Deck 25: Bleeding and Shock

Question 1

Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level?

A) Hydrostatic pressure
B) Perfusion
C) Osmosis
D) Circulation

Answer 1

Perfusion

Question 2

In the average adult,the sudden loss of ________ cc of blood is considered serious.

A) 150
B) 500
C) 1,000
D) 750

Answer 2

1,000

Question 3

Which of the following is a characteristic of venous bleeding?

A) It commonly requires the use of pressure point compression.
B) It can be profuse, but is generally easily controlled.
C) It cannot lead to life-threatening amounts of blood loss.
D) It often requires the use of a tourniquet.

Answer 3

It can be profuse, but is generally easily controlled.

Question 4

Which of the following BEST describes the function of blood?

A) It is a life-giving liquid that supports all the body's functions to maintain hypoperfusion.
B) It clots, flows, transports, protects, and excretes on a daily basis.
C) It transports gases along with nutrients, aids in excretion, and provides protection and regulation.
D) It flows from the heart with the vital gases and nutrients to maintain lack of perfusion.

Question 5

Which of the following may occur when there is bleeding from a large vein?

A) Transmission of bloodborne illnesses
B) Air embolism
C) Hypoperfusion
D) All of the above

Question 6

Which of the following is NOT part of the circulatory system?

A) Heart
B) Brain
C) Blood vessels
D) Blood

Question 7

Which of the following types of vessels have valves to maintain one-way blood flow?

A) Arteries
B) Capillaries
C) Veins
D) Arterioles

Question 8

External bleeding may be classified according to types.Which one of the following is one of those types?

A) Cardiac bleeding
B) Brain bleeding
C) Capillary bleeding
D) Liver bleeding

Question 9

Shock is the circulatory system's failure to provide sufficient blood and oxygen to all the body's tissues.Which of the answers is NOT a major type of shock?

A) Hypovolemic
B) Hemorrhagic
C) Hypervolemic
D) Cardiogenic

Question 10

Which of the following must be kept in mind when considering the severity of external bleeding?

A) Signs of shock do not appear until a large amount of blood has been lost.
B) The amount of blood loss is easily estimated by the amount of blood visible on the ground.
C) A younger person can tolerate more blood loss than an adult.
D) All of the above

Question 11

Which of the following vessels contain blood under the highest amount of pressure?

A) Veins
B) Arteries
C) Venules
D) Capillaries

Question 12

Which of the following vessels has the thickest muscular walls that allow constriction and dilation?

A) Arteries
B) Capillaries
C) Veins
D) Lymphatic vessels

Question 13

In which of the following vessels does the vital exchange take place and also has the thinnest walls through which oxygen,nutrients,and wastes can pass?

A) Capillaries
B) Microvenules
C) Arterioles
D) Veins

Question 14

Your patient is a 6-year-old child who has fallen down while running on a sidewalk.She has abrasions on both knees and the palms of both hands,which are oozing blood.This is an example of bleeding from which of the following types of vessels?

A) Veins
B) Arteries
C) Lymphatic vessels
D) Capillaries

Question 15

Your patient is a 33-year-old man who has a gunshot wound to his right leg and has active,steady,dark red bleeding.He is awake,pale,and diaphoretic.He has a strong radial pulse of 112 per minute,a respiratory rate of 24 breaths per minute,and a blood pressure of 122/82 mmHg.He has no other injuries or complaints.Which of the following is the BEST sequence of steps in the management of this patient?

A) High-concentration oxygen, elevation of the extremity, and application of ice
B) Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
C) High-concentration oxygen, tourniquet, PASG, and elevation of the extremity
D) Direct pressure, high-concentration oxygen, and splinting the leg

Question 16

Your patient has attempted suicide by slitting his wrists.You notice that he has run the knife across his wrist,perpendicular to the arm,and that the wound is rather deep.Which of the following statements is true regarding the likelihood for serious blood loss?

A) You should expect severe blood loss.
B) There is most likely tremendous internal blood loss.
C) Blood loss is probably not life-threatening.
D) A tourniquet will probably be necessary.

Question 17

Which of the following blood vessels CANNOT stop bleeding by constricting?

A) Arteries
B) Capillaries
C) Venules
D) Arterioles

Question 18

Which of the following is a characteristic of arterial bleeding?

A) Steady flow
B) Dark red color
C) Spurting under pressure
D) Both B and C

Question 19

Which of the following is NOT recommended when controlling epistaxis?

