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Emergency Care, 13e (Limmer et al.)
Chapter 32 Obstetric and Gynecologic Emergencies
1) Which of the following BEST describes the term crowning?
A) Complete dilation of the cervix
B) Presenting part of the baby being visible at the vaginal opening
C) Delivery of the head during a breech birth, completing delivery
D) Discharge of bloody mucus
Objective: 32.1
2) Which of the following describes a breech presentation?
A) The infant presents buttocks first.
B) The infant presents with both feet first.
C) The infant presents face first.
D) Both A and B
Objective: 32.1
3) Which of the following BEST describes placenta previa?
A) The placenta prematurely separates from the uterine wall.
B) The pregnancy is lost before the 20th week of gestation.
C) The umbilical cord is the presenting part.
D) The placenta is implanted over the opening of the cervix.
Objective: 32.1
1
4) The condition in which the placenta separates from the uterine wall is known as which of the
following?
A) Abruptio placentae
B) Placenta previa
C) Ectopic pregnancy
D) Preeclampsia
Objective: 32.1
5) You are assessing a pregnant woman whose chief complaint is vaginal bleeding. She is 8
months pregnant and has moderate, bright red bleeding. She says that her doctor was concerned
about the location of the placenta. This condition is known as:
A) placenta disruption.
B) abruptio placenta.
C) unstable placenta.
D) placenta previa.
Objective: 32.1
2
6) The term for a baby developing inside the mother's womb after week 8 is:
A) infant.
B) chorion.
C) fetus.
D) neonate.
Objective: 32.1
7) The muscular organ in which a baby develops during pregnancy is called the:
A) fetal membrane.
B) placenta.
C) uterus.
D) amniotic sac.
Objective: 32.2
8) What is the temporary organ of pregnancy, which functions to supply the developing fetus
with oxygen and nutrients?
A) Cervix
B) Uterus
C) Amnion
D) Placenta
Objective: 32.2
3
9) You are called for a women who is about to deliver. During the labor process, your patient's
water breaks. She experiences a rush of warm water and an increase in uterine contractions. The
purpose of the amniotic fluid is to:
A) provide lubrication during the delivery of the baby.
B) help maintain a constant fetal body temperature.
C) allow the fetus to float during development.
D) All of the above
Objective: 32.3
10) Which of the following describes the normal appearance of amniotic fluid?
A) A fluid containing blood and mucus
B) Thin fluid, greenish-yellow in color
C) Clear and colorless fluid
D) Thick fluid, greenish-black in color
Objective: 32.3
4
11) By which of the following means does the fetus's blood pick up nourishment from the
mother?
A) Direct circulation
B) Indirect circulation
C) Diffusion
D) Osmosis
Objective: 32.3
12) Your pregnant patient is in active labor. You note that her contractions are getting closer
together and much stronger as the baby moves deeper into the birth canal. The muscle
contraction mechanism that moves the baby toward birth is the same mechanism that moves:
A) air down the bronchial tubes to the alveoli.
B) fluid into and out of the cell.
C) sweat to the surface of the skin.
D) food from the esophagus to the stomach.
Objective: 32.3
5
13) You are called to assess a pregnant woman who is approximately 7 months pregnant. She
states that her pregnancy has been uneventful but she is experiencing intermittent headaches. Her
vital signs are pulse 118, respirations 22, blood pressure 138/88, and blood sugar 148. Which of
the following is true regarding a pregnant woman?
A) Her pulse rate should be lower than normal.
B) Her respirations usually remain the same during pregnancy.
C) Her blood pressure is usually higher during pregnancy.
D) Diabetes may be made worse during pregnancy.
Objective: 32.3
14) Which of the following may result from a woman in her third trimester of pregnancy lying in
a supine position?
A) Fetal compromise
B) Maternal hypotension
C) The mother's body attempting to compensate for shock
D) All of the above
Objective: 32.3
6
15) Supine hypotensive syndrome is easily prevented by transporting the pregnant female into
which of the following positions?
A) Supine, with the head lower than the hips
B) Lying on her left side
C) On her hands and knees with her hips elevated
D) Tilted slightly onto the right side
Objective: 32.4
16) You have been called for a young female in labor. She is lying on the floor in obvious
distress from the labor pains. While you are assessing her for crowning, your partner is getting a
set of vital signs. She tells you that she is getting dizzy and nauseated. Vital signs are pulse rate
120, respiratory rate 22, and blood pressure 98/62. You should be concerned that she has:
A) contracted food poisoning.
B) supine hypotensive syndrome.
C) Braxton-Hicks contractions.
D) placenta previa.
Objective: 32.4
7
17) During which stage of labor is the baby born?
A) Primary
B) First
C) Second
D) Third
Objective: 32.5
18) Which of the following BEST describes the events that occur during the first stage of labor?
A) Rupture of the amniotic sac
B) Expulsion of the fetus through the birth canal
C) Expulsion of the placenta
D) Thinning and dilation of the cervix
Objective: 32.5
8
19) You are assessing a patient in labor. Her contractions are 2 minutes apart lasting 30 seconds
with increasing pain. The patient states that she feels the urge to push. These signs indicate which
stage of delivery?
A) Third stage
B) Second stage
C) Fourth stage
D) First and second stage
Objective: 32.5
20) You are assessing a 27-year-old female who is 9 months pregnant with her first child. She has
been having contractions for the past 6 hours. As you are about to assist her to your cot, she asks
you to wait because she feels the need to use the bathroom first. Which of the following is the
BEST course of action?
A) Tell the patient she needs to be transported immediately and using the bathroom will have to
wait until she arrives at the hospital.
B) Advise the patient that this could be a sign of a serious complication, have her lie on her left
side, apply high-concentration oxygen, and transport immediately.
C) Allow the patient to use the bathroom as it will make transport, and also delivery, more
comfortable.
D) Advise the patient that this could be an indication that the baby is ready to be born and you
need to check to see if the baby's head is visible.
Objective: 32.6
9
21) Which of the following is NOT relevant in determining whether or not delivery is imminent
for a woman in labor?
A) Determining if the patient feels as if she needs to move her bowels
B) Finding out how many pregnancies the patient has had
C) Phoning the patient's obstetrician for advice
D) Asking how long ago the contractions began
Objective: 32.6
22) Which of the following is an appropriate question to ask while evaluating a woman in labor?
A) Do you know who the father is and what is his medical history?
B) When was the last time you were sexually active?
C) Is this your first pregnancy?
D) None of the above
Objective: 32.6
10
