OB and Pediatrics

Sample questions.

8 free ob and pediatrics questions with answers and explanations. MedRelay's full question bank covers every NREMT domain, plus live scenarios that grade the decision, not just the answer.

1. Question 1

   You have delivered a baby in the field. The neonate is limp and not crying at 1 minute. His skin is centrally cyanotic. His heart rate is 82. His APGAR score calculated is 3 out of 10. After drying and stimulating the neonate with no improvement what is the NEXT intervention?

   • A.Positive pressure ventilation with a neonatal BVM atCorrect
   • B.Chest compressions at 30:2
   • C.Administer epinephrine 0.1 mg IM
   • D.Apply supplemental oxygen via blow-by only

   Why:Correct. APGAR 3 with HR 82 and apnea requires positive pressure ventilation (PPV) after stimulation fails. PPV is initiated when HR is below 100 or breathing is inadequate. Compressions begin only after 30 seconds of PPV if HR remains below 60. The neonatal BVM rate is 40-60 breaths per minute.

2. Question 2

   At a soccer field, a 31-year-old female child has a fever-related seizure and is now postictal. What is the priority?

   • A.Restrain tightly
   • B.Put food in mouth
   • C.Airway and monitoringCorrect
   • D.Give aspirin

   Why:Correct. Postictal pediatric care focuses on airway, breathing, glucose when indicated, cooling support, and reassessment.

3. Question 3

   At a warehouse, a 27-year-old male breech birth is in progress. What is the EMT-B priority?

   • A.Push infant back
   • B.Pull forcefully
   • C.Support and rapid transportCorrect
   • D.Wait alone

   Why:Correct. Breech delivery is high risk. Support per protocol, request ALS, and transport rapidly if possible.

4. Question 4

   You respond to a 32-year-old female at 37 weeks gestation who reports a sudden gush of fluid from her vagina 30 minutes ago. She is having mild contractions every 8 minutes. The fluid appears clear with a greenish-brown tint. She reports the fluid had an unusual smell. What does greenish-brown amniotic fluid indicate?

   • A.Normal amniotic fluid — the color varies with gestational age
   • B.Blood-stained amniotic fluid is being mistaken for meconium
   • C.Meconium-stained amniotic fluidCorrect
   • D.The fluid color is from a vaginal

   Why:Correct. Meconium-stained amniotic fluid: greenish-brown or pea-soup colored fluid indicates fetal meconium passage. Meconium aspiration syndrome (MAS) can cause severe respiratory failure if the neonate inhales meconium. Priority 1 transport. If delivery is imminent, have suction immediately ready. The neonate's airway should be assessed and suctioned if there is respiratory distress or depressed tone after delivery.

5. Question 5

   A 30-year-old female at 38 weeks delivers a baby. McRoberts maneuver and suprapubic pressure have not resolved shoulder dystocia after 90 seconds. What is the next maneuver?

   • A.Apply firmer traction to the baby's head
   • B.Place the mother on hands and knees (Gaskin maneuver)Correct
   • C.Perform fundal pressure to push the baby down
   • D.Have the patient bear down harder

   Why:Correct. Gaskin maneuver (all-fours) for persistent shoulder dystocia after McRoberts failure: rotating to hands and knees changes pelvic geometry and may free the impacted shoulder. Never increase head traction (brachial plexus avulsion risk). Never apply fundal pressure (worsens impaction). Priority 1 transport throughout.

6. Question 6

   You respond to a call for a 2-year-old male with difficulty breathing. His mother says he has had a barking cough since last night that sounds like a seal. He has mild inspiratory stridor and moderate retractions. He is alert and his SpO2 is 94%. He becomes more distressed when you try to examine him. Vital signs: HR 148, RR 34, temp 38.2°C. What is this presentation and how do you manage it?

   • A.Epiglottitis — examine the throat immediately
   • B.Asthma — administer albuterol 2 puffs via MDI
   • C.Croup — cool mist oxygen or blow-by oxygenCorrect
   • D.Foreign body obstruction — perform abdominal thrusts

   Why:Correct. Seal-bark cough and inspiratory stridor in a toddler with fever is croup (laryngotracheobronchitis). Management: cool mist or humidified oxygen, minimal stimulation (agitation worsens obstruction), allow parent to hold the child, transport calmly. Agitating the child by forcing examination can worsen the obstruction.

7. Question 7

   A 24-year-old female at 36 weeks has severe headache, visual flashing lights, facial swelling, BP 166/112, 3+ pitting edema, and 3+ urine protein. What do these findings indicate?

   • A.Normal late pregnancy hypertension — transport non-urgently
   • B.Normal edema and headache from the third trimester
   • C.Severe pre-eclampsia with severe featuresCorrect
   • D.Preterm labor triggered by hypertension

   Why:Correct. Severe pre-eclampsia: BP above 160/110 + severe headache + visual disturbances + heavy proteinuria = imminent eclampsia risk. Left lateral decubitus, high-flow oxygen, Priority 1 ALS for seizure prophylaxis and antihypertensive therapy. Communicate the full clinical picture to the receiving OB team.

8. Question 8

   You respond to a 5-year-old male with fever of 40.1 degrees C and a petechial rash that appeared over the past 2 hours. He has a severe headache and is very irritable. He is still conscious with GCS 14 but is difficult to examine. He cannot tolerate bright lights. HR 148, BP 88/58. His parents say the rash was not present this morning. The petechiae have become purple in some areas. What does purple petechiae (purpura) combined with fever and meningismus in a 5-year-old indicate?

   • A.Normal viral rash — reassure and transport
   • B."Immune thrombocytopenic purpura — this is not an emergency"
   • C.Meningococcal septicemia with purpura fulminansCorrect
   • D.This is a drug reaction — discontinue all medications

   Why:Correct. Meningococcal septicemia with purpura fulminans: petechiae progressing to purpura in a febrile child with meningismus is meningococcal disease until proven otherwise. Purpura indicates coagulopathy (DIC) from endotoxin — progression to purpura fulminans has 20-30% mortality even with treatment. Priority 1 ALS transport immediately — IV penicillin/ceftriaxone must be given as soon as possible.