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10 free AEMT practice questions: Obstetric and Gynecologic Emergencies

These are real questions from the same bank the app draws from. Each one is written to the NREMT AEMT content specifications and kept inside the AEMT scope of practice. Pick an answer and you get the full rationale, including why the other three options are wrong.

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Question 1 of 10

A 31-year-old patient with heavy postpartum bleeding has two large-bore intravenous lines running warmed isotonic crystalloid in measured increments. The vital signs are BP 92/56, P 120, R 22, and SpO₂ 97% on room air. Which endpoint should guide how much fluid is given?

Show the answer and rationale

Correct answer · The patient is awake and has a palpable radial pulse

Fluid in a bleeding patient is a bridge to an operating room, and you dose it against the patient rather than against a number. Give it in measured increments, then look at mental status, skin, and the radial pulse between them. A patient who is awake and talking with a pulse you can feel at the wrist is perfusing, and that is the target. Chasing a specific systolic number pushes volume the patient did not need and costs you clotting factors and body heat. Pregnancy makes this worse in a way you have to plan for, because the expanded blood volume lets a patient hold a normal-looking pressure well into serious loss and then fall off quickly.

Why the others are wrong

The systolic pressure has climbed to at least 120: A systolic of 120 looks like a normal pressure, and chasing it feels like restoring the patient. Driving the pressure to a preset number pushes more volume than the patient needs, dilutes what is left of the clotting factors, and cools the patient down while the bleeding continues.

The heart rate has settled below 100 for two readings: Tachycardia is an early shock sign, so watching it fall is genuinely reassuring. Pregnancy itself raises the resting heart rate by roughly 10 to 20 beats per minute, so a rate near 100 can be this patient at baseline and a rate under 100 does not confirm the bleeding has been matched.

The full 20 milliliters per kilogram has been infused: That is the taught bolus volume, so it is a real number rather than an invented one. A bolus is something you give and then reassess, not a quota to be completed, and the patient can reach the endpoint well short of it or need a full reassessment before any of it is repeated.

Question 2 of 10

A 22-year-old patient at 36 weeks of gestation has a single arm protruding through the vaginal opening. Contractions are 3 minutes apart. A paramedic unit is 10 minutes out and the receiving hospital is 18 minutes away. The vital signs are BP 116/70, P 106, R 20, and SpO₂ 98% on room air. Which action is indicated?

Show the answer and rationale

Correct answer · Transport immediately with the hips elevated and notify en route

Here is the rule that covers every abnormal delivery, and it is worth memorizing as one sentence: an abnormal delivery is a rapid transport problem, not a call for a higher level of care. The fix for a limb presentation is an operating room, and no prehospital provider at any level carries what this patient needs. Summoning a unit, waiting for an intercept, or holding on scene for advanced care buys nothing. Put the patient knee-chest or supine with the hips elevated, cover the exposed limb with a moist sterile dressing, get access en route if it does not delay you, and notify the hospital while you are moving.

Why the others are wrong

Wait for the paramedic unit to arrive before leaving the scene: Most calls that look this far outside your training really do resolve by getting a higher level of care on scene. Nothing a paramedic carries delivers a limb presentation either, so the wait costs minutes the fetus does not have and adds nothing.

Apply gentle traction on the arm to complete the delivery: A limb you can see looks like something you can work with, and gentle sounds safe. This delivery cannot be completed vaginally at all, and traction on the limb injures the newborn without moving the presentation.

Push the arm back through the opening and coach the patient to push: Repositioning the limb looks like converting an abnormal presentation into a normal one. Pushing a presenting part back in is never a field maneuver, and coaching a push drives an undeliverable presentation harder into the pelvis.

Question 3 of 10

The fetal head delivers and a loop of umbilical cord is found wrapped around the neck. The loop will not slip over the head and will not loosen enough for the shoulders to pass. The patient is 26 years old and at term. Which action is indicated?

