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Section 7 Trauma > Chapter 30 Bleeding > Flashcards

Chapter 30 Bleeding Flashcards

1
Q

1. Which of the following components is LEAST crucial to the continuous circulation of oxygenated blood throughout the body? A) Heart B) Spleen C) Vasculature D) Fluid volume

A

Ans: B Page: 1519

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2
Q
  1. The cardiac cycle begins with the onset of myocardial contraction and ends: A) as blood returns to the right atrium. B) as both ventricles are filling with blood. C) when the ventricles are emptied of blood. D) with the beginning of the next contraction.
A

Ans: D Page: 1520

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3
Q
  1. Afterload is defined as the: A) pressure in the aorta against which the left ventricle must pump. B) amount of resistance to blood flow offered by the heart valves. C) amount of blood ejected from the ventricle with each contraction. D) volume of blood remaining in the ventricles following contraction.
A

Ans: A Page: 1520

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4
Q
  1. Which of the following two factors DIRECTLY affect cardiac output? A) Preload and afterload B) Vessel size and stroke volume C) Stroke volume and pulse rate D) Blood pressure and pulse rate
A

Ans: C Page: 1520

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5
Q
  1. Which of the following statements regarding blood flow is correct? A) Ejection fraction is the percentage of blood that the heart pumps per contraction. B) If more blood returns to the heart, stroke volume decreases and cardiac output falls. C) As more blood is pumped with each contraction, the ejection fraction increases. D) The amount of blood that returns to the atrium remains fixed from minute to minute.
A

Ans: A Page: 1520-1521

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6
Q
  1. Hemoglobin functions by: A) dissolving in blood plasma to create the partial pressure of carbon dioxide. B) binding to oxygen that is absorbed in the lungs and transporting it to the tissues. C) absorbing hydrogen ions in the blood in order to maintain acid-base balance. D) transporting red blood cells throughout the body to ensure adequate oxygenation.
A

Ans: B Page: 1522

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7
Q
  1. What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation? A) Fibrin B) Calcium C) Plasmin D) Platelets
A

Ans: D Page: 1522

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8
Q
  1. Perfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body’s demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.
A

Ans: B Page: 1522

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9
Q
  1. Which of the following organs or body systems requires a constant blood supply, regardless of external factors? A) Skin B) Muscles C) Kidneys D) Gastrointestinal tract
A

Ans: C Page: 1522

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10
Q
  1. Which of the following organs can sustain the longest period of inadequate perfusion? A) Gastrointestinal tract B) Kidneys C) Spinal cord D) Skeletal muscle
A

Ans: A Page: 1522-1523

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11
Q
  1. An organ or tissue that is considerably colder than 98.6°F is better able to resist damage from hypoperfusion because: A) the body’s metabolic rate is slower. B) cells shrink as body temperature falls. C) hypothermia promotes oxygen metabolism. D) hypothermia protects hemoglobin molecules.
A

Ans: A Page: 1523

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12
Q
  1. The amount of blood returned to the heart is called: A) preload. B) cardiac output. C) afterload. D) stroke volume.
A

Ans: A Page: 1520

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13
Q
  1. External bleeding would be the MOST difficult to control in a patient with a large laceration to the _____________ and a blood pressure of ______ mm Hg. A) jugular vein, 96/62 B) brachial artery, 68/46 C) femoral vein, 114/60 D) carotid artery, 100/70
A

Ans: D Page: 1524-1525

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14
Q
  1. Patients with internal hemorrhage will benefit MOST from: A) IV therapy. B) high-flow oxygen. C) rapid transport. D) PASG placement.
A

Ans: C Page: 1524

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15
Q
  1. What is the approximate total blood volume of a 150-pound male? A) 4.8 L B) 5.1 L C) 6.2 L D) 6.5 L
A

