Block 5 study guide PDF

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1. A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: Select one: A. assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. B. administer high-ow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. C  . administer high-ow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. D. administer high-ow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly. 2. A patient with pelvic inflammatory disease will typically complain of _________. A. abdominal pain associated with menstruation B. aches and fever associated with urination C. bleeding associated with stress D. nausea and vomiting associated with intercourse 3. Causes of vaginal bleeding include which of the following? A. Ectopic pregnancy B. Vaginal trauma C. Spontaneous abortion D. All of these answers are correct. 4. During gynecologic emergencies, in addition to the standard SAMPLE questions, the EMT should attempt to determine which of the following? A. The amount of time since of the patent's last menstrual cycle B. The possibility that the patient may be pregnant C. If the patient is sexually active D. All of these answers are correct. 5. In anticipation of receiving a fertilized ovum, the lining of the uterine wall: A. diverts blood flow to the vagina. B. becomes engorged with blood. C. sheds and is expelled externally. D. thins and begins to separate. 6. In cases of sexual assault, it is important to ensure that you do which of the following? A. Immediately write down your observations of the scene before assessing the patient. B. Call for a female EMT or ALS care provider. C. Discuss with law enforcement any suspicions that you may have about the perpetrator. D. All of these answers are correct.

7. In contrast to bleeding caused by external trauma to the vagina, bleeding caused by conditions such as polyps or cancer: A. may be relatively painless. B. is typically not as severe. C. often presents with acute pain. D. can be controlled in the field. 8. It is common for young females who experience their first menstrual period to: A. lose up to 500 mL of blood within the first 24 hours. B. experience abdominal cramping, which may be misinterpreted. C. have a false positive home pregnancy test result. D. become so emotionally distraught that they contemplate suicide 9. Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: A. provide emotional support and visually assess her for obvious trauma. B. perform a limited hands-on assessment to detect life-threatening injuries. C. advise her that she cannot clean herself up because this will destroy evidence. D. ask her if there is anyone you can contact, such as a friend or relative. 10. Patient complaints of pain during intercourse, lower abdominal discomfort, and nausea may be indicative of which of the following? A. Chlamydia B. Gonorrhea C. Pelvic inflammatory disease D. Bacterial vaginosis 11. Some women experience ___________ during ovulation. A. severe bleeding B. hypotension C. slight cramping D. severe abdominal pain 12. The __________ and _________ are folds of tissue that surround the urethral and vaginal openings. A. vagina; cervix B. fallopian tubes; uterus C. perineum; anus D. labia majora; labia minora

13. The _____________ connect(s) each ovary with the uterus. A. abdomen B. egg C. cervix D. fallopian tubes 14. The EMT should ensure that vaginal bleeding is _________. A. taken seriously and the patient is transported for gynecologic evaluation B. severe enough to warrant transport C. controlled directly by the patient D. not caused by traumatic injury 15. The physical examination of a sexual assault victim should be: A. limited to a brief survey for life-threatening injuries. B. performed in the presence of at least two police ocers. C. deferred until the patient can be evaluated by a physician. D. as detailed as possible so all injuries can be documented. 16. When caring for a female patient who has been sexually assaulted, you should: A. advise her that she will not be allowed to shower or change her clothes. B. place any bloodstained clothing or other articles in separate paper bags. C. ask the patient for a concise, detailed report of what happened to her. D. allow law enforcement to take her statement before you begin treatment. 17. Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? A. Ectopic pregnancy B. Ovarian cysts C. Genital herpes D. Chlamydia 18. Which of the following drugs is commonly referred to as “roofies”? A. Rohypnol B. Ketamine C. MDMA D. GHB 19. Which of the following infections, when left untreated, may lead to infection of the blood and brain? A. Chlamydia B. Gonorrhea C. Pelvic inflammatory disease D. Bacterial vaginosis

20. While the ages can vary, women typically experience menstruation from approximately _________ to ____________ years of age. A. 10; 70 B. 11; 50 C. 20; 60 D. 10; 40 CH. 33 OB & NEONATE 1. A 26-year-old female who is 34 weeks pregnant is experiencing a seizure. Her husband tells you that her blood pressure has been high and that she had been complaining of a headache for the past few days. You should: A. insert an oral airway and ventilate her with a bag-valve mask. B. administer oral glucose for presumed hypoglycemia and transport. C. elevate her legs to improve brain perfusion and keep her warm. D. place her on her side, administer high-ow oxygen, and transport. 2. A history of pelvic inflammatory disease or tubal ligations increases a woman's risk for: A. gestational diabetes. B. preeclampsia. C. an ectopic pregnancy. D. placenta previa. 3. A mother who is pregnant with her first baby is typically in the first stage of labor for approximately: A. 16 hours. B. 10 hours. C. 4 hours. D. 8 hours. 4. A nuchal cord is defined as an umbilical cord that: A. has separated from the placenta. B. has abnormally developed blood vessels. C. is wrapped around the baby's neck. D. is lacerated due to a traumatic delivery 5. A pregnant trauma patient may lose a significant amount of blood before showing signs of shock because: A. pregnant patients have an overall increase in blood volume. B. pregnancy causes vasodilation and a lower blood pressure. C. blood is shunted to the uterus and fetus during major trauma. D. pregnant patients can dramatically increase their heart rate