Show the answer and rationale

Correct answer · Place two clamps on the cord, cut between them, and deliver

After the head delivers, run a finger around the neck to feel for a loop of cord. A loose loop slips over the head and you carry on as normal. A loop that will not slip and will not loosen enough for the shoulders is different, because the body is about to deliver against it. Place two clamps on the cord, cut between them, and deliver the newborn right away. This is the one circumstance in a field delivery where the cord is cut before the body is out, and once you cut it the newborn has no placental circulation, so the delivery and the newborn assessment run without a pause.

Why the others are wrong

Wait for the next contraction to loosen the loop before continuing: Contractions have moved this delivery along so far, so letting one more do the work sounds patient rather than passive. A contraction advances the body against a fixed loop, which tightens it further and costs the newborn time it does not have.

Apply traction on the head to create slack under the loop: Pulling to make room is the intuitive fix for something wrapped too tightly. Traction does not relieve a nuchal cord, and it injures the brachial plexus and the cervical spine while the loop stays exactly as tight as it was.

Support the head in place and transport with the loop undisturbed: Transport is the right instinct for most abnormal deliveries, which is what makes this one catch people. A tight loop will strangle the newborn or tear as the body delivers, and the delivery is happening now rather than at the hospital.

Question 4 of 10

A 27-year-old patient at 34 weeks of gestation is secured to a long board after a highway collision and reports lightheadedness. The board cannot be tilted on the cot mount in this ambulance. The vital signs are BP 90/56, P 118, R 22, and SpO₂ 97% on room air. Which action is indicated?

Show the answer and rationale

Correct answer · Push the uterus up and toward the left with both hands

The goal in a pregnant trauma patient is simple: get the uterus off the inferior vena cava. If the patient needs no spinal precautions, roll her left lateral. If she is on a board that can be tilted, tilt the whole board 15 to 30 degrees left with padding under the right side, keeping her spine in line with the board rather than twisting her on it. If she cannot be tilted at all, do it with your hands: place one or both hands on the right side of the abdomen and push the uterus up and toward her left, and hold it there. Left is the correct direction because the inferior vena cava runs on the right side of the spine.

Why the others are wrong

Loosen the straps and turn the patient onto the left side: Left lateral is the correct position for almost every other pregnant patient, so reaching for it is well trained. Loosening the straps on a boarded trauma patient trades one problem for another, and manual displacement gets the uterus off the vessel without breaking the packaging.

Raise the foot end of the cot to improve venous return: Elevating the legs is a reflex when a pressure drops, and it does move some volume centrally. The patient stays flat, so the uterus stays on the vena cava, and the obstruction that is causing the hypotension is untouched.

Press the uterus downward toward the pelvis with both hands: Moving the uterus is the right idea, and this gets the direction wrong. Pressing down drives the uterus harder onto the vessels behind it, and the displacement has to go up and to the left because the inferior vena cava runs on the right side of the spine.

Question 5 of 10

A 35-year-old patient at 32 weeks of gestation is pulseless and apneic on the floor of a store. Compressions are under way, the automated external defibrillator has analyzed, and an advised shock has been delivered. A third provider is available. Which action is indicated for the uterus during the resuscitation?

Show the answer and rationale

Correct answer · The uterus is pushed up and toward the left by one provider

Cardiac arrest in a pregnant patient past roughly 20 weeks is a standard arrest with one modification. Compressions go in the usual place at the usual depth and rate, ventilations are normal, and the automated external defibrillator is applied and used exactly as it would be on anyone else. The modification is that a provider moves the uterus off the inferior vena cava by hand, pushing it up and toward the patient's left. Tilting is what you do for a patient who still has a pulse, and during CPR a tilted torso makes effective compressions impossible, which is why the technique changes. One more thing that does not change: after any analysis, compressions resume immediately, shock or no shock.

Why the others are wrong

The whole torso is tilted 15 to 30 degrees to the left: That tilt is what you would do for a pregnant patient who still has a pulse, which is exactly why it pulls so hard here. Tilting the torso during CPR makes effective compressions impossible, and losing compression quality costs more than the tilt gains.

A wedge is placed under the right hip and the board is tilted: A wedge under the right hip is standard teaching for transporting a late-pregnancy patient, so it feels like the packaged version of the same fix. Any tilt angles the chest away from the compressor, and a chest that is not flat cannot be compressed to the right depth.

