Chapter 30 Bleeding

What is the approximate total blood volume of a 150-pound male A. 4.8 L B. 5.1 L C. 6.2. L D. 6.5 L

A. 4.8 L

A healthy adult can tolerate blood loss of up to _____mL over a period of 15 to 20 minutes without any negative effects A. 500 B. 750 C. 1,000 D. 1,500

A. 500

How can you tell if bleeding from the ears or nose contains cerebrospinal fluid (CSF) A. CSF has a high glucose content B. CSF clots within 10 seconds C. CSF is a bright yellow color D. CSF has a dark brown color

A. CSF has a high glucose content

Which of the following signs would you MOST likely observe in a patient with compensated shock A. anxiety or agitation B. dilation of the pupils C. absent peripheral pulses D. response to painful stimuli

A. anxiety or agitation

If you discover minor external bleeding during you primary assessment of a patient, you should A. stop you assessment and take the patient's blood pressure B. establish a large-bore IV line immediately C. stop your assessment and control the bleeding D. make not of it and continue your assessment

D. make not of it and continue your assessment

Which of the following injuries or mechanisms would MOST likely lead to nonhemorrhagic shock A. fractures B. blunt trauma C. hemothorax D. severe burns

D. severe burns

The physiologic process of hemostasis is achieved through A. an increased production of red blood cells B. the destruction of fibrin and platelets C. the use of anticoagulants such as Coumadin D. vasoconstriction and platelet aggregation

D. vasoconstriction and platelet aggregation

The presence of a radial pulse A. can lead to a gross overestimation of blood pressure B. equates to a systolic blood pressure of at least 90 mmHg C. is a clinical indicator that the patient is adequately perfused D. should be the sole guide for fluid resuscitation in shock

A. can lead to a gross overestimation of blood pressure

Agents such as Celox, HemCon, and QuikClot are used to: A) repair damaged vessels. B) replace lost blood. C) raise blood pressure. D) promote hemostasis.

D) promote hemostasis.

What is the ejection fraction of a patient whose ventricle fills with 120 mL of blood and contracts 90 mL A. 30% B. 63% C. 68% D. 75%

D. 75%

Which of the following factors would have the MOST negative effect on the body's process of hemostasis A. bradycarida B. hyperthermia C. chronic heroin use D. anticoagulant use

D. anticoagulant use

External bleeding would be the MOST difficult to control in a patient with a large laceration to the ____ and a blood pressure of ____ mmHg A. jugular vein, 96/62 B. brachial artery, 68/46 C. femoral vein, 114/60 D. carotid artery, 100/70

D. carotid artery, 100/70

Decompensated shock in the adult is characterized by A. increased tidal volume B. bounding radial pulses C. 15% blood loss or more D. falling blood pressure

D. falling blood pressure

If you suspect internal bleeding during the primary assessment, you should A. stop the assessment and transport at once B. start two large-bore IV lines of normal saline C. determine the source of the internal bleeding D. keep the patient warm and administer oxygen

D. keep the patient warm and administer oxygen

If you suspect internal bleeding during your primary assessment, you should A. stop the assessment and transport at once B. start two large-bore IV lines of normal saline C. determine the source of the internal bleeding D. keep the patient warm and administer oxygen

D. keep the patient warm and administer oxygen

Which of the following statements regarding blood flow is correct A. ejection fraction is the percentage of blood that the hearts pumps per contraction B. if more blood returns to the heart, stroke volume decreases and cardiac output falls C. as more blood is pumped with each contraction, the ejection fraction increases D. the amount of blood that returns to the atrium remains fixed from minute to minute

A. ejection fraction is the percentage of blood that the hearts pumps per contraction

Which of the following organs can sustain the longest period of inadequate perfusion A. gastrointestinal tract B. kidneys C. spinal cord D. skeletal muscle

A. gastrointestinal tract

Which of the following injury locations can cause a junctional hemorrhage A. in the axilla B. behind the knee C. side of the neck D. antecubital fossa

A. in the axilla

The amount of blood returning to the heart is the called A. preload B. cardiac output C. afterload D. stroke volume

A. preload

After load is defined as A. pressure in the aorta against which the left ventricle must pump B. amount of resistance to blood flow offered by the heart valves C. amount of blood ejected from the ventricle with each contraction D. volume of blood remaining in the ventricle following contraction

A. pressure in the aorta against which the left ventricle must pump

Which of the following would be the earliest sign of hemorrhagic shock A. tachycardia B. thready pulse C. cold, clammy skin D. shallow, rapid breathing

A. tachycardia

A trauma patient with suspected internal hemorrhage and inadequate breathing requires A. ventilation assistance and rapid transport B. intubation that is facilitated by medications C. on-scene IV therapy and rapid fluid boluses D. oxygen via nonrebreathing mask and transport

