Chapter 25 Chapter Test: Bleeding and Shock
Which of the following vessels contain blood under the highest amount of pressure? A. Arteries B. Capillaries C. Veins D. Venules
A. Arteries
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. Capillaries B. Veins C. Arteries D.Lymphatic vessels
A. Capillaries
Which of the following is a classification of the severity of shock? A. Compensated B. Uncompensated C. Non-compensated D. Consumption
A. Compensated
Which of the following is NOT recommended when controlling epistaxis? A. Having the patient tilt the head backward to elevate the nose B. Placing the unconscious patient in the recovery position C. Keeping the patient calm and quiet D. Pinching the nostrils together
A. Having the patient tilt the head backward to elevate the nose
Which of the following is another name for describing the condition of shock? A. Hypoperfusion B. Hypotension C. Internal bleeding D. Hemorrhage
A. Hypoperfusion
Which of the following signifies a failure in the patient's compensatory response to blood loss? A. Hypotension B. Pale, cool skin C. Tachypnea D. Tachycardia
A. Hypotension
Your trauma patient is anxious, tachycardic, pale, and hypotensive. Which of these signs indicates failure of the body's compensatory mechanisms? A. Hypotension B. Anxiousness C. Tachycardia D. Pallor
A. Hypotension
Which of the following is a characteristic of venous bleeding? A. It can be profuse, but is generally easily controlled. B. It commonly requires the use of pressure point compression. C. It often requires the use of a tourniquet. D. It cannot lead to life-threatening amounts of blood loss.
A. It can be profuse, but is generally easily controlled.
Which of the following types of bleeding is most serious? A. Massive bleeding of any type B. External bleeding C. Arterial bleeding D. Internal bleeding
A. Massive bleeding of any type
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 caused by the blood vessels overfilling with blood, causing leaking into the nerves. C. Neurogenic shock is very common in the field. D. Neurogenic shock is the result of the blood vessels decreasing in size.
A. Neurogenic shock is sometimes caused by spinal injuries.
Your patient is a 28-year-old male who cut his thigh with a chainsaw. Bleeding is significant and difficult to control. Which of the following is NOT part of the proper management of this patient? A. Replacement of fluid level by giving the patient adequate amounts of water B. Administering oxygen C. Use of a tourniquet D. Using direct pressure to control the bleeding
A. Replacement of fluid level by giving the patient adequate amounts of water
Which of the following is NOT indicated in the management of a patient in shock? A. High-speed ambulance transportation B. Minimizing on-scene time C. On-scene spinal precautions, if indicated D. Delaying a detailed exam until en route to the hospital
A. High-speed ambulance transportation
If you do not have a commercial tourniquet available, what common device found on the ambulance can be used as a substitute? A. Ice packs tied in place with triangle bandage B. Blood pressure cuff C. Use a rope tie-down to make a tourniquet D. Air or vacuum splint
B. Blood pressure cuff
Which of the following is part of the body's compensatory response to blood loss? A. Blood vessels dilate and the heart rate decreases. B. Blood vessels constrict and the heart rate increases. C. Blood vessels constrict and the heart rate decreases. D. Blood vessels dilate and the heart rate increases.
B. Blood vessels constrict and the heart rate increases.
Which of the following is the leading cause of internal bleeding? A. Crush injury B. Blunt trauma C. Penetrating trauma D. Aortic aneurysm
B. Blunt trauma
Which of the following is NOT part of the circulatory system? A. Blood vessels B. Brain C. Blood D. Heart
B. Brain
External bleeding may be classified according to types. Which one of the following is one of those types? A. Brain bleeding B. Capillary bleeding Your answer is correct. C.Cardiac bleeding D. Liver bleeding
B. Capillary bleeding
Which of the following will worsen the condition of the patient in shock? A. Transporting without first splinting all extremity fractures B. Conducting oneself in a manner that increases the patient's fear and anxiety C. Applying high-concentration oxygen when it is not needed D. Elevating the patient's legs 8 to 10 inches
B. Conducting oneself in a manner that increases the patient's fear and anxiety
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, tourniquet, PASG, and elevation of the extremity B. Direct pressure, high-concentration oxygen, and splinting the leg C. High-concentration oxygen, elevation of the extremity, and application of ice D. Cervical spine immobilization, high-concentration oxygen, direct pressure, and pressure point compression
B. Direct pressure, high-concentration oxygen, and splinting the leg
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. Availability of a chaplain B. Immediate surgical capabilities C. Critical-care nursing D.Rehabilitation services
B. Immediate surgical capabilities
Which of the following BEST describes the delivery of oxygen and nutrients at the body's cellular level? A. Circulation B. Perfusion C. Hydrostatic pressure D. Osmosis
B. Perfusion
Which of the following must be kept in mind when considering the severity of external bleeding? A. The amount of blood loss is easily estimated by the amount of blood visible on the ground. B. Signs of shock do not appear until a large amount of blood has been lost. C. A younger person can tolerate more blood loss than an adult. D. All of the above
B. Signs of shock do not appear until a large amount of blood has been lost.
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. Rapid trauma exam B. Splinting swollen extremities C. Immobilization D. ABCs with spinal precautions
B. Splinting swollen extremities
Which of the following is a characteristic of arterial bleeding? A. Steady flow B. Spurting under pressure C. Dark red color D. Both B and C
B. Spurting under pressure
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. The clock for the "golden hour" of trauma begins at the time of your arrival. B. Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival. C. There is nothing the EMT can do for a patient in shock. D. It gives the EMT less opportunity to make mistakes in the patient's care.
B. Studies have indicated that trauma patients who receive surgery within 1 hour of injury have better chances of survival.
