Question 1

``` H-1) If blood is not circulated adequately through the​ body's capillaries, cells become starved for oxygen and​ nutrients, and overloaded with carbon dioxide and waste products. This condition is known​ as: A. cardiac compromise. B. hypoperfusion. C. circulatory depression. D. hypotension. ```

Accepted Answer

B. hypoperfusion Under some​ conditions, blood does not circulate adequately through all the​ body's capillaries. The chief result of inadequate circulation is a state of profound depression of cell​ perfusion, called shock​ (or hypoperfusion​). The cells become starved for oxygen​ (hypoxia) and​ nutrients, and become overloaded with carbon dioxide and other waste products.

Question 2

H-2) How does the vascular system control temperature​ regulation? A. By dilating blood vessels in the periphery of the body to conserve heat B. By expanding or narrowing the blood vessels C. By increasing blood flow to the thermoregulatory center in the brain D. By gathering heat from the surface of the body and delivering it to the core

Accepted Answer

B. By expanding or narrowing the blood vessels (Page 788) The​ body's mechanism to conserve heat is to expand​ (dilate) or narrow​ (constrict) the blood vessels. Dilation of the blood vessels contributes to heat​ dissipation, whereas constriction of the blood vessels preserves core temperature by decreasing heat dissipation.

Question 3

``` H-3) Gas exchange of oxygen for carbon dioxide occurs at the cellular level of the body​ between: A. capillaries and veins. B. capillaries and body cells. C. arteries and body cells. D. arteries and capillaries. ```

Accepted Answer

B. capillaries and body cells (Page 788) Where capillaries meet body cells is where the exchange of oxygen for carbon dioxide occurs.

Question 4

``` H-4) Hemorrhagic shock is due​ to: A. dehydration. B. spinal trauma. C. sepsis. D. blood loss. ```

Accepted Answer

D. blood loss

Question 5

``` H-5) Of the following adjustments to the vascular​ system, which will contribute the most to increased perfusion to the​ core? A. Decreased vascular diameter B. Increased blood volume C. Decreased heart rate D. Increased oxygen consumption ```

Accepted Answer

A. Decreased vascular diameter Laws of hemodynamics demonstrate that a reduction in vascular diameter has the greatest influence on perfusion.​ Conversely, increasing the diameter would cause a reduction in​ perfusion, as is seen with septic and anaphylactic shock.

Question 6

``` H-6) Which of the following is a defense mechanism that the body uses to defend against​ shock? A. Increased heart rate B. Vasodilation C. Decreased respirations D. Decreased heart rate ```

Accepted Answer

A. Increased heart rate (Page 792) To combat​ shock, the body will typically increase the heart rate and force of contraction.

Question 7

``` H-7) All shock​ involves: A. inadequate tissue perfusion. B. hypertension. C. heart failure. D. sepsis. ```

Accepted Answer

A. inadequate tissue perfusion (Page 788) All shock involves inadequate tissue perfusion

Question 8

``` H-8) When the body responds to​ shock, what physiological effects would you expect to​ occur? A. Bradypnea B. Peripheral vasoconstriction C. Peripheral vasodilation D. Bradycardia ```

Accepted Answer

B. Peripheral vasoconstriction The body starts to "shunt" the blood from the extremities to the core of the body to protect the main organs of life (Lungs, Heart, Brain, Liver, Spleen, etc.)

Question 9

H-9) Which patient is in the initial stages of​ shock? A. ​45-year-old motor vehicle crash victim with​ pale, cool, skin and tachycardia B. ​16-year-old female with a possible traumatic brain injury presenting with altered mental status and low blood pressure C. ​36-year-old fall victim with absent peripheral pulses D. ​52-year-old assault victim with bilaterally dilated pupils and cyanosis

Accepted Answer

A. ​45-year-old motor vehicle crash victim with​ pale, cool, skin and tachycardia. nitial presentation of shock symptoms include​ pale, cool, clammy​ skin; tachycardia; and tachypnea. As shock​ progresses, vital signs will​ deteriorate, with low blood​ pressure, thirst, dilated​ pupils, and cyanosis as late signs.

Question 10

``` H-10) Your patient is a​ 49-year-old female with complaints of shortness of breath and generalized weakness. On​ examination, you note that she has extensive crackles in her​ lungs, swelling of her feet and​ ankles, and difficulty in breathing when lying down. This is troublesome for her because she gets lightheaded when sitting​ up, because of her low blood pressure. You would classify her shock​ as: A. neurogenic shock. B. anaphylactic shock. C. septic shock. D. cardiogenic shock. ```

Accepted Answer

D. cardiogenic shock. The​ patient's signs and symptoms suggest congestive heart​ failure, indicating cardiogenic​ shock, because the pumping mechanism has been compromised.

