Ch 41 - Ob/GYN
Questions and Answers
- 1.
Supportive and kind care for a sexual assault patient includes:
- A.
Cleaning and bandaging the patient's minor cuts and scratches
- B.
Providing emotional support by a same-sex paramedic, if possible
- C.
Discarding the patient's clothes if they are bloody
- D.
Allowing the patient to wash before transport
Correct Answer
B. Providing emotional support by a same-sex paramedic, if possibleExplanation
Providing emotional support by a same-sex paramedic, if possible, is important for a sexual assault patient because it helps create a safe and comfortable environment. Sexual assault can be a traumatic experience, and having a same-sex paramedic can help the patient feel more at ease and reduce any potential distress caused by gender-related triggers or discomfort. This approach promotes sensitivity and respect for the patient's needs and can contribute to their overall well-being and recovery.Rate this question:
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- 2.
D and C is a:
- A.
Disease of the endometrium
- B.
Surgical procedure
- C.
Medication that regulates menstrual cycles
- D.
Type of birth-control device
Correct Answer
B. Surgical procedureExplanation
D and C, also known as dilation and curettage, is a surgical procedure. It involves dilating the cervix and scraping the lining of the uterus to remove abnormal tissue or to treat certain gynecological conditions such as heavy or irregular bleeding, miscarriage, or to obtain a tissue sample for further testing.Rate this question:
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- 3.
A 20-year old female is 10 weeks pregnant. she experiences vaginal bleeding and abdominal cramps. What is the most likely cause of these symptoms?
- A.
Spontaneous abortion
- B.
Abrupto placenta
- C.
Ovarian torsion
- D.
Placenta previa
Correct Answer
A. Spontaneous abortionExplanation
The most likely cause of the symptoms described in the question is a spontaneous abortion, also known as a miscarriage. Vaginal bleeding and abdominal cramps are common signs of a miscarriage, especially during the first trimester of pregnancy. This occurs when the pregnancy ends on its own before the 20th week. It is important for the woman to seek medical attention in order to confirm the diagnosis and receive appropriate care.Rate this question:
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- 4.
What are two factors that increase a baby's chance of a breech birth?
- A.
Low birth weight, nuchal cord
- B.
Multiple births, low birth weight
- C.
Nuchal cord, premature birth
- D.
Premature birth, multiple births
Correct Answer
D. Premature birth, multiple birthsExplanation
Premature birth and multiple births are two factors that increase a baby's chance of a breech birth. Premature birth refers to when a baby is born before completing the full term of pregnancy, which can affect the baby's positioning in the womb. Multiple births, such as twins or triplets, can also increase the likelihood of a breech birth as there may be less space for the babies to move and position themselves head down.Rate this question:
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- 5.
A predisposing factor for ectopic pregnancy is:
- A.
Hypertension
- B.
Oral contraceptive use
- C.
PID
- D.
Previous cesarean delivery
Correct Answer
C. PIDExplanation
PID, or pelvic inflammatory disease, is a known predisposing factor for ectopic pregnancy. PID is an infection of the female reproductive organs, often caused by sexually transmitted infections like chlamydia or gonorrhea. When left untreated, PID can lead to scarring and damage to the fallopian tubes, increasing the risk of ectopic pregnancy. In an ectopic pregnancy, the fertilized egg implants outside of the uterus, usually in the fallopian tubes. This can be a life-threatening condition and requires immediate medical attention. Therefore, PID is a correct answer as it is a known risk factor for ectopic pregnancy.Rate this question:
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- 6.
Which of the following is NOT appropriate in the care of a victim of sexual assault?
- A.
Explain all procedures and ask for permission before beginning them.
- B.
Approach the patient calmly, in a professional manner.
- C.
Be especially attentive to the victim's modesty.
- D.
Touch the patient's shoulder or pat her on the leg often to reassure her.
Correct Answer
D. Touch the patient's shoulder or pat her on the leg often to reassure her.Explanation
Touching the patient's shoulder or patting her on the leg often to reassure her is not appropriate in the care of a victim of sexual assault. Victims of sexual assault may have experienced trauma and may feel uncomfortable with physical touch. It is important to respect their boundaries and ask for permission before any physical contact. Reassurance can be provided through verbal communication and empathetic listening rather than physical touch.Rate this question:
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- 7.
You are treating a woman with a fever, chills, and lower abdominal pain. She tells yout hat she has been urinating frequently and feels the need to urinate urgently. Only a small amount of urine is passed each time, causing intense burning. There are classic symptoms of:
- A.
Ovarian cyst
- B.
Cystitis
- C.
Chlamydia
- D.
