AEMCA - Advanced Emergency Medical Care Assistant Obstetrics and Neonatology Questions and Answers

Question 1

You are called to a 34-year-old female, G3P2 at 38 weeks gestation, whose membranes have just ruptured.
During assessment, you visualize the umbilical cord protruding from the vagina.
The patient is anxious and states she feels contractions.
What is the most critical immediate intervention?

Accepted Answer

Place the patient in a knee-chest position and manually elevate the presenting fetal part.

Answer

Administer high-flow oxygen and initiate rapid transport.

Answer

Attempt to gently push the cord back into the vaginal canal.

Answer

Encourage the patient to push forcefully with her next contraction to expedite delivery.

Question 2

A 29-year-old in her third trimester of pregnancy presents with sudden, painless, bright red vaginal bleeding. Her abdomen is soft and non-tender on palpation. Which of the following conditions is most likely?

Accepted Answer

Placenta previa

Answer

Placental abruption

Answer

Uterine rupture

Answer

Braxton Hicks contractions

Question 3

Following a field delivery of a vigorous, crying newborn at term, what are the appropriate initial steps of neonatal care?

Accepted Answer

Dry the infant, provide warmth with skin-to-skin contact, clear the airway only if necessary, and stimulate breathing.

Answer

Immediately clamp and cut the umbilical cord, then begin chest compressions.

Answer

Provide positive pressure ventilation, check a blood glucose level, and apply a pulse oximeter.

Answer

Administer blow-by oxygen, perform deep suctioning of the oropharynx, and wrap the infant in a dry blanket.

Question 4

When assessing a newborn's APGAR score, how is respiratory effort evaluated and scored?

Accepted Answer

A score of 1 is given for a slow or irregular cry; a score of 2 is for a vigorous cry.

Answer

A score of 2 is given for a heart rate over 100 bpm.

Answer

A score of 0 is for acrocyanosis; a score of 2 is for a completely pink body.

Answer

A score of 1 is for no response to stimulation; a score of 2 is for a grimace.

Question 5

You have just assisted with a delivery in the patient's home. The placenta has delivered, but the mother is now experiencing heavy vaginal bleeding and the uterine fundus feels soft and 'boggy'. What is the primary and most important prehospital intervention for this condition?

Accepted Answer

Firmly massage the uterine fundus.

Answer

Administer high-flow oxygen.

Answer

Initiate IV access and administer a 500 mL fluid bolus.

Answer

Place the patient in the Trendelenburg position.

Question 6

Which of the following is an absolute contraindication for administering oxytocin in the management of postpartum hemorrhage?

Accepted Answer

The placenta has not yet been delivered.

Answer

The mother is breastfeeding.

Answer

The patient has a history of Cesarean section.

Answer

The patient received an epidural during labor.