Chapter 23

When documenting a call in which a female was sexually assaulted, you should: translate the patient's words or statements using proper medical terminology. keep the report concise and record only what the patient stated in her own words. only use quotation marks when recording any statements made by witnesses. record your opinion only if you have reasonable proof to justify the statement.

Potentially life-threatening consequences of pelvic inflammatory disease (PID) include: uterine rupture with severe bleeding. ovarian cysts and gonorrhea. ovarian abscess and ectopic pregnancy. bacterial vaginosis and chlamydia.

Each ovary produces an ovum in alternating months and releases it into the: uterus. vagina. cervix. fallopian tube.

When a woman presents with abdominal pain or other vague symptoms, the EMT is often unable to determine the nature of the problem until he or she: ascertains if the patient was ever pregnant. has gathered patient history information. has obtained a complete set of vital signs. has formed a general impression of the patient.

When caring for a female patient who has been sexually assaulted, you should: allow law enforcement to take her statement before you begin treatment. advise her that she will not be allowed to shower or change her clothes. place any bloodstained clothing or other articles in separate paper bags. ask the patient for a concise, detailed report of what happened to her.

Which of the following statements regarding rape is correct? Only a licensed physician can make a diagnosis of rape. Rape causes more physical harm than emotional harm. Rape is a legal diagnosis, not a medical diagnosis. The EMT should try to determine if rape occurred.

The physical examination of a sexual assault victim should be: as detailed as possible so all injuries can be documented. limited to a brief survey for life-threatening injuries. performed in the presence of at least two police officers. deferred until the patient can be evaluated by a physician.

In anticipation of receiving a fertilized ovum, the lining of the uterine wall: diverts blood flow to the vagina. sheds and is expelled externally. becomes engorged with blood. thins and begins to separate.

General treatment for a woman with vaginal bleeding and shock following sexual assault includes all of the following, EXCEPT: supplemental oxygen and keeping the patient supine. carefully removing any foreign bodies from the vagina. treating external lacerations with sterile compresses. refraining from placing any dressings into the vagina.

When a female has reached menarche: she can no longer produce an ovum. she usually requires hormone therapy. she is capable of becoming pregnant. menstrual periods become less frequent.

Which of the following drugs is commonly referred to as "roofies"? MDMA GHB Ketamine Rohypnol

If a woman with vaginal bleeding reports syncope, the EMT should assume that she: has an infection. is in shock. is pregnant. has an ectopic pregnancy.

You are dispatched to a residence for a 40-year-old female who complains of lower abdominal pain, fever and chills, and a foul-smelling vaginal discharge. Which of the following additional assessment findings would increase your index of suspicion for pelvic inflammatory disease? A history of ectopic pregnancy A shuffling gait when walking Bright red blood in the urine Vaginal passage of blood clots

Which of the following conditions would MOST likely lead to pelvic inflammatory disease if left untreated? Ovarian cysts Chlamydia Ectopic pregnancy Genital herpes

EMTs receive a call for a possible sexual assault. The patient is a young female who is conscious and alert and has no apparent injuries. She states, "I cannot remember anything, but I know I was raped." The EMTs should suspect that: an underlying head injury is causing her amnesia. the patient knew her attacker, but is afraid to say. the patient was given a drug prior to the incident. the traumatic experience has created a mental block.

Whenever possible, a female sexual assault victim should be: thoroughly assessed, even if no signs of injury exist. asked to provide a brief description of the perpetrator. encouraged to take a shower and change her clothes. given the option of being treated by a female EMT.

A 26-year-old female presents with heavy vaginal bleeding. She is conscious, but restless. Her blood pressure is 84/54 mm Hg, her pulse is 120 beats/min and weak, and her respirations are 22 breaths/min with adequate depth. She tells you that she inserted a tampon about 2 hours ago. You should: assist her ventilations with a bag-valve mask, place one sterile dressing into her vagina, perform a rapid secondary assessment, and transport. administer high-flow oxygen, place a sterile pad over her vagina, keep her warm, elevate her lower extremities, and transport without delay. administer high-flow oxygen, perform a detailed assessment of her vaginal area for signs of trauma, place her on her side, and transport. administer high-flow oxygen, ask her to remove the tampon, perform a detailed secondary assessment, and transport promptly.

During your assessment of a young female with nontraumatic vaginal bleeding, you note that her level of consciousness is decreased, her respirations are rapid and shallow, her skin is cool and moist, and her pulse is rapid and weak. You should: assess her blood pressure and elevate her legs. assist her ventilations with a BVM. perform a rapid secondary assessment. perform a visual assessment of her vaginal area.