No uterine displacement is performed until a pulse returns: Focusing entirely on compressions and the defibrillator sounds like good arrest discipline. A uterus sitting on the vena cava blocks venous return, and compressions cannot move blood that is not getting back to the heart, so displacement is part of the resuscitation rather than something that waits for it.

Question 6 of 10

A 31-year-old patient at 32 weeks of gestation reports a headache that has not eased with acetaminophen, along with blurred vision and pain under the right rib margin. The face and hands are swollen. The vital signs are BP 166/112, P 92, R 18, and SpO₂ 98% on room air. Which condition do these findings describe?

Show the answer and rationale

Correct answer · Preeclampsia with severe features

Preeclampsia is new hypertension after 20 weeks of pregnancy, and it shows up as a cluster rather than a single number. Watch for a headache that will not respond to ordinary measures, visual changes like blurring or spots, and epigastric or right upper quadrant pain, which comes from the liver capsule stretching. Swelling of the face and hands supports the picture without confirming it, since normal pregnancy swells too. Severe features start at a systolic of 160 or higher or a diastolic of 110 or higher, and this patient is above both. Eclampsia is the next step along the same spectrum, and what defines it is a seizure, not the height of the pressure.

Why the others are wrong

Chronic hypertension in pregnancy: A pressure that high does suggest a long-standing problem to most people. New hypertension after 20 weeks is preeclampsia until proven otherwise, and chronic hypertension does not bring a headache, visual changes, and right upper quadrant pain with it.

A hypertensive response to labor pain: Pain genuinely raises blood pressure, and there is real pain in this picture. Labor pain does not produce blurred vision, facial swelling, and liver-area pain, and nothing here says the patient is in labor at all.

Eclampsia in its early stage: The findings are severe enough that reaching for the more serious name feels right. Eclampsia is defined by a seizure rather than by how high the pressure climbs, so without one this patient has not crossed that line yet.

Question 7 of 10

A newborn delivered at term is 5 minutes old, has a strong cry, and moves all extremities actively. A pulse oximeter probe is on the right wrist. The vital signs are P 148, R 46, and SpO₂ 83% on room air. Which action is indicated?

Show the answer and rationale

Correct answer · Continue routine care and recheck the saturation at 10 minutes

Reading a newborn saturation against adult normals is the most common way to over-treat a newborn who is transitioning exactly as expected. A newborn starts life around 60% and climbs: roughly 60 to 65% at 1 minute, 65 to 70% at 2, 70 to 75% at 3, 75 to 80% at 4, 80 to 85% at 5, and 85 to 95% by 10 minutes. A reading of 83% at 5 minutes in a newborn with a strong cry, good tone, and a heart rate over 100 is on target and is not a reason to add oxygen. Put the probe on the right hand or wrist, which is preductal, because the right subclavian artery leaves the aorta before the ductus arteriosus. The assessment that decides what you do is still the same one: breathing, tone, and heart rate.

Why the others are wrong

Give blow-by oxygen until the saturation reaches 95%: A reading of 83% would be a genuine emergency in anyone older, and treating hypoxia is a reflex worth having. Newborn targets climb minute by minute, and 80 to 85% is on target at 5 minutes of life, so this reading is normal transition rather than hypoxia.

Begin positive pressure ventilations with room air: Low numbers plus a new patient makes ventilation feel like the safe default. Ventilation is triggered by apnea, gasping, or a heart rate under 100, and this newborn is crying strongly with a heart rate of 148.

Move the probe to the left wrist and recheck the reading: Rechecking a surprising number on a different site is good instinct with most monitors. The right hand or wrist is the correct newborn site because it is preductal, and moving to the left gives you a reading that is lower and harder to interpret.

Question 8 of 10

A newborn delivered at term has thick secretions visible in the mouth and is not moving air well after drying and stimulation. Which action is indicated?

