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Flashcards in Chapter 34 Deck (41):
1

1. Which of the following structures is not a boundary of the pelvic cavity?

a. The diaphragm (superiorly)
b. The ischium (inferiorly)
c. The internal muscles (anteriorly)
d. The sacrum (posteriorly)

a. The diaphragm (superiorly)
b. The ischium (inferiorly)
c. The internal muscles (anteriorly)
d. The sacrum (posteriorly)
Answer: a
Objective: 34-1
Reference: 1069

2

Which of the following structures is not located within the pelvic cavity?

a. The ovaries
b. The uterus
c. The appendix
d. The fallopian tubes

a. The ovaries
b. The uterus
c. The appendix
d. The fallopian tubes

Answer: c
Objective: 34-1
Reference: 1069

3

The function of the uterus in pregnancy is to:

a. permit the excretion of wastes from the baby to the mother.
b. protect the abdominal organs during fetal growth.
c. manufacture specific blood cells needed for fetal survival.
d. provide an environment for the ovum to develop into a fetus.

a. permit the excretion of wastes from the baby to the mother.
b. protect the abdominal organs during fetal growth.
c. manufacture specific blood cells needed for fetal survival.
d. provide an environment for the ovum to develop into a fetus.

Answer: d
Objective: 34-2
Reference: 1071

4

Which of the following statements about the role of the cervix in pregnancy is true?

a. The cervix constricts during the time of delivery to prevent a premature birth.
b. The placenta is normally positioned directly over the cervix.
c. The cervix can be palpated to determine the frequency of the mother’s contractions.
d. “Bloody show” comes from the cervix and is a sign of imminent delivery.

a. The cervix constricts during the time of delivery to prevent a premature birth.
b. The placenta is normally positioned directly over the cervix.
c. The cervix can be palpated to determine the frequency of the mother’s contractions.
d. “Bloody show” comes from the cervix and is a sign of imminent delivery.

Answer: d
Objective: 34-6
Reference: 1079

5

The second stage of labor ends with:

a. contractions that become regular and occur every 3–4 minutes.
b. delivery of the placenta.
c. delivery of the baby.
d. rupture of the amniotic sac.

a. contractions that become regular and occur every 3–4 minutes.
b. delivery of the placenta.
c. delivery of the baby.
d. rupture of the amniotic sac.

Answer: c
Objective: 34-6
Reference: 1079

6

In which of the following patients would an OEC Technician recognize a full-term pregnancy?

a. A 21 year old who is 39 weeks pregnant and is feeling dizzy
b. A 40 year old beginning her third trimester whose water just broke
c. A 25 year old who is 220 days into pregnancy and is complaining of pain
d. A 33 year old with twins in the eighth month of pregnancy

a. A 21 year old who is 39 weeks pregnant and is feeling dizzy
b. A 40 year old beginning her third trimester whose water just broke
c. A 25 year old who is 220 days into pregnancy and is complaining of pain
d. A 33 year old with twins in the eighth month of pregnancy

Answer: a
Objective: 34-5
Reference: 1071

7

Prior to an emergency delivery, an OEC Technician prepares the delivery field. Which of the following instructions describes the best way to do that task?

a. Place sheets from the OB kit over both of the woman’s legs and her abdomen.
b. Use towels to wrap each of the woman’s legs and to cover her abdomen.
c. Use a sheet or a clean blanket from the aid room to cover the woman’s abdomen and groin.
d. Place a clean (or if available, a sterile) sheet or towel under the mother’s buttocks and then unfold it down to her feet.

a. Place sheets from the OB kit over both of the woman’s legs and her abdomen.
b. Use towels to wrap each of the woman’s legs and to cover her abdomen.
c. Use a sheet or a clean blanket from the aid room to cover the woman’s abdomen and groin.
d. Place a clean (or if available, a sterile) sheet or towel under the mother’s buttocks and then unfold it down to her feet.

