Assessment of the Gynecologic Patient Practice Questions

25 multiple-choice questions on Assessment of the gynecologic patient for paramedic and EMT students, from Chapter 23 (Gynecologic Emergencies). Read each question, pick your answer, then tap Show answer to check it and read the explanation.

25 practice questions

1. A woman with lower abdominal pain and dizziness says she cannot be pregnant because she had her tubes tied. You should:

   1. A. Still consider an ectopic pregnancy
   2. B. Rule out pregnancy based on her history
   3. C. Assume the pain is from her bladder
   4. D. Ask her to take a home test later
   Show answer

   Answer: A. Still consider an ectopic pregnancy

   Tubal sterilization can fail, and when pregnancy occurs after it, a high proportion are ectopic. Pain with dizziness in this setting should be treated as a possible ruptured ectopic.

2. In gynecologic emergencies, the primary survey focuses on:

   1. A. A detailed pelvic exam on scene
   2. B. Airway, breathing, circulation
   3. C. Obstetric history first
   4. D. Vaginal inspection first
   Show answer

   Answer: B. Airway, breathing, circulation

   Identify and treat life threats first. Signs of shock are more important than the specific diagnosis.

3. To estimate vaginal blood loss, ask about:

   1. A. The color of the blood
   2. B. Whether she has cramps
   3. C. Her cycle length
   4. D. Pads soaked per hour
   Show answer

   Answer: D. Pads soaked per hour

   Soaking more than one pad per hour is heavy bleeding. Look for clots and signs of shock. Blood color, cramping, and cycle length can help find a cause but do not measure how much blood is being lost.

4. Internal (speculum) pelvic exams in the field are:

   1. A. Always required
   2. B. Done for every pain complaint
   3. C. Not performed by paramedics
   4. D. Needed to confirm pregnancy
   Show answer

   Answer: C. Not performed by paramedics

   Inspect externally only if needed, such as for bleeding or trauma. Internal exams are done in the hospital.

5. The term G3P2 means the patient:

   1. A. Pregnant 3 times, delivered 2
   2. B. Has 3 children and 2 miscarriages
   3. C. Is 3 months pregnant with twins
   4. D. Has had 2 cesareans
   Show answer

   Answer: A. Pregnant 3 times, delivered 2

   Gravida is the number of pregnancies; para is the number of deliveries after 20 weeks.

6. When obtaining a gynecologic history, privacy matters because:

   1. A. It shortens the scene time
   2. B. Patients share more honestly
   3. C. It allows a pelvic exam to be done
   4. D. It replaces a chaperone
   Show answer

   Answer: B. Patients share more honestly

   Ask sensitive questions privately and respectfully. Partners or family may affect what is shared. Privacy does not shorten the scene, paramedics do not do internal pelvic exams, and a chaperone is still appropriate.

7. Which finding suggests significant internal bleeding in a gynecologic patient?

   1. A. Normal pulse and warm, dry skin
   2. B. Mild cramps with spotting
   3. C. Pain relieved by rest
   4. D. Tachycardia, pale and cool skin
   Show answer

   Answer: D. Tachycardia, pale and cool skin

   Signs of shock suggest internal bleeding, such as from a ruptured ectopic pregnancy or ovarian cyst.

8. When exposing the genital area to assess bleeding, you should:

   1. A. Expose fully without explanation
   2. B. Ask the family to leave the room without reason
   3. C. Explain, limit exposure, use a chaperone
   4. D. Skip documenting the findings
   Show answer

   Answer: C. Explain, limit exposure, use a chaperone

   Respect privacy, explain each step, and have a same-sex or second provider present when possible.

9. Vaginal discharge that is foul-smelling with fever and pelvic pain suggests:

   1. A. Normal discharge
   2. B. Kidney stones
   3. C. Ovarian cyst rupture
   4. D. Pelvic infection
   Show answer

   Answer: D. Pelvic infection

   Infection such as PID causes abnormal discharge, fever, and pain.

10. Which positioning is usually best for a stable patient with pelvic pain?

    1. A. Position of comfort
    2. B. Prone
    3. C. Flat with legs straight
    4. D. Trendelenburg
    Show answer

    Answer: A. Position of comfort

    Many patients prefer lying with knees bent. If hypotensive, position supine with legs raised per protocol.

11. Which piece of history helps assess a patient with heavy bleeding?

    1. A. Recent use of antacids
    2. B. Use of anticoagulants
    3. C. Seasonal allergies
    4. D. Use of vitamin D
    Show answer

    Answer: B. Use of anticoagulants

    Blood thinners can worsen bleeding and should be reported.

12. Which method helps reduce embarrassment during a gynecologic assessment?

    1. A. Using slang terms
    2. B. Asking questions in front of strangers
    3. C. Avoiding all explanation
    4. D. Using clear, professional terms
    Show answer

    Answer: D. Using clear, professional terms

    Clear, respectful language builds trust and gets better information.

13. A sanitary pad or tampon found during assessment should be:

    1. A. Noted and brought along
    2. B. Discarded right away
    3. C. Left behind at the scene
    4. D. Rinsed before transport
    Show answer

    Answer: A. Noted and brought along

    Bring soaked pads to help estimate blood loss and look for tissue that may indicate miscarriage.

14. Which question best helps identify a patient's risk of a sexually transmitted infection?

    1. A. Do you use tampons or pads?
    2. B. How regular are your periods?
    3. C. Any new sexual partners?
    4. D. Have you had a recent UTI?
    Show answer

    Answer: C. Any new sexual partners?