PID
Correct Answer
B. CystitisExplanation
The correct answer is cystitis. Cystitis is an infection of the urinary tract, specifically the bladder. The symptoms described, such as frequent urination, urgency, burning sensation, and lower abdominal pain, are all indicative of cystitis. Ovarian cysts are fluid-filled sacs that form on the ovaries and typically do not cause these urinary symptoms. Chlamydia is a sexually transmitted infection that can cause symptoms such as vaginal discharge and pelvic pain but does not typically cause urinary symptoms. PID (pelvic inflammatory disease) is an infection of the reproductive organs and can cause symptoms such as pelvic pain and abnormal vaginal discharge, but may not present with urinary symptoms like frequent urination and burning sensation.Rate this question:
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- 8.
Your patient is a 32-year-old female who complains of the onset of contractions 45 minutes ago. She is 39 weeks pregnant, G3P2. She states that the contractions are 2 minutes apart but that her membranes have not ruptured. She is anxious and responds affirmatively when you ask if she feels an urge to move her bowels. Which of the following is mose likely?
- A.
Imminet delivery
- B.
Stage one labor
- C.
Preterm labor
- D.
Braxton-hicks contractions
Correct Answer
A. Imminet deliveryExplanation
Based on the information provided, the patient is experiencing contractions that are 2 minutes apart and feeling an urge to move her bowels. These are signs of imminent delivery, indicating that she is likely in active labor and will give birth soon.Rate this question:
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- 9.
Tidal volume and minute ventilation increase during pregnancy by:
- A.
10 to 20%
- B.
20 to 30%
- C.
30 to 40%
- D.
40 to 50%
Correct Answer
C. 30 to 40%Explanation
During pregnancy, the body goes through various physiological changes to support the growing fetus. One of these changes is an increase in tidal volume and minute ventilation, which refers to the amount of air that is inhaled and exhaled in one breath and the total amount of air exchanged per minute, respectively. This increase is necessary to meet the increased oxygen demand of the mother and the fetus. Research has shown that tidal volume and minute ventilation typically increase by 30 to 40% during pregnancy.Rate this question:
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- 10.
Seventeen-Year-Old-Patient You are responding to a call for a 17-year-old pregnant patient at 36 weeks gestation. She complains of a haedache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP 174/104, P 84, R 20. You suspect this patient has:
- A.
Eclampsia
- B.
Essential hypertension
- C.
Preeclampsia
- D.
Gestational hypertension
Correct Answer
C. PreeclampsiaExplanation
The patient's symptoms, including headache, dizziness, puffy hands, and elevated blood pressure, are consistent with preeclampsia. Preeclampsia is a pregnancy complication characterized by high blood pressure and damage to organs, often affecting the liver and kidneys. It typically occurs after 20 weeks of gestation and can be life-threatening if left untreated. This patient's symptoms, along with her gestational age and elevated blood pressure, strongly suggest preeclampsia.Rate this question:
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- 11.
Gender is differentiated during the ___________ month of gestation.
- A.
Fifth
- B.
Sixth
- C.
Seventh
- D.
Fourth
Correct Answer
D. FourthExplanation
During the fourth month of gestation, the gender of the fetus can be differentiated. This is because by this time, the reproductive organs have developed enough to be identified through ultrasound or other medical techniques.Rate this question:
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- 12.
Your 28-year-old female patient was sexually assaulted with a foreign object and is bleeding heavily from the vagina. Which of the following is appropriate?
- A.
Performing a manual pelvic exam
- B.
Speculum examination
- C.
Packing dressings in the vagina to stop bleeding
- D.
IV access and fluid replacement
Correct Answer
D. IV access and fluid replacementExplanation
In this scenario, the appropriate action is to establish IV access and provide fluid replacement. The patient is experiencing heavy bleeding from the vagina, indicating significant blood loss. IV access allows for the administration of fluids to restore blood volume and prevent hypovolemic shock. It is important to prioritize stabilizing the patient's condition before further examinations or procedures can be performed. Manual pelvic exam or speculum examination may exacerbate the bleeding, and packing dressings in the vagina may not address the underlying issue of blood loss.Rate this question:
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- 13.
You are assisting with a birth and the patient has become extremely frustrated. She says things like "I can't do it" and "Just get the baby out." This patient is in which stage of labor?
- A.
Middle labor
- B.
Active labor
- C.
Transition phase
- D.
Early labor
Correct Answer
C. Transition phaseExplanation
The patient's frustration and statements like "I can't do it" and "Just get the baby out" suggest that she is experiencing intense emotions and feelings of helplessness, which are common during the transition phase of labor. This stage occurs right before the pushing stage and is characterized by strong and frequent contractions, as well as a rapid cervical dilation. The transition phase is often the most challenging and painful part of labor, but it also indicates that the baby's arrival is imminent.Rate this question:
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- 14.
