Chapter 30

Your patient has a blood pressure of 80/60 mm Hg. What is his mean arterial pressure? A. 20 mm Hg B. 27 mm Hg C 34 mm Hg D 38 mm Hg

B. 27 mm Hg

Hematochezia: A. indicates digested blood from the upper gastrointestinal tract. B. is the passage of stool that contain bright red blood. C. suggests kidney injury and is characterized by bloody urine D. is the passage of dark stools and indicates lower gastrointestinal bleeding.

B. is the passage of stool that contain bright red blood.

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

D. CSF has a high glucose content

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

D. keep the patient warm and administer oxygen.

A trauma patient with hypotension secondary to internal hemorrhage should receive IV fluid boluses in order to: A. increase the systolic blood pressure to at least 110 mm Hg B. restore the patient's blood pressure to its pretrauma reading C. increase the pulse rate by no more than 10 beats/min D. maintain the systolic blood pressure in a low normal range

D. maintain the systolic blood pressure in a low normal range

What aggregates in a clump and forms much of the foundation of a blood clot during the process of coagulation. A. fibrin B. calcium C. plasmin D. platelets.

D. platelets.

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

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

The cardiac cycle begins with the onset myocardial contraction and ends: A. as blood returns to the right atrium B. as both ventricles are filling with blood C. when the ventricles are emptied of blood D. with the beginning of the next contraction.

D. with the beginning of the next contraction.

Hemorrhagic shock represents the most common form of shock. True False

True

Infants and children have proportionally less blood volume than adults. True False

True

Patients in hemorrhagic shock should be given small amounts of water to drink to offset fluid loss. True LOL MOTHER****ER WHAT???? False

True

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. 1,500 D. 1,000

A. 500

All of the following statements are true of tourniquets except: A. They should be applied as close to the wound as possible B. They Are useful in the control of external hemorrhage when other techniques have failed C. They are used for external hemorrhage occurring below the axilla or groin D. They should not be loosened until after arrival at hospital.

A. They should be applied as close to the wound as possible

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.

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

A. Ventilation assistance and rapid transport.

Hematemisis is: A. Vomited blood B. Coughed up blood C. Blood in the urine D. Blood in the feces

A. Vomited blood

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

A. anaphylactic

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

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

Damage control resuscitation (DRC) focuses on: A. controlling hemorrhage, maintaining circulating volume and correcting coagulopathy, acidosis and hypothermia. B. definitive repair of all internal injuries, induction of hypothermia to reduce metabolic demand and oxygen therapy. C. maintaining a systolic BP of at least 100 mmHG, administration of TXA and providing advanced airway management. D. inducing a slightly alkaline state, increasing the BP with vasoactive drugs and administering high-flow oxygen.

A. controlling hemorrhage, maintaining circulating volume and correcting coagulopathy, acidosis and hypothermia.

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

A. direct pressure and pressure dressings.

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

A. spleen

When applying a tourniquet to control major external hemorrhage from an extremity injury, you should: A. apply the tourniquet over a joint, as this will further help compress blood vessels B. maintain direct pressure to the wound until the tourniquet has been fully applied. C. secure the tourniquet in place until the pulses distal to the injury have weakened. D. apply a pressure dressing over the tourniquet to further help control bleeding.

B. maintain direct pressure to the wound until the tourniquet has been fully applied.

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

B. stroke volume and pulse rate

You are providing care to a 32 year old male patient who sustained a large laceration to his left upper leg during an assault with a knife. Initially the wound was spurting bright red blood. The patient is very anxious and confused. His radial pulse is 128 weak and regular and quite difficult to palpate. His blood pressure has dropped significantly since your initial assessment and he is quite pale, cold, and clammy. Based on this information the patient has most likely sustained a: A. Class I hemorrhage B. Class II hemorrhage C. Class III hemorrhage D. Class IV hemorrhage

C. Class III hemorrhage

Hemostasis includes all of the following processes except: A. Vasoconstriction B. Platelet aggregation C. Hemolysis D. Clot formation.

C. Hemolysis

Confusion, a sustained heart rate of 130 beats/min and a respiratory rate of 32 breaths/min in a 70-kg patient are consistent with class ___hemorrhage? A. I B. II C. III D. IV.

C. III

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

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

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

C. hold direct pressure for 3 minutes

Venous bleeding: A. is dark red in color and usually oozes from the wound. B. is bright red in color and typically spurts from a wound C. is more likely to clot spontaneously than arterial bleeding D. is generally more difficult to control than arterial bleeding.

C. is more likely to clot spontaneously than arterial bleeding

Patients with internal hemorrhage will benefit MOST from: A. iv therapy. B. high-flow oxygen C. rapid transport D. TXA administration.

C. rapid transport

the paramedic's MAIN goal in treating a patient with shock is to: A. administer oxygen in a concentration sufficient to maintain an oxygen saturation greater than 95% B. start two large-bore IV lines and infuse enough isotonic crystalloid solution to maintain adequate tissue perfusion. C. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs. D. maintain body temperature and elevate the patient's legs for 6 to 12 inches in order to improve blood flow to the core of the body.

C. recognize the signs and symptoms of shock in its earliest phase and begin immediate treatment before permanent damage occurs.

Older adults are less likely to be taking medications that interfere with normal compensatory mechanisms. True False

False

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

carotid artery, 100/70