1
OB & Pediatric EMT FISDAP Exam 2025–2026 | 120+
Updated Questions, Verified Answers & Detailed
Rationales | High-Yield A+ Study Guide"
Question 1: THIRD-TRIMESTER BLEEDING
You are called to assess a 27-year-old woman who is 34 weeks pregnant and
experiencing sudden onset of vaginal bleeding and constant lower abdominal pain.
She reports lifting a heavy box earlier in the day but denies any trauma. Upon
assessment, she appears pale and diaphoretic, her blood pressure is 90/58 mmHg,
heart rate is 122 bpm, and fetal movement is noticeably decreased. Based on this
presentation, which of the following is the most likely diagnosis?
A. Placenta previa
B. Preterm labor
C. Uterine rupture
D. Abruptio placentae
Correct Answer: D. Abruptio placentae
Rationale:
This patient is most likely experiencing abruptio placentae, which is the premature
separation of the placenta from the uterine wall. It presents with painful vaginal
bleeding, uterine tenderness, and signs of hypovolemic shock such as hypotension
and tachycardia. Decreased fetal movement is also a key indicator of fetal
compromise. This condition is commonly triggered by trauma or physical strain.
Placenta previa, while also involving third-trimester bleeding, is typically painless
and does not cause uterine tenderness or maternal hypotension. Preterm labor
usually presents with regular uterine contractions and cervical dilation, not
, 2
constant pain and bleeding. Uterine rupture, although life-threatening, is less likely
here as there is no history of previous cesarean section or uterine surgery, and there
is no indication of fetal parts outside the uterus. Therefore, the most appropriate
diagnosis is abruptio placentae.
Question 2: PRE-ECLAMPSIA VS. ECLAMPSIA
A 22-year-old woman who is 36 weeks pregnant complains of a persistent
headache, visual disturbances described as "flashing lights," and swelling in her
hands and face. Her blood pressure is 168/110 mmHg, and she appears anxious.
Shortly after your arrival, she begins to seize. What is the most appropriate
immediate management step?
A. Administer IV fluids and monitor vitals
B. Position the patient on her back and provide oxygen
C. Administer high-concentration oxygen and prepare for magnesium sulfate
administration
D. Deliver the baby immediately on scene
Correct Answer: C. Administer high-concentration oxygen and prepare for
magnesium sulfate administration
Rationale:
The patient is experiencing eclampsia, a progression of pre-eclampsia
characterized by the onset of seizures. Eclampsia typically presents with
hypertension, proteinuria (if known), visual disturbances, and neurologic
symptoms such as headaches and seizures. The first priority is airway
management, oxygenation, and seizure control. High-flow oxygen improves
maternal and fetal oxygenation. Magnesium sulfate is the drug of choice to prevent
further seizures. Lying the patient flat (option B) is dangerous as it increases
aspiration risk and impairs venous return. Delivering the baby on scene (option D)
is not practical unless delivery is imminent and unavoidable. Administering fluids
(option A) should be done cautiously, as fluid overload can worsen pulmonary
edema in pre-eclamptic patients. Thus, oxygen and preparation for magnesium
sulfate is the most appropriate immediate step.
, 3
Question 3: SHOULDER DYSTOCIA
You assist in a delivery where the infant’s head delivers but then retracts slightly
against the perineum and the body does not follow despite contractions. The
mother is in distress and pushing ineffectively. What is the most likely
complication occurring in this delivery?
A. Breech presentation
B. Shoulder dystocia
C. Cord prolapse
D. Uterine rupture
Correct Answer: B. Shoulder dystocia
Rationale:
This presentation is characteristic of shoulder dystocia, a delivery complication
where the infant’s anterior shoulder becomes lodged behind the maternal pubic
symphysis after the head is delivered. The key sign is the “turtle sign,” where the
head retracts slightly after delivery. Immediate interventions include McRoberts
maneuver and suprapubic pressure to relieve the obstruction. Breech presentation
involves the buttocks or feet delivering first, not the head. Cord prolapse would
usually involve a visible or palpable cord before delivery, accompanied by fetal
bradycardia. Uterine rupture would involve sudden pain, maternal shock, and
possibly palpable fetal parts through the abdomen. Therefore, the clinical signs
point clearly to shoulder dystocia.