Answer: d
Objective: 34-11
Reference: 1081

8

You arrive in the aid room to find an EMT assisting a mother during delivery. You’re told that the patient’s perineum tore and that you need to control the bleeding. Which of the following actions would you take?

a. Place a cold pack on the mother’s abdomen just below the umbilicus.
b. Apply a sterile gauze dressing with gentle pressure above the mother’s vagina.
c. Place a sterile dressing between the mother’s vagina and rectum.
d. Insert sterile gauze into the mother’s vagina and leave it in place until the bleeding stops.

a. Place a cold pack on the mother’s abdomen just below the umbilicus.
b. Apply a sterile gauze dressing with gentle pressure above the mother’s vagina.
c. Place a sterile dressing between the mother’s vagina and rectum.
d. Insert sterile gauze into the mother’s vagina and leave it in place until the bleeding stops.

Answer: c
Objective: 34-11
Reference: 1083

9

When asked, a young woman with abdominal pain replies that she is not sure whether she is pregnant or not. Which of the following questions would best help you determine whether the patient could be pregnant?

a. “Do you feel pressure in your lower belly?”
b. “When was your last menstrual period?”
c. “Have you been vomiting in the morning?”
d. “Does it feel like the last time you were pregnant?”

a. “Do you feel pressure in your lower belly?”
b. “When was your last menstrual period?”
c. “Have you been vomiting in the morning?”
d. “Does it feel like the last time you were pregnant?”

Answer: b
Objective: 34-4
Reference: 1089

10

When assessing a 27-year-old woman who is pregnant, which of the following statements would concern you the most?

a. “I had some cramps two weeks ago.”
b. “I was a drug addict when I was a teenager.”
c. “I have not been able to see a doctor during this pregnancy.”
d. “My last baby came two weeks late.”

a. “I had some cramps two weeks ago.”
b. “I was a drug addict when I was a teenager.”
c. “I have not been able to see a doctor during this pregnancy.”
d. “My last baby came two weeks late.”

Answer: c
Objective: 34-8
Reference: 1079

11

You have completed an assessment of a 32-year-old woman in the seventh month of pregnancy. Which of the following assessment findings would concern you the most?

a. Several painless contractions
b. An increased desire to eat
c. Increased weight gain over the past month
d. Intermittent vaginal bleeding

a. Several painless contractions
b. An increased desire to eat
c. Increased weight gain over the past month
d. Intermittent vaginal bleeding

Answer: d
Objective: 34-8
Reference: 1078

12

A 16 year old has come to the aid room complaining of vaginal bleeding. She tells you that she is pregnant and has been bleeding for about 3 hours. After having her lie down, your care would include:

a. placing a sterile pad in her vagina to stop the bleeding.
b. having her keep her legs apart so the bleeding can occur freely and you can tell how much blood she has lost.
c. offering her a sanitary napkin to place over her vagina to slow the bleeding.
d. putting a sterile-gloved hand into her vagina to apply pressure to stop the bleeding.

a. placing a sterile pad in her vagina to stop the bleeding.
b. having her keep her legs apart so the bleeding can occur freely and you can tell how much blood she has lost.
c. offering her a sanitary napkin to place over her vagina to slow the bleeding.
d. putting a sterile-gloved hand into her vagina to apply pressure to stop the bleeding.

Answer: c
Objective: 34-8
Reference: 1091

13

You would most suspect the occurrence of a spontaneous abortion in which of the following patients?

a. A 16 year old who is 24 weeks pregnant and is having painless contractions
b. A 21 year old who is 6 weeks pregnant and is passing blood clots from her vagina
c. A 32 year old who is 7 months pregnant and is passing a foul-smelling and bloody vaginal discharge
d. A 38 year old who is 36 weeks pregnant and is having abdominal pain and painless vaginal bleeding

a. A 16 year old who is 24 weeks pregnant and is having painless contractions
b. A 21 year old who is 6 weeks pregnant and is passing blood clots from her vagina
c. A 32 year old who is 7 months pregnant and is passing a foul-smelling and bloody vaginal discharge
d. A 38 year old who is 36 weeks pregnant and is having abdominal pain and painless vaginal bleeding

Answer: b
Objective: 34-8
Reference: 1078

14

A 21 year old is five weeks pregnant and is experiencing vaginal bleeding. When reviewing the possible causes of the bleeding, you would suspect:

a. a ruptured uterus.
b. a dysfunctional placenta.
c. drug addiction.
d. a spontaneous abortion.

a. a ruptured uterus.
b. a dysfunctional placenta.
c. drug addiction.
d. a spontaneous abortion.

