Chapter 25: Bleeding

If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity, you should apply:

a tourniquet proximal to the injury.

What is the approximate blood volume of a 75-kg adult?

5.25 L

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost.

100 mL

If direct pressure fails to immediately stop severe bleeding from an extremity, you should apply: Select one: A. a tourniquet proximal to the injury. B. digital pressure to a proximal artery. C. a splint and elevate the extremity. D. additional sterile dressings.

A

In older patients, the first indicator of non-traumatic internal bleeding may be: Select one: A. weakness or dizziness. B. diaphoresis and pale skin. C. a heart rate over 120 beats/min. D. a low blood pressure.

A

Which of the following statements regarding the clotting of blood is correct?

A person taking aspirin will experience slower blood clotting.

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Preferred treatment for this patient includes: Select one: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. packing both nostrils with gauze pads until the bleeding stops. D. placing a rolled 4² × 4² dressing between his lower lip and gum.

B

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing: Select one: A. acute appendicitis. B. gastrointestinal bleeding. C. intrathoracic hemorrhaging. D. an aortic aneurysm.

B

Circulation of blood within an organ or tissue in adequate amounts to meet the cells' oxygen, nutritional, and waste-removal needs is termed _______. Select one: A. coagulation B. perfusion C. hemorrhage D. hypoperfusion

B

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that: Select one: A. you should try to control the bleeding by applying pressure to a proximal arterial pressure point first. B. the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released. C. bulky dressings should be securely applied over the tourniquet to further assist in controlling the bleeding. D. the tourniquet should be applied directly over a joint if possible because this provides better bleeding control.

B

Which of the following statements regarding hemophilia is correct? Select one: A. Hemophiliacs take aspirin to enhance blood clotting. B. Patients with hemophilia may bleed spontaneously. C. Approximately 25% of the population has hemophilia. D. Hemophilia is defined as a total lack of platelets.

B

Which organ or organ system has the greatest tolerance for lack of perfusion (shock)? Select one: A. Brain B. Gastrointestinal system C. Skeletal muscle D. Kidneys

B

Which section of the heart receives deoxygenated blood? Select one: A. Left B. Right C. Ventricles D. Atria

B

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should: Select one: A. perform a secondary assessment. B. apply a nonrebreathing mask. C. assist the patient's ventilations. D. obtain baseline vital signs.

C

Hypovolemic shock occurs when: Select one: A. the clotting ability of the blood is enhanced. B. the patient's systolic blood pressure is less than 100 mm Hg. C. the body cannot compensate for rapid blood loss. D. at least 10% of the patient's blood volume is lost.

C

Internal bleeding into a fractured extremity is MOST often controlled by: Select one: A. applying chemical ice pack. B. applying a tourniquet. C. keeping the patient warm. D. splinting the extremity.

D

Following blunt trauma to the abdomen, a 21-year-old female complains of diffuse abdominal pain and pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the: Select one: A. liver. B. pancreas. C. gallbladder. D. spleen.

D

If applying a dressing to control the bleeding of a patient's arm, the EMT should ________. Select one: A. apply direct pressure first B. use large or small gauze pads or dressings depending upon the size of the wound C. cover the entire wound, above and below, with the dressing D. All of these answers are correct.

D

Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume. Select one: A. 10% B. 5% C. 15% D. 20%

D

The severity of bleeding should be based on all of the following findings, EXCEPT: Select one: A. clinical signs and symptoms. B. poor general appearance. C. the mechanism of injury. D. systolic blood pressure.

D

What mechanism(s) does the body use to control bleeding? Select one: A. Clotting B. Coagulation C. Vasoconstriction D. All of these answers are correct.

D

Which of the following findings would be the MOST significant when assessing a patient with possible internal bleeding? Select one: A. The patient has not eaten in 24 hours. B. The patient had a stroke 5 years prior. C. The patient has a history of hypertension. D. The patient takes rivaroxaban (Xeralto).

D

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding? Select one: A. Vacuum splint B. Sling and swathe C. Cardboard splint D. Air splint

D

Which portion of the blood carries oxygen to and wastes away from body tissues? Select one: A. Platelets B. Plasma C. White blood cells D. Red blood cells

D

Which of the following statements regarding hemophilia is correct?

Patients with hemophilia may bleed spontaneously.

Hypoperfusion is another name for:

Shock.

Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?

air splint

Most cases of external bleeding from an extremity can be controlled by:

applying local direct pressure.

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:

arterioles.

A young male was shot in the abdomen by an unknown type of gun. He is semiconscious, has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:

assist the patient's ventilations.

An organ or tissue may be better able to resist damage from hypoperfusion if the:

body's temperature is considerably less than 98.6°F (37.0°C).

A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing, but is bleeding significantly from the wound. You should:

control the bleeding with direct pressure.

In nontrauma patients, an early indicator of internal bleeding is:

dizziness upon standing.

In which of the following situations would external bleeding be the MOST difficult to control?

femoral artery laceration and a blood pressure of 140/90 mm Hg

A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should:

follow appropriate standard precautions.

A 67-year-old male presents with weakness, dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:

gastrointestinal bleeding.

Gastrointestinal bleeding should be suspected if a patient presents with:

hematemesis.

The ability of a person's cardiovascular system to compensate for blood loss is MOST related to:

how rapidly he or she bleeds.

Early signs and symptoms of intra-abdominal bleeding include:

pain and distention.

A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:

pinching the patient's nostrils and having him lean forward.

After applying a pressure dressing to a laceration on a patient's arm, you notice that blood is slowly beginning to saturate it. You should:

place additional dressings over the wound.

During transport of a 40-year-old female with acute abdominal pain, you note that she has stopped talking to you and has become extremely diaphoretic. You should:

repeat the primary assessment.

The systemic veins function by:

returning deoxygenated blood back to the heart.

Which of the following organs can tolerate inadequate perfusion for up to 2 hours?

skeletal muscle

Following blunt trauma to the abdomen, a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:

spleen.

The severity of bleeding should be based on all of the following findings, EXCEPT:

systolic blood pressure.

Hypovolemic shock occurs when:

the body cannot compensate for rapid blood loss.

Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?

the filtering of blood cells in the spleen

You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her, it is MOST important to recall that:

the patient is at risk for vomiting and aspiration.

Whether you are using a commercial device or a stick and triangular bandage as a tourniquet, it is important to remember that:

the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.

External bleeding from a vein is relatively easy to control because:

veins are under a lower pressure.

In older patients, the first indicator of nontraumatic internal bleeding may be

weakness or dizziness.