New Full Questions and Answers Included 100 Correct

2024 EMT JBL Obstetrics and Peds New Full Questions and Answers ( Included ) 100% Correct

• While assessing a woman in labor, the EMT notices that a loop of the umbilical cord is

protruding from her vagina. In which position should the EMT place the patient?

• Left side with her head elevated
• Supine with her pelvis elevated
• Left side with her legs elevated
• Semi-sitting with her knees bent

Answer: B

(PROLAPSED UMBILICAL CORD: Elevate the mother's pelvis; this will allow the baby to slide slightly back into the vagina, off the cord. The knee to chest position may also help to accomplish the same goal. Cover any exposed cord with a moist, sterile dressing, administer O2 to mother, and rapid transport.

• A newborn has cyanosis to the chest and face and a heart rate of 90 beats/min. What should

you do?

• Resuction the mouth
• Briskly dry off the infant
• Begin chest compressions
• Begin artificial ventilations

Answer: D

(Central cyanosis [head, face, and trunk] alone should be treated with blow-by O2; however, when it is accompanied by HR less than 100bpm, artificial ventilations should be initiated and continued until the HR exceeds 100bpm. Chest compressions are needed when HR is less than 60bpm, despited 30 seconds of adequate positive-pressure ventilation)

• A woman is 30 weeks pregnant. During your assessment, she tells you that she delivered a

stillborn baby at 38 weeks and currently has no living children. How should you document her obstetric history?

• Gravida 1; para 1
• Gravida 2; para 1
• Gravida 1; para 2
• Gravida 2; para 2

Answer: D

(Gravida= # of times a woman has been pregnant, regardless of the length of the pregnancy.Para= # of babies carried beyond 28 weeks, regardless of whether the baby was born dead or alive. Since this pt has surpassed week 28 of her current pregnancy, and delivered her last baby past 28 weeks, she is para 2)

• Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. You

should:

• immediately resuction its mouth and nose. 1 / 4

• begin ventilations with a bag-valve-mask.
• gently flick the soles of its feet for up to 60 seconds.
• start CPR if the heart rate is less than 80 beats/min.

Answer: B

(Initial steps of newborn resuscitation: drying, warming, positioning, suctioning, and tactile stimulation. If newborn remains apneic [gasping] after initial steps or has a HR less than 100bpm, begin PPV with BVM at rate of 40-60 breaths/min. Continued tactile stimulation [flicking soles of feet, rubbing the lateral thorax] of an apneic newborn WASTES TIME. If the newborn's HR is less than 60bpm despite effective PPV, you should begin chest compressions)

• In contrast to the contractions associated with true labor, Braxton-Hicks contractions:
• do not increase in intensity and are alleviated by a change in position.
• may be intensified by activity and are accompanied by a pink discharge.
• generally follow rupture of the amniotic sac and occur with regularity.
• consistently become stronger and are not alleviated by changing position.-

Answer: A

(Braxton-Hicks: false labor. Do not represent true labor since they do not increase in intensity, are not regular, and are typically alleviated by activity or a change in position. Contractions during true labor, once they begin: consistently get stronger and closer together and are regular; change in position does not help; may be followed by rupture of amniotic sac and a pink or red vaginal discharge that is gen. accompanied by mucus [bloody show])

• Compared to nonpregnant women, otherwise healthy pregnant woman are at greater risk

for:

• joint dislocations.
• type 1 diabetes.
• pathologic fractures.
• congestive heart failure.

Answer: A

(Blood volume, cardiac output and HR all increase with pregnancy. BP decreases slightly.Uterus expands which affects the respiratory system by pushing up on the diaphragm which increases the respiratory rate and decreases minute volume [pregnant women breathe faster but have a hard time taking a deep breath]. In-creased hormones make the joints looser and less stable; this increases risk of joint dislocations. Some pregnant women develop gestational diabetes, which is caused when the pregnancy hormones create insulin resistance; this is different from Type 1 diabetes, where the body does not produce any insulin)

• A 7-year-old child has an altered mental status, high fever, and a generalized rash. You perform

your assessment and administer supplemental oxygen. En route to the hospital, you should be

MOST alert for:

• hypotension. 2 / 4

• convulsions.
• combativeness.

• respiratory distress.

