Chapter 25 - Bleeding

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? A. Air splint B. Vacuum splint C. Sling and swathe D. Cardboard splint

A. Air splint

Bleeding from the nose following head trauma: A. is a sign of a skull fracture and should not be stopped. B. should be controlled by packing the nostril with gauze. C. should be assumed to be caused by a fractured septum. D. is usually due to hypertension caused by the head injury.

A. is a sign of a skull fracture and should not be stopped.

An infant with a total blood volume of 800 mL would start showing signs of shock when as little as ______ of blood is lost. A. 50 mL B. 100 mL C. 50 mL D. 200 mL

B. 100 mL

What is the approximate blood volume of an 80-kg adult male? A. 5.25 L B. 5.60 L C. 6.25 L D. 6.50 L

B. 5.60 L

A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh. A. 250 mL B. 500 mL C. 1 L D. L

C. 1 L

In which of the following situations would external bleeding be the MOST difficult to control? A. Femoral artery laceration and a blood pressure of 140/90 mm Hg B.Jugular vein laceration and a systolic blood pressure of 90 mm Hg C. Carotid artery laceration and a systolic blood pressure of 60 mm Hg D. Antecubital vein laceration and a blood pressure of 138/92 mm Hg

A. Femoral artery laceration and a blood pressure of 140/90 mm Hg

A 70-year-old man presents with a severe nosebleed. His medical history includes COPD, depression, and a hemorrhagic stroke 3 years ago. His BP is 190/110 mm Hg, his pulse is 100 beats/min, and his respirations are 24 breaths/min. His medications include albuterol, sertraline (Zoloft), and multivitamins. Which of the following is MOST likely causing his nosebleed today? A. High blood pressure B. Diabetic complications C. Hemorrhagic stroke D. His prescribed albuterol

A. High blood pressure

A 48-year-old male has a suspected open-book pelvic fracture. He is conscious, but restless, and his skin is pale and diaphoretic. His respirations are 22 breaths/min and his pulse rate is 120 beats/min. There is no external bleeding noted. The EMT should: A. apply a compression device around his pelvis. B. assess his blood pressure to detect hypotension. C. stabilize his pelvis by placing him onto his side. D. elevate his legs, keep him warm, and transport.

A. apply a compression device around his pelvis.

A 22-year-old male was kicked in the abdomen multiple times during an assault. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes: A. preparing for immediate transport. B. pplying oxygen via nasal cannula. C. performing a focused physical exam. D. a detailed assessment of his abdomen.

A. preparing for immediate transport.

The systemic veins function by: A. returning deoxygenated blood back to the heart. B. delivering oxygen-poor blood to the capillaries. C. returning oxygen-rich blood back to the left atrium. D. delivering deoxygenated blood to the capillaries.

A. returning deoxygenated blood back to the heart.

Hypoperfusion is another name for: A. shock. B. cyanosis. C. hypoxemia. D. cellular death.

A. shock.

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

A. systolic blood pressure.

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

A. weakness or dizziness.

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

B. Patients with hemophilia may bleed spontaneously.

Blood stasis, changes in the vessel wall, and certain medications affect the: A. systolic blood pressure exclusively. B. ability of the blood to effectively clot. C. ability of red blood cells to carry oxygen. D. white blood cells' ability to fight infection.

B. ability of the blood to effectively clot.

The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the: A. venules. B. arterioles. C. vena cavae. D. capillary arteries.

B. arterioles.

An organ or tissue may be better able to resist damage from hypoperfusion if the: A. body's demand for oxygen is markedly increased. B. body's temperature is considerably less than 98.6°F (37.0°C). C. systolic arterial blood pressure is at least 60 mm Hg. D. heart rate is maintained at more than 100 beats/min.

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

Early signs and symptoms of intra-abdominal bleeding include: A. bruising only. B. pain and distention. C. widespread ecchymosis. D. significant hypotension.

B. 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. Preferred treatment for this patient includes: A. having the patient pinch his own nostrils and then lie supine. B. pinching the patient's nostrils and having him lean forward. C. placing a rolled 4 × 4 inch dressing between his lower lip and gum. D. packing both nostrils with gauze pads until the bleeding stops.

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

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: A. assess the quality of her pulse. B. repeat the primary assessment. C. begin assisting her ventilations. D. perform a secondary assessment.