A(n) __________ is a non-physical clinical healthcare practitioner who focuses on prenatal care and childbirth.
- A.
Doula
- B.
Attendant
- C.
Midwife
- D.
Obstetrician
Correct Answer
C. MidwifeExplanation
A midwife is a non-physical clinical healthcare practitioner who specializes in providing prenatal care and assisting with childbirth. They are trained professionals who support women during pregnancy, labor, and postpartum period. Midwives are knowledgeable about the physiological and emotional aspects of childbirth and provide personalized care to promote a safe and positive birthing experience. They often work in collaboration with obstetricians and other healthcare providers to ensure the well-being of both the mother and the baby.Rate this question:
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- 15.
At what age does menarche usually start?
- A.
47 years
- B.
10 years
- C.
13 years
- D.
50 years
Correct Answer
C. 13 yearsExplanation
Menarche is the term used to describe a girl's first menstrual period. It typically occurs around the age of 13, although there can be some variation. This is the age at which most girls start to experience the physical and hormonal changes associated with puberty, including the onset of menstruation. It is important for girls to be prepared for this milestone and have access to information and resources to manage their menstrual health.Rate this question:
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- 16.
Seventeen-Year-Old-Patient You are responding to a call for a 17-year-old pregnant patient at 36 weeks gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP 174/104, P 84, R 20. The classic presentations of this syndrome are hypertension, excessive weight gain, and:
- A.
Proteinuria
- B.
Increased intracranial pressure
- C.
Seizures
- D.
Hypoglycemia
Correct Answer
A. ProteinuriaExplanation
The correct answer is proteinuria. In this scenario, the patient is presenting with symptoms consistent with preeclampsia, a condition that typically occurs after 20 weeks of pregnancy. Preeclampsia is characterized by high blood pressure, excessive weight gain, and the presence of protein in the urine (proteinuria). Other symptoms may include headaches, dizziness, swelling, and changes in vision. Prompt medical attention is necessary to manage preeclampsia and prevent complications for both the mother and the baby.Rate this question:
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- 17.
A 30 year old female has recently given birth. Her respirations and heart rate are both elevated, and the patient has difficulty inhaling. Her skin is warm and she is sweating. This is probably caused by
- A.
Hemorrhage.
- B.
Eclampsia.
- C.
Amniotic fluid embolism
- D.
Hyperemesis gravidarum.
Correct Answer
C. Amniotic fluid embolismExplanation
The symptoms described in the question, such as elevated heart rate, difficulty inhaling, warm skin, and sweating, are consistent with an amniotic fluid embolism. Amniotic fluid embolism occurs when amniotic fluid enters the maternal bloodstream, leading to an allergic reaction and causing respiratory distress, cardiovascular collapse, and disseminated intravascular coagulation. This can be a life-threatening condition and requires immediate medical attention. Hemorrhage, eclampsia, and hyperemesis gravidarum do not typically present with these specific symptoms.Rate this question:
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- 18.
As she is pushing, your patient, who is at 34 weeks' gestation, states that the baby is coming. You notice a cord protruding from the vagina. You should:
- A.
Place the mother int he knee-chest position
- B.
Deliver the infant as quickly as possible
- C.
Cut and clamp the cord
- D.
Replace the cord into the vagina
Correct Answer
A. Place the mother int he knee-chest positionExplanation
Placing the mother in the knee-chest position is the correct answer because it helps relieve pressure on the cord and reduces the risk of cord compression or prolapse. This position allows gravity to pull the baby away from the cord, preventing further complications. It is important to keep the cord moist and elevated to maintain blood flow to the baby. Delivering the infant as quickly as possible may cause further damage to the cord or increase the risk of complications. Cutting and clamping the cord or replacing it into the vagina are not appropriate actions in this situation.Rate this question:
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- 19.
An IUD is a:
- A.
Surgical procedure
- B.
Disease of the endometrium
- C.
Type of birth control device
- D.
Medication that regulates menstrual cycles
Correct Answer
C. Type of birth control deviceExplanation
An IUD (Intrauterine Device) is a type of birth control device. It is a small T-shaped device that is inserted into the uterus to prevent pregnancy. It works by releasing hormones or copper to inhibit fertilization and implantation of the fertilized egg. This method of contraception is highly effective and can last for several years before it needs to be replaced.Rate this question:
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- 20.