A) Pinching the nostrils together
B) Keeping the patient calm and quiet
C) Having the patient tilt the head backward to elevate the nose
D) Placing the unconscious patient in the recovery position

Question 20

Which of the following is the most important reason for controlling external bleeding?

A) To prevent hypoperfusion
B) To prevent the spread of infectious diseases
C) To make clean-up of the ambulance and your equipment easier after the call
D) To prevent the patient from becoming upset at the sight of blood

Question 21

Which one of the following is incorrect in the application of a tourniquet?

A) The tourniquet should be placed approximately 2 inches above the bleeding.
B) The tourniquet should be 2 to 4 inches wide.
C) A blood pressure cuff can be used as a tourniquet.
D) If possible, the tourniquet should be placed on a joint.

Question 22

Which of the following is the LEAST effective method of controlling bleeding?

A) Direct pressure
B) Elevation
C) Tourniquet
D) Hemostatic agent

Question 23

Which of the following is responsible for most of the signs and symptoms of early shock?

A) Increased respirations of the patient
B) Constriction of the peripheral blood vessels
C) Dilation of the peripheral blood vessels
D) The body's attempts at compensation for blood loss

Question 24

The most common form of a hemostatic agent is hemostatic:

A) granules.
B) dressings.
C) tourniquet.
D) powders.

Question 25

Which of the following should increase the EMT's suspicion of internal bleeding?

A) Penetrating trauma to the chest or abdomen
B) High-speed motor vehicle collision
C) Fall from a height three or more times the patient's height
D) All of the above

Question 26

Which of the following signifies a failure in the patient's compensatory response to blood loss?

A) Hypotension
B) Tachycardia
C) Tachypnea
D) Pale, cool skin

Question 27

Which of the following is recommended in situations in which a tourniquet must be used?

A) Apply a bulky dressing and bandage over the tourniquet.
B) Apply the tourniquet over the elbow or knee.
C) Use a material that is wide and thick.
D) Remove the tourniquet as soon as bleeding is controlled to minimize further damage to the limb.

Question 28

Which of the following is the MOST effective way of controlling external bleeding?

A) Running cold water over the wound
B) Using direct pressure with a dressing
C) Elevating the affected part
D) Using an ice pack

Question 29

Cold is sometimes used to help control bleeding.When using cold,the following guidelines and statements are true except:

A) it should not be used alone but rather in conjunction with other manual techniques.
B) it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound.
C) it should not be left in place for more than 20 minutes.
D) it will reduce pain.

Question 30

Which of the following is the major cause of shock that the EMT will encounter?

A) Vomiting
B) High blood pressure
C) Hemorrhage
D) Excessive sweating

Question 31

If you do not have a commercial tourniquet available,what common device found on the ambulance can be used as a substitute?

A) Air or vacuum splint
B) Blood pressure cuff
C) Ice packs tied in place with triangle bandage
D) Use a rope tie-down to make a tourniquet

Question 32

As an EMT,your BEST clue indicating the possibility of internal bleeding may be the presence of:

A) a tender, rigid, or distended abdomen.
B) painful, swollen, or deformed extremities.
C) mechanism of injury.
D) bruising, swelling, or pain over vital organs.

Question 33

Which of the following is another name for describing the condition of shock?

A) Internal bleeding
B) Hypotension
C) Hypoperfusion
D) Hemorrhage

Question 34

You will frequently be called upon to deal with internal bleeding.Blunt trauma is the leading cause of internal injuries and bleeding.Which of the following are mechanisms of blunt trauma that may cause internal bleeding?
1)Falls
2)Motor vehicle or motorcycle crashes
3)Auto-pedestrian collisions
4)Blast injuries

A) 1, 2, 3
B) 2, 3
C) 1, 2, 3, 4
D) 1, 4

Question 35

Your patient is a 28-year-old male who cut his thigh with a chain saw.It appears that he has lost about 600 cc of blood.Which of the following is NOT part of the proper management of this patient?

A) Use of a tourniquet
B) Replacement of fluid level by giving the patient adequate amounts of water
C) Using direct pressure to control the bleeding
D) Administering oxygen

Question 36

Your patient is a 12-year-old boy who ran his arm through a glass window and has an 8-inch laceration on his anterior forearm.You have applied a pressure dressing and bandage,but these have become saturated due to continued bleeding.Which of the following should you do now?

A) Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage.
B) Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
C) Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery.
D) Remove the pressure dressing and bandage, apply direct pressure with your gloved hand, and elevate the arm.