B. repeat the primary assessment.

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: A. liver. B. spleen. C. pancreas. D. gallbladder.

B. spleen.

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

B. splinting the extremity.

When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm, the EMT should: A. cover the tourniquet with a sterile dressing. B. stop twisting the stick when the bleeding stops. C. twist the stick until the radial pulse becomes weak. D. remove the tourniquet if the bleeding has stopped.

B. stop twisting the stick when the bleeding stops.

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

B. the body cannot compensate for rapid fluid loss.

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: A. the patient may be significantly hypertensive. B. the patient is at risk for vomiting and aspiration. C. a detailed exam is needed to determine the cause. D. many medications interfere with blood clotting.

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

Which of the following occurs after tissues are injured? A. Local blood vessels begin to dilate B. Red blood cells separate from plasma C. Platelets collect at the injury site D. Red blood cells become less sticky

C. Platelets collect at the injury site

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

C. The patient takes rivaroxaban (Xeralto).

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

C. a tourniquet proximal to the injury.

In nontrauma patients, an early indicator of internal bleeding is: A. a rapid, thready pulse. B. rapid, shallow breathing. C. dizziness upon standing. D. a decreasing blood pressure.

C. dizziness upon standing.

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 first: A. apply direct pressure to the wound. B. place the patient on high-flow oxygen. C. follow appropriate standard precautions. D. perform a rapid head-to-toe assessment.

C. 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: A. an aortic aneurysm. B. acute appendicitis. C. gastrointestinal bleeding. D. intrathoracic hemorrhaging.

C. gastrointestinal bleeding.

The ability of a person's cardiovascular system to compensate for blood loss is MOST related to: A. his or her baseline blood pressure. B. the part of the body injured. C. how rapidly he or she bleeds. D. how fast his or her heart beats.

C. how rapidly he or she bleeds.

External bleeding from a vein is relatively easy to control because: A. veins carry deoxygenated blood. B. veins hold smaller blood volume. C. veins are under a lower pressure. D. blood typically oozes from a vein.

C. veins are under a lower pressure.

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

D. 20%

Which of the following statements regarding the clotting of blood is correct? A. Venous and capillary blood typically does not clot spontaneously. B. Bleeding begins to clot when the end of a damaged vessel dilates. C. Direct contact with the environment prevents blood from clotting. D. A person taking blood thinners will experience slower blood clotting.

D. A person taking blood thinners will experience slower blood clotting.

A patient is bleeding severely from a severed femoral artery high in the groin region. Which of the following would MOST likely control the bleeding? A. Position the patient with his injured side down B. Apply a pelvic binder device to stabilize the pelvis C. Apply chemical ice packs to the wound and transport D. Apply a topical hemostatic agent with direct pressure

D. Apply a topical hemostatic agent with direct pressure

Which of the following organs can tolerate inadequate perfusion for 2 to 3 hours? A. Brain B. Heart C. Kidneys D. Skeletal muscle

D. Skeletal muscle

Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body? A. An effectively pumping heart B. An intact system of blood vessels C. Adequate blood in the vasculature D. The filtering of blood cells in the spleen

D. The filtering of blood cells in the spleen

Most cases of external bleeding from an extremity can be controlled by: A.elevating the injured extremity. B. packing the wound with gauze. C. compressing a pressure point. D. applying local direct pressure.

D. applying local direct pressure.

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: A. obtain baseline vital signs. B. apply a nonrebreathing mask. C. perform a secondary assessment. D. assist the patient's ventilations.

D. assist the patient's ventilations.

Perfusion is MOST accurately defined as the: A. effective transfer of oxygen from the venules across the systemic capillary membrane walls. B. ability of the systemic arteries to constrict as needed to maintain an adequate blood pressure. C. effective removal of carbon dioxide and other metabolic waste products from the body's cells. D. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

D. circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.

Gastrointestinal bleeding should be suspected if a patient presents with: A. dyspnea. B. hematuria. C. hemoptysis. D. hematemesis.

D. hematemesis.

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: A. replace the dressing with another dressing. B. apply a tourniquet proximal to the wound. C. splint the arm and keep it below heart level. D. place additional dressings over the wound.

D. place additional dressings over the wound.