Which of the following clinical presentations is MOST consistent with pelvic inflammatory disease (PID)? Left lower quadrant pain, referred pain to the left shoulder, and fever Upper abdominal cramping, severe headache, and heavy vaginal bleeding Lower abdominal pain, fever, general malaise, and foul-smelling vaginal discharge Pain around the umbilicus, low-grade fever, and generalized weakness

The onset of menstruation usually occurs in women who are: between 25 and 28 years of age. between 8 and 10 years of age. between 11 and 16 years of age. between 18 and 23 years of age.

As a woman approaches menopause: she cannot become pregnant because of fluctuating hormone levels. she usually experiences abdominal cramping without vaginal bleeding. her menstrual periods may become irregular and vary in severity. her risk of developing pelvic inflammatory disease lowers significantly.

Law enforcement personnel request your assistance to assess a 31-year-old female who was sexually assaulted. When you arrive at the scene, you find the patient sitting on a curb outside her apartment. She is conscious, alert, and crying. When you ask her what happened, she tells you that she does not want to be treated or transported to the hospital. She further tells you that all she wants to do is clean up. You should: advise her that she cannot clean herself up because this will destroy evidence. provide emotional support and visually assess her for obvious trauma. perform a limited hands-on assessment to detect life-threatening injuries. ask her if there is anyone you can contact, such as a friend or relative.

Which of the following statements regarding pelvic inflammatory disease (PID) is correct? PID can scar the fallopian tubes, which increases the risk of an ectopic pregnancy. The most severe cases of PID occur in women who are not sexually active. The most common presenting symptom of PID is generalized upper abdominal pain. PID most commonly affects women who have had an ectopic pregnancy in the past.

When caring for a woman who is experiencing a gynecologic emergency, the EMT's main focus should be to: maintain her ABCs and transport without delay. keep assessment and treatment to a minimum. ask questions related to her gynecologic history. determine the underlying cause of her problem.

Which of the following statements regarding gonorrhea is correct? Most men who are infected with gonorrhea do not experience symptoms. Symptoms of gonorrhea usually appear within 3 months after being infected. Painful urination is a common symptom of gonorrhea in men and women. Mild infections with gonorrhea cause abdominal pain, vomiting, and fever.

It is common for young females who experience their first menstrual period to: have a false positive home pregnancy test result. experience abdominal cramping, which may be misinterpreted. lose up to 500 mL of blood within the first 24 hours. become so emotionally distraught that they contemplate suicide.

Pelvic inflammatory disease (PID) typically does NOT affect the: urinary bladder. ovaries. fallopian tubes. uterus.

Bacterial vaginosis is a condition that occurs when: abnormal bacteria enter the vagina and cause damage without causing any symptoms. numerous bacteria enter the uterus through the cervix and cause severe tissue damage. normal bacteria in the vagina are replaced by an overgrowth of other bacterial forms. harmful bacteria infect and cause damage to the uterus, cervix, and fallopian tubes.

What is the narrowest portion of the uterus? A. Vagina B. Cervix C. Fallopian tubes D. Ovaries

What is the outermost cavity of a woman's reproductive system? A. Cervix B. Ovaries C. Vagina D. Uterus

If fertilization has not occurred within about ___ days following ovulation, the lining of the uterus begins to separate and menstruation occurs. A. 8 B. 10 C. 12 D. 14

The onset of menstruation is called: A. menopause. B. menarche. C. ovulation. D. bleeding.

Which of the following can cause vaginal bleeding? A. Ectopic pregnancy B. Spontaneous abortion C. Trauma D. All of the above.

What is the most common presenting sign of PID? A. Vomiting B. Vaginal discharge C. Lower abdominal pain D. Fever

When obtaining a SAMPLE history, which of the following pieces of information is important to obtain? A. Use of a birth control device or birth control pills B. The date of the patient's last menstrual period C. The possibility of pregnancy D. All of the above.

What is the EMT's FIRST priority when dealing with a patient experiencing excessive vaginal bleeding? A. Determine the cause of the bleeding. B. Treat the patient for shock and transport. C.Determine if the bleeding is a result of sexual assault. D. Keep the patient warm and apply oxygen.

Which of the following drugs is commonly used to facilitate sexual assault? A. Rohypnol B. Heroin C. Cocaine D. Marijuana

You should discourage a rape or sexual assault victim from doing which of the following? A. Urinating B. Cleaning herself C. Changing clothes D. All of the above.