Question 11

``` H-11) Which of the following would most likely lead to hypovolemic​ shock? A. Open fracture of the hand B. Subdural hematoma C. Crush injury to the foot D. Crush injury to the abdomen ```

Accepted Answer

D. Crush injury to the abdomen Hypovolemic shock is most often caused by significant blood loss due to trauma or internal hemorrhage from a medical cause​ (such as an​ AAA, GI​ bleed, or crush injuries to major body​ cavities, such as the chest or​ abdomen). Hypovolemic shock may also result from​ third-space losses such as fluid shifts into various body​ compartments, as in severe​ pancreatitis, or fluid loss from protracted vomiting.

Question 12

``` H-12) Which of the following forms of shock is associated with volume​ loss? A. Hypovolemic shock B. Septic shock C. Cardiogenic shock D. Neurogenic shock ```

Accepted Answer

A. Hypovolemic shock Hypovolemic shock results from a loss of​ fluid, whether acutely -- as in hemorrhagic shock -- or over a period of​ time, as in dehydration. The other forms of shock are pipe problems. The amount of fluid is​ available, but the​ pipes' ability to perfuse the body is compromised.

Question 13

``` H-13) Your​ 55-year-old female patient is suffering from a rupturing abdominal aortic​ aneurysm, and is entering into the decompensating stage of shock. What finding would not be an indicator of decompensated shock in this​ patient? A. Cyanosis B. Dilated pupils C. Increased heart rate D. Falling blood pressure ```

Accepted Answer

C. Increased heart rate Because an increased heart rate would be a sign of​ early, compensating​ shock, it would not be an indicator of decompensated shock.

Question 14

``` H-14) You are assessing a​ 53-year-old male with severe blood loss from a wound that is covered with a pressure bandage. Bleeding appears to have stopped. The​ patient's pulse and respiration are​ elevated, but blood pressure is falling. The​ patient's skin around the lips shows signs of​ cyanosis, and the​ patient's pupils are dilated. What is a sign that the patient has entered decompensated​ shock? A. Cyanotic skin B. Severe blood loss C. Elevated pulse D. Elevated respiration ```

Accepted Answer

A. Cyanotic skin Cyanosis around the lips and nail beds is one of the signs of late​ shock, which would indicate the onset of decompensated shock. Severe blood loss alone does not indicate decompensated shock. An elevated pulse and respiration would be consistent with compensated shock.

Question 15

H-15) You are caring for a​ 28-year-old male patient who was involved in a motor vehicle crash. He has sustained a closed head injury and​ blunt-force trauma to his chest and​ abdomen, and is unconscious and in shock. In what position should you transport​ him? A. In a sitting​ position, because of his closed head trauma B. In a reverse Trendelenburg​ position, because of the​ patient's head trauma and pulmonary injury C. In a left lateral​ position, to allow for vomiting and to prevent aspiration D. In a supine position with sufficient spinal immobilization

Accepted Answer

D. In a supine position with sufficient spinal immobilization

Question 16

H-16) You are treating a​ 64-year-old female patient complaining of weakness and abdominal pain. You find the patient​ pale, cool, and​ diaphoretic, leaning against the wall adjacent to her toilet. You note the presence of​ bright, red blood in the toilet. Based on these​ findings, what treatment option will improve the​ body's ability to​ clot? A. Cover the patient in a blanket to prevent hypothermia. B. Request advanced life support​ assistance, so that intravenous fluids can be infused to replace lost blood volume. C. Place the patient on​ high-flow oxygen via nonrebreather. D. Transport the patient to the most appropriate facility as soon as possible.

Accepted Answer

A. Cover the patient in a blanket to prevent hypothermia. In addition to depleting the​ body's energy​ stores, hypothermia may reduce the​ body's ability to clot. Keeping the patient warm may prevent heat​ loss, which contributes to hypothermia.