6. By the 20th week of pregnancy, the uterus is typically at or above the level of the mother's: A. pubic bone. B. xiphoid process. C. belly button. D. Superior diaphragm. 7. Common interventions used to stimulate spontaneous respirations in the newborn include all of the following, EXCEPT: A. suctioning of the upper airway. B. thorough drying with a towel. C. some form of tactile stimulation. D. positive-pressure ventilations. 8. During your visual inspection of a 25-year-old woman in labor, you see the baby's head crowning at the vaginal opening. What should you do? A. Place your fingers in the vagina to assess for a nuchal cord. B. Apply gentle pressure to the baby's head as it delivers. C. Maintain firm pressure to the head until it completely delivers. D. Tell the mother not to push and transport her immediately. 9. Following delivery of a full-term baby, you have properly cared for the baby and have clamped and cut the umbilical cord. During transport, you note that the mother is experiencing moderate vaginal bleeding. You should: A. place her legs together and position her on her left side. B. elevate her legs 6 to 8 inches and cover her with a blanket. C. carefully insert a sterile trauma dressing into her vagina. D. firmly massage the uterine fundus with a circular motion. 10. From what internal female organ is the fetus expelled during delivery? A. Uterus B. Perineum C. Cervix D. Vagina 11. If a baby is born at 7:52, the second Apgar score should be calculated at: A. 7:59. B. 8:00. C. 7:57. D. 7:53.

12. The amniotic fluid serves to: A. transfer oxygen to the fetus. B. insulate and protect the fetus. C. remove viruses from the fetus. D. assist in fetal development. 13. The presence of meconium in the amniotic fluid indicates: A. that the fetus is at least 4 weeks premature. B. that full newborn resuscitation will be needed. C. an expected nding in full-term infants. D. that the baby's airway may be obstructed. 14. Three days after delivering her baby, a 30-year-old woman complains of a sudden onset of difficulty breathing. Her level of consciousness is decreased and she is tachycardic. The EMT should suspect: A. pulmonary embolism. B. intrauterine bleeding. C. acute pulmonary edema. D. spontaneous pneumothorax. 15. When determining the frequency of contractions, you should time the contractions from the: A. end of one to the start of the next. B. start of one to the end of the next. C. start of one to the start of the next. D. end of one to the end of the next. 16. When preparing a pregnant patient for delivery, you should position he A. in a supine position with her legs spread. B. on a firm surface with her hips elevated 2 to 4 inches. C. in a sitting position with her hips elevated 12 inches. D. on her left side with the right leg elevated. 17. Which of the following questions is of LEAST pertinence when determining whether a mother will deliver her baby within the next few minutes? A. “When are you due?” B. “Have you had a sonogram?” C. “Do you feel the need to push?” D. “Is this your first baby?”

18. You and your partner are both male and are attending to a 28-year-old female patient complaining of diffuse abdominal pain. The patient is 34 weeks pregnant with her first child. The patient refuses to allow you to examine her, and her husband informs you that their culture does not allow males to examine or care for pregnant women. You should: A. respect the patient's wishes, ensure that the appropriate documentation is completed, and transport the patient. B. inform the patient that by calling for an ambulance, she is agreeing to the care provided and continue with your assessment and management. C. insist that the patient requires proper care and that requires an adequate physical assessment and that you cannot be responsible for the outcome. D. call for the police to ensure that patient assessment is carried out. 19. You are attending to a 23-year-old female patient who is 16 weeks pregnant with her second child. The patient has apparently fallen and sustained an injury to her upper right arm. When you ask about the incident history, the patient is reluctant to explain what happened and becomes very quiet. Based on this information, you should: A. continue your care in a private area, document any details regarding the scene and the incident, and reassure her as you provide care. B. ask more detailed questions and press the issue until you have a more detailed understanding of the incident. C. immediately remove the patient from the environment and transport. D. contact police and remain at the scene until they arrive and escort you to the hospital. 20. Your 22-year-old patient is in active labor. Upon visual inspection, you note that the infant's leg is protruding from the vagina. Appropriate management of this situation includes: A. carefully attempting to push the infant's leg o of the umbilical cord. B. gently pulling on the infant's leg in an attempt to facilitate delivery. C. placing the mother supine with her head down and pelvis elevated. D. placing the mother in a recumbent position and rapidly transporting CH. 34 PEDIATRIC 1.A 2-year-old female has experienced a seizure. When you arrive at the scene, the child is conscious, crying, and clinging to her mother. Her skin is hot and moist. The mother tells you that the seizure lasted approximately 5 minutes. She further tells you that her daughter has no history of seizures, but has had a recent ear infection. You should: A. cool the child with tepid water and transport to the hospital. B. place the child in cold water to attempt to reduce her fever. C. allow the mother to drive her daughter to the hospital. D. suspect that the child has meningitis and transport at once.

