FISDAP OB/GYN Emergencies 3

Question 1

A 24-year-old woman with a positive pregnancy test presents with sharp left lower quadrant pain and vaginal spotting. Vital signs: BP 90/60, HR 118, pale and diaphoretic. The EMT should suspect:

Accepted Answer

Ruptured ectopic pregnancy

Answer

Hypotension, tachycardia, peritoneal signs, and a positive pregnancy test with unilateral pelvic pain strongly suggest a ruptured ectopic pregnancy with hemoperitoneum.

Question 2

During a field delivery, the placenta has not delivered 30 minutes after the baby. The EMT should:

Accepted Answer

Monitor for hemorrhage, keep the cord clamped, and transport for hospital management

Answer

Retained placenta beyond 30 minutes requires hospital management; the EMT should monitor for hemorrhage and transport without attempting manual removal.

Question 3

A term neonate is born covered in thick, green-tinged amniotic fluid and is not vigorous (limp, HR 60, no respiratory effort). The MOST appropriate initial prehospital action is:

Accepted Answer

Bring the neonate to the warmer, dry and stimulate, then assess for need for PPV

Answer

Current NRP guidelines state that even with meconium-stained fluid, initial steps are warmth, drying, and stimulation followed by assessment; routine intubation for meconium suctioning is no longer recommended for non-vigorous neonates without evidence of obstruction in many EMS systems.

Question 4

A woman at 36 weeks gestation presents with painless, bright-red vaginal bleeding. She denies contractions. This presentation is MOST consistent with:

Accepted Answer

Placenta previa

Answer

Painless bright-red antepartum hemorrhage in the third trimester is the classic presentation of placenta previa, where the placenta overlies the cervical os.

Question 5

When managing a patient with placenta previa in the field, the EMT should:

Accepted Answer

Apply a sterile pad, do NOT perform a vaginal exam, and transport rapidly

Answer

Vaginal examination in suspected placenta previa can cause catastrophic hemorrhage; the EMT should apply an external pad and transport immediately.

(FISDAP) Field Internship Student Data Acquisition Project Practice Test

(FISDAP) Field Internship Student Data Acquisition Project Practice Test

FISDAP OB/GYN Emergencies 3