Answer: d
Objective: 34-8
Reference: 1078

15

A 25-year-old woman arrives in the aid room with her husband. She is 37 weeks pregnant and in labor. Your exam reveals crowning with 60-second contractions occurring at 50-second intervals. Which of the following actions would you take?

a. Tell her husband that the hospital is only 10 minutes away and that he should take her there.
b. Obtain her vital signs and call for an ambulance to take her to the hospital.
c. Open and prepare an obstetrical kit.
d. Have her hold her legs together to prevent delivery until an ALS ambulance arrives.

a. Tell her husband that the hospital is only 10 minutes away and that he should take her there.
b. Obtain her vital signs and call for an ambulance to take her to the hospital.
c. Open and prepare an obstetrical kit.
d. Have her hold her legs together to prevent delivery until an ALS ambulance arrives.

Answer: c
Objective: 34-11
Reference: 1092

16

You are with a 29-year-old woman who has signs of imminent delivery. She tells you that she has a history of HIV infection. Compared to a patient who has no infectious disease, how will Standard Precautions differ for this patient?

a. Gloves, a gown, and goggles should be used for this patient; only gloves and a gown are required for a noninfectious patient in labor.
b. Gloves are needed for a noninfectious patient in labor; goggles and gloves must be worn for a patient with HIV.
c. A HEPA filter mask should be used for a patient with HIV, but not for a noninfectious patient.
d. Gloves, a gown, and goggles must be worn for both patients with HIV and noninfectious patients.

a. Gloves, a gown, and goggles should be used for this patient; only gloves and a gown are required for a noninfectious patient in labor.
b. Gloves are needed for a noninfectious patient in labor; goggles and gloves must be worn for a patient with HIV.
c. A HEPA filter mask should be used for a patient with HIV, but not for a noninfectious patient.
d. Gloves, a gown, and goggles must be worn for both patients with HIV and noninfectious patients.

Answer: c
Objective: Supplemental
Reference: 1080

17

During a delivery, you note that the umbilical cord is wrapped around the baby’s neck. Which of the following actions should you take immediately?

a. Clamp and cut the cord.
b. Stop the delivery and call for an ALS ambulance.
c. Slip the cord over the baby’s head.
d. Try to push the baby’s head back in so you can slip the cord over it.

a. Clamp and cut the cord.
b. Stop the delivery and call for an ALS ambulance.
c. Slip the cord over the baby’s head.
d. Try to push the baby’s head back in so you can slip the cord over it.

Answer: c
Objective: 34-11
Reference: 1080–1082

18

Which of the following instructions describes the correct way to suction a newborn?

a. Suction the mouth first and then the nose.
b. Insert the bulb syringe deep into the oropharynx to remove any thick secretions located there.
c. Use a portable suction device on its “high” setting.
d. Don’t use suction until the baby has been delivered.

a. Suction the mouth first and then the nose.
b. Insert the bulb syringe deep into the oropharynx to remove any thick secretions located there.
c. Use a portable suction device on its “high” setting.
d. Don’t use suction until the baby has been delivered.

Answer: a
Objective: 34-11
Reference: 1082

19

As soon as a baby is delivered from the vaginal canal, it is crucial that you:

a. clamp and cut the umbilical cord.
b. vigorously dry and warm the newborn.
c. perform an APGAR assessment.
d. obtain a complete set of baseline vital signs.

a. clamp and cut the umbilical cord.
b. vigorously dry and warm the newborn.
c. perform an APGAR assessment.
d. obtain a complete set of baseline vital signs.