Answer: B

(High fever and AMS indicate sepsis. A generalized rash should alert you to the possibility of meningitis [a condition caused by infection and inflammation of the meninges that protect the brain and spinal cord]. Children with meningitis are at risk for seizures, usually due to increased ICP and/or high fever. Seizure deaths are caused by cerebral hypoxia)

• A 4-year-old girl fell from a third-story window and landed on her head. She is

semiconscious with slow, irregular breathing and is bleeding from her mouth and nose. You

should:

• open her airway with the jaw-thrust maneuver while manually stabilizing her head, suction

her oropharynx, and assist her ventilations.

• open her airway by carefully tilting her head back, suction her oropharynx, and administer

high-flow oxygen via nonrebreathing mask.

• manually stabilize her head, open her airway with the jaw-thrust maneuver, insert a

nasopharyngeal airway, and suction her oropharynx.

• suction her oropharynx, open her airway with the jaw-thrust maneuver, insert an

oropharyngeal airway, and assist her ventilations.

Answer: A

(In any semiconscious or unconscious pt with a head injury, you should manually stabilize the head and open the airway with jaw-thrust maneuver. Suction any secretions. If possible, insert a simple airway adjunct. Slow, irregular breathing will not provide adequate minute volume and should be treated with ventilatory assistance)

• Following delivery of the baby and placenta, the mother continues to experience moderate

vaginal bleeding. The EMT should:

• carefully insert several gauze pads into her vagina.
• sit her up and apply direct pressure to her vaginal area.
• keep her supine and massage the fundus of her uterus.
• place her on her side and elevate her lower extremities.

Answer: C

(Postpartum hemorrhage: place mother supine and firmly massage the funds (top) of the uterus.Fundal massages causes vasoconstriction of the uterine blood vessels, which helps control bleeding. Another option is to allow the mother to nurse her baby; doing so causes her pituitary gland to release oxytocin which also causes vasoconstriction of the uterus. AWARE

OF SHOCK WITH ANY BLEEDING)

• A 5-year-old child is unresponsive and cyanotic. His pulses are weak and slow and his

breathing is slow. What should you do?

• Begin chest compressions
• Ventilate with a bag-mask device
• Give oxygen by nonrebreathing mask 3 / 4

• Apply the AED

Answer: B

(Most cardiac arrests in infants and children are caused by hypoxia secondary to respiratory failure. When infants and children become hypoxic, they develop bradycardia. Any infant or child who has bradycardia and poor breathing should be ventilated with a BVM. Cyanosis indicates severe hypoxia. If the child's HR is below 60bpm start chest compressions)

• Which of the following is a sign of inadequate breathing in an infant?
• Sunken fontanelles
• Abdominal breathing
• Expiratory grunting
• Heart rate of 130 beats/min

Answer: C

(Expiratory grunting: in an infant or child with a respiratory problem is an ominous sign; it indicated impending respiratory arrest. Grunting represents the child's at- tempt to maintain O2 reserve in the lungs. Sunken fontanelles indicate dehydration. Bradycardia in an infant or a child with a respiratory problem indicated impending cardiopulmonary arrest)

• A week after a near-drowning incident, a 6-year-old boy presents with respiratory distress,

tachypnea, and fever. What should you suspect?

• Asthma
• Pertussis
• Pneumonia
• Bronchiolitis

Answer: C

(Pneumonia: infection of the lungs; often a secondary infection and commonly occurs during or after a pre-existing infection such as a cold. It can also be caused by direct lung injuries [accidental chemical ingestion or a submersion incident]. S/Sx: tachypnea, breathing with grunting or wheezing sounds, nasal flaring, and hypothermia or fever. Hallmark of asthma: wheezing, however, a fever is not usually present. Bronchiolitis is likely but due to this certain situation, pneumonia is more likely, and bronchiolitis more commonly affects infants and toddlers. Pertussis [whooping cough] is not likely because the child does not have a cough)

• A 3-year-old female presents with respiratory distress. She is conscious, crying, and

clinging to her mother. She has mild intercostal retractions and an oxygen saturation of 91%.What should you do?

• Gently restrain the child and assist her ventilations
• Ask the mother to hold an oxygen mask near the child's face
• Apply a nasal cannula with the flow rate set to 6 L/min
• Apply a nonrebreathing mask with the flow rate set to 12 L/min

Answer: B

• / 4