2. A 5-year-old child has had severe vomiting and diarrhea for 4 days. Which of the following assessment findings would be the MOST indicative of decompensated shock? A. Blood pressure of 70/40 mm Hg B. Pulse rate greater than 120/min C. Capillary rell time of 4 seconds D. Respiratory rate of 30 breaths/min 3. A viral infection that may cause obstruction of the upper airway in a child is called: A. asthma. B. epiglottitis. C. croup. D. bronchitis. 4. An infant with severe dehydration would be expected to present with: A. moist oral mucosa. B. bulging fontanelles. C. excessive tearing. D. absent urine output. 5. Burns in children are commonly caused by all of the following, EXCEPT: A. entrapment in a structural fire. B. exposure to caustic chemicals. C. scalding water in a bathtub. D. hot items on a stovetop. 6. Common causes of seizures in children include all of the following, EXCEPT: A. electrolyte imbalances. B. infection. C. hyperglycemia. D. poisonings or ingestion. 7. Infection should be considered a possible cause of an airway obstruction in an infant or child, especially if he or she presents with: A. drooling or congestion. B. acute respiratory distress. C. skin that is cool and dry. D. extreme restlessness. 8. Pale skin in a child indicates that the: A. child is in severe decompensated shock. B. blood vessels near the skin are constricted. C. child's core body temperature is elevated. D. oxygen content in the blood is decreased.

9. Signs and symptoms of meningitis in the infant or child include all of the following, EXCEPT: A. a sti or painful neck. B. headache and fever. C. sunken fontanelles. D. altered mental status. 10. The first month of life after birth is referred to as the: A. premature phase. B. start of infancy. C. neonatal period. D. toddler period. 11. The purpose of the pediatric assessment triangle (PAT) is to: A. determine if the child's vital signs are within the age-appropriate limits. B. allow you to rapidly and visually form a general impression of the child. C. facilitate a rapid head-to-toe assessment of the child by visualization only. D. gather critical data by performing a rapid hands-on assessment of the child. 12. Unless he or she is critically ill or injured, you should generally begin your assessment of a toddler: A. in the ambulance. B. at the head. C. en route to the hospital. D. at the feet. 13. When a child is struck by a car, the area of greatest injury depends MOSTLY on the: A. speed at which the car was traveling when impact occurred. B. size of the child and the height of the bumper upon impact. C. age of the child and the size of the car that struck him or her. D. height of the child and the speed at which the car was traveling. 14. When assessing an 8-year-old child, you should: A. refrain from taking a blood pressure. B. use a toe-to-head assessment approach. C. talk to the child, not just the caregiver. D. rely solely on the parent for information. 15. When caring for a female child who has possibly been sexually abused, you should: A. immediately report your suspicions to the parents. B. encourage the child to urinate and take a shower. C. carefully examine the genitalia for signs of injury. D. have a female EMT remain with her if possible.

16. When questioning the parent of a child who ingested a poisonous substance, which of the following questions would be of LEAST pertinence initially? A. Do you know what substance was ingested? B. Why did your child ingest the poison? C. Have you noticed any signs or symptoms? D. What time did the ingestion occur? 17. Which of the following findings is LEAST suggestive of child abuse? A. An unexplained delay in seeking medical care after the injury B. Burns to the hands or feet that involve a glove distribution C. Consistency in the method of injury reported by the caregiver D. Evidence of alcohol consumption or drug use at the scene 18. Which of the following statements regarding sudden infant death syndrome (SIDS) is correct? A. The cause of death following SIDS can be established by autopsy. B. Death as a result of SIDS can occur at any time of the day or night. C. Certain cases of SIDS are predictable and therefore preventable. D. SIDS is most commonly the result of an overwhelming infection. 19. While triaging patients at the scene of a motor-vehicle crash, you encounter a 5-year-old child who is unresponsive and apneic. After positioning his airway, you should: A. categorize him as immediate. B. categorize him as deceased. C. deliver 5 rescue breaths. D. palpate for a carotid pulse. 20.You are dispatched to a residence for a child with respiratory distress. The patient, an 18-month-old female, is tachypneic, has sternal retractions, and is clinging to her mother. Her skin is pink and dry, and her heart rate is 120 beats/min. The MOST appropriate treatment for this child includes: A. administering blow-by oxygen and transporting the child with her mother. B. requesting a paramedic ambulance to insert an advanced airway device. C. allowing the child to remain with her mother and applying a nasal cannula. D. separating the child from her mother and providing ventilatory assistance....