Bleeding & Soft-Tissue Trauma—Chapter 37

43. Bacteria can accumulate to hazardous levels in a wound in as few as ____ hours after the injury? A) 3 B) 6 C) 9 D) 12

A) 3

23. Which of the following is a primary blast injury? A) Blast lung B) Eye puncture C) Amputated hand D) Burned abdomen

A) Blast lung

32. For a junctional hemorrhage, you might use a: A) CRoC tourniquet. B) C-A-T tourniquet. C) heavy bandage. D) clot-promoting powder.

A) CRoC tourniquet.

10. A blood clot contains all of the following elements, EXCEPT: A) dermal cells. B) red blood cells. C) platelets. D) fibrinogen.

A) dermal cells.

38. A dressing applied over the mastoid: A) wraps around the top of the head. B) involves taping gauze to the chin. C) requires an occlusive material. D) is ineffective in controlling bleeding.

A) wraps around the top of the head.

3. Which of the following findings should make you the MOST suspicious for internal hemorrhage? A) Road rash B) Bloodshot eyes C) Abdominal distention D) Shortness of breath

C) Abdominal distention

16. Which of the following injuries presents the greatest risk of infection? A) Hematoma B) Ecchymosis C) Laceration D) Thrombus

C) Laceration

49. Which molecule can cause acute renal failure in a patient with crush syndrome? A) Fibrinogen B) Thrombin C) Myoglobin D) Keratin

C) Myoglobin

48. Which of the following patients would be at greatest risk for crush syndrome? A) Passenger ejected 30 feet (9 m) from the vehicle B) Stabbing victim treated within 60 minutes C) Person buried by a building collapse for 8 hours D) Fall victim retrieved after 45 minutes

C) Person buried by a building collapse for 8 hours

36. Dressings applied near or around the ankle generally: A) impede blood flow to the foot. B) do not control the bleeding. C) involve the use of a splint. D) control bleeding with less pressure.

C) involve the use of a splint.

12. A wound over the ____________ would MOST likely heal the best and fastest. A) elbow B) shoulder C) ribs D) ankle

C) ribs

29. Relative to an open injury with severe bleeding, the tourniquet should be placed: A) directly on top of the wound. B) 0.5 inch (1 cm) proximal to the wound. C) 1 inch (3 cm) proximal to the wound. D) 2 inches (5 cm) proximal to the wound.

D) 2 inches (5 cm) proximal to the wound.

24. Which of the following should have the MOST immediate priority at the scene of a bombing? A) EMS provider safety B) Notifying the Federal Bureau of Investigation C) Hemorrhage control D) Airway management

A) EMS provider safety

1. A patient with a laceration across the back of the hand has what kind of hemorrhage? A) External B) Fatal C) Internal D) Occult

A) External

22. Why would you check the temperature of a limb if you suspect compartment syndrome? A) Poikilothermy B) Edema C) Ecchymosis D) Broken bone

A) Poikilothermy

45. Which of the following is a sign of infection that you should tell your patient to be alert for? A) Redness B) Itching C) Ecchymosis D) Loss of sensation

A) Redness

5. As a sharp object slices through the skin, what layer is cut first? A) Stratum corneum B) Stratum lucidum C) Stratum germinativum D) Stratum spinosum

A) Stratum corneum

46. When caring for a patient with a gunshot wound near the diaphragm, you should: A) apply an occlusive dressing. B) administer 1 g of tranexamic acid intravenously. C) ventilate with a bag-mask device. D) administer 2 liters of normal saline.

A) apply an occlusive dressing.

28. A patient has a puncture wound to the upper thigh with bright red blood flowing from the site. You should: A) apply direct pressure. B) apply a proximal tourniquet. C) transport the patient immediately. D) start an intravenous line and administer fluids.

A) apply direct pressure.

11. During your assessment of a patient, you find old scars on the wrists. You are mostly looking at: A) connective tissue. B) platelets. C) dermal cells. D) fibrinogen.

A) connective tissue.

30. When improvising a tourniquet, fishing line or other thin materials should not be used to avoid: A) damage to underlying tissue. B) too localized of a formed clot. C) amputation of the extremity. D) an increased risk for infection.

A) damage to underlying tissue.

39. Which of the following statements regarding care for an ear laceration that is contaminated with manure is correct? A) Irrigate the wound copiously with sterile water. B) Assessment is best made by a physician. C) Inject an antibiotic directly into the wound. D) A tetanus shot is required within 2 weeks.

B) Assessment is best made by a physician.

20. What kind of force results in a crush injury? A) Shear B) Compression C) Vacuum D) Gas pressure

B) Compression

7. Which of the following is the last stage of wound healing for a dermal injury? A) Vasoconstriction B) Fibrous tissue growth C) Platelet plug D) Coagulation

B) Fibrous tissue growth

25. A patient experienced the following injuries from a gas explosion. Which one should be treated FIRST? A) Broken arm B) Heavy bleeding from foot C) Contusions to head D) Shallow lacerations

B) Heavy bleeding from foot

44. Which of the following injuries has the greatest chance of becoming infected? A) Closed femur fracture B) Puncture injury to foot C) Lacerations on neck D) Ecchymosis on face

B) Puncture injury to foot

27. Bright red blood that oozes slowly from a patient's wound is characteristic of injury to: A) a lymphatic vessel. B) capillaries. C) a vein. D) an artery.