Seventeen-Year-Old-Patient You are responding to a call for a 17-year-old pregnant patient at 36 weeks gestation. She complains of a headache and dizziness and states that her doctor is upset with her for gaining too much weight. Her hands are puffy and her rings are cutting into her flesh. Her vital signs are BP 174/104, P 84, R 20. The patients most likely to experience this condition are:
- A.
First-time mothers
- B.
Older patients
- C.
Women with previous histories of hypertension
- D.
Patients taking steroids
Correct Answer
A. First-time mothersExplanation
First-time mothers are most likely to experience this condition, known as preeclampsia. Preeclampsia is a condition that typically occurs after 20 weeks of pregnancy and is characterized by high blood pressure, swelling, and protein in the urine. It can be dangerous for both the mother and the baby if left untreated. The patient in this scenario is exhibiting symptoms of preeclampsia, such as headache, dizziness, puffy hands, and high blood pressure. The fact that she is a first-time mother makes her more at risk for developing preeclampsia.Rate this question:
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- 21.
You are called to the scene of a sexual assault. You are presented witha 19-year-old female who is withdrawn and sitting in a corner in her bedroom. Which of the following questions is appropriate to ask?
- A.
"Why did you bring him home with you from the nightclub?"
- B.
"Are you injured anywhere?"
- C.
"What type of clothing were you wearing?"
- D.
"Do you know if you were penetrated?"
Correct Answer
B. "Are you injured anywhere?"Explanation
The appropriate question to ask in this situation is "Are you injured anywhere?" This question shows concern for the victim's well-being and focuses on their immediate physical needs. It allows the victim to disclose any injuries they may have sustained during the assault, which is important for their medical treatment and collecting evidence. It also acknowledges the trauma they have experienced without placing blame or making assumptions about their actions or clothing choices.Rate this question:
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- 22.
Ovulation occurs:
- A.
Secondary to a decrease in FSh and estrogen
- B.
As a result of an LH surge around day 14 of the menstrual cycle
- C.
When the corpus albicans ruptures
- D.
When the corpus luteum ruptures
Correct Answer
B. As a result of an LH surge around day 14 of the menstrual cycleExplanation
Ovulation occurs as a result of an LH surge around day 14 of the menstrual cycle. LH, or luteinizing hormone, is responsible for triggering the release of the mature egg from the ovary. This surge in LH is a crucial event in the menstrual cycle and marks the fertile period for a woman. The release of the egg allows for the possibility of fertilization and subsequent pregnancy.Rate this question:
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- 23.
Your patient is a 43-year-old female who is 36 weeks pregnant and alert, complaining of abdominal pain. She states that she slipped on a wet floor earlier today, striking her abdomen on a kitchen chair. She did not have any acture onset of pain but over the enxt hour developed lower abdominal cramping similar to menstrual pain, as well as a lower back ache. She is G4P3, has a history of CVD, renal disease, and had abdominal surgery for a hernia 4 months ago. Based on this history, the patient is MOST likely experiencing:
- A.
Placenta previa
- B.
Preterm labor
- C.
Braxton-Hicks contractions
- D.
Uterine rupture
Correct Answer
B. Preterm laborExplanation
Based on the patient's history, it is most likely that she is experiencing preterm labor. The patient is 36 weeks pregnant and complaining of abdominal pain after a fall, which could have caused trauma to the uterus. The onset of lower abdominal cramping and backache is consistent with preterm labor. Additionally, the patient's history of previous pregnancies and abdominal surgery may increase her risk for preterm labor. Placenta previa, Braxton-Hicks contractions, and uterine rupture are less likely based on the given information.Rate this question:
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- 24.
You can estimate the amount of vaginal blood lost by asking the patient:
- A.
"Is there more or less blood than during your normal period?"
- B.
"For how many hours have you been bleeding?"
- C.
"How much blood have you lost?"
- D.
"How many pads or tampons were soaked per hour?"
Correct Answer
D. "How many pads or tampons were soaked per hour?"Explanation
Asking the patient how many pads or tampons were soaked per hour can provide a more accurate estimation of the amount of vaginal blood lost. This question allows for a quantitative measurement of the bleeding, which can help determine the severity of the situation and guide appropriate medical intervention.Rate this question:
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- 25.
A 35-year-old female presents complaining of a 1-year history of dull, crampy pain in her pelvis that comes with her menstrual cycle, yet is very different from normal menstrual discomfort. She also describes dyspareunia and frequent spotting. Of the following, what is the most likely clincal condition of this patient?
- A.
Uterine fibroids
- B.
Mittelschmerz
- C.
Endometriosis
- D.
