Vol 4 Ch 3

Blood present in the stool of a patient is known​ as: A. hematochezia. B. hematemesis. C. hemorrhage. D. hemoptysis.

A. hematochezia.

Red blood cells make up approximately​ ________ percent of whole blood volume. A. 45 B. 15 C. 60 D. 30

A. 45

Which of the following is NOT a characteristic of arterial​ bleeding? A. Clots quickly on its own B. Bright red C. Spurting or pumping as it leaves the body D. Rapid blood loss

A. Clots quickly on its own

What is the best course of action in the case of hemorrhage from either the nose or ear​ canal? A. Cover the area with a​ soft, porous dressing Your answer is correct.B. Squeeze the nostrils closed C. Apply pressure to the forehead D. Apply direct pressure to the upper face

A. Cover the area with a​ soft, porous dressing

Your patient is a​ 45-year-old man who has received several stab wounds to the chest and abdomen. Although bleeding was significant at​ first, the rate of bleeding had slowed considerably before your arrival. The patient is agitated and​ confused, pale,​ diaphoretic, and cool to the touch. He lacks a radial​ pulse, and his carotid pulse is weak and rapid. Respirations are 28 and shallow. Which of the following is certain with this​ patient? A. He is in decompensated shock. B. He is in irreversible shock. C. He is in compensated shock. D. None of the above is certain.

A. He is in decompensated shock.

Which of the following indicates that a patient has transitioned from compensated to decompensated​ shock? A. Hypotension B. Widening pulse pressure C. Increased respiratory rate D. Peripheral vasoconstriction

A. Hypotension

A fracture of the femur may result in a hematoma that contains enough blood to make it a class​ ________ hemorrhage. A. III B. II C. I D. IV

A. III

When a patient has lost 2 liters or more of blood from​ hemorrhage, which classification is​ that? A. IV B. II C. III D. I

A. IV

In which stage of shock are the​ body's cells are so badly injured and die in such quantities that organs no longer are able to function​ normally? A. Irreversible B. Decompensated C. Class I D. Compensated

A. Irreversible

Which of the following early signs of shock is easily​ missed? A. Tachycardia B. Narrowing pulse pressure C. Decrease in blood pressure D. Decrease in respiratory rate and volume

A. Tachycardia

Which of the following statements about the patient in neurogenic shock is​ FALSE? A. Unopposed sympathetic nervous stimulation results in systemic pallor and diaphoresis. B. Can present with neck​ and/or back pain. C. Signs of hypovolemic shock may be masked. D. Neurogenic shock may require IV fluid resuscitation.

A. Unopposed sympathetic nervous stimulation results in systemic pallor and diaphoresis.

Which of the following vessels does NOT make up the microcirculation in the circulatory​ system? A. Veins B. Capillaries C. Arterioles D. Venules

A. Veins

The blood flowing to the heart best​ describes: A. preload. B. afterload. C. contractility. D. vascular phase.

A. preload.

The phase of blood clotting in which the smooth muscle of an injured blood vessel contracts is known as the​ ________ phase. A. vascular B. hemostatic C. ischemic D. hemolytic

A. vascular

The rapid trauma exam focuses on finding injuries that may cause shock by quickly assessing which of the following body​ areas? 1. Head 2. Neck 3. Chest 4. Abdomen 5. Pelvis 6. Proximal extremities 7. Distal extremities A. ​1, 2,​ 3, 4, and 5 B. ​3, 4,​ 5, and 6 C. ​1, 2,​ 3, 4,​ 5, 6, and 7 D. ​1, 4,​ 5, and 6

A. ​1, 2,​ 3, 4, and 5

Your patient is a​ 42-year-old man with multiple lacerations on his​ arms, head, and torso after falling through a​ plate-glass window. On your​ arrival, he appears to be​ unresponsive, lying prone on the sidewalk. Which of the following is the correct sequence of actions in caring for this​ patient? 1. Control major hemorrhage. 2. Take Standard Precautions. 3. Check the area for broken glass before kneeling next to the patient. 4. Turn him to a supine position. 5. Open his airway. A. ​2, 3,​ 4, 1, 5 B. ​2, 5,​ 1, 3, 4 C. ​2, 3,​ 4, 5, 1 D. ​2, 3,​ 1, 4, 5

A. ​2, 3,​ 4, 1, 5

Which of the following would be the most likely cause of neurogenic​ shock? A. Systemic infection B. Massive histamine release C. Spinal cord injury D. Pericardial tamponade

C. Spinal cord injury

Which of the following guidelines applies to the prehospital administration of IV fluids in the patient with hemorrhagic​ shock? A. Administer hypertonic saline solution or colloids at a​ keep-open rate. B. Administer isotonic crystalloid fluids only as necessary to maintain perfusion. C. Begin with a​ 2,000 mL bolus of isotonic crystalloid solution infused under pressure. D. Administer synthetic​ oxygen-carrying fluids as necessary to increase the level of consciousness.

