A caller reports she is pregnant and has abdominal pain at 22 weeks gestation. How many additional Key Questions would the EMD need to ask beyond Key Question #1?

• A. One
• B. Four
• C. Two
• D. Three

Answer: (C)

In this scenario, the essential focus is obstetric risk assessment. After establishing that the patient is pregnant and has abdominal pain at 22 weeks, you need to quickly pull out the two most critical information pieces that drive urgent management: whether labor is starting (contractions) and whether the membranes have ruptured or there is vaginal bleeding. Contractions suggest preterm labor and potential need for rapid transport and obstetric support. Ruptured membranes or vaginal bleeding raise the concern for placental issues or infection and also demand urgent assessment and likely transport. These two questions provide the key data you need to determine urgency and next steps. Therefore, two additional Key Questions would be asked beyond the initial one.