Answer: b
Objective: 34-11
Reference: 1085

20

You are in the process of delivering a baby and have just delivered the baby’s head. Which of the following actions should you take next?

a. Turn the baby clockwise and continue the delivery.
b. Check the baby’s neck for the presence of the umbilical cord.
c. Gently pull the baby toward you.
d. Suction the baby’s mouth, and then the nose.

a. Turn the baby clockwise and continue the delivery.
b. Check the baby’s neck for the presence of the umbilical cord.
c. Gently pull the baby toward you.
d. Suction the baby’s mouth, and then the nose.

Answer: b
Objective: 34-11
Reference: 1082

21

At what point during a delivery should you first suction the baby?

a. After the baby’s head has been delivered but before the torso is out of the vaginal opening and if there is obvious obstruction to spontaneous breathing
b. Before the cord has been cut but after the baby has been assessed and determined to be stable and if there is obvious obstruction to spontaneous breathing
c. When the baby has been delivered and has been dried and warmed
d. When the baby’s chest has been delivered but before the legs are free of the vaginal canal

a. After the baby’s head has been delivered but before the torso is out of the vaginal opening and if there is obvious obstruction to spontaneous breathing
b. Before the cord has been cut but after the baby has been assessed and determined to be stable and if there is obvious obstruction to spontaneous breathing
c. When the baby has been delivered and has been dried and warmed
d. When the baby’s chest has been delivered but before the legs are free of the vaginal canal

Answer: a
Objective: 34-11
Reference: 1082

22

When should an OEC Technician cut the umbilical cord?

a. Immediately after the delivery of the placenta
b. Immediately following the delivery of the baby
c. Just before the passage of the legs through the vaginal canal
d. After the delivery of the baby whenever transportation will be delayed more than 20 minutes

a. Immediately after the delivery of the placenta
b. Immediately following the delivery of the baby
c. Just before the passage of the legs through the vaginal canal
d. After the delivery of the baby whenever transportation will be delayed more than 20 minutes

Answer: d
Objective: 34-11
Reference: 1082

23

Which of the following statements describes the proper care for the cord after delivery?

a. The cord is clamped and cut one inch from the baby’s abdomen.
b. The clamps are removed after the cord has been cut.
c. The cord is clamped but is not cut until the arrival of the baby at a hospital.
d. The cord is appropriately clamped and then cut approximately 6 inches from the infant’s abdomen.

a. The cord is clamped and cut one inch from the baby’s abdomen.
b. The clamps are removed after the cord has been cut.
c. The cord is clamped but is not cut until the arrival of the baby at a hospital.
d. The cord is appropriately clamped and then cut approximately 6 inches from the infant’s abdomen.

Answer: d
Objective: 34-11
Reference: 1082

24

Which of the following statements about the placenta is accurate?

a. The placenta is delivered by applying gentle pressure to the abdomen after the baby has been born.
b. The placenta is full of bacteria and should not be transported near the baby in the ambulance.
c. It is essential that the mother not be moved until the placenta has been delivered.
d. The placenta typically delivers itself within 30 minutes of the birth of the baby.

a. The placenta is delivered by applying gentle pressure to the abdomen after the baby has been born.
b. The placenta is full of bacteria and should not be transported near the baby in the ambulance.
c. It is essential that the mother not be moved until the placenta has been delivered.
d. The placenta typically delivers itself within 30 minutes of the birth of the baby.

Answer: d
Objective: 34-11
Reference: 1083

25

After delivery, you note that blood continues to ooze from the mother’s vaginal canal. The sanitary pads that you placed between her legs continue to become soaked. Which of the following actions should you take next?

a. Insert sterile gauze into the vaginal canal.
b. Call for an ALS ambulance.
c. Perform a uterine abdominal massage.
d. Place the mother on her left side.

a. Insert sterile gauze into the vaginal canal.
b. Call for an ALS ambulance.
c. Perform a uterine abdominal massage.
d. Place the mother on her left side.