Ans: A Page: 1524

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16
Q
  1. The MOST significant factor that determines how well the body compensates for blood loss is: A) the patient’s pulse rate at the time of the injury. B) the period of time over which the blood is lost. C) whether the bleeding is internal or external. D) whether the bleeding is venous or arterial.
A

Ans: B Page: 1524

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17
Q
  1. Venous bleeding: A) is dark red in color and usually oozes from the wound. B) is bright red in color and typically spurts from a wound. C) is more likely to clot spontaneously than arterial bleeding. D) is generally more difficult to control than arterial bleeding.
A

Ans: C Page: 1525

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18
Q
  1. Which of the following factors would have the MOST negative effect on the body’s process of hemostasis? A) Bradycardia B) Hyperthermia C) Chronic heroin use D) Anticoagulant use
A

Ans: D Page: 1525

19
Q
  1. If you suspect internal bleeding during the primary assessment, you should: A) stop the assessment and transport at once. B) start two large-bore IV lines of normal saline. C) determine the source of the internal bleeding. D) keep the patient warm and administer oxygen.
A

Ans: D Page: 1529

20
Q
  1. Hematochezia: A) indicates digested blood from the upper gastrointestinal tract. B) is the passage of stools that contain bright red blood. C) suggests kidney injury and is characterized by bloody urine. D) is the passage of dark stools and indicates lower gastrointestinal bleeding.
A

Ans: B Page: 1529

21
Q
  1. All of the following are common early signs or symptoms of nontraumatic internal hemorrhage in older patients, EXCEPT: A) vomiting. B) syncope. C) weakness. D) dizziness.
A

Ans: A Page: 1528

22
Q
  1. Most external hemorrhage can be controlled with a combination of: A) pressure dressings and ice. B) elevation and immobilization. C) direct pressure and pressure dressings. D) pressure point control and elevation.
A

Ans: C Page: 1528

23
Q
  1. What is “warm ischemic time”? A) The period of time that organs and tissues can survive without perfusion, assuming a normal body temperature B) The preservation of ischemic organs and tissues when the patient’s body temperature is reduced by 1°F per hour C) The period of time in which perfusion can be restored to ischemic organs and tissues before permanent damage occurs D) The preservation of ischemic organs and tissues when the patient’s body temperature is increased to at least 101°F
A

Ans: A Page: 1523

24
Q
  1. Much of the bleeding associated with unsplinted fractures continues because: A) most fractures are unstable and usually lacerate major blood vessels. B) swelling associated with such fractures prevents platelet aggregation. C) bone ends will continue to move and destroy partially formed clots. D) patient anxiety increases the blood pressure, which exacerbates bleeding.
A

Ans: C Page: 1534

25
Q
  1. When applying a tourniquet to control major external hemorrhage from an extremity injury, you should: A) apply the tourniquet over a joint, as this will further help compress blood vessels. B) maintain direct pressure to the wound until the tourniquet has been fully applied. C) secure the tourniquet in place until the pulses distal to the injury have weakened. D) apply a pressure dressing over the tourniquet to further help control the bleeding.
A

Ans: B Page: 1532-1534

26
Q
  1. Agents such as Celox, HemCon, and QuikClot are used to: A) repair damaged vessels. B) replace lost blood. C) raise blood pressure. D) promote hemostasis.
A

Ans: D Page: 1535

27
Q
  1. A patient with hemorrhagic shock would be expected to have: A) warm, flushed skin. B) flattened jugular veins. C) a widened pulse pressure. D) an increased hematocrit.
A

Ans: B Page: 1527

28
Q
  1. Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock? A) Fractures B) Blunt trauma C) Hemothorax D) Severe burns
A

Ans: D Page: 1525

29
Q
  1. A trauma patient with suspected internal hemorrhage and inadequate breathing requires: A) ventilation assistance and rapid transport. B) intubation that is facilitated by medications. C) on-scene IV therapy and rapid fluid boluses. D) oxygen via nonrebreathing mask and transport.
A

