Chapter 25: Bleeding

25 July 2022
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question
Which section of the heart receives deoxygenated blood? Select one: A. Left B. Right C. Ventricles D. Atria
answer
B
question
In older patients, the first indicator of non-traumatic internal bleeding may be: Select one: A. weakness or dizziness. B. diaphoresis and pale skin. C. a heart rate over 120 beats/min. D. a low blood pressure.
answer
A
question
Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Select one: A. The patient has not eaten in 24 hours. B. The patient had a stroke 5 years prior. C. The patient has a history of hypertension. D. The patient takes rivaroxaban (Xeralto).
answer
D
question
Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. liver. B. pancreas. C. gallbladder. D. spleen.
answer
D
question
Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Select one: A. Brain B. Gastrointestinal system C. Skeletal muscle D. Kidneys
answer
B
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Which portion of the blood carries oxygen to and wastes away from body tissues? Select one: A. Platelets B. Plasma C. White blood cells D. Red blood cells
answer
D
question
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one: A. acute appendicitis. B. gastrointestinal bleeding. C. intrathoracic hemorrhaging. D. an aortic aneurysm.
answer
B
question
Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. applying chemical ice pack. B. applying a tourniquet. C. keeping the patient warm. D. splinting the extremity.
answer
D
question
What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct.
answer
D
question
Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. coagulation B. perfusion C. hemorrhage D. hypoperfusion
answer
B
question
The severity of bleeding should be based on all of the following findings, EXCEPT: Select one: A. clinical signs and symptoms. B. poor general appearance. C. the mechanism of injury. D. systolic blood pressure.
answer
D
question
If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Select one: A. a tourniquet proximal to the injury. B. digital pressure to a proximal artery. C. a splint and elevate the extremity. D. additional sterile dressings.
answer
A
question
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. perform a secondary assessment. B. apply a nonrebreathing mask. C. assist the patient's ventilations. D. obtain baseline vital signs.
answer
C
question
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. packing both nostrils with gauze pads until the bleeding stops. D. placing a rolled 4² × 4² dressing between his lower lip and gum.
answer
B
question
If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound C. cover the entire wound, above and below, with the dressing D. All of these answers are correct.
answer
D
question
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Vacuum splint B. Sling and swathe C. Cardboard splint D. Air splint
answer
D
question
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. Select one: A. 10% B. 5% C. 15% D. 20%
answer
D
question
Hypovolemic shock occurs when: Select one: A. the clotting ability of the blood is enhanced. B. the patient's systolic blood pressure is less than 100 mm Hg. C. the body cannot compensate for rapid blood loss. D. at least 10% of the patient's blood volume is lost.
answer
C
question
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.
answer
B
question
Which of the following statements regarding hemophilia is correct? Select one: A. Hemophiliacs take aspirin to enhance blood clotting. B. Patients with hemophilia may bleed spontaneously. C. Approximately 25% of the population has hemophilia. D. Hemophilia is defined as a total lack of platelets.
answer
B
question
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to:
answer
how rapidly he or she bleeds.
question
Which of the following statements regarding hemophilia is correct?
answer
Patients with hemophilia may bleed spontaneously.
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The severity of bleeding should be based on all of the following findings, EXCEPT:
answer
systolic blood pressure.
question
A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
answer
gastrointestinal bleeding.
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You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:
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the patient is at risk for vomiting and aspiration.
question
Hypovolemic shock occurs when:
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the body cannot compensate for rapid blood loss.
question
Which of the following statements regarding the clotting of blood is correct?
answer
A person taking aspirin will experience slower blood clotting.
question
An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost.
answer
100 mL
question
External bleeding from a vein is relatively easy to control because:
answer
veins are under a lower pressure.
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After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:
answer
place additional dressings over the wound.
question
In which of the following situations would external bleeding be the MOST difficult to control?
answer
femoral artery laceration and a blood pressure of 140/90 mm Hg
question
Early signs and symptoms of intra-abdominal bleeding include:
answer
pain and distention.
question
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should:
answer
follow appropriate standard precautions.
question
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?
answer
the filtering of blood cells in the spleen
question
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
answer
assist the patient's ventilations.
question
The systemic veins function by:
answer
returning deoxygenated blood back to the heart.
question
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:
answer
pinching the patient's nostrils and having him lean forward.
question
What is the approximate blood volume of a 75-kg adult?
answer
5.25 L
question
Which of the following organs can tolerate inadequate perfusion for up to 2 hours?
answer
skeletal muscle
question
Gastrointestinal bleeding should be suspected if a patient presents with:
answer
hematemesis.
question
In older patients, the first indicator of nontraumatic internal bleeding may be
answer
weakness or dizziness.
question
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
answer
air splint
question
Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:
answer
spleen.
question
A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:
answer
control the bleeding with direct pressure.
question
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply:
answer
a tourniquet proximal to the injury.
question
An organ or tissue may be better able to resist damage from hypoperfusion if the:
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body's temperature is considerably less than 98.6°F (37.0°C).
question
Most cases of external bleeding from an extremity can be controlled by:
answer
applying local direct pressure.
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During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:
answer
repeat the primary assessment.
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Hypoperfusion is another name for:
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Shock.
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The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:
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arterioles.
question
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:
answer
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
question
In nontrauma patients, an early indicator of internal bleeding is:
answer
dizziness upon standing.