Question 4: PROLAPSED UMBILICAL CORD
A 32-year-old woman in active labor calls EMS for sudden intense pressure and
the sensation that “something is coming out” before full dilation. On examination,
a loop of the umbilical cord is seen protruding from the vaginal opening. What is
the EMS provider’s next best action?
A. Attempt to reposition the cord
B. Apply cold compresses to the cord
C. Place the mother in knee-chest position and insert gloved fingers to relieve
pressure
D. Continue to monitor and prepare for delivery
, 4
Correct Answer: C. Place the mother in knee-chest position and insert gloved
fingers to relieve pressure
Rationale:
A prolapsed umbilical cord is a true obstetric emergency because the cord can be
compressed between the fetus and birth canal, compromising fetal oxygenation.
The immediate goal is to relieve pressure on the cord. The mother should be
positioned in knee-chest or Trendelenburg position, and the provider should insert
two gloved fingers into the vagina to gently elevate the presenting fetal part off the
cord until emergency delivery can be arranged. Repositioning or manipulating the
cord (option A) can worsen the situation. Cold compresses (option B) may preserve
cord viability but are not first-line EMS actions. Simply monitoring (option D)
without relieving compression will result in fetal hypoxia or death. Therefore,
option C is the correct response.
Question 5: POSTPARTUM HEMORRHAGE
Shortly after delivering a healthy baby, a 29-year-old woman begins to bleed
heavily. The placenta has delivered spontaneously, but she continues to bleed
despite fundal massage. She is pale and weak, and her vital signs show BP 92/60
mmHg and HR 118 bpm. What is the most likely cause of this continued bleeding?
A. Retained placenta fragments
B. Placenta previa
C. Uterine rupture
D. Amniotic fluid embolism
Correct Answer: A. Retained placenta fragments
Rationale:
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL after
vaginal delivery. One of the most common causes is retained placental fragments,
which prevent adequate uterine contraction and allow ongoing bleeding. Although
uterine atony is more common, in this case, fundal massage is ineffective,
suggesting something is interfering with uterine tone. Placenta previa is a condition
that occurs before delivery, not postpartum. Uterine rupture would involve more
dramatic symptoms such as tearing pain and possibly loss of fetal station. Amniotic
OB & Pediatric EMT FISDAP Exam 2025–2026 | 120+
Updated Questions, Verified Answers & Detailed
Rationales | High-Yield A+ Study Guide"
Question 1: THIRD-TRIMESTER BLEEDING
You are called to assess a 27-year-old woman who is 34 weeks pregnant and
experiencing sudden onset of vaginal bleeding and constant lower abdominal pain.
She reports lifting a heavy box earlier in the day but denies any trauma. Upon
assessment, she appears pale and diaphoretic, her blood pressure is 90/58 mmHg,
heart rate is 122 bpm, and fetal movement is noticeably decreased. Based on this
presentation, which of the following is the most likely diagnosis?
A. Placenta previa
B. Preterm labor
C. Uterine rupture
D. Abruptio placentae
Correct Answer: D. Abruptio placentae
Rationale:
This patient is most likely experiencing abruptio placentae, which is the premature
separation of the placenta from the uterine wall. It presents with painful vaginal
bleeding, uterine tenderness, and signs of hypovolemic shock such as hypotension
and tachycardia. Decreased fetal movement is also a key indicator of fetal
compromise. This condition is commonly triggered by trauma or physical strain.
Placenta previa, while also involving third-trimester bleeding, is typically painless
and does not cause uterine tenderness or maternal hypotension. Preterm labor
usually presents with regular uterine contractions and cervical dilation, not
, 2
constant pain and bleeding. Uterine rupture, although life-threatening, is less likely
here as there is no history of previous cesarean section or uterine surgery, and there
is no indication of fetal parts outside the uterus. Therefore, the most appropriate
diagnosis is abruptio placentae.
Question 2: PRE-ECLAMPSIA VS. ECLAMPSIA
A 22-year-old woman who is 36 weeks pregnant complains of a persistent
headache, visual disturbances described as "flashing lights," and swelling in her
hands and face. Her blood pressure is 168/110 mmHg, and she appears anxious.
Shortly after your arrival, she begins to seize. What is the most appropriate
immediate management step?