Which of the following is responsible for most of the signs and symptoms of early shock? A. Constriction of the peripheral blood vessels B. The body's attempts at compensation for blood loss C. Dilation of the peripheral blood vessels D. Increased respirations of the patient
B. The body's attempts at compensation for blood loss
The most common form of a hemostatic agent is hemostatic: A. tourniquet. B. dressings. C. granules. D. powders.
B. dressings.
Cold is sometimes used to help control bleeding. When using cold, the following guidelines and statements are true except: A. it should not be left in place for more than 20 minutes. 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 used alone but rather in conjunction with other manual techniques. D.it will reduce pain.
B. it should be applied directly to the skin; it will not be effective if anything is between the cold agent and the wound.
As an EMT, your BEST clue indicating the possibility of internal bleeding may be the presence of: A. the absence of a tender, rigid, or distended abdomen. B. mechanism of injury. C. painful, swollen, or deformed extremities. D. bruising, swelling, or pain over vital organs.
B. mechanism of injury
Which of the following is NOT a consequence of hypoperfusion? A. Cells are not supplied with oxygen. B. Cellular waste products are not removed. C. Aerobic metabolism will continue in the cell. D. Cells are not supplied with nutrients.
C. Aerobic metabolism will continue in the cell.
Which of the following vessels has the thickest muscular walls that allow constriction and dilation? A. Lymphatic vessels B. Veins C. Arteries D. Capillaries
C. Arteries
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 not deep. Which of the following statements is true regarding the likelihood for serious blood loss? A. There is most likely tremendous internal blood loss. B. You should expect severe blood loss. C. Blood loss is probably not life-threatening. D. A tourniquet will probably be necessary.
C. Blood loss is probably not life-threatening.
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. Veins B. Microvenules C. Capillaries D. Arterioles
C. Capillaries
Which of the following blood vessels cannot stop bleeding by constricting? A. Arterioles B. Vena cava C. Capillaries D. Arteries
C. Capillaries
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. Cardiogenic B. Hypovolemic C. Hypervolemic D.Hemorrhagic
C. Hypervolemic
Which one of the following is incorrect in the application of a tourniquet? A. A blood pressure cuff can be used as a tourniquet. B. The tourniquet should be placed approximately 2 inches above the bleeding. C. If possible, the tourniquet should be placed on a joint. D. The tourniquet should be 2 to 4 inches wide.
C. If possible, the tourniquet should be placed on a joint.
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 minimizes the chances of aspiration of blood or vomit. B. It allows for improved elimination of carbon dioxide. C. It allows the bronchoconstriction of the smaller airways to be reversed. D. It allows for oxygenation of the lungs.
C. It allows the bronchoconstriction of the smaller airways to be reversed.
Which of the following statements is NOT true when you are on-scene and treating a patient that appears to be in shock? A. Prompt transportation is a very high priority. B. The patient should be promptly put on high-concentration oxygen. C. 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. D. Airway management is of top priority.
C. 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.
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 flows from the heart with the vital gases and nutrients to maintain lack of perfusion. C. It transports gases along with nutrients, aids in excretion, and provides protection and regulation. D. 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.
Which of the following distinguishes decompensated shock from compensated stage of shock? A. Altered mental status B. Tachycardia C. Low blood pressure D. Delayed capillary refill time
C. Low blood pressure
Which of the following circumstances may result in hypoperfusion? A. The heart is damaged. B. Blood vessels are dilated. C. There is external bleeding. D. All of the above
D. All of the above
Which of the following may occur when there is bleeding from a large vein? A. Hypoperfusion B. Transmission of bloodborne illnesses C. Air embolism D. All of the above
D. All of the above
Which of the following should increase the EMT's suspicion of internal bleeding? A. Fall from a height three or more times the patient's height B. Penetrating trauma to the chest or abdomen C. High-speed motor vehicle collision D. All of the above
D. All of the above
Which of the following is the MOST sensitive indicator of hypoperfusion? A. Dilation of the pupils B. Delayed capillary refill C. Increased heart rate D. Altered mental status
D. Altered mental status
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 direct pressure with your gloved hand, and elevate the arm. B. Apply additional dressing material, bandage it in place, and apply pressure to the brachial artery. C. Remove the pressure dressing and bandage, apply an ice pack to the wound, and bandage it in place with an elastic bandage. D. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
D. Elevate that arm and prepare to apply a tourniquet or consider administering a hemostatic agent.
Which of the following is the LEAST effective method of controlling bleeding? A. Direct pressure B. Hemostatic agent C. Tourniquet D. Elevation
D. Elevation
Which of the following is the major cause of shock that the EMT will encounter? A. High blood pressure B. Excessive sweating C. Vomiting D. Hemorrhage
D. Hemorrhage
Which of the following is the most important reason for controlling external bleeding? A. To prevent the spread of infectious diseases B. To make clean-up of the ambulance and your equipment easier after the call C. To prevent the patient from becoming upset at the sight of blood D. To prevent hypoperfusion
D. To prevent hypoperfusion
Which of the following is recommended in situations in which a tourniquet must be used? A. Apply the tourniquet over the elbow or knee. B. the tourniquet as soon as bleeding is controlled to minimize further damage to the limb. C. Apply a bulky dressing and bandage over the tourniquet. D. Use a material that is wide and thick.
D. Use a material that is wide and thick.
Which of the following is the MOST effective way of controlling external bleeding? A. Using an ice pack B. Running cold water over the wound C. Elevating the affected part D. Using direct pressure with a dressing
D. Using direct pressure with a dressing
Which of the following types of vessels have valves to maintain one-way blood flow? A. Capillaries B. Arterioles C. Arteries D. Veins
D. Veins