Question 17

``` H-17) A bulky dressing that is held in place by a tightly wrapped bandage and is used to control bleeding is called​ a: A. hemostatic dressing. B. tourniquet. C. cravat bandage. D. pressure dressing. ```

Accepted Answer

D. pressure dressing.

Question 18

``` H-18) You arrive on scene to an​ 8-year-old male patient who fell while skating. He is responsive but is lying down on the pavement. As you assess the​ patient, you notice abrasions with​ self-controlled bleeding located on both his knees. Based on your​ assessment, what type of external bleeding is​ this? A. Arterial B. ​Non-significant C. Venous D. Capillary ```

Accepted Answer

D. Capillary Slowly oozing blood that is a dark or intermediate color of red usually indicates damaged capillaries. In most​ cases, capillary bleeding is easily controlled. This type of bleeding often clots spontaneously.

Question 19

``` H-19) Your​ 14-year-old male patient has fallen off his bike and scraped his arm. The bleeding is dark red and oozing slowly. This type of bleeding is usually from​ damaged: A. arteries. B. veins. C. capillaries. D. venules. ```

Accepted Answer

C. capillaries Slowly oozing blood that is a dark or intermediate color of red usually indicates damaged capillaries. In most​ cases, capillary bleeding is easily controlled. This type of bleeding often clots spontaneously.​ However, if a large body surface is​ involved, bleeding may be​ profuse, and the threat of infection is great.

Question 20

``` H-20) You are treating a​ 43-year-old female who was hunting with a pistol. When she sat down in the​ outhouse, her gun went off and created a large hole in her right​ femur, which is now severely spurting blood. What is the most appropriate method of bleeding control for this injury if direct pressure​ fails? A. Direct pressure and elevation B. Looking for a pressure point to apply C. Application of ice on the wound D. Application of a tourniquet ```

Accepted Answer

D. Application of a tourniquet When a patient has a severe extremity​ injury, as in this case in which the blood is spurting from an​ artery, the most effective bleeding control method will be a tourniquet.

Question 21

H-21) If you find a major bleed during your initial assessment of the​ patient, you​ should: A. immediately apply direct pressure to the site with your gloved hand. B. apply a blood pressure cuff above the site and inflate it until the bleeding stops. C. immediately hold the injury above heart level and compress the appropriate pressure point. D. complete your initial​ assessment, then control the bleeding with a pressure bandage.

Accepted Answer

A. immediately apply direct pressure to the site with your gloved hand. ​Life-threatening conditions should be corrected first. Major bleeds must be stopped immediately before you move on to the rest of the primary assessment.

Question 22

H-22) You are on scene for a​ 31-year-old female with bleeding from the medial aspect of her right upper arm. Emergency medical responders on scene applied a tourniquet. As you inspect the​ wound, you decide that a tourniquet is unnecessary. What are the proper steps for removing the​ tourniquet? A. Once a tourniquet has been​ placed, you should remove it within 30 minutes. B. Elevate the extremity and remove the tourniquet quickly. C. Lower the extremity and remove the tourniquet slowly. D. Once a tourniquet has been​ placed, you should not remove it unless approved by medical direction.

Accepted Answer

D. Once a tourniquet has been​ placed, you should not remove it unless approved by medical direction

Question 23

H-23) In applying a​ tourniquet, which of the following is the proper​ technique? A. Place the tourniquet at least 2 inches above the bleeding wound. B. If no commercial tourniquet device is​ available, the EMT can use ropes or wires to create an improvised tourniquet. C. Cover the injury and the tourniquet site to prevent overexposure to the environment. D. Ensure that the patient has a pulse and sensory and motor function distal to the site after application of the tourniquet.

Accepted Answer

A. Place the tourniquet at least 2 inches above the bleeding wound.

Question 24

H-24) Emergency medical care for internal bleeding​ includes: A. placing the patient with head and torso​ elevated, to better perfuse the brain. B. rapid transport for patients with signs and symptoms of shock. C. applying supplemental oxygen by nasal cannula​ only, so that the circulatory system is not overwhelmed. D. applying direct manual pressure to the areas of internal bleeding.

Accepted Answer

B. rapid transport for patients with signs and symptoms of shock. The goal of all emergency medical care for internal bleeding is to recognize its presence​ quickly, maintain the​ body's perfusion, treat for​ shock, and provide rapid transport to an appropriate medical facility.