Endometritis
Correct Answer
C. EndometriosisExplanation
The patient's symptoms of dull, crampy pain in the pelvis that is different from normal menstrual discomfort, along with dyspareunia and frequent spotting, are consistent with endometriosis. Endometriosis is a condition where the tissue that normally lines the uterus grows outside the uterus, causing pain and other symptoms. Uterine fibroids are benign growths in the uterus and may cause pain, but they do not typically cause dyspareunia or spotting. Mittelschmerz refers to ovulation pain, which is usually a sharp, brief pain and does not cause dyspareunia or spotting. Endometritis is inflammation of the endometrium, which may cause pain and abnormal bleeding, but it is usually associated with other symptoms like fever and uterine tenderness.Rate this question:
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- 26.
A newborn has blue extremities, a pink torso, a strong and active cry, a heart rate of 104, and some felxion of its extremities. What is this newborn's APGAR score?
- A.
5
- B.
9
- C.
8
- D.
7
Correct Answer
C. 8Explanation
The newborn's APGAR score is 8. The APGAR score is a quick assessment of a newborn's overall well-being and is determined by evaluating five factors: appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), and respiration (breathing effort). In this case, the newborn has blue extremities indicating some cyanosis, a pink torso indicating good perfusion, a strong and active cry indicating good reflex irritability, a heart rate of 104 indicating a normal pulse, and some flexion of its extremities indicating good muscle tone. Based on these factors, the newborn's overall well-being is assessed as 8 out of 10.Rate this question:
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- 27.
Many patients with pain caused by gynecological complaints prefer to be transported:
- A.
In a left-lateral recumbent position
- B.
Sitting on the bench seat
- C.
Lying prone
- D.
Lying supine with legs extended
Correct Answer
A. In a left-lateral recumbent positionExplanation
Many patients with pain caused by gynecological complaints prefer to be transported in a left-lateral recumbent position because this position allows for optimal comfort and support. It helps to relieve pressure on the lower abdomen and pelvic area, reducing pain and discomfort. Additionally, this position also ensures better blood flow and circulation, which is beneficial for patients experiencing gynecological pain.Rate this question:
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- 28.
Braxton-Hicks contractions:
- A.
Occur after 35 weeks of gestation
- B.
Subside with rest
- C.
Are generally benign
- D.
Signal the beginning of labor
Correct Answer
C. Are generally benignExplanation
Braxton-Hicks contractions are generally benign, meaning they are not harmful or dangerous. These contractions are a normal part of pregnancy and are often referred to as "practice contractions." They typically occur after 35 weeks of gestation and are characterized by a tightening or hardening of the uterus. Unlike true labor contractions, Braxton-Hicks contractions subside with rest or a change in position. They are not a sign that labor is starting, but rather a normal occurrence as the body prepares for childbirth.Rate this question:
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- 29.
Endometriosis occurs when:
- A.
The walls of the uterus become inflamed
- B.
An ovarian cyst ruptures
- C.
Fragments of the endometrium grow in the peritoneal cavity
- D.
The fallopian tubes become blocked
Correct Answer
C. Fragments of the endometrium grow in the peritoneal cavityExplanation
Endometriosis occurs when fragments of the endometrium, the tissue that lines the uterus, grow outside of the uterus in the peritoneal cavity. This can cause inflammation and pain in the affected areas. It is a condition that primarily affects women of reproductive age and can lead to symptoms such as pelvic pain, painful periods, and infertility. Treatment options for endometriosis include medication, hormonal therapy, and surgery.Rate this question:
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- 30.
A breech birth is one in which the
- A.
Head is delivered last
- B.
Infants head is face up instead of face down
- C.
Cord preceds the ehad in the vaginal opening
- D.
Shoulders have become lodged in the vaginal opening
Correct Answer
A. Head is delivered lastExplanation
In a breech birth, the head is delivered last instead of the usual position where the head is delivered first. This means that the baby's body is born first, followed by the head. This can be a more complicated delivery process as it increases the risk of complications such as umbilical cord compression or difficulties in delivering the head. Medical professionals need to be prepared to handle a breech birth to ensure the safety of both the mother and the baby.Rate this question:
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- 31.
The premature separation of the placenta from the uterine wall is called:
- A.
Abruptio placentae
- B.
Placenta previa
- C.
Spontaneious placentae
- D.
Abortion
Correct Answer
A. Abruptio placentaeExplanation
The correct answer is abruptio placentae. This term refers to the premature separation of the placenta from the uterine wall before the baby is born. It can cause severe bleeding and is a medical emergency. Placenta previa, on the other hand, is a condition where the placenta partially or completely covers the cervix. Spontaneous placentae and abortion are not accurate terms for describing the premature separation of the placenta.Rate this question:
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