1.       What is the first stage of labor?

a.       The baby crowns

b.      The baby is in the birth canal

c.       The cervix is dilating

d.      The placenta is delivered

2.       You and your partner Stacy are called to an apartment complex for a 17 year old female complaining of abdominal pain. Upon entering the residence you see the patient looking pale and lying on the couch. Her abdomen is completely distended and she has a towel in her lap with traces of blood on it. Her respirations are at 20 breaths per minute and her pulse is 114. She denies any trauma and tells you she has a small amount of vaginal bleeding. After applying high flow O2 and moving her to the ambulance, you discover a loop of tissue protruding from the patients vagina. What is likely happening with this patient and how would you treat her?

a.       She has preeclampsia with placenta abruptio. She should be transported in a left lateral recumbent position and treated for shock. Initiate IV therapy if scope of practice allows.

b.      She is giving birth and has a nucal cord. Transport with the patient’s head and torso down while monitoring vitals in route. Initiate IV therapy if scope of practice allows. If ETA is more than 30 minutes gently maneuver the cord back into the vagina.

c.       She has an acute lower GI bleed and should be transported in a position of comfort and treated for shock. Establish IV if scope of practice allows.

d.      She has a prolapsed cord. Insert a gloved hand into the vagina and check for pulsations in the cord. Gently lift child’s head off of the cord and transport in a supine position with the hips elevated. Treat for shock and establish IV en route if scope of practice allows.