Answer: c
Objective: 34-11
Reference: 1083

26

The APGAR scoring system is useful in determining:

a. the type of resuscitation a newborn needs.
b. a fetus’s precise age of gestation.
c. the status of a newborn’s overall condition.
d. the maturity of a newborn’s heart and lungs.

a. the type of resuscitation a newborn needs.
b. a fetus’s precise age of gestation.
c. the status of a newborn’s overall condition.
d. the maturity of a newborn’s heart and lungs.

Answer: c
Objective: 34-11
Reference: 1085

27

The components of the APGAR scoring system include:

a. airway, breathing, and time of birth.
b. appearance, irritability, and activity.
c. airway, breathing, and weight at birth.
d. respiration, breathing, and skin moisture.

a. airway, breathing, and time of birth.
b. appearance, irritability, and activity.
c. airway, breathing, and weight at birth.
d. respiration, breathing, and skin moisture.

Answer: b
Objective: 34-11
Reference: 1085

28

A newborn’s first APGAR score is 6; his second APGAR score is 9. This information:

a. indicates an improvement in the newborn’s condition.
b. indicates a need for extensive resuscitation of the newborn.
c. provides a total score of 15.
d. indicates poor heart and lung function in the newborn.

a. indicates an improvement in the newborn’s condition.
b. indicates a need for extensive resuscitation of the newborn.
c. provides a total score of 15.
d. indicates poor heart and lung function in the newborn.

Answer: a
Objective: 34-11
Reference: 1085

29

Which of the following findings should be of greatest concern when assessing a 33-year-old woman who is 8 months pregnant?

a. Shortness of breath when lying flat
b. Recent onset of a fever of 99.3°F
c. Daily contractions that are irregular and painful
d. Vaginal bleeding that is not associated with pain

a. Shortness of breath when lying flat
b. Recent onset of a fever of 99.3°F
c. Daily contractions that are irregular and painful
d. Vaginal bleeding that is not associated with pain

Answer: d
Objective: 34-8
Reference: 1078

30

In abruptio placenta, the greatest threat to the baby is:

a. infection.
b. maternal shock.
c. hypoxia.
d. pain.

a. infection.
b. maternal shock.
c. hypoxia.
d. pain.

Answer: c
Objective: 34-8
Reference: 1078

31

A 24-year-old woman complains of sharp pain in her left lower abdominal quadrant. She states that her last period was 7 weeks ago. Which of the following conditions would you most suspect?

a. Appendicitis
b. Abruptio placenta
c. Ectopic pregnancy
d. Colitis

a. Appendicitis
b. Abruptio placenta
c. Ectopic pregnancy
d. Colitis

Answer: c
Objective: 34-8
Reference: 1074

32

Which of the following statements about the umbilical cord is true?

a. It connects the placenta and the mother’s uterus.
b. It detoxifies blood reaching the baby before delivery.
c. It transmits nourishment from the placenta to the fetus.
d. It produces hormones for the baby’s body.

a. It connects the placenta and the mother’s uterus.
b. It detoxifies blood reaching the baby before delivery.
c. It transmits nourishment from the placenta to the fetus.
d. It produces hormones for the baby’s body.

Answer: c
Objective: 34-6
Reference: 1071

33

The underlying pathophysiology associated with an ectopic pregnancy is that a fertilized egg is:

a. lodged in a fallopian tube.
b. developing without a placenta.
c. contaminated with abdominal bacteria.
d. attached to the ovary.

a. lodged in a fallopian tube.
b. developing without a placenta.
c. contaminated with abdominal bacteria.
d. attached to the ovary.

Answer: a
Objective: 34-6
Reference: 1079

34

In an ectopic pregnancy, the primary threat to the pregnant woman is:

a. infection.
b. hemorrhage.
c. severe pain.
d. damage to pelvic organs.

a. infection.
b. hemorrhage.
c. severe pain.
d. damage to pelvic organs.