B. Administer isotonic crystalloid fluids only as necessary to maintain perfusion.

Which of the following mechanisms is responsible for accumulating lactic acid in​ shock? A. Gluconeogenesis B. Anaerobic metabolism C. The citric acid cycle D. Hemostasis

B. Anaerobic metabolism

Which of the following may move more slowly through the early stages of hemorrhage with greater loss percentages needed to transition from one stage class to​ another? A. Infants B. Athletes C. Alcoholics D. Elderly patients

B. Athletes

Which of the following patients with hemorrhagic shock is likely to be internally​ bleeding, solely? A. A​ 38-year-old man with an open femur fracture B. A​ 45-year-old woman with a suspected ruptured ectopic pregnancy C. A​ 26-year-old man with a gunshot wound involving the popliteal artery D. A​ 50-year-old man with a stab wound to the neck

B. A​ 45-year-old woman with a suspected ruptured ectopic pregnancy

Which of the following terms is best described as the loss of blood from the vascular​ space? A. Shock B. Hemorrhage C. Hemostasis D. Hypovolemia

B. Hemorrhage

Your patient is a​ 29-year-old man who works in a​ meat-processing plant. He received a knife wound in the proximal anteromedial​ thigh, which is continuing to bleed on your arrival. He is restless and thirsty and has​ pale, cool skin. He has a weak radial pulse of 130 and a blood pressure of​ 118/88 mmHg. This patient is exhibiting signs and symptoms consistent with a class​ ________ hemorrhage. A. IV B. II C. III D. I

B. II

Which of the following best describes definitive care for the trauma patient with​ ongoing, significant​ hemorrhage? A. Administration of blood or blood products B. Immediate surgery C. Administration of hypertonic crystalloid or colloid solution D. Invasive hemodynamic monitoring and serial hematocrits

B. Immediate surgery

Which of the following fluids is appropriate for the prehospital management of hypovolemic​ shock? A. Five percent dextrose in water B. Lactated​ Ringer's C. A​ 0.45% sodium chloride solution D. A​ 0.2% sodium chloride solution

B. Lactated​ Ringer's

Peripheral vascular resistance is measured as which of the​ following? A. Pulse pressure B. Mean arterial pressure C. Oncotic pressure D. Hydrostatic pressure

B. Mean arterial pressure

In responding to a trauma patient at the scene of a motor vehicle​ crash, which of the following is an early sign or signs of shock you might encounter during the primary​ assessment? A. Rapidly dropping level of responsiveness B. Rapid heart rate and anxiety C. Rapid breathing and air hunger D. Rapidly dropping blood pressure

B. Rapid heart rate and anxiety

Rapid volume replacement is best achieved under which of the following​ conditions? A. Use of a long catheter with a small internal diameter B. Use of a short catheter with a large internal diameter C. Use of a long catheter with a large internal diameter D. Use of a short catheter with a small internal diameter

B. Use of a short catheter with a large internal diameter

Which of the following is a manifestation of orthostatic​ hypotension? A. Your​ patient's pulse is 80 when she is supine but 96 when she sits up. B. Your​ patient's blood pressure is​ 142/90 when she is supine but​ 116/88 when she sits up. C. Your​ patient's blood pressure is​ 150/100 when he is supine but​ 134/90 when he sits up. D. Your​ patient's pulse is 76 when he is supine but 88 when he sits up.

B. Your​ patient's blood pressure is​ 142/90 when she is supine but​ 116/88 when she sits up.

Which of the following does NOT indicate compensated​ shock? A. Weakness B. Thirst C. Altered mental status D. Anxiety

C. Altered mental status

What is the mechanism of​ TXA? A. Development of metabolic acidosis B. Thrombocytopenia C. Antifibrinolytic D. Coagulopathy

C. Antifibrinolytic

Which of the following vessels has the greatest ability to change​ diameter? A. Capillary B. Aorta C. Arteriole D. Systemic artery

C. Arteriole

Brighter​ red, slow, oozing blood flow is characteristic of which type of​ hemorrhage? A. Arterial B. Venous C. Capillary D. Arteriole

