta.
B:	Placenta previa.
C:	Spontaneous abortion.
D:	Pre-eclampsia.

34.

You have been called to assist with a delivery. Upon your arrival, you discover the first responders have just delivered a newborn. Which of the following should be your highest priority regarding the management of this newborn?

A:	Cutting the umbilical cord.
B:	Suctioning the mouth then nose.
C:	Drying, warming and stimulating.
D:	Assisting ventilations with a bag-valve-mask.

35.

Which of the following is NOT part of the management for an ectopic pregnancy?

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.

36.

During an assessment of a 28-year-old female, you question her regarding her estimated date of confinement (EDC). Which of the following questions would you be asking?

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?

37.

You are preparing to deliver a baby in the field. Which of the following should you perform FIRST?

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.

38.

You are on the scene of a pregnant female. Assessment reveals an imminent delivery. The patient states she has been receiving prenatal care and has had a history of gestational diabetes during the pregnancy. Which of the following should you expect, based on the history provided?

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.

39.

Which of the following is MOST consistent with imminent delivery?

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.

40.

Which of the following components of the menstrual cycle is dominated by estrogen and causes the uterine lining to thicken and engorge with blood?

A:	The secretory phase.
B:	The ovulation phase.
C:	The proliferative phase.
D:	The ischemic phase.

41.

You are dispatched for a 24-year-old female patient who is complaining of moderate abdominal pain. She has a fever of 102 F and has had bloody, foul-smelling vaginal discharges for the past two hours. She reports that she had a miscarriage two days ago. Which of the following is MOST likely the cause?

A:	Cystitis.
B:	Endometritis.
C:	Endometriosis.
D:	Ruptured ovarian cyst.

42.

Which of the following is the MOST common cause of non-traumatic abdominal pain in the female?

A:	Mittelschmerz.
B:	Pelvic inflammatory disease.
C:	Endometriosis.
D:	Ectopic pregnancy.

43.

Which of the following is NOT a normal event during childbirth?

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.

44.

During delivery of a newborn, the umbilical cord becomes wrapped around the neck. Which of the following is the best way to manage this?

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.

45.

Your 23-year-old female patient who is complaining of abdominal pain indicates she had a D&C procedure performed early last week. What does the abbreviation D&C represent?

A:	Dusting and cleaning.
B:	Dilation and curettage.
C:	Dyspareunia and coitus.
D:	Dysmenorrhea and cervicalitis.

46.

Which of the following would properly represent a female who has been pregnant three times, gave birth twice and had one spontaneous abortion?

A:	P3, G2, AB1.
B:	G3, P2, AB1.
C:	G2, P2, AB1.
D:	P5, G2, AB1.

47.

Which of the following is the method of action of oral contraceptives (birth control pills)?

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.

48.

What is the name for severe discomfort during the menstrual period?

A:	Amenorrhea.
B:	Dyspareunia.
C:	Dysmenorrhea.
D:	Premenstrual syndrome.

49.

Which of the following is the medical term for a female’s first menstruation?

A:	Period.
B:	Puberty.
C:	Menarche.
D:	Menopause.

50.

Which of the following hormones is secreted by the ovaries?

A:	Testosterone.
B:	Progesterone.
C:	Leutenizing hormone.
D:	Follicle stimulating hormone.

51.

The middle layer of the uterus responsible for contractions is called the:

A:	Epimetrium.
B:	Perimetrium.
C:	Myometrium.
D:	Endometrium.

52.

What is the medical term for the tissue that separates the vagina and the anus?

A:	Prepuce.
B:	Perineum.
C:	Peritoneum.
D:	Episiotoneum.

53.

An advanced life support unit is staffed with a female Basic EMT and a male advanced provider which is at the scene of a stable female patient who has been sexually assaulted. Which of the following would be the MOST appropriate action?

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.

54.

During transport of a mother and recent newborn to the hospital, the mother complains of a sudden onset of difficulty breathing and excruciatingly sharp chest pain. She becomes unresponsive, has noted jugular venous distension, and is hypotensive. Which of the following is MOST likely the cause?

A:	Postpartum hemorrhage.
B:	Meconium staining.
C:	Pulmonary embolism.
D:	Myocardial infarction.

55.

Which of the following is NOT part of the internal genitalia of the female reproductive system?

A:	The cervix.
B:	The vagina.
C:	The uterus.
D:	The urethra.

56.

The second stage of labor ends with which of the following?

A:	Delivery of the fetus.
B:	Delivery of the placenta.
C:	Complete dilatation and effacement.
D:	Contractions 2-3 minutes apart.

57.

Where should the first clamp be placed on the umbilical cord after delivery?

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.

58.

Which of the following is NOT a function of the vagina?

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.

59.

You are called to the scene of a 29-year-old pregnant female. The patient is bleeding vaginally, with approximately 750 ml blood loss prior to your arrival. The woman denies any pain. Which of the following is MOST likely the cause?

A:	Abruptio placenta.
B:	Ectopic pregnancy.
C:	Placenta previa.
D:	Gestational diabetes.

60.

You have recently performed a field delivery. The mother continues to bleed vaginally and has lost approximately 800-1000 ml. Which of the following should you do FIRST?

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.

61.

What is the name for mid-cycle abdominal pain as a result of ovulation?

A:	Menses.
B:	Menarche.
C:	Mittelschmerz.
D:	Premenstrual syndrome.

62.

During childbirth the placenta has just delivered. The mother is bleeding and the uterus has failed to contract. Which of the following should you do NEXT?

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.

63.

Which of the following is the most inferior portion of the uterus?

A:	The fundus.
B:	The fallopian tubes.
C:	The cervix.
D:	The endometrium.

64.

You are examining the abdomen of a female who is five month’s pregnant. Where would you expect to palpate the superior portion of the uterus?

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.

65.

Where should the three drapes in an obstetrical kit be placed?

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.

66.

The term gravidity refers to which of the following?

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.

67.

You are assessing an 18-year-old female complaining of abdominal pain. All of the following questions would be appropriate EXCEPT?

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?

During transport of a pregnant female in her late second trimester, she begins tonic clonic seizure activity. The patient is already on oxygen via non-rebreather, and has an IV in place.

68.

Which of the following should you do NEXT?

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

69.

Referring to the above scenario, what would you expect the patient's blood pressure to be?

A:	120/80.
B:	90/70.
C:	180/120.
D:	60/40.

You are preparing for a field delivery of a newborn. After preparing the area for delivery, you note the umbilical cord is protruding through the vaginal opening, yet you see no evidence of crowning.

70.

Referring to the previous scenario, which of the following is the BEST way to manage this patient?

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.

71.

The situation in the above scenario is known as which of the following?

A:	Breech presentation.
B:	Transverse presentation.
C:	Prolapsed cord.
D:	Nuchal cord.