A. ventilation assistance and rapid transport

You have successfully controlled a large arterial hemorrhage from a 42-year-old man's leg with direct pressure and a pressure dressing. He is conscious, but restless. His blood pressure is 84/58 mm Hg, pulse is 120 beats/min, and respirations are 24 breaths/min. You should: A. keep him warm, administer high-flow oxygen, establish one large -bore IV line at the scene and transport B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route C. administer high-flow oxygen, start two large-bore IV lines at the scene and give 2-to-3-L fluid bolus, and transport D. keep him warm, assist his ventilations, place a hemostatic agent in the wound, transport, and start a large-bore IV en route

B. administer high-flow oxygen, keep him warm, transport, and establish two large-bore IV lines en route

Hemoglobin functions by: A. dissolving in blood plasma to create the partial pressure of carbon dioxide B. binding to oxygen that is absorbed in the lungs and transporting it to the tissues C. absorbing hydrogen ions in the blood in order to maintain acid-base balance D. transporting red blood cells throughout the body to ensure adequate oxygenation

B. binding to oxygen that is absorbed in the lungs and transporting it to the tissues

Which of the following types of medication would MOST likely reduce a patient's ability to compensate when in shock A. trcyclic antidepressant B. calcium channel blockers C. nasal decongestants D. beta-2 adrenergic agonists

B. calcium channel blockers

After packing a severe groin injury with hemostatic gauze, you should: A. administer an IV analgesic B. hold direct pressure for 3 minutes C. soak the dressing with sterile saline D. cover gauze with a trauma dressing

B. hold direct pressure for 3 minutes

Which of the following components is LEAST crucial to the continuers circulation of oxygenated blood throughout the body A. heart B. spleen C. vasculature D. fluid volume

B. spleen

Which of the following would be the earliest sign of hemorrhagic shock A. cold, clammy skin B. tachycardia C. thready pulse D. shallow, rapid breathing

B. tachycardia

Perfusion is defined as: A) the effective exchange of oxygen and carbon dioxide within the lungs and at the cellular level. B) the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands. C) an ejection fraction that is adequate to maintain radial pulses or a systolic blood pressure of at least 90 mm Hg. D) the circulation of an adequate volume of blood to ensure uninterrupted cerebral and myocardial oxygenation.

B. the circulation of blood through an organ or tissue in amounts adequate to meet the body's demands

The MOST significant factor that determines how well the body compensates for blood loss is A. the patient's pulse rate at the time of injury B. the period of time over which the blood is lost C. whether the bleeding is internal or external D. whether the bleeding is venous or arterial

B. the period of time over which the blood is lost

Air splints will not apply enough pressure to control arterial bleeding until the patient's systolic BP is: A. 30 mm Hg B. 40 mmHg C. 50 mmHg D. 60 mmHg

C. 50 mmHg

Your patient has a blood pressure of 80/60 mmHg. What is his mean arterial pressure A. 20 mmHg B. 27 mmHg C. 67 mmHg D. 38 mmHg

C. 67 mmHg

A fall in blood pressure and the resultant changes in plasma osmolality cause the release of: A. glycogen and luteinizing hormone B. T3 and T4 from the thyroid gland C. aldosterone and antidiuretic hormone D. acetylcholine and angiotensin I

C. aldosterone and antidiuretic hormone

You are treating a 20-year-old woman with a large laceration involving the brachial artery. The patient is confused, is pale, and has weak peripheral pulses. Your initial attempts to control the bleeding have failed. You should A. administer high-flow oxygen, establish vascular access at the scene, transport, and apply a proximal tourniquet en route B. administer high-flow oxygen, transport, and apply a proximal tourniquet and establish vascular access en route C. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route D. control bleeding by applying pressure to a proximal pressure point, administer high-flow oxygen, and transport

C. apply a proximal tourniquet, administer high-flow oxygen, transport, and establish vascular access en route

Much of the bleeding associated with unsplinted fractures continues because: A. most fractures are unstable and usually lacerate major blood vessels B. swelling associated with suck fractures prevents platelet aggregation C. bone ends will continue to move and destroy partially formed clots D. patient anxiety increases that blood pressure, which exacerbates bleeding

C. bone ends will continue to move and destroy partially formed clots

Most external hemorrhage can be controlled with a combination of: A. pressure dressing and ice B. elevation and immobilization C. direct pressure and pressure dressings D. pressure point control and elevation

C. direct pressure and pressure dressings

Which of the following types of shock is caused by poor blood vessel function A. anaphylactic B. cardiogenic C. hypovolemic D. hemorrhagic

C. hypovolemic

Which of the following organs or body systems requires blood supply, regardless of external factors A. skin B. muscles C. kidneys D. gastrointestinal tract

C. kidneys

In contrast to a patient with compensated shock, a patient with decompensated shock would be expected to present with: A. polyuria and weak pulses B. bounding radial pulses C. mottled skin and dilated pupils D. restlessness and pale cool skin

C. mottled skin and dilated pupils

Which of the following two factors DIRECTLY affect cardiac output A. preload and afterload B. vessel size and stroke volume C. stroke volume and pulse rate D. blood pressure ad pulse rate

C. stroke volume and pulse rate