Ans: A Page: 1535-1536

30
Q
  1. A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to: A) increase the systolic blood pressure to at least 110 mm Hg. B) restore the patient’s blood pressure to its pretrauma reading. C) increase the pulse rate by no more than 10 beats/min. D) maintain the systolic blood pressure in a low normal range.
A

Ans: D Page: 1537

31
Q
  1. Which of the following types of medication would MOST likely reduce a patient’s ability to compensate when in shock? A) Tricyclic antidepressants B) Calcium channel blockers C) Nasal decongestants D) Beta-2 adrenergic agonists
A

Ans: B Page: 1529

32
Q
  1. Confusion, a sustained heart rate greater than 120 beats/min, and a respiratory rate of 32 breaths/min are MOST consistent with class ___ hemorrhage? A) I B) II C) III D) IV
A

Ans: C Page: 1526

33
Q
  1. A healthy adult can tolerate blood loss of up to ____ mL over a period of 15 to 20 minutes without any negative effects. A) 500 B) 750 C) 1,000 D) 1,500
A

Ans: A Page: 1524

34
Q
  1. The physiologic process of hemostasis is achieved through: A) an increased production of red blood cells. B) the destruction of fibrin and platelets. C) the use of anticoagulants such as Coumadin. D) vasoconstriction and platelet aggregation.
A

Ans: D Page: 1525

35
Q
  1. In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with: A) polyuria and weak pulses. B) bounding radial pulses. C) mottled skin and dilated pupils. D) restlessness and pale cool skin.
A

Ans: C Page: 1527

36
Q
  1. A fall in blood pressure and the resultant changes in plasma osmolality cause the release of: A) glycogen and luteinizing hormone. B) T3 and T4 from the thyroid gland. C) aldosterone and antidiuretic hormone. D) acetylcholine and angiotensin I.
A

Ans: C Page: 1523

37
Q
  1. Circulation of blood within an organ or tissue in adequate amounts to meet the cells’ current needs is called: A) perfusion. B) respiration. C) oxygenation. D) metabolism.
A

Ans: A Page: 1522

38
Q
  1. Which of the following types of shock is caused by poor blood vessel function? A) Septic B) Cardiogenic C) Hypovolemic D) Hemorrhagic
A

Ans: A Page: 1525

39
Q
  1. If you discover minor external bleeding during your primary assessment of a patient, you should: A) stop your assessment and take the patient’s blood pressure. B) establish a large-bore IV line immediately. C) stop your assessment and control the bleeding. D) make note of it and continue your assessment.
A

Ans: D Page: 1529

40
Q
  1. The paramedic’s MAIN goal in treating a patient with shock is to: A) administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95%. B) start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion. C) recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs. D) maintain body temperature and elevate the patient’s legs 6 to 12 inches in order to improve blood flow to the core of the body.
A

Ans: C Page: 1526

41
Q
  1. Decompensated shock in the adult is characterized by: A) increased tidal volume. B) bounding radial pulses. C) 15% blood loss or more. D) a falling blood pressure.
A

Ans: D Page: 1527

42
Q
  1. Which of the following signs would you MOST likely observe in a patient with compensated shock? A) Anxiety or agitation B) Dilation of the pupils C) Absent peripheral pulses D) Response to painful stimuli
A

Ans: A Page: 1527

43
Q
  1. You are treating a 20-year-old man with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should: A) administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route. B) administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route. C) apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route. D) control the bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport.
A

Ans: C Page: 1530-1532, 1537

44
Q
  1. A motorcycle rider struck a parked car and was catapulted over the handlebars of his bike. Your assessment reveals that he is tachypneic, diaphoretic, and tachycardic. There is no gross external bleeding present. What is the MOST likely cause of this patient’s clinical presentation? A) Closed head injury B) Bilateral femur fractures C) Proximal upper extremity fractures D) Sympathetic nervous system failure
A

Ans: B Page: 1524, 1528

Section 7 Trauma (10 decks)

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