    New or multiple partners raise STI and PID risk. Ask in a nonjudgmental way.

15. Why should vital signs be repeated often in a patient with vaginal bleeding?

    1. A. They stay stable in young women
    2. B. Shock can develop quickly
    3. C. Bleeding usually stops on its own
    4. D. They matter only at the hospital
    Show answer

    Answer: B. Shock can develop quickly

    Trends reveal worsening blood loss. Repeat at least every 5 minutes if unstable.

16. A woman who has had female genital cutting needs a perineal assessment. The best approach is to:

    1. A. Explain, ask consent, avoid surprise
    2. B. Ask her family why it was done
    3. C. Photograph it for the ED staff
    4. D. Skip the exam and say nothing at all
    Show answer

    Answer: A. Explain, ask consent, avoid surprise

    Patients who have experienced female genital cutting deserve the same respectful, consent-based care as others. Avoid expressions of surprise or judgment, limit exposure, and examine only as needed for care.

17. A urine pregnancy test taken a few days after conception is negative. This result:

    1. A. Proves she is not pregnant
    2. B. May miss a very early pregnancy
    3. C. Means she has an ectopic pregnancy
    4. D. Is caused by drinking little water
    Show answer

    Answer: B. May miss a very early pregnancy

    hCG may still be too low to detect very early, and dilute urine lowers sensitivity further. A negative test should not override a history and exam that suggest pregnancy.

18. Why is it important to document the color and amount of vaginal discharge or bleeding?

    1. A. It replaces repeat vital signs
    2. B. It confirms the diagnosis in the field
    3. C. It decides the transport destination
    4. D. It helps the ED find the cause
    Show answer

    Answer: D. It helps the ED find the cause

    Objective descriptions help the receiving team assess infection, bleeding, or pregnancy loss.

19. Which patient may need transport to a facility with gynecologic surgery?

    1. A. A stable patient with mild period cramps
    2. B. A patient with a normal period
    3. C. An unstable patient, possible ectopic
    4. D. A patient with mild PMS symptoms
    Show answer

    Answer: C. An unstable patient, possible ectopic

    Unstable patients with possible ectopic need surgical care quickly.

20. Pain on one side of the lower abdomen in a woman with a positive pregnancy test is concerning for:

    1. A. Ectopic pregnancy
    2. B. Normal pregnancy
    3. C. Appendicitis only
    4. D. Constipation
    Show answer

    Answer: A. Ectopic pregnancy

    Unilateral pain in early pregnancy needs urgent evaluation for ectopic pregnancy.

21. A woman with lower abdominal pain tells you she has an intrauterine device (IUD). Which statement about IUDs is accurate?

    1. A. An IUD raises her overall risk of ectopic pregnancy
    2. B. A pregnancy that occurs is more likely ectopic
    3. C. Its PID risk stays high as long as it is in place
    4. D. An IUD in place rules out pregnancy as a cause
    Show answer

    Answer: B. A pregnancy that occurs is more likely ectopic

    IUDs are highly effective, so a woman with an IUD has a lower absolute risk of ectopic pregnancy than a woman using no contraception; but when the rare failure does happen, a pregnancy that occurs is much more likely to be ectopic, so abdominal pain or bleeding in an IUD user still calls for thinking of ectopic pregnancy. Saying the IUD raises her overall ectopic risk confuses that proportion with absolute risk. The small rise in PID risk is concentrated in the first few weeks (about 20 days) after insertion and then falls to near baseline, so the PID risk does not stay high for as long as the device is in place. Because IUDs can fail, a device in place does not rule out pregnancy.

22. Which question about contraception is most useful for a woman with lower abdominal pain?

    1. A. Whether she likes her current method
    2. B. Which brand she used as a teenager
    3. C. How much the method costs her each month
    4. D. Which method she uses and how reliably
    Show answer

    Answer: D. Which method she uses and how reliably

    Knowing the method and how consistently it is used helps estimate pregnancy risk and points to complications, such as an IUD (ectopic, PID, perforation) or estrogen (clots). Cost and preference do not guide emergency care.

23. Which approach is best when a teen patient's parent is present?

    1. A. Only ask the parent
    2. B. Skip sensitive questions
    3. C. Offer to speak privately
    4. D. Ask in front of others
    Show answer

    Answer: C. Offer to speak privately

    Teens may not share sexual history in front of parents. Follow laws on consent and confidentiality.

24. Fever, rash, and hypotension in a woman using tampons suggests:

    1. A. Normal menstruation
    2. B. A simple ovarian cyst
    3. C. Toxic shock syndrome
    4. D. Endometriosis
    Show answer

    Answer: C. Toxic shock syndrome

    Toxic shock syndrome is a bacterial toxin illness that causes rapid shock.

25. For a woman with pelvic pain who might be pregnant, which pain medication is generally avoided?

    1. A. Fentanyl given per protocol
    2. B. Acetaminophen at usual doses
    3. C. Ketamine at analgesic doses
    4. D. Ibuprofen and other NSAIDs
    Show answer

    Answer: D. Ibuprofen and other NSAIDs

    NSAIDs are avoided in pregnancy, particularly after 20 weeks, because of fetal kidney and ductus arteriosus effects, and they increase bleeding risk if an ectopic is present. Fentanyl or acetaminophen per protocol are common choices.