Show the answer and rationale

Correct answer · Suction the mouth first and then the nose with a bulb syringe

Suction a newborn only when secretions are obstructing the airway or the newborn is going to need positive pressure ventilation, because routine suctioning of every newborn wastes time and can trigger a slow heart rate through a vagal response. When it is indicated, use a bulb syringe rather than a rigid catheter: compress the bulb before you insert it, suction the mouth first and the nose second, and hold any attempt in an infant to 5 seconds. Mouth first matters because a newborn is an obligate nose breather, so touching the nose can prompt a gasp that drags mouth contents into the airway. The time limits go 15 seconds for an adult, 10 for a child, and 5 for an infant, and the suction force itself is the same at every age. What changes with size is the device and the clock.

Why the others are wrong

Suction the nose before the mouth to clear the nasal passage: A newborn breathes through the nose, so clearing it first sounds like the priority. Suctioning the nose first can prompt a gasp that pulls whatever is in the mouth down into the airway, which is why the mouth is always cleared first.

Suction the mouth and then the nose with a rigid catheter: The order here is right, and a rigid catheter is what you reach for on an adult with thick secretions. A rigid catheter is too traumatic for newborn tissue, and a bulb syringe is the device at this size.

Suction each nostril with a bulb syringe for 10 seconds: The device is correct and 10 seconds sounds cautious next to an adult limit. Ten seconds is the child limit, an infant is held to 5 seconds, and starting in the nose repeats the order mistake on top of the time one.

Question 9 of 10

A patient develops heavy vaginal bleeding after delivering the placenta, and the uterus feels boggy on palpation. In addition to fundal massage and oxygen, what AEMT-level intervention should be initiated?

Show the answer and rationale

Correct answer · Establish intravenous access with an isotonic crystalloid

A boggy uterus after the placenta delivers is uterine atony, and the mechanism explains both halves of the treatment. After delivery the uterus is supposed to clamp down hard, and that muscular contraction is what physically pinches shut the vessels at the placental site. A soft uterus leaves them wide open, which is why the bleeding is heavy. Fundal massage is not comfort care; it is a mechanical intervention that forces the muscle to contract and close those vessels. Intravenous access with an isotonic crystalloid, normal saline or lactated Ringer's, is the other half. It does not stop the bleeding, it holds up circulating volume and perfusion while the massage works and while you transport, and isotonic fluid is chosen because it stays in the vascular space long enough to support pressure.

Why the others are wrong

Establish intravenous access using D5W as the resuscitation fluid: D5W has real uses as a diluent and carrier, but it is the wrong fluid for hemorrhage. It is isotonic only in the bag; once the dextrose is taken up by cells, what remains behaves as free water and distributes throughout the body rather than staying where the blood was lost. Right route, wrong fluid, and you would end up with a working line that fails to support the pressure you opened it for.

Begin oral rehydration and reassess again in 30 minutes: Oral rehydration with a delayed recheck is reasonable for the mildly dry but stable patient who is tolerating fluids and is not bleeding, such as heat exhaustion or gastroenteritis. This patient is actively hemorrhaging from an atonic uterus, and postpartum blood loss can outrun anything the gut can absorb. A 30-minute reassessment interval is long enough for a compensating patient to become a decompensated one, and oral fluids add aspiration risk if she deteriorates.

Pack the vagina with dressings to control the bleeding directly: Packing is the right instinct for an external, compressible wound, where direct pressure onto the bleeding surface controls it. It does not transfer here, because the blood is coming from the uterus above the cervix, so packs placed below it never reach the source and only conceal ongoing loss while it continues internally. The intervention that does reach the source is fundal massage, which is why massage plus fluid is the AEMT answer and vaginal packing is not a field procedure.

Question 10 of 10

An AEMT is treating a pregnant patient who begins seizing en route to the hospital, with a known history of severe hypertension and pre-eclampsia. Which positioning is most appropriate for this patient?

Show the answer and rationale

Correct answer · Left lateral position

Left lateral positioning takes pressure off the inferior vena cava, improving blood return and blood pressure, and helps protect the airway if the patient is actively seizing.

Why the others are wrong

Supine with legs elevated: Supine positioning with legs elevated does not relieve IVC compression and is not the recommended positioning for eclampsia.

Prone position: ing is not used and would compromise airway management during a seizure.

Right lateral position: ing does not relieve pressure on the IVC, which lies to the right of the spine: left lateral is specifically indicated.

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