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23) Your pregnant patient is in active labor. She has been lying on her back throughout her labor
and is experiencing signs and symptoms of shock. Her vital signs are pulse rate 118, respirations
22, blood pressure 96/62, and skin cool and diaphoretic. The BEST way to treat her is to:
A) give her some fluids to drink to help elevate her blood pressure.
B) elevate her legs to increase the blood return to the heart.
C) place a rolled blanket under her left hip to displace the uterus.
D) cover her up with a blanket to maintain body heat.
Objective: 32.6
24) When delivering a baby, you should do all of the following except:
A) have someone stay at the mother's head if possible.
B) suction the mouth first, then the nose.
C) place your fingers in the armpit to assist with delivery of the shoulders.
D) position your gloved hands at the vaginal opening.
Objective: 32.7
11
25) You have been called for a 32-year-old female who is in active labor. During your assessment
and interview, you note that she is 37 weeks along, this is her first child, and her contractions are
5 minutes apart. She also tells you that her pregnancy is considered "high risk." Your first
concern should be:
A) assembling your delivery kit.
B) calling for a back-up unit.
C) getting to the hospital.
D) preparing for the delivery.
Objective: 32.7
26) You respond to a call for a patient in active labor with her second child. Your interview with
the patient shows that she is 40 weeks pregnant and has been in active labor for several hours.
You determine that her vital signs are all within normal limits. After your physical exam, you
determine the baby is crowning. You should next:
A) begin transport and plan to deliver in the ambulance.
B) prepare to deliver the baby on-scene.
C) delay delivery until arrival at the hospital.
D) contact medical direction for orders.
Objective: 32.7
12
27) You have responded to a woman who has possible premature labor. She is 8 months pregnant
and is experiencing labor pains. During your assessment, you note that the baby is not yet
crowning. You need to determine whether delivery is imminent or not. You should next:
A) time her contractions.
B) complete a set of vital signs.
C) check for cervix dilation.
D) check the level of the fundus.
Objective: 32.7
28) Which of the following is the correct way to time the frequency of contractions in the
pregnant woman?
A) From the beginning of a contraction to the end of the same contraction
B) From the end of one contraction to the beginning of the next
C) From the beginning of one contraction to the beginning of the next
D) After counting the number of contractions in a 15-minute period, multiply by 4
Objective: 32.7
13
29) You are called for a possible imminent delivery. Your patient is a 15-year-old girl who is in
your estimation about 8 months pregnant. She tells you that she has been hiding her pregnancy.
You are especially concerned about problems she might have during the delivery. Which of the
following are findings that may indicate the need for neonatal resuscitation?
A) Patient with a blood pressure of 130/82
B) Mother who has had five previous births
C) Young mother who has not had prenatal care
D) Patient whose water has already broken
Objective: 32.8
30) You have just delivered a full-term baby girl and she is doing well. You have dried her off
and wrapped her in a warm blanket. You are preparing to cut the umbilical cord. Which of the
following is normally true regarding cutting the umbilical cord?
A) The cord should be cut immediately following delivery.
B) The infant must be breathing on his or her own before you cut the cord.
C) You must try to cut the cord before it stops pulsating.
D) You should hold the baby above the level of the mother when cutting the cord.
Objective: 32.9
14
31) Which of the following is NOT part of a basic obstetrics kit?
A) Umbilical cord clamps
B) Surgical scissors
C) Baby blanket
D) Packet of suture material
Objective: 32.9
32) If assisting in a prehospital delivery while off-duty, which of the following would be the
BEST choice for tying or clamping the umbilical cord?
A) Section of wire coat hanger
B) Pair of shoelaces
C) White cotton thread
D) Clothespin
Objective: 32.9
15
33) Which of the following is the correct technique to check for crowning in the assessment of a
woman in labor?
A) Ask the woman to "push" or "bear down" as you inspect the vaginal opening.
B) Place your hand on the woman's abdomen, just above the umbilicus, and check for the
firmness of the uterus during contractions.
C) Cover her with a sheet, have her remove her underwear, wait for a contraction, and then
visualize the vaginal opening.
D) None of the above
Objective: 32.9
34) When assisting with a delivery in the field, which of the following should be done as the
head begins to emerge from the vagina?
A) Check for crowning.
B) Advise the mother not to push or strain.
C) Apply gentle pressure to the head with your gloved hand.
D) Pull on the baby.
Objective: 32.9
16
35) If the baby's head is delivered with the amniotic sac still intact, which of the following
should be done first?
A) Use your fingers to tear the sac away from the baby's face.
B) Leave the sac intact until the entire body is delivered.
C) Use the scissors in the obstetrics kit to cut the sac away from the baby's head.
D) Call medical control before taking action.
Objective: 32.9
36) Which of the following is NOT advisable following complete birth of the infant?
A) Dry the infant and wrap him in a blanket.
B) Keep the infant at the level of the mother's vagina until the cord is clamped and cut.
C) Place the infant on his side with his head slightly lower than his body.
D) Hold the infant by the ankles to allow the airway to drain.
Objective: 32.10
37) Which of the following should be done when the infant's head has been delivered?
A) Check to see if the umbilical cord is around the neck.
B) Suction the mouth.
C) Suction the nose.
D) All of the above
Objective: 32.10
17
38) All of the following are signs of adequate breathing and circulation in the newborn except:
A) heart rate greater than 100.
B) relaxation of the extremities.
C) cyanosis of only the hands and feet.
D) vigorous crying.
Objective: 32.10
39) You have assisted in the delivery of a full-term infant by suctioning the mouth and nose as
the head was delivered and again following complete delivery. The infant is not yet breathing.
Which of the following is the correct sequence of interventions?
A) Perform a series of back blows and chest thrusts interposed with mouth-to-mouth ventilation.
B) Transport without further intervention.
C) Rub the infant's back, tap the bottom of his foot, begin bag-valve-mask ventilations, and
check the pulse.
D) Begin bag-valve-mask ventilations, suction the airway with a rigid tonsil tip, and begin CPR.
Objective: 32.10
18
40) When clamping the umbilical cord, the clamp closest to the baby should be approximately
________ inch(es) from the infant's body.
A) 3
B) 12
C) 1
D) 7
Objective: 32.10
41) Which of the following conditions should be present before the umbilical cord is cut?
A) The infant is breathing on his or her own.
B) The cord is no longer pulsating.
C) The cord is clamped in two places.
D) All of the above
Objective: 32.10
19
42) Your patient is an infant who has just been delivered 3 weeks before her due date. She is
breathing adequately, has a heart rate of 140 beats per minute, and has cyanosis of her face and
chest. Which of the following interventions should be done first?
A) Perform ventilations with a bag-valve-mask device and supplemental oxygen.
B) Place oxygen tubing near the infant's face at a flow rate of 10 to 12 liters per minute.
C) Begin CPR with a compression rate of 120/minute.
D) Place a neonatal nonrebreather mask on the infant's face.
Objective: 32.11
43) You are assessing a newborn patient 1 minute after delivery. You notice the patient has blue
extremities with a pink trunk, a pulse of 120, and strong crying with good movement of all
extremities. What is the newborn's APGAR score?
A) 7
B) 10
C) 9
D) 8
Objective: 32.11
20