Question 37

Which of the following is part of the body's compensatory response to blood loss?

A) Blood vessels constrict and the heart rate increases.
B) Blood vessels dilate and the heart rate increases.
C) Blood vessels dilate and the heart rate decreases.
D) Blood vessels constrict and the heart rate decreases.

Question 38

Although many of the signs and symptoms of shock are the same no matter what the cause,the symptoms follow a logical progression as shock develops and worsens.Arrange the following signs and symptoms in the likely order that they will appear. 1.Altered mental status
2)Dropping blood pressure
3)Nausea and vomiting
4)Pale,cool,and clammy skin
5)Increased pulse
6)Increased respirations

A) 1, 4, 3, 6, 5, 2
B) 2, 5, 6, 3, 4, 1
C) 1, 3, 4, 5, 6, 2
D) 5, 3, 4, 2, 6, 1

Question 39

Which of the following is NOT a consequence of hypoperfusion?

A) Cellular waste products are not removed.
B) Cells are not supplied with nutrients.
C) Cells are not supplied with oxygen.
D) Aerobic metabolism will continue in the cell.

Question 40

Which of the following is the MOST sensitive indicator of hypoperfusion?

A) Delayed capillary refill
B) Dilation of the pupils
C) Increased heart rate
D) Altered mental status

Question 41

Which of the following is a classification of the severity of shock?

A) Consumption
B) Compensated
C) Uncompensated
D) Non-compensated

Question 42

Which of the following BEST explains the reason for minimizing scene-time for the trauma patient with significant hemorrhage or the potential for significant hemorrhage?

A) There is nothing the EMT can do for a patient in shock.
B) It gives the EMT less opportunity to make mistakes in the patient's care.
C) Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.
D) The clock for the "golden hour" of trauma begins at the time of your arrival.

Question 43

Which of the following will worsen the condition of the patient in shock?

A) Applying high-concentration oxygen when it is not needed
B) Elevating the patient's legs 8 to 10 inches
C) Conducting oneself in a manner that increases the patient's fear and anxiety
D) Transporting without first splinting all extremity fractures

Question 44

Which of the following circumstances may result in hypoperfusion?

A) There is external bleeding.
B) Blood vessels are dilated.
C) The heart is damaged.
D) All of the above

Question 45

Which of the following is NOT the purpose of making airway management the highest priority of patient care when managing the patient in shock?

A) It allows for oxygenation of the lungs.
B) It allows for improved elimination of carbon dioxide.
C) It minimizes the chances of aspiration of blood or vomit.
D) It allows the bronchoconstriction of the smaller airways to be reversed.

Question 46

Which of the following statements is true when talking about neurogenic shock?

A) Neurogenic shock is sometimes caused by spinal injuries.
B) Neurogenic shock is the result of the blood vessels decreasing in size.
C) Neurogenic shock is caused by the blood vessels overfilling with blood, causing leaking into the nerves.
D) Neurogenic shock is very common in the field.

Question 47

Which of the following distinguishes decompensated shock from compensated stage of shock?

A) Cell damage and death in the vital organs
B) Altered mental status
C) Delayed capillary refill time
D) Low blood pressure

Question 48

Limiting time spent at a scene can be especially important if the mechanism of injury suggests that the patient could go into shock.In order to keep the time at the scene to a minimum,which of the following assessments or treatments should NOT be performed on the scene?

A) ABCs with spinal precautions
B) Immobilization
C) Rapid trauma exam
D) Splinting swollen extremities

Question 49

Which of the following statements is NOT true when you are on-scene and treating a patient that appears to be in shock?

A) It is important to spend on-scene time to be sure you have corrected and dealt with any of the causes of the shock so that it does not get worse. This is more important than rapid transport.
B) The patient should be promptly put on high-concentration oxygen.
C) Airway management is of top priority.
D) Prompt transportation is a very high priority.

Question 50

Which of the following is NOT indicated in the management of a patient in shock?

A) Minimizing on-scene time
B) Delaying a detailed exam until en route to the hospital
C) High-speed ambulance transportation
D) On-scene spinal precautions, if indicated

Question 51

When deciding where to transport a patient who is in hypovolemic shock or who has the potential for developing hypovolemic shock,which of the following is the MOST important service to be provided by the receiving hospital?

A) Critical-care nursing
B) Immediate surgical capabilities
C) Availability of a chaplain
D) Rehabilitation services