Answer: b
Objective: 34-6
Reference: 1074

35

When the placenta attaches over the cervix, the baby and the mother are at risk for which of the following conditions?

a. Placenta previa
b. Placenta abruptio
c. An ectopic pregnancy
d. A uterine tear

a. Placenta previa
b. Placenta abruptio
c. An ectopic pregnancy
d. A uterine tear

Answer: a
Objective: 34-6
Reference: 1078

36

A woman who is 36 weeks pregnant has fallen and is complaining of sharp abdominal pain. She is also experiencing vaginal spotting. She has tenderness on palpation just right of the midline of her abdomen. Her pulse is 122, respirations are 22, and blood pressure is 118/82 mmHg. Based on this presentation, which of the following actions would you take?

a. Provide low-concentration oxygen and transport her.
b. Place her in a supine position and immediately transport her.
c. Administer high-flow oxygen and immediately transport her.
d. Massage her abdomen, provide high-flow oxygen, and nonemergently transport her.

a. Provide low-concentration oxygen and transport her.
b. Place her in a supine position and immediately transport her.
c. Administer high-flow oxygen and immediately transport her.
d. Massage her abdomen, provide high-flow oxygen, and nonemergently transport her.

Answer: c
Objective: 34-12
Reference: 1072

37

Which of the following statements concerning the functions of the vagina is true?

a. The vagina allows the passage of a baby during delivery and the outflow of urine from the bladder.
b. The vagina permits the outflow of menstrual blood and is the site at which a sperm fertilizes an egg.
c. The vagina serves as a passageway for the fetus during delivery and an outlet for blood during menstruation.
d. The vagina allows the excretion of urine from the bladder and the outflow of menstrual blood.

a. The vagina allows the passage of a baby during delivery and the outflow of urine from the bladder.
b. The vagina permits the outflow of menstrual blood and is the site at which a sperm fertilizes an egg.
c. The vagina serves as a passageway for the fetus during delivery and an outlet for blood during menstruation.
d. The vagina allows the excretion of urine from the bladder and the outflow of menstrual blood.

Answer: c
Objective: 34-2
Reference: 1071

38

A 27-year-old woman is complaining of midline lower abdominal pain that worsens with urination and is associated with blood in her urine. One possible cause of her symptoms would be:

a. cystitis.
b. dysmenorrhea.
c. an ovarian cyst.
d. pelvic inflammatory disease.

a. cystitis.
b. dysmenorrhea.
c. an ovarian cyst.
d. pelvic inflammatory disease.

Answer: a
Objective: 34-4
Reference: 1074

39

When assessing a pregnant woman it is important to remember that:

a. the uterus will be expanded and may be as high as the diaphragm.
b. systolic and diastolic blood pressures are normally high in the third trimester.
c. due to physiologic changes in pregnancy, women may lose only 15 percent of their blood volume before they go into shock.
d. maternal heart rate is usually normal in the third trimester.

a. the uterus will be expanded and may be as high as the diaphragm.
b. systolic and diastolic blood pressures are normally high in the third trimester.
c. due to physiologic changes in pregnancy, women may lose only 15 percent of their blood volume before they go into shock.
d. maternal heart rate is usually normal in the third trimester.

Answer: a
Objective: 34-6
Reference: 1071

40

Hypotension can occur after 20 weeks of gestation when a pregnant woman is in a supine position. Which of the following actions by a OEC Technician will not prevent hypotension?

a. Placing her in the left lateral recumbent position
b. Elevating her right hip approximately 1–2 inches
c. Elevating her feet 6–12 inches
d. Tipping the spine board so that she is slightly tilted onto her left side

a. Placing her in the left lateral recumbent position
b. Elevating her right hip approximately 1–2 inches
c. Elevating her feet 6–12 inches
d. Tipping the spine board so that she is slightly tilted onto her left side

Answer: c
Objective: 34-8
Reference: 1079

41

The most common cause of fetal death due to trauma to a pregnant woman’s abdomen is:

a. abruptio placenta.
b. a crushing injury to the fetus.
c. penetration of the uterus.
d. premature labor.

a. abruptio placenta.
b. a crushing injury to the fetus.
c. penetration of the uterus.
d. premature labor.

Answer: a
Objective: 34-12
Reference: 1088