A. Administer IV fluids and monitor vitals
B. Position the patient on her back and provide oxygen
C. Administer high-concentration oxygen and prepare for magnesium sulfate
administration
D. Deliver the baby immediately on scene
Correct Answer: C. Administer high-concentration oxygen and prepare for
magnesium sulfate administration
Rationale:
The patient is experiencing eclampsia, a progression of pre-eclampsia
characterized by the onset of seizures. Eclampsia typically presents with
hypertension, proteinuria (if known), visual disturbances, and neurologic
symptoms such as headaches and seizures. The first priority is airway
management, oxygenation, and seizure control. High-flow oxygen improves
maternal and fetal oxygenation. Magnesium sulfate is the drug of choice to prevent
further seizures. Lying the patient flat (option B) is dangerous as it increases
aspiration risk and impairs venous return. Delivering the baby on scene (option D)
is not practical unless delivery is imminent and unavoidable. Administering fluids
(option A) should be done cautiously, as fluid overload can worsen pulmonary
edema in pre-eclamptic patients. Thus, oxygen and preparation for magnesium
sulfate is the most appropriate immediate step.
, 3
Question 3: SHOULDER DYSTOCIA
You assist in a delivery where the infant’s head delivers but then retracts slightly
against the perineum and the body does not follow despite contractions. The
mother is in distress and pushing ineffectively. What is the most likely
complication occurring in this delivery?
A. Breech presentation
B. Shoulder dystocia
C. Cord prolapse
D. Uterine rupture
Correct Answer: B. Shoulder dystocia
Rationale:
This presentation is characteristic of shoulder dystocia, a delivery complication
where the infant’s anterior shoulder becomes lodged behind the maternal pubic
symphysis after the head is delivered. The key sign is the “turtle sign,” where the
head retracts slightly after delivery. Immediate interventions include McRoberts
maneuver and suprapubic pressure to relieve the obstruction. Breech presentation
involves the buttocks or feet delivering first, not the head. Cord prolapse would
usually involve a visible or palpable cord before delivery, accompanied by fetal
bradycardia. Uterine rupture would involve sudden pain, maternal shock, and
possibly palpable fetal parts through the abdomen. Therefore, the clinical signs
point clearly to shoulder dystocia.
Question 4: PROLAPSED UMBILICAL CORD
A 32-year-old woman in active labor calls EMS for sudden intense pressure and
the sensation that “something is coming out” before full dilation. On examination,
a loop of the umbilical cord is seen protruding from the vaginal opening. What is
the EMS provider’s next best action?
A. Attempt to reposition the cord
B. Apply cold compresses to the cord
C. Place the mother in knee-chest position and insert gloved fingers to relieve
pressure
D. Continue to monitor and prepare for delivery
, 4
Correct Answer: C. Place the mother in knee-chest position and insert gloved
fingers to relieve pressure
Rationale:
A prolapsed umbilical cord is a true obstetric emergency because the cord can be
compressed between the fetus and birth canal, compromising fetal oxygenation.
The immediate goal is to relieve pressure on the cord. The mother should be
positioned in knee-chest or Trendelenburg position, and the provider should insert
two gloved fingers into the vagina to gently elevate the presenting fetal part off the
cord until emergency delivery can be arranged. Repositioning or manipulating the
cord (option A) can worsen the situation. Cold compresses (option B) may preserve
cord viability but are not first-line EMS actions. Simply monitoring (option D)
without relieving compression will result in fetal hypoxia or death. Therefore,
option C is the correct response.
Question 5: POSTPARTUM HEMORRHAGE
Shortly after delivering a healthy baby, a 29-year-old woman begins to bleed
heavily. The placenta has delivered spontaneously, but she continues to bleed
despite fundal massage. She is pale and weak, and her vital signs show BP 92/60
mmHg and HR 118 bpm. What is the most likely cause of this continued bleeding?
A. Retained placenta fragments
B. Placenta previa
C. Uterine rupture
D. Amniotic fluid embolism
Correct Answer: A. Retained placenta fragments
Rationale:
Postpartum hemorrhage (PPH) is defined as blood loss greater than 500 mL after
vaginal delivery. One of the most common causes is retained placental fragments,
which prevent adequate uterine contraction and allow ongoing bleeding. Although
uterine atony is more common, in this case, fundal massage is ineffective,
suggesting something is interfering with uterine tone. Placenta previa is a condition
that occurs before delivery, not postpartum. Uterine rupture would involve more
dramatic symptoms such as tearing pain and possibly loss of fetal station. Amniotic