B) capillaries.

31. A tourniquet is tight enough if: A) the patient becomes pain-free. B) distal pulses cannot be palpated. C) bleeding slows by at least half. D) edema forms above the wound

B) distal pulses cannot be palpated.

50. Prior to removing a patient with possible crush syndrome from a car after 12 hours, you should: A) amputate any affected limb. B) establish vascular access. C) check body temperature. D) administer an antibiotic.

B) establish vascular access.

15. Rupture of a large vein beneath the surface of the skin would MOST likely cause a(n): A) laceration. B) hematoma. C) avulsion. D) abrasion.

B) hematoma.

42. If a patient from a car crash has only minor bleeding and refuses EMS transport, the paramedic: A) should still transport the patient to the hospital. B) might be allowed to release that patient after treatment. C) should call for an emergency department physician to come to the scene. D) should stay with the patient for at least 30 to 45 minutes.

B) might be allowed to release that patient after treatment.

18. A 33-year-old woman has her long hair caught in an industrial-strength fan. She will MOST likely have: A) ecchymosis. B) scalp avulsion. C) contusions near the ears. D) lacerations of the eyes.

B) scalp avulsion.

8. In an otherwise healthy patient, how long would it take for bleeding to stop following a minor laceration? A) 30 seconds B) 1-2 minutes C) 3-6 minutes D) 10-12 minutes

C) 3-6 minutes

2. Which of the following is the MOST serious external hemorrhage? A) Capillary damage from road rash B) Pierced jugular vein C) Bisected carotid artery D) Slowly leaking femoral artery

C) Bisected carotid artery

6. Damage to which layer of the skin would lead to problems with thermoregulation? A) Stratum lucidum B) Stratum germinativum C) Dermis D) Stratum spinosum

C) Dermis

35. After dressing and bandaging a wound on a patient's forearm, the patient loses feeling in two of his fingers. Which of the following is the MOST likely explanation? A) Compartment syndrome B) Infection of the muscle C) Excessively tight dressing D) Partial formation of a clot

C) Excessively tight dressing

13. Which injury should be treated FIRST? A) Serious abrasions B) Multiple shallow cuts from flying glass C) Severed femoral artery D) Lacerations to the back that are 2 mm deep

C) Severed femoral artery

17. Which of the following is the MOST critical prehospital action for a patient with an injury from a grease gun that involves little bleeding, the injection of high-pressure grease into the upper left arm, and pale color around the injection site? A) Inject antibiotics into the wound. B) Provide palliative care. C) Transport to the hospital. D) Administer intravenous therapy.

C) Transport to the hospital.

34. A patient has a laceration to the side of the neck and you suspect that the external jugular vein has been damaged. You should apply a(n): A) porous dressing. B) nonsterile bandage. C) occlusive dressing. D) nonadherent dressing.

C) occlusive dressing.

40. A patient was stabbed in the groin, just above the junction of the femoral artery. After applying direct pressure, you should: A) place the patient in a sitting position. B) apply a tourniquet around the waist. C) pack the wound with hemostatic gauze. D) irrigate the wound to locate the injured vessel.

C) pack the wound with hemostatic gauze

4. The largest organ in the human body is the: A) heart. B) liver. C) skin. D) brain.

C) skin.

37. When applying a bandage to the forehead, you should: A) avoid the use of an occlusive dressing. B) routinely use an occlusive dressing. C) wrap it around the back of the head. D) wrap it underneath the chin as well.

C) wrap it around the back of the head.

47. Avulsed tissue no longer connected to the wound should be: A) placed on ice. B) found at all costs. C) wrapped in gauze. D) kept warm.

C) wrapped in gauze.

19. A bite from a large dog can generate pressure of up to: A) 100 pounds per square inch. B) 200 pounds per square inch. C) 300 pounds per square inch. D) 400 pounds per square inch.

D) 400 pounds per square inch.

14. Ecchymosis may not manifest for up to _____ hours following blunt trauma. A) 6 B) 12 C) 24 D) 48

D) 48

21. Which of the following injuries would MOST likely cause compartment syndrome? A) Laceration B) Large clot C) Puncture wound D) Electrical injury

D) Electrical injury

9. What provides the structure of a blood clot? A) Prothrombin B) Thrombin C) Calcium D) Fibrinogen

D) Fibrinogen

26. Which of the following information is of LEAST pertinence when documenting the description of a wound? A) Time of injury B) Estimate of blood loss C) Description of pain D) History of MMR vaccinations

D) History of MMR vaccinations

33. Which of the following factors would make it the MOST difficult to control external hemorrhage on a combative patient? A) Tachycardia B) Prior drug use C) Low blood pressure D) Patient movement

D) Patient movement

41. Use of tranexamic acid in a patient who is bleeding heavily from a lacerated femoral artery: A) should be considered only if the blood pressure is less than 110 mm Hg. B) will require a transfusion when the patient arrives at the hospital. C) will mostly likely negate the need for tourniquet placement. D) should be considered after a tourniquet has been applied.

D) should be considered after a tourniquet has been applied.