Question 25

``` H-25) Which of the following provides the greatest chance of survival for a critical trauma​ patient? A. ​High-flow oxygen B. ALS response C. Surgery D. IV fluids ```

Accepted Answer

C. Surgery Surgery is the only definitive treatment for many trauma patients.

Question 26

``` PT-1) A substance that will stop bleeding is called​ a: A. pressure dressing. B. compression device. C. tourniquet. D. hemostatic agent. ```

Accepted Answer

D. hemostatic agent

Question 27

PT-2) You are treating a​ 29-year-old motorcycle crash victim who appears​ pale, cool, and diaphoretic. You suspect he sustained a traumatic brain injury based on decreased pupillary response. Based on these findings and the mechanism of​ injury, which of the following is the most appropriate method to manage this​ patient? A. Limit​ on-scene time and promptly transport the patient to the hospital. B. Perform a detailed secondary assessment on the patient prior to transportation. C. Assess and catalog all major and minor injuries prior to transporting the patient to the hospital. D. Splint all orthopedic injuries found prior to transporting the patient to the hospital.

Accepted Answer

A. Limit​ on-scene time and promptly transport the patient to the hospital.

Question 28

``` PT-3) You have been called to a nursing​ home, where you find an​ 88-year-old female patient who is confused and combative. The staff states that this is not her normal behavior but that she has been bedridden from a previous stroke. They also report that she has had a recent urinary tract infection from an indwelling catheter. You note that her skin is flushed and​ warm, her pulse is​ 108, and her blood pressure is​ 80/44. You should​ suspect: A. hypovolemic shock. B. septic shock. C. anaphylactic shock. D. neurogenic shock. ```

Accepted Answer

B. septic shock

Question 29

``` PT-4) What could be a sign that a patient is experiencing internal bleeding into the​ abdomen? A. Tenderness B. Contraction C. Erythema D. Cyanosis ```

Accepted Answer

A. Tenderness

Question 30

``` PT-5) You suspect that your patient has a GI bleed. She presents with​ tachycardia, hypotension, and pale skin. What stage of shock is she most likely​ in? A. Compensated shock B. Decompensated shock C. Early shock D. Hypovolemic shock ```

Accepted Answer

B. Decompensated shock

Question 31

``` PT-6) Which of the following is a function of the​ blood? A. Metabolism B. Production of red blood cells C. Hormone production D. Transportation of gases ```

Accepted Answer

D. Transportation of gases

Question 32

PT-7) You are treating a patient who was dizzy and​ fell, sustaining a laceration to the forehead. Aside from determining the cause of the dizziness and dealing with the bleeding with direct pressure and​ bandaging, should you assess the patient for internal​ bleeding? Why? A. ​Yes, because of the fall B. ​No, because the fall only inflicted a laceration C. ​No, because there are no signs of shock D. ​Yes, because of the laceration

Accepted Answer

A. ​Yes, because of the fall

Question 33

PT-8) You are managing a​ 27-year-old female with severe hemorrhage from her right ankle after a motor vehicle collision. You are unable to stop the hemorrhage with direct pressure. What intervention should you try​ next? A. Apply a tourniquet proximal to the wound on the​ patient's femur. B. Place the patient on​ high-flow oxygen. C. Apply a bulky sterile dressing. D. Apply a pressure dressing.

Accepted Answer

A. Apply a tourniquet proximal to the wound on the​ patient's femur.

Question 34

``` PT-9) Waste can build up in the body​ when: A. excretion increases. B. the blood volume reduces. C. perfusion decreases. D. the heart rate decreases. ```

Accepted Answer

C. perfusion decreases.

Question 35

PT-10) In all forms of​ shock, what is the greatest consequence to the​ body? A. Decreased blood flow to the tissue B. Inadequate delivery of oxygen to the cells C. Decreased removal of waste from the tissue D. Inadequate delivery of nutrients to the tissue

Accepted Answer

B. Inadequate delivery of oxygen to the cells

Question 36

``` PT-11) If a patient in shock is able to maintain​ perfusion, then this​ is: A. compensated shock. B. decompensated shock. C. physiological shock. D. irreversible shock. ```

Accepted Answer

A. compensated shock.

Question 37

``` PT-12) You respond to the scene of a​ 27-year-old female who was working on her car when she​ "snagged her hand on a sharp​ edge." She has napkins around her hand covering the wound. You uncover it and note that the bleeding is slow and dark red in color. Direct pressure easily stops the bleeding. Based on this​ information, what is the source of her​ bleeding? A. Radial artery B. Capillary bleed C. Brachial artery D. Cephalic vein ```

Accepted Answer

D. Cephalic vein

Question 38

``` PT-13) Your patient has been severely injured in a fight. He is now lying​ supine, with gurgling respirations and visible blood in the throat. Which of the following should you do​ first? A. Suction the airway B. Apply oxygen C. Initiate PPV with oxygen D. Fully immobilize the patient ```

Accepted Answer

A. Suction the airway

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CH 29 Bleeding and Shock Flashcards

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