C. Capillary

Which of the following findings is NOT likely with a patient in cardiogenic​ shock? A. Pulmonary edema B. Arrhythmias C. Excessive urination D. Jugular vein distention

C. Excessive urination

Your patient is an obese​ 39-year-old woman involved in a​ lateral-impact motor vehicle collision. Which of the following should you remember when assessing and treating this​ patient? A. Blood volume increases proportionally with body​ weight, and the patient will experience signs of shock consistent with the classic stages of hemorrhage. B. This patient will tolerate blood loss​ well, as only​ non-vital tissues will become ischemic. C. Relative to body​ weight, a smaller amount of hemorrhage may result in shock. D. Relative to body​ size, this patient can tolerate a larger amount of hemorrhage before showing signs of shock.

C. Relative to body​ weight, a smaller amount of hemorrhage may result in shock.

What method of controlling hemorrhage should be done as a last​ resort? A. Elevation B. Direct pressure C. Tourniquet D. Packing the wound with bandages and dressings

C. Tourniquet

Managing a laceration with arterial bleeding most often​ requires: A. cauterization. B. a tourniquet. C. direct pressure. D. PASG.

C. direct pressure.

Even with​ intervention, survival is unlikely with blood loss over​ ________ percent of the total blood volume. A. 50 B. 25 C. 15 D. 35

D. 35

Which of the following impairs blood​ clotting? A. Administration of IV fluids B. Hypothermia C. Use of​ nonsteroidal, anti-inflammatory medications D. All of the above

D. All of the above

Which of the following is TRUE of the elderly trauma​ patient? A. The elderly trauma patient is more likely to experience myocardial ischemia as a result of hemorrhage. B. Hemorrhage may not result in tachycardia as expected. C. Medications like​ beta-blockers may interfere with normal compensatory mechanisms. D. All of the above are true.

D. All of the above are true.

Which of the following findings indicates a progression from compensated shock to decompensated​ shock? A. Narrowing pulse pressure B. Diaphoresis C. Tachycardia D. Altered mental status

D. Altered mental status

As a patient with hemorrhagic blood loss becomes more​ acidotic, what homeostatic process is usually​ impaired? A. Vascular phase B. Aerobic metabolism C. Hemoptysis D. Coagulation

D. Coagulation

Your patient is a​ 23-year-old man with a gunshot wound to the abdomen and an exit wound in the right flank. He responds to verbal​ stimuli; has​ pale, cool, diaphoretic​ skin; and has a heart rate of​ 128, respirations at​ 24, and a blood pressure of​ 82/60. These findings indicate which of the following kind of​ shock? A. Neurogenic B. Compensated C. Irreversible D. Decompensated

D. Decompensated

Which of the following represents the correct sequence for controlling hemorrhage from an​ extremity? A. Finger pressure through the dressing to the leaking​ vessel, splinting,​ ice, elevation B. Direct pressure on the dressing and​ wound, elevation, ice C. Direct pressure on the dressing and wound​ , elevation,​ ice, tourniquet as a last resort D. Direct pressure on the dressing and​ wound, finger pressure through the dressing to the leaking​ vessel, and, if pressure​ fails, application of a tourniquet

D. Direct pressure on the dressing and​ wound, finger pressure through the dressing to the leaking​ vessel, and, if pressure​ fails, application of a tourniquet

When assessing the chest during a rapid trauma​ assessment, what is most likely to indicate major internal​ hemorrhage? A. Muffled heart tones B. Distended neck veins C. Increased respiratory rate D. Hyporesonance to percussion

D. Hyporesonance to percussion

A hematoma resulting from a fracture of the humerus may contain enough blood to make it a class​ ________ hemorrhage. A. III B. II C. IV D. I

D. I

Which of the following is defined as the volume of blood ejected from the heart with each​ beat? A. Ventricular capacitance B. Afterload C. Cardiac output D. Stroke volume

D. Stroke volume

Which type of wound facilitates the effectiveness of normal blood clotting​ mechanisms? A. Longitudinal laceration of the vessel B. Crushing injuries C. Vessels torn by​ stretching, such as when a limb is caught in farm machinery D. Transverse laceration of the vessel

D. Transverse laceration of the vessel

Under normal​ circumstances, at any given moment most of the blood is in the​ ________ system. A. capillary B. hematopoietic C. arterial D. venous

D. venous

Which of the following is the preferred​ in-hospital fluid for resuscitation in hemorrhagic​ shock? A. Normal saline B. Fresh frozen plasma C. Lactated​ Ringer's D. Whole blood

Whole blood