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FISDAP OB/PEDS PARAMEDIC STUDY GUIDE
2025-2026: 110+ NCLEX-STYLE QUESTIONS
WITH RATIONALES, NRP ALGORITHMS, AND
EMERGENCY SCENARIOS – LATEST EDITION
OB/GYN – Anatomy & Physiology of Pregnancy (Questions 1-10)
**Question 1**
A 28-year-old G2P1 at 36 weeks presents with painless, bright red
vaginal bleeding. What is the priority question?
A. "Do you have a headache?"
B. "Was the bleeding after intercourse?"
C. "Do you have contractions?"
D. "Have you had a C-section before?"
**Rationale:**
Correct answer: **C**. Painless bright red bleeding in the 3rd trimester
is placenta previa until proven otherwise. Asking about contractions
helps rule out labor, which can cause bleeding but is typically painful.
Vaginal exam is contraindicated in suspected previa. Headache (A)
suggests preeclampsia. Post-coital bleeding (B) can occur but is not the
priority. Prior C-section (D) increases risk for uterine rupture, which is
painful.
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---
**Question 2**
A primigravida at 39 weeks has a blood pressure of 150/96 and 3+
proteinuria. She complains of RUQ pain and headache. What medication
is contraindicated?
A. Magnesium sulfate
B. Labetalol
C. Hydralazine
D. Terbutaline
**Rationale:**
Correct answer: **D**. This patient has severe preeclampsia (BP
>140/90 + proteinuria + RUQ pain = liver capsule distension).
Terbutaline is a beta-agonist used for tocolysis (stopping preterm labor).
It can worsen tachycardia, increase BP, and is not indicated for
preeclampsia. Magnesium sulfate (A) prevents seizures. Labetalol (B)
and hydralazine (C) are first-line for acute BP control.
---
**Question 3**
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Which finding in a 34-week pregnant patient most suggests abruptio
placentae?
A. Painless bleeding
B. Board-like abdomen with dark red blood
C. Vomiting and diarrhea
D. Fever and foul discharge
**Rationale:**
Correct answer: **B**. Abruptio placentae is premature separation of
the placenta → painful, dark red bleeding, uterine rigidity (board-like
abdomen from retroplacental clot). Painless bleeding (A) = placenta
previa. Vomiting/diarrhea (C) = gastroenteritis or HELLP syndrome.
Fever/foul discharge (D) = chorioamnionitis.
---
**Question 4**
A 25-year-old G1P0 at 32 weeks has a seizure at home. BP 170/110.
After securing airway, what is the next drug?
A. Diazepam 5 mg IV
B. Magnesium sulfate 4 g IV
C. Lorazepam 2 mg IM
D. Fosphenytoin 15 mg/kg
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**Rationale:**
Correct answer: **B**. This is eclampsia (preeclampsia + seizure).
Magnesium sulfate 4-6 g IV is the drug of choice to prevent recurrent
seizures. Benzodiazepines (A, C) can be used if actively seizing but
MgSO4 is preferred for prophylaxis. Fosphenytoin (D) is for non-
eclamptic seizures.
---
**Question 5**
What is the normal expected blood loss in a vaginal delivery?
A. 150-300 mL
B. 300-500 mL
C. 500-1000 mL
D. >1000 mL
**Rationale:**
Correct answer: **B**. Normal vaginal delivery blood loss is 300-500
mL. C-section average is 800-1000 mL. >1000 mL = postpartum
hemorrhage (PPH). Up to 500 mL is considered normal due to
physiologic hypervolemia of pregnancy.
---
FISDAP OB/PEDS PARAMEDIC STUDY GUIDE
2025-2026: 110+ NCLEX-STYLE QUESTIONS
WITH RATIONALES, NRP ALGORITHMS, AND
EMERGENCY SCENARIOS – LATEST EDITION
OB/GYN – Anatomy & Physiology of Pregnancy (Questions 1-10)
**Question 1**
A 28-year-old G2P1 at 36 weeks presents with painless, bright red
vaginal bleeding. What is the priority question?
A. "Do you have a headache?"
B. "Was the bleeding after intercourse?"
C. "Do you have contractions?"
D. "Have you had a C-section before?"
**Rationale:**
Correct answer: **C**. Painless bright red bleeding in the 3rd trimester
is placenta previa until proven otherwise. Asking about contractions
helps rule out labor, which can cause bleeding but is typically painful.
Vaginal exam is contraindicated in suspected previa. Headache (A)
suggests preeclampsia. Post-coital bleeding (B) can occur but is not the
priority. Prior C-section (D) increases risk for uterine rupture, which is
painful.
,2|Page
---
**Question 2**
A primigravida at 39 weeks has a blood pressure of 150/96 and 3+
proteinuria. She complains of RUQ pain and headache. What medication
is contraindicated?
A. Magnesium sulfate
B. Labetalol
C. Hydralazine
D. Terbutaline
**Rationale:**
Correct answer: **D**. This patient has severe preeclampsia (BP
>140/90 + proteinuria + RUQ pain = liver capsule distension).
Terbutaline is a beta-agonist used for tocolysis (stopping preterm labor).
It can worsen tachycardia, increase BP, and is not indicated for
preeclampsia. Magnesium sulfate (A) prevents seizures. Labetalol (B)
and hydralazine (C) are first-line for acute BP control.
---
**Question 3**
,3|Page
Which finding in a 34-week pregnant patient most suggests abruptio
placentae?
A. Painless bleeding
B. Board-like abdomen with dark red blood
C. Vomiting and diarrhea
D. Fever and foul discharge
**Rationale:**
Correct answer: **B**. Abruptio placentae is premature separation of
the placenta → painful, dark red bleeding, uterine rigidity (board-like
abdomen from retroplacental clot). Painless bleeding (A) = placenta
previa. Vomiting/diarrhea (C) = gastroenteritis or HELLP syndrome.
Fever/foul discharge (D) = chorioamnionitis.
---
**Question 4**
A 25-year-old G1P0 at 32 weeks has a seizure at home. BP 170/110.
After securing airway, what is the next drug?
A. Diazepam 5 mg IV
B. Magnesium sulfate 4 g IV
C. Lorazepam 2 mg IM
D. Fosphenytoin 15 mg/kg
, 4|Page
**Rationale:**
Correct answer: **B**. This is eclampsia (preeclampsia + seizure).
Magnesium sulfate 4-6 g IV is the drug of choice to prevent recurrent
seizures. Benzodiazepines (A, C) can be used if actively seizing but
MgSO4 is preferred for prophylaxis. Fosphenytoin (D) is for non-
eclamptic seizures.
---
**Question 5**
What is the normal expected blood loss in a vaginal delivery?
A. 150-300 mL
B. 300-500 mL
C. 500-1000 mL
D. >1000 mL
**Rationale:**
Correct answer: **B**. Normal vaginal delivery blood loss is 300-500
mL. C-section average is 800-1000 mL. >1000 mL = postpartum
hemorrhage (PPH). Up to 500 mL is considered normal due to
physiologic hypervolemia of pregnancy.
---
