EMT-Chapter 23 Bleeding

25 July 2022
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question
In nontrauma patients, an early indicator of internal bleeding is: a) dizziness upon standing. b) a rapid, thready pulse. c) a decreasing blood pressure. d) rapid, shallow breathing.
answer
dizziness upon standing.
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: a) acute appendicitis. b) intrathoracic hemorrhaging. c) an aortic aneurysm. d) gastrointestinal bleeding.
answer
gastrointestinal bleeding.
question
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: a) how fast his or her heart beats. b) how rapidly he or she bleeds. c) his or her baseline blood pressure. d) the part of the body injured.
answer
how rapidly he or she bleeds.
question
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. a) 20% b) 10% c) 15% d) 5%
answer
20%
question
The severity of bleeding should be based on all of the following findings, EXCEPT: a) the mechanism of injury. b) systolic blood pressure. c) clinical signs and symptoms. d) poor general appearance.
answer
systolic blood pressure.
question
Blood stasis, changes in the vessel wall, and certain medications affect the: a) systolic blood pressure exclusively. b) white blood cell's ability to fight infection. c) ability of red blood cells to carry oxygen. d) ability of the blood to effectively clot.
answer
ability of the blood to effectively clot.
question
In which of the following situations would external bleeding be the MOST difficult to control? a) carotid artery laceration and a systolic blood pressure of 60 mm Hg b) antecubital vein laceration and a blood pressure of 138/92 mm Hg c) femoral artery laceration and a blood pressure of 140/90 mm Hg d) jugular vein laceration and a systolic blood pressure of 90 mm Hg
answer
femoral artery laceration and a blood pressure of 140/90 mm Hg
question
Perfusion is MOST accurately defined as the: a) effective transfer of oxygen from the venules across the systemic capillary membrane walls. b) ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. c) effective removal of carbon dioxide and other metabolic waste products from the body's cells. d) circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
answer
circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
question
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: a) bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. b) the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. c) the tourniquet should be applied directly over a joint if possible because this provides better bleeding control. d) you should try to control the bleeding by applying pressure to a proximal arterial pressure point first.
answer
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
question
Which of the following statements regarding hemophilia is correct? a) Approximately 25% of the population has hemophilia. b) Hemophilia is defined as a total lack of platelets. c) Patients with hemophilia may bleed spontaneously. d) Hemophiliacs take aspirin to enhance blood clotting.
answer
Patients with hemophilia may bleed spontaneously.
question
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body? a) an intact system of blood vessels b) the filtering of blood cells in the spleen c) an effectively pumping heart d) adequate blood in the vasculature
answer
the filtering of blood cells in the spleen
question
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: a) the patient may be significantly hypertensive. b) the patient is at risk for vomiting and aspiration. c) many medications interfere with blood clotting. d) a detailed exam is needed to determine the cause.
answer
the patient is at risk for vomiting and aspiration.
question
An organ or tissue may be better able to resist damage from hypoperfusion if the: a) heart rate is maintained at more than 100 beats/min. b) body's demand for oxygen is markedly increased. c) body's temperature is considerably less than 98.6Ā°F (37.0Ā°C). d) systolic arterial blood pressure is at least 60 mm Hg.
answer
body's temperature is considerably less than 98.6Ā°F (37.0Ā°C).
question
Gastrointestinal bleeding should be suspected if a patient presents with: a) hemoptysis. b) hematuria. c) hematemesis. d) dyspnea.
answer
hematemesis.
question
The systemic veins function by: a) delivering oxygen-poor blood to the capillaries. b) delivering deoxygenated blood to the capillaries. c) returning deoxygenated blood back to the heart. d) returning oxygen-rich blood back to the left atrium.
answer
returning deoxygenated blood back to the heart.
question
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: a) assess the quality of her pulse. b) repeat the primary assessment. c) perform a secondary assessment. d) begin assisting her ventilations.
answer
repeat the primary assessment.
question
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. a) 1 L b) 2 L c) 500 mL d) 250 mL
answer
1 L
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: a) apply a nonrebreathing mask. b) assist the patient's ventilations. c) perform a secondary assessment. d) obtain baseline vital signs.
answer
assist the patient's ventilations.
question
As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells. a) fibrin b) plasminogen c) plasma d) fibrinogen
answer
fibrinogen
question
Hypoperfusion is another name for: a) hypoxemia. b) cyanosis. c) shock. d) cellular death.
answer
shock.
question
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply: a) a tourniquet proximal to the injury. b) additional sterile dressings. c) a splint and elevate the extremity. d) digital pressure to a proximal artery.
answer
a tourniquet proximal to the injury.
question
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: a) venules. b) arterioles. c) vena cavae. d) capillary arteries.
answer
arterioles.
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. a) 150 mL b) 50 mL c) 200 mL d) 100 mL
answer
100 mL
question
Bleeding from the nose following head trauma: a) should be controlled by packing the nostril with gauze. b) is a sign of a skull fracture and should not be stopped. c) should be assumed to be caused by a fractured septum. d) is usually due to hypertension caused by the head injury.
answer
is a sign of a skull fracture and should not be stopped.
question
In older patients, the first indicator of nontraumatic internal bleeding may be: a) a low blood pressure. b) weakness or dizziness. c) a heart rate over 120 beats/min. d) diaphoresis and pale skin.
answer
weakness or dizziness.
question
Which of the following organs can tolerate inadequate perfusion for up to 2 hours? a) kidneys b) heart c) skeletal muscle d) brain
answer
skeletal muscle
question
Hypovolemic shock occurs when: a) at least 10% of the patient's blood volume is lost. b) the patient's systolic blood pressure is less than 100 mm Hg. c) the body cannot compensate for rapid blood loss. d) the clotting ability of the blood is enhanced.
answer
the body cannot compensate for rapid blood loss.
question
Most cases of external bleeding from an extremity can be controlled by: a) packing the wound with gauze. b) elevating the injured extremity. c) applying local direct pressure. d) compressing a pressure point.
answer
applying local direct pressure.
question
A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: a) preparing for immediate transport. b) applying oxygen via nasal cannula. c) a detailed assessment of his abdomen. d) performing a focused physical exam.
answer
preparing for immediate transport.
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: a) pancreas. b) liver. c) spleen. d) gallbladder.
answer
spleen.
question
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: a) the patient is at risk for vomiting and aspiration. b) many medications interfere with blood clotting. c) a detailed exam is needed to determine the cause. d) the patient may be significantly hypertensive.
answer
the patient is at risk for vomiting and aspiration.
question
Question 17 (1 point) Question 17 Unsaved Which of the following statements regarding the clotting of blood is correct? a) Bleeding begins to clot when the end of a damaged vessel dilates. b) Venous and capillary blood typically does not clot spontaneously. c) Direct contact with the environment prevents blood from clotting. d) A person taking aspirin will experience slower blood clotting.
answer
A person taking aspirin will experience slower blood clotting.
question
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: a) assess the quality of her pulse. b) perform a secondary assessment. c) begin assisting her ventilations. d) repeat the primary assessment.
answer
repeat the primary assessment.
question
In older patients, the first indicator of nontraumatic internal bleeding may be: a) a heart rate over 120 beats/min. b) diaphoresis and pale skin. c) a low blood pressure. d) weakness or dizziness.
answer
weakness or dizziness.
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: a) apply a tourniquet proximal to the wound. b) control the bleeding with direct pressure. c) apply oxygen with a nonrebreathing mask. d) ensure the patient has a patent airway.
